Burnout Is a Systems Failure: The HR Blueprint for Retaining Veterinary Teams

Adeesha: The veterinary profession is facing a tragic mental health crisis, and…The suicide rates in this field are actually heartbreaking. So as practice owners, offering a pizza party or a yoga day isn’t cutting it anymore. So, from a structural HR perspective, what tangible changes must an owner implement to actually protect their team from compassion fatigue and client abuse?

Kara: So, before we dive in, I definitely want to disclaim that I’m not a mental health professional, I’m not an attorney, I’m not giving legal or medical advice in any way. This is definitely a difficult topic for some, and so, trigger warning for anybody who might be listening, you know, we definitely want to make sure that you are protecting your own mental health.

And to that end, I also want to address, like, what we were… what you just mentioned, where it is about protecting teens and their mental health, but it’s also about protecting the owner’s mental health. You know, a lot of times, unless this is… we’re talking about corporate veterinary business, this is a private practice, and it’s somebody who, you know, has a deep love of animals, and

Wants to be able to practice in a way that they feel they can best serve their patients, their patients, you know, for a family.

And it’s something that they don’t always think about, that whenever they jump into the business side, that adds a whole other layer of stress, in addition to the clinical side, in addition to the financial side, and, you know, veterinary school’s not exactly, you know, the cheapest education you could possibly get, and so there’s a lot of pressure overall across the board.

And then, of course, there is… there’s your team, and your team is bringing in everything that they have to deal with personally. They’re bringing in the stress of, you know, of working for a private practice, potentially, or corporate, either way, there’s… there’s stresses both ways.

And it’s one of those things that it does tend to show up at work. As much as we would like to say, well, we’re gonna keep home at home and work at work, and we’re gonna have work-life balance, those two things will never meet, we all know that that’s not realistic.

We want to make sure that we have a work-life harmony. We want to make sure we’re creating cultures in whatever position you’re in that builds toward that work-life harmony, where, you know, your work fuels your life, and your life

is made better by your work, because I think a lot of veterinary practices are very, very passionate about what they do. I feel like they’re very mission-driven, and we’re all, you know, striving toward that same goal. I don’t know that anybody specifically goes into it saying, you know, I’m doing this for the money.

Right? We’re doing this because

We love working with animals, and myself, though not a veterinarian or vet tech, I am definitely an animal lover, and definitely a pet owner, and have had numerous dogs and cats and chickens and one-legged turkeys and various other pets along the way, and so I deeply understand, and it’s probably why I personally wouldn’t go into it, because I don’t know that I could do that job. It is very hard.

So, to your question.

how do we actually create these cultures that are going to help alleviate burnout, and are not just putting a band-aid over something like a pizza party, or yoga day, or bringing in a massage therapist? Those are all great

When you can do them, they’re nice.

I’m pretty sure that practices at this point have found out that employees are not appreciating that as much as maybe they used to, or as much as we would hope that they would. And while that speaks to a certain level of culture and a certain level of individuals that are in the workplace, some of it, too, is just that we use that as a band-aid. We say, well, we can’t afford to give raises this week, or this year, but we’re gonna go ahead and, you know, bring in pizza on Friday. And that’s not really showing the appreciation

in a way that makes an impact when it comes to burnout in the workplace and when it comes to feeling valued as a team member. So how do we do that? Some of it is going to be compensation-based. You talked about, you know, I do help build compensation packages and making sure that people feel like they’re paid market value for the work that they do, that they love the work that they do, and they’re able to provide for their families. You know, I understand that in, you know, certain

budgetary crisis and economic positions that we’re all in, that that’s something that is definitely difficult. And, you know, veterinary medicine, we have a different type of insurance than maybe, you know, human healthcare. To me, it seems more like it’s optometry or dental, where it’s kind of insurance, maybe like a coupon. It’s not really doing a ton for you.

And so you do have a lot more, I would think, private pay patients, depending on the practice that you run. And so that can give you some more flexibility, but at the same time, it is also very, very stressful.

