Life Boost with Amelia

Ep. 79 | Clinical Empathy: Turn Stressful Conversations Into Your Superpower with Dr. Josh Rosen

• Amelia Knight Pinkston • Season 1 • Episode 79

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This episode features a conversation with Dr. Josh Rosen, locum veterinarian and expert in veterinary clinical empathy. The discussion explores the importance of clinical empathy in veterinary practice, focusing on improving communication with pet parents to create a more inclusive, supportive, and sustainable veterinