Leading Change in Veterinary Practice: Building Stronger Teams, Better Communication, and Lasting Behaviour Change

Don Adeesha:

We talk a lot about systems, software, and spreadsheets. But at the end of the day, a veterinary practice is a group of hardworking people trying to do something very difficult together.

Real change does not happen simply because you purchase a new practice management system or change your pricing. It happens when you understand the people on your team.

Welcome back to the Veterinary Business Podcast. It is great to have you here.

Today’s guest has experienced this at the highest level. Dr. Nicola Bromley has spent more than two decades in the veterinary profession, including serving as Hospital Director at Fitzpatrick Referrals, where she led a team of approximately 170 people.

She is now exploring the psychology behind why people behave the way they do. In this conversation, we discuss leadership, how to reduce the “us versus them” mentality between management and staff, and what it takes to build a resilient veterinary team.

This episode is powered by Ekwa Marketing, the growth partner of the Veterinary Business Podcast and a trusted resource in the veterinary community.

Dr. Bromley, thank you for joining us.

Dr. Nicola Bromley:

Thank you. I really appreciate the opportunity to speak with you.

Don Adeesha:

You have led large veterinary teams in high-pressure environments. What separates a practice that simply manages change from one that genuinely grows through it?

Dr. Nicola Bromley:

It may sound like a cliché, but it starts with genuinely listening to your team and making an effort to view the situation from another person’s perspective.

It is very easy to enter a new leadership role and immediately want to change everything because the changes seem sensible to you. Looking back, I can see times in my own career when I did that.

When we introduce changes too quickly, however, we often meet significant resistance. We then wonder why people are resisting us. In many cases, it is because we have not taken enough time to settle into the role, understand the environment, and listen to other people’s perspectives.

We naturally see situations from our own point of view. Psychologist Daniel Kahneman described this as, “What you see is all there is.” We see the view from our own window, but we do not always look at the wider picture.

We often talk about seeing something through another person’s lens, but we rarely take enough time to do it. That becomes especially important when you are leading a large team through change.

Taking this time can feel frustrating because most of us want quick fixes and simple solutions. However, quick solutions rarely become fully embedded.

When you have several different teams, you need to understand what the proposed change means for each group. How will it affect them? What difference will it make to their work?

Without that understanding, you may believe the change has been successful, only to look back later and wonder why it did not happen as expected.

I can think of several examples of that throughout my career. My understanding is much better now, particularly after studying psychology and behaviour change. I hope that when I return fully to veterinary leadership after completing my master’s degree, I will be better equipped to understand why people do, or do not, adopt particular behaviours.

Don Adeesha:

Team members often feel that change is being done to them rather than developed with them. How can leaders bridge that gap?

Dr. Nicola Bromley:

Sometimes changes have to happen because they are important. We cannot always prevent people from feeling uncomfortable. Change naturally involves some discomfort.

The important thing is to understand what is making people uncomfortable.

As a leader, it may seem obvious that the business needs to make more money or that a new procedure is required to improve safety. The decision feels logical because you have probably spent a considerable amount of time thinking about it.

The rest of the team has not necessarily had that same time to process the idea.

You therefore need to speak with people and ask what is preventing them from adopting the change. Is there a motivational barrier? Do they understand why the change is happening?

A common problem is that leaders do not clearly explain the reason behind a decision. Different people may also need different reasons to connect with it, and that is perfectly acceptable.

We also need to consider practical and psychological barriers.

For example, a leader may ask a veterinarian to consult more quickly or recommend a particular service. But what is preventing that from happening during the consultation? Is there enough time? Does the recommendation fit with the values of the veterinarian and the practice?

We must understand both the physical and psychological barriers. It takes time, but it is extremely important.

Don Adeesha:

Leaders may spend months thinking about and rationalising an idea. By the time they present it, it feels like the best idea in the world.

They then expect other people to understand it immediately and begin implementing it, even though those people have only just heard about it.

Don Adeesha:

Was there a particular point in your career when you realised that managing was not enough and that you needed to lead differently?

Dr. Nicola Bromley:

I used to believe you could create a list of objectives, have a meeting, tell everyone what needed to happen, and then consider it done.

Veterinarians are often action-oriented perfectionists. We like solving problems and completing tasks. I used to think that people could be managed in the same way.

You hold a meeting, explain the plan, and expect it to happen. Later, you look back and ask why it has not been implemented.