Especially if you’ve recently bought your practice, especially if you’ve recently graduated. And so, compensation is certainly one of those areas. Another is going to be truly valuing when people need time, whenever they need space for something. I know that sounds hard, and you are not.

as their boss, their leader, you are not their mental health professional, you are not their mother, you are not their spouse, you may be a support system in a different way, but there is a limit to what you really can do. But when people tell you that they need the time, trying to create a space that maybe they need 10 minutes to go cry in a closet after a really difficult patient appointment. Maybe they do need a mental health day. No, maybe they can’t give you 3 weeks notice to be able to take that mental health day.

I really do need it now.

How can we create a schedule that is not so, you know, bare-bones skeleton crew that we are able to be flexible and give people time off when they need it to be able to protect their mental health? Maybe they do need to leave early on Tuesdays so that they can go, you know, deal with their therapist or their mental health professional. Maybe they, you know, need some benefits, if you’re talking total compensation, that help support their ability to get that.

There are EAPs, employee assistance programs, there are services out there that can help provide mental health support for team members, and so looking at it from a broader, less transactional approach of, they’re showing up to work and I’m giving them a paycheck, is a really great place to start. Just that mindset shift is a great place to start creating cultures that are not only worth working for, but that help support that mental health aspect.

Adeesha: Right, no, I was curious, over here, you mentioned, Kara, with regards to finding, Value when they need time. What exactly do you mean by, needing time? Like. You mentioned a few occasions, but I feel like there’s a little bit more deeper answer there.

Kara: Sure, paid time off is one of the areas that I feel we tend to be lacking in a lot of healthcare aspects. Honestly, it’s not just veterinary medicine, but in a lot of healthcare aspects, ETO is one of the things that I feel we are still stuck in this very weird, old-school era of, well, they have to work for a year before they get vacation. That’s a long time to work without a sick day or a vacation. Or, you know, we have to work 90 days before we get a paid holiday. Okay, well.

That’s an interesting welcome to the team. Hey, we’re glad you’re here. We’re all gonna go take a paid day off next week, but you get a pay cut instead. Merry Christmas!

isn’t really the culture that we want to build, and so looking at it from the perspective of what have we been offering in the past, and what’s truly competitive, and what truly supports our team members. I actually had a Workforce 360 interview with a practice several years ago at this point, and so hopefully this is improved, but several years ago, and one of the vet techs I was interviewing.

I asked him about, you know, the benefits, and what he thought about them, and he’s like, they suck. They really do. Like, we don’t get any time off here. I have a friend, is what he said, I have a friend who works at

chain pizza restaurant, I won’t name drop, but chain pizza Restaurant, who is currently out on vacation, because he gets more vacation time than I do working as a pizza employee, than I do as a veterinary tech with years of experience and training and certification.

So, if we’re really looking at where we’re comparing nowadays, you know, we have team members that are leaving the profession.

Because we’re not just competing with the other veterinary practice across town, we’re competing with the ability to work from home, the ability to flex our schedule, we’re competing on some levels, at some levels of pay, with the grocery store that’s paying just as much as some of our certified employees are. And if the grocery store employee can give them flexibility on schedule, about the same amount of pay and better benefits.

Why would they come work for you?

It’s a hard question to ask, and the answer to that sometimes is that they wouldn’t.

Adeesha: There we go. Now, veterinarians spend years mastering medicine, but almost no time learning how to manage people. So, when a brilliant vet buys a practice and suddenly becomes the CEO, what is the most common leadership blind spot that immediately damages team morale?

Kara: That immediately damages team morale, that’s a hard question, because there are certainly a lot of things, but one that might immediately damage team morale is feeling like they have to earn

benefits. And I don’t say this saying that they don’t have to earn benefits to some extent, but again, if we’re making people wait till they’ve worked with us for a year before they get anything, 90 days before they get health insurance, you know, 6 months before they get vacation, or something like that, if we’re not viewing this as part of the total compensation package.

We’re not going to be able to hire and retain the top talent that we really need in our clinics.

the… one of the things I’ll say is that the people that you want working for you are probably already working for somebody else. And it’s difficult for someone who’s got 3 weeks of PTO, and paid holidays, and a bonus plan, and health insurance, or a stipend, or something like that, to say, well, sure, I’ll come work for this startup, or this new doc that is gonna offer some paid holidays, maybe, for the first year, and doesn’t have health insurance, and doesn’t have…

anything outside of just an hourly rate, which may be competitive, but we sit there and we say, well, we need them to work for an entire year before they’re eligible for XYZ.