Some things work and others do not.

Studying psychology helped me understand why people may remain silent during a meeting. As a leader, you may assume that silence or nodding means agreement. In reality, people may not support the change or see it from your perspective.

Taking time to understand that is essential, even though it can be frustrating.

When I joined Fitzpatrick Referrals, I arrived with many ideas that I believed were excellent. Some of them were good ideas for me, but they were not necessarily good ideas for the entire team.

It has taken time and reflection to understand why some changes did not progress as smoothly as I expected.

Introducing new technology is a good example. Leaders may think, “This application is fantastic. It will be wonderful for our clients.”

It may genuinely improve the client experience and remove communication barriers. But what does it mean for the reception team or the veterinarians?

Veterinarians may feel that they are already overloaded and that the new technology is creating more work. They may not see its benefit because their day is already so busy.

In veterinary medicine, we frequently say that we are too busy to change.

The team needs to understand the change from its own perspective. When I introduced new technology at Fitzpatrick, it helped some teams considerably. However, there was also resistance because I had not initially understood the situation from everyone’s perspective.

We learned, adapted, and improved the process.

Some people became more willing to participate after seeing the positive impact it had on their colleagues. However, that process took time.

A leader may expect new technology to be embedded within a month. Six months later, the team may still be working through it. That does not necessarily mean the change has failed.

We need to recognise the progress along the way. If 20 percent of the team is actively engaged, that is a starting point.

It is easy to become frustrated. Instead, take a breath and listen.

It is acceptable for someone to say no. The leader’s responsibility is to understand where that no is coming from.

Someone may say, “I am too busy.” Ask what is making them too busy and what can be done about it. Ask them to explain more.

Leadership involves speaking with people. It also requires creating teams that are small enough for meaningful communication.

I led an organisation of approximately 170 people, but I did not individually manage all 170. That would have been impossible.

Part of my role involved restructuring the business into smaller groups of approximately 12 people. That gave leaders more time to communicate with individuals, understand their challenges, break down barriers, and empower them.

Breaking the organisation into smaller teams made a significant difference. Creating opportunities for people to grow was also an important part of that work.

Don Adeesha:

What inspired you to pursue a master’s degree in psychology and better understand why people respond to leadership and change in different ways?

Dr. Nicola Bromley:

After managing large teams for several years, I became increasingly interested in reading about behaviour change.

I was invited to speak about behaviour change at Vet Forum Europe. I found the research fascinating, although I experienced some imposter syndrome when speaking in front of so many experienced business leaders.

After the presentation, many people approached me and said the subject was interesting and relatable. That made me realise that everyone struggles with change. None of us has all the answers.

That experience inspired me to explore the subject in greater depth.

My studies have also been humbling because I have realised how much more there is to learn. However, that knowledge has been extremely helpful throughout my leadership journey.

Don Adeesha:

Veterinary teams regularly experience stress, emotional pressure, and constant demands. What role does compassionate leadership play in helping teams remain engaged and perform well?

Dr. Nicola Bromley:

Once again, it comes back to listening.

Leaders need to genuinely hear what people are saying. Sometimes the team needs time to debrief after a difficult event.

It is easy to rush through these situations and accept high levels of stress as normal. We often normalise them because they are so common in veterinary practice, but that does not mean they should be ignored.

Leaders need to give people time and create consistent opportunities for them to ask for support.

Many leaders say they have an open-door policy. However, when someone approaches you, you must give that person your attention.

Look at them while they are speaking. Give them the space they deserve. Do not continue typing an email or looking at your computer.

Be present with them during the moment in which they need you.

Leaders should also be aware of the atmosphere within the practice. Most of us know the feeling of walking into a building and immediately sensing that something is wrong.

You may notice that the atmosphere feels different. Take time to walk around, speak with people, and understand what happened. Did the team experience a difficult case? Did an animal die? Is someone struggling?

Veterinary teams manage emotionally challenging situations every day.

It is also important to ensure that there are enough people available to support and direct team members toward the right resources.

Psychological safety is an area that I am particularly passionate about.

Although supporting individuals is important, the evidence suggests that it can be even more powerful to address wellbeing and psychological safety at the organisational level.

When support focuses only on individuals, people can sometimes feel singled out. Many supportive interventions can benefit the entire practice.

We should look at the practice holistically. Support may involve giving people time away from a difficult situation, making sure they leave work on time, or ensuring they have an appropriate lunch break.

I recently read a veterinary industry paper in which one of the central recommendations was simply to make sure people have lunch.

It was concerning that, after so many years of discussing workplace wellbeing, we still need to remind organisations of something so basic.

I have worked as a locum in several practices, and many teams are still not managing this well. We need to look after people and show them that taking a break is acceptable.

Support the team collectively, offer individual support when needed, and give people time.

We are often able to protect a 20-minute client consultation, yet we struggle to prioritise 20 minutes to support a member of our own team. That does not make sense.

We need to remove those barriers and normalise taking time to look after people. It is essential for retaining teams, developing people, and creating an environment in which they feel safe.

Don Adeesha:

From a business perspective, spending 20 minutes with a team member is an investment rather than an expense.

It can support retention, which is a significant challenge for practices in the United States. Is the situation similar in the United Kingdom?

Dr. Nicola Bromley:

Yes, it is very similar.

Recruitment is extremely expensive. When people do not feel heard, it becomes much more difficult to retain them.

I worked with a colleague on a presentation about generational differences. He shared an experience in which he had been appointed to a very senior role but did not feel heard by his manager.

He was part of a large team, and his manager repeatedly cancelled or failed to provide one-to-one meetings.

After six months, he felt he could no longer continue because no one was listening to him.

If his manager had spent half an hour properly engaging with him, he may have remained committed to the role, and a great deal of positive work could have resulted.

It is sad to hear these stories. Leaders frequently say they are too busy.

We need to create the time. Retain and develop your team, and people will contribute much more when they feel heard and supported.

I understand that it is difficult. Leaders often feel there is no time left in the day. However, we can structure and plan for these conversations.

The conversation may not be possible at that exact moment. You can say, “I cannot give you the attention you deserve right now, but let us schedule 20 minutes tomorrow.”

You may need to block one consultation to make it happen. That should be considered acceptable.

One of the main reasons people leave organisations is that they do not feel heard.

I do not have all the answers, and I have made mistakes in the past. I simply hope that I can apply these lessons more effectively in the future.

Don Adeesha:

Communication is a major part of leadership. Where do veterinary leaders struggle most when trying to bring teams together around change?

Dr. Nicola Bromley:

Leaders often become frustrated because they want change to happen quickly.

In the United Kingdom, many veterinary practices are led by veterinarians. That brings many advantages, but veterinarians are often direct problem-solvers.

We may communicate something once and consider the task complete. We send an email or hold a meeting and think, “I have communicated it. I am finished.”

When someone says they did not read the email or did not follow the instructions, the leader becomes frustrated.

We want to move quickly, but we do not always see the situation from the other person’s side.

Sometimes we need to slow down, repeat the message, and communicate it through different methods.

Repeated messages are effective. We experience this on social media all the time. When a message is repeated, it gradually stays in our minds.

Saying something once is rarely enough. Some people may need a conversation, a reminder, or an opportunity to explore the idea.

Everyone communicates and processes information differently.

When teams are small enough, leaders can understand how individual members prefer to communicate.

Some people need time to read and process information before discussing it. Others prefer to talk through an idea immediately.

I am naturally quite direct. I explain to people how I communicate, but I also ask how they would like me to communicate with them. That helps us understand one another.

Communication can feel slow, but failing to adapt it means we may not achieve the desired result.

Practices often say, “We need to fix communication.” But what does that actually mean? What specifically needs to change?

Communication is continuously evolving because teams continuously change. That can feel frustrating, but it is normal.

In our personal lives, we naturally speak differently to different people. In the workplace, however, we often assume that one email or one meeting should be enough.

Unfortunately, it rarely is.

Don Adeesha:

As professionals, we sometimes expect everyone to read every email, understand every bullet point, absorb the information, and implement it exactly as intended.

Even when everyone is communicating in the same language, people can interpret information very differently.

Should leaders begin a change initiative by accepting that changing the behaviour of 10, 50, or 170 people will take time?

Dr. Nicola Bromley:

Yes, that is a good starting point. However, it can also make the goal feel almost impossible.

You have to begin somewhere.

Take the wins as they happen. You may notice that a particular group has adopted the change successfully. Explore why it is working for them.

Then speak with the people who are still struggling.

Leaders must be careful not to become defensive. That is difficult when the change was your idea.

Be open to feedback and avoid reacting immediately. Ask the team to explain the situation from its perspective.