Okay, that is a choice, but it’s a choice that sometimes leaves us without as deep of a candidate pool as we would like to have to be able to hire the top talent, because we’re not looking at it

when we step out as a brand new CEO, brand new veterinary CEO, we’re not looking at it from that lens. We’re looking at it as, well, they have to work for this many years to earn it. I’ve talked to brand new doctors owning brand new practices that say things like, well, I was a 1099 contractor, I never got paid time off and paid vacations, why should I give them to my team? And I’m like, oh man, well.

Because you probably won’t have one if you don’t think of something.

Adeesha: That’s right. And now, if we’re not giving our employees the 90 days. Are… is there a tiered structure that you’re suggesting instead, that they could earn?

Dr. Andrew: I mean, if you’re… if you’re saying that they have to wait longer than what would be a typical 30, 60, 90 day period, there are some other things you can do, you know, making sure that you are paying above your market value on wages. That can be difficult to work with, because if you are going to then add benefits later, you can’t do it in exchange for lowering their pay. That’s not gonna go well.

Right,

But we can also think outside of the veterinary box, if you will, and think about more than just pizza parties or PTO. There are, you know, things that you can do that can create a culture, again, where people feel like they’re still valued, and acknowledging up front that, you know, hey, maybe we don’t have the budget for corporate benefits, if you’re a private practice, or even corporate, honestly, nowadays, with the cost of health insurance, is struggling to be able to provide benefits.

If we could acknowledge that, you know, hey, we are still growing, we’re still building, or we just bought this practice, and it’s definitely a shift in financial situation, you know, what we’re going to do instead, though, is be as flexible as possible. We may only have a few days of PTO that we can offer you, but we’re going to, you know, be as flexible as possible with that. We’re not going to try to say that you have to take it when the doctor’s out, or that you can only use it on XYZ days, or we’re going to have all these blackout dates. I understand, I understand that there are

There are definitely days where we need as many team members on board as possible, but if you’re not going to provide the benefit from the financial perspective, then trying to be as flexible as you possibly can.

Like I mentioned earlier, even little things, like, hey, we understand you have mental health that we want to protect. We’re going to try to offer something like an EAP, which is usually very, very inexpensive. Or even just, we’re going to let you take some time. We’re all going to take off, you know, a Friday afternoon and go do something fun every other month. We’re going to give you that time that you need to go cry in the closet, or get yourself together.

or whatever it is, whenever we know that they’ve got something hard coming up. We’re gonna build that in, and not just immediately pack the schedule. We’re gonna try to build this into a practice that you want to work for, even if we can’t offer the absolute top-of-the-tier platinum benefit package.

Adeesha: I love that. So you’re, matching your expectations, forecast, with what is possible, and, not really cutting short on both sides of the conversation. And that acknowledgement piece, I feel like is such a cornerstone in that conversation. Now, Kelly, due to high stress and emotional exhaustion, veterinary hospitals unfortunately have a reputation for developing toxic back of the house cultures. So, clicks, gossip, and some what may call mean girl syndrome. You’re an expert in everything disk behavioral prof… profiling. How can a practice use behavioral assessments to spot a toxic hire before ever offering them a job?

Kara: Well, I will say this,

there are a lot of types of assessments out there, and not every one of them is a valid predictor of success. And just from my HR side, we have to be very careful that we’re compliant when we use these types of assessments, that we’re not using something that isn’t going to be a valid predictor of success. There’s, like I said, plenty of things out there, we don’t want to just pick anything, because it could lead to unintentional discrimination.

So we definitely want to avoid that. I’m actually generally not a fan of doing a personality assessment when somebody comes on board, because I… or whenever they’re coming in to interview, because I feel like that leads us to pigeonhole people. That DISC, as an example, if you know anything about DISC, there’s the four primary types, your D, your I, your S, and your C, which are your dominant, your influential, your steadiness, and then your conscientiousness. And sometimes we might say, well, I need a billing person, I need them to

Very detail-oriented. We have to hire somebody who’s a C.

And you get somebody that comes in, and because this is a first interview, they’re very bubbly, they’re outgoing, they’re trying to put their best foot forward, and you’re like, oh, this person’s an I, they can’t do that job. And so we don’t hire somebody who could have very easily jumped into it. And I’m one of those people. I actually very frequently get mistaken for an I whenever I’m, in fact, a highly inclined CD. I’m very analytical, I’m very detail-oriented, I spend a lot of time

Looking at employment laws and policies, and drafting employee handbooks, and, you know, working in that space.

With a lot of very detail-oriented type of work. But I also am a speaker, and so I will go and facilitate workshops for intact teams.

I will go and keynote hundreds of people in the audience.

You know, I do get in front of people, and people will see that, and they’re like, oh my gosh, there’s no way that she’s a C. So, we don’t want to pigeonhole people. Say all of that just as an example, like, we don’t want to stereotype and say this person can’t do this job because they ranked as a whatever on this assessment. I love using them whenever somebody does hire on, however, so that we understand our new team member better, and we can understand how

we communicate, how this person might work, how they might learn, how they are in productive conflict conversations, hopefully productive conflict conversations, how they make decisions. I love learning about new team members by using an assessment like DISC. Five Behaviors of a Piece of Team is another one that I’m certified in, I think that’s a fantastic one. Both of those are through Wiley, and so if you ever get the opportunity, actually, if you do the 5Bs assessment, it will also tell you their DISC

If you go through Wiley. And there’s plenty of others out there as well, but I want to use those as a tool to better understand people and communicate with people and work more productively than to specifically select somebody beforehand. Now, that doesn’t mean that you can’t pick some of those things out.

I always love to hear people talk about their former boss. I love to hear them talk about their former team members.

And asking, even in questions like, why are you leaving? I’ve done some interviews for bookkeepers when I worked for a healthcare-focused CEPA firm, where we did work with a lot of doctors, so I was hiring bookkeepers at the time.

And had one that, you know, got on the phone for her pre-screen call, and said, oh, I’m at work, let me shut the door. She’s doing this on the clock. Okay, that’s not ideal to start with. And then I asked something about why is she leaving, and she’s like, are you kidding? Have you not seen the news?

how was I supposed to know her CEO was entangled in some embezzlement scandal? I didn’t know that, but just the way that she talked about it and the attitude that she kind of gave me on the phone, I’m like, thank you for your time, don’t call us, we’ll call you.

There’s things like that you can pick up on, about how people talk about people they’ve worked with, or talk about patients that they’ve worked with, asking them situational judgment questions. You know, what would you do in this circumstance? What would you do if a patient comes in and is upset, or thinks that we’ve done something wrong? How do you handle that and hear what they say?

As it comes to clicks and things, toxic behavior, once they’ve been hired, a lot of that is a leadership conversation.

I know a lot of doctors who are very averse to confrontation, and they just don’t want to deal with it, and so they let it go on.

Or they’ve got a team member who might be their star assistant, and they’re amazing at what they do, and the patients love them, and they’re the worst person in the world to have on the team. And 4 people have already left because of that one person in the last 3 months.

And we just don’t feel like we can let that person go, because they’re just so valuable. Well, okay, but let’s look at what our turnover numbers are costing us. Are they really that valuable? Can we really not replace them? So we let those people stay on our teams, and they end up being the problem. You know, it’s knee-high on the problem, when in reality, it’s a leadership problem. It’s the doctor that refuses to let it go, or who’s pushing off the disciplinary issues onto the office manager.

who doesn’t really have authority, but the doctor doesn’t want to handle anything, so they let the office manager handle it, but then the team member goes around the office manager to the doctor, and the doctor just doesn’t really back the office manager. So we create this little cycle of toxicity where nobody’s held accountable, and we just continue with this terrible culture that nobody really wants to work for at the end of the day.

And then we wonder why we have a turnover problem.

Adeesha: Can you give me the ideal structure of a meeting that the doctor might have with one of these very high-performing, but a bit of a toxic personality, and how to address that appropriately?