You might say, “This is working for one group, but I understand it is not working for you. Please help me understand what is preventing it and how we can work together.”

The change may still need to happen because the organisation needs to progress. However, giving people some control and autonomy often makes the transition easier.

Veterinarians can be particularly reactive when they feel their autonomy is being removed. Their barriers immediately rise.

Working collaboratively can reduce that reaction.

We often focus heavily on education. We assume that if we provide enough information and explain the logic, people will change.

Knowledge is important, but people are not entirely rational. We often make decisions quickly and rationalise them afterwards.

Our actions may be influenced by habit, personal bias, or simply choosing the easiest available option.

Leaders need to slow down and consider those factors.

None of this makes managing a large team easy. Leaders should give themselves some grace.

Successful leadership is not only about what you say. It is about hearing the team and working with people.

You do not need to have every answer. Listen to what your team has to say and work with them to move forward.

A diverse group of people may produce excellent ideas that the leader would never have developed alone.

No leader knows everything. We must be humble enough to recognise that.

Don Adeesha:

You are studying the psychology of behaviour change. What should practice owners understand about why people resist change, even when the change is clearly necessary?

Dr. Nicola Bromley:

The leader may understand why the change is needed. In a corporate organisation, the leader may also have been told why the change must happen.

The decision seems logical because the leader has had time to process it.

Other members of the team may have several reasons why the change does not feel right to them.

That does not mean the change should not happen. It means we need to explore why it feels wrong or difficult.

One useful framework is the COM-B model. COM-B examines capability, opportunity, and motivation as the main factors influencing behaviour.

Breaking the situation into those categories can help leaders understand what needs to change.

Is there a capability barrier? Is it physical or psychological?

Does the person have the opportunity to perform the behaviour? Do they have enough time? Can all the required steps realistically fit into a 10-minute consultation?

What is the person’s motivation? Does the change conflict with their professional values?

Consider a situation in which a veterinary organisation needs to increase sales to remain financially sustainable.

A corporate message might simply say, “We need to sell more of this product.”

That message may not connect with a veterinarian whose primary motivation is helping animals.

The leader may need to frame the change around its clinical value. Explain how the product or service could help more animals or improve patient outcomes.

That is more likely to connect with the shared values of the veterinary team than simply saying the organisation needs to make more money.

The goal is to understand the barriers and determine how to move through them.

Don Adeesha:

Most veterinary professionals do not want to feel like salespeople, even though communication and recommendation are part of their work.

When the change is framed around outcomes that matter to veterinarians, such as animal wellbeing and better care, does it become more educational and meaningful?

Dr. Nicola Bromley:

Yes, although we should not assume everything can be solved through education alone.

Knowledge is important, but leaders also need to explain why the change will help the individual team member.

For example, consider introducing an artificial intelligence scribe.

A veterinarian may need to modify the way they speak during a consultation, and that may initially feel strange or uncomfortable.

However, if they understand that the tool could reduce the time they spend writing clinical notes, it may become personally valuable.

Leaders need to understand how the change benefits each individual. That benefit may be different for different people.

The key is finding the reason that matters to them.

Don Adeesha:

Veterinary teams frequently experience change fatigue. How can a leader distinguish between resistance and genuine exhaustion?

Dr. Nicola Bromley:

Leaders need to be very aware of this.

We can become enthusiastic and want to change everything immediately. Sometimes we need to stop and ask, “Do I really need to introduce this change now?”

Explore the likely impact before proceeding.

There have been times when I wanted to change a rota but realised that it had already been changed six months earlier.

Making another major change so quickly could have caused people to leave. The potential impact on the business could have been catastrophic.

In that situation, it was better to accept that the rota was not perfect and allow the team more time.

The idea did not need to be discarded. It could be parked and revisited when the timing was better.

Sometimes all the necessary conditions need to align.

People need time to move through a change, accept it, and allow it to become embedded. They need to feel comfortable and confident in what they do each day.

When everything changes at once, people feel uncertain and stressed.

High levels of stress affect the brain’s ability to think clearly. When teams are overwhelmed, errors become more likely.

That creates a cycle in which mistakes increase stress, and the additional stress creates more mistakes.

Leaders may need to write down all their ideas and choose a maximum of three to implement at one time.

Wait until those changes are established before introducing more, assuming the remaining ideas are still relevant.

I generally avoid pursuing more than three significant initiatives at once. You can continue collecting ideas without immediately acting on all of them.