Kara: Having a conversation is always a good place to start. Think of it as a coaching conversation. You are there to get information, you are there to be curious. What’s going on? Usually that gets reported because somebody is putting in their two-week notice, and we say it’s because of this person, during their accident interview.

Or, you know, reports may get back that so-and-so’s doing this, or, you know, whatever the case may be.

So we get curious about that.

bring the person who’s reporting it in… into your office. You know, we coach in private and praise in public, so make sure this is a private conversation, and say, you know, tell me what’s going on. Well, so-and-so does this, and she’s doing this, and it’s not always a sheep, but, you know, they’re doing this.

And okay, so we’ve got that information. So now let’s bring in the other individual, the one who’s being accused of being the toxic person. And honestly, truthfully, if you look real hard, you probably know that this person is being accused of that for a reason, right?

But we bring that person in and say, you know, hey, I have noticed, or there have been some conversations about, or I have overheard. We try not to say, well, this person came and told me, so on and so forth. Especially in a smaller practice.

pinning it on the person who brought it to your attention is not going to help matters on a small team. And so, have that conversation, but try to do it from, you know, grow a pair and have a little bit of courage, and try to do this from a leadership perspective of saying, I have noticed, or I’ve observed, I’ve heard, whatever.

That this is going on. Again, can you tell me about this? Can you tell me why this might be the case? You know, the general tone in the office is that, and so on and so forth, can you tell me why? And they give their piece, because sometimes, it’s not them.

Usually, it is, but sometimes it’s not. Sometimes it’s everybody hates this person is trying to get them fired, so everyone’s reported against this one person. And so, give them the benefit of the doubt that you’ve hired adults you can trust, and they can have a conversation with, and see what’s going on.

And get curious about it. And depending on the outcome of that conversation, you could do several different things. You know, this may be something that you end up with this coaching conversation of, okay, I understand your perspective, but we have to be able to work together, and we do need to respect each other. And so, while I understand your perspective.

I need you to do XYZ. This is what I’ve been seeing, this is what I’m expecting to see, this is what’s gonna happen if it doesn’t.

If we can’t figure out a way to work together, if we can’t figure out a way to get along and communicate with each other, you know, I’m giving the silent treatment, for example. And that example comes to mind because I’m actually about to have a coaching conversation within the next week with a couple of team members.

who went on vacation together at some point and came back, and they hate each other, and I don’t know exactly what happened. I don’t know if I’ll get the whole story, but the outcome of that is that they are sniping at each other at work, they’re giving each other the silent treatment from time to time, they’re just not getting along, and they work in the same department of this clinic.

And so, going to have that conversation and try to find out what’s the problem. And okay, even though we’re having a problem with each other, you don’t have to like the people that you work with, but you do need to be able to respect them and work with them. And so, making that expectation clear, and saying, you know, if we need to follow up, if there’s something that happens, please come and talk to me. But this is what I expect to see, and if I don’t, we’re going to need to have a different conversation. And that different conversation next time may be, okay, well, we’ve

talked about this in the past, and I’m still seeing these issues, we’re still not working together, and the work’s not getting done.

let me be very clear that this is now going to start moving into a disciplinary conversation. If you cannot manage… manage your tone, manage the conversations that you’re having, whatever the issue is.

If you can’t manage to act the way that we need you to, and meet those expectations, then we are going to start looking at this as an exit strategy for you. This may not be the best place for you to work going forward. And so this is what I need to see, and I’m very clear and very serious about this. And you document all these conversations, because then when you do have to terminate, these are sometimes more difficult, because it’s not an exact policy violation, it’s just

one of those things where it’s just one of those people, then you should be able to terminate with, you know, some pretty strong documentation that this person has been coached several times, they were aware that they were going to be fired if they did not continue, or if they did not make any changes. Now they have not made changes, and we’re going to give them the opportunity to find other employment.

Adeesha: When a legacy practice is bought out, what is the exact HR playbook to merge cultures without losing the key staff that made the practice valuable in the first place?

Kara: Transparency as much as you possibly can. They feel blindsided when they find out, oh, by the way, they have a new boss on Monday morning.

I understand why it happens. Like I said, I’ve been working with buyer side and seller side, honestly, M&A, return acquisitions, for, oh my goodness, 12, 13, 14 years, somewhere in there now, at this point. What year are we on? For a number of years now.

And I understand why, you know, the seller can’t always share that they’re selling the practice, because if the team gets spooked, the team leaves, there’s a lot of goodwill that went into that, and they lose some of the value of that practice. I totally understand that side of it.

And, when it’s possible to be transparent with the team, and to take some time to have that conversation, and not just expect them to jump into work.

on day one, when that acquisition rolls out, or whenever they find out, to actually take some time and communicate, because that’s the answer to everything here, have that conversation with them about, this is what this looks like. You know, I understand that there… believe me, I understand there are compliance things that have to be done. There’s, you know, new paperwork that has to be done. If they’re not acquiring the entity itself, if they’re basically bringing individuals in.

under a new entity, well, then you’re effectively hiring new team members, even though they’ve been there for 15 years. You’re hiring new team members, you have to get all of that documentation done on day one. I understand there may be some new policies that need to be put in place.

Do they all need to be on day one? Probably not. Maybe if we don’t slap them with 60 pages of a rulebook on day one, that might help integrate a little bit better.

Overall, I love to take the approach that we don’t want them to feel like they’re losing anything. We talked about integrating benefits, for example. We don’t want them to feel like they’re losing anything. Maybe this was a completely fee-for-service practice that didn’t take insurance, and it’s an amazing culture, they’ve got a ton of patients, and everybody had these high-level benefits because they could, you know, they could afford them, because the doctor selling didn’t have student loan debt, has paid off the practice note 10 years ago.

And could invest all of this right back into their team and still take home a healthy paycheck. And the person buying the practice

Might be someone who is new or out of school, but still has student loan debt, that is going to have a practice note, and or, depending on if it’s corporate, of course, you know, there’s different leverage there.

But that person coming in is gonna have a completely different financial situation than the seller when you’re buying up some of, like you said, these legacy practices.

So it may be that we can’t take on that health insurance plan, that gold level, you know, BCBS health insurance plan that they love. Maybe we can’t do the 401K right away. Maybe we can’t do certain things. Alright, so what can we do?

don’t make promises you can’t keep, but what can we do to make them feel like they’re not losing anything? Do we, you know, integrate with a bonus structure? Do we, you know, get more flexible on PTO? What are other things that we could possibly do where they don’t feel like they’re losing out on something they had before? Because that’s going to be one of the fastest ways to make them start looking somewhere else.

they may not find a better opportunity somewhere else. Grass is not always greener on the other side, and especially if you’re in a rural area where you’re the only practice around, right? But we are still competing with the rest of the global economy at this point. We’re competing with other employers that offer remote work and other ways that they can go and earn that money. We don’t generally, unless it’s an associate, maybe an office manager position, have such high pay in some of these positions that they can’t replace that income somewhere else.

So if we’re trying to get them to stay, acknowledging that they are a team, that they have a culture, that we’re trying to make sure that they still feel like this is their, you know, veterinary home, and make sure that they don’t feel like they’re losing anything, while also taking care of the things that we have to take care of. You know, what are the hills we have to die on? Let’s make sure we do that from the compliance perspective.

But do we have to, right away, make all the changes in the world?

Probably not. Might spook the patients, too. So, there’s usually a good 6-month transition period that tends to be advised, and I’m not a practice management consultant, so I’m not going to pretend to say, here’s the exact playbook for doing that, but there are going to be some things over the first 6 months that we might slowly transition in once we’ve gained some trust from that team that we’ve acquired.

Adeesha: There you go. Now, Clara, before we wrap up the show here, a key takeaway from our whole conversation, if you were able to sum it up in one golden nugget, what would it be?

Kara: Communication solves all the leadership problems and that’s communication in a face-to-face conversation, it can be communication just over-communicating via text during the interview process. It could be making sure we have our policies written down in an employee handbook. All of those are forms of communication. So, if we could get better at that, we would have a lot fewer issues in the workplace.