Introducing too much too quickly is not fair to the team.

Don Adeesha:

Overloading the team can increase stress and lead to more errors.

Most people want to do a good job. When the system continually overwhelms them and prevents them from performing well, they may begin to question whether they have any other option besides leaving.

It can also lead to burnout.

Dr. Nicola Bromley:

Burnout is a significant problem in the veterinary profession. People experience increasing pressure without enough time to recover.

When we are highly stressed, our ability to think rationally becomes much narrower. That is one reason errors are more likely in high-pressure situations.

This brings us back to basic practices such as leaving work on time and taking lunch breaks.

These actions may appear small, but they give people essential space to breathe.

I recently completed several weeks of master’s degree examinations, and my stress levels were extremely high.

The experience reminded me that no one can operate at that level continuously. Our behaviour changes when we remain in a heightened state of stress.

Veterinary team members may be completing examinations, professional qualifications, or managing personal challenges outside work. Leaders need to consider that existing load before adding another major workplace change.

A new demand may become the final straw.

Sometimes the right response is, “Not now. We will come back to this.”

Leaders should also reflect honestly on whether a proposed change was actually the right decision.

Not every change will succeed.

You may need to say, “I believed this was a good idea, but it did not work. Let us understand why.”

You can then decide whether the idea is worth revisiting or whether it should be discontinued.

Leaders are not infallible. It is important to acknowledge mistakes and show the team that you do not always get everything right.

We are all human.

Don Adeesha:

Leadership brings significant responsibility and privilege. A practice owner or leader can influence many lives at different points.

However, in the pursuit of revenue or innovation, leaders can sometimes lose sight of that responsibility.

A leader may see a new artificial intelligence tool or another piece of technology and immediately want to implement it.

Meanwhile, the team may have only just become comfortable with a system that was introduced three weeks earlier.

Thank you for sharing that perspective.

Don Adeesha:

The discussion about behaviour change is important because veterinary practice growth does not happen simply because the owner wants it to happen.

People need clarity, teams need alignment, and the business needs systems that support the direction in which it is trying to move.

The same principle applies to marketing.

A veterinary practice owner may be updating the website, running advertisements, requesting reviews, and posting online without having a clear understanding of what is helping the practice grow and what is simply creating more noise.

That is where Ekwa Marketing can help.

Ekwa Marketing is offering Veterinary Business Podcast listeners a complimentary Marketing Strategy Meeting.

Think of it as an opportunity to step back and examine your practice’s growth more clearly.

You will meet with Lila, a veterinary marketing strategist who has worked with more than 200 clinics across North America.

Together, you will examine where your marketing is working, where gaps may exist, and how your online presence can better support a healthy, aligned, and growth-ready practice.

You can request your complimentary Marketing Strategy Meeting at:

Ekwa Marketing accepts a limited number of meetings each month, so it is worth reserving a place while availability remains.

Don Adeesha:

For veterinary leaders who want to improve culture, collaboration, and team performance, what is one practical place to begin?

Dr. Nicola Bromley:

People I have worked with in the past will probably associate me with a phrase I use frequently:

“Curiosity, not criticism.”

That is the key starting point.

Enter the conversation prepared to hear what the other person has to say. Avoid reacting immediately.

When we approach people with curiosity, we are much more likely to engage the team and move forward with the behaviour or change the organisation needs.

I hope that phrase continues with me throughout my career and that previous colleagues remember it.

Human beings can easily become judgemental. We naturally rely on biases and mental shortcuts, which psychologists call heuristics.

Instead, pause and settle your reaction. Ask why something is happening and seek a better understanding.

I hope that is helpful.

Don Adeesha:

Where can listeners find you and learn more about your work?

Dr. Nicola Bromley:

You can find me on LinkedIn by searching for Nicola Bromley.

I am currently completing my master’s degree and will be working on my dissertation over the summer.

I am also moving into a new role with a growing referral centre on the south coast of the United Kingdom.

It is an exciting project in its early stages, and I am looking forward to working with new teams.

Don Adeesha:

Thank you very much, Dr. Nicola Bromley.

Dr. Nicola Bromley:

Thank you. I appreciate it.

Don Adeesha:

For veterinary practice owners who want greater clarity about what is driving their growth, request a complimentary Marketing Strategy Meeting at:

Thank you for listening to the Veterinary Business Podcast. We will see you in the next episode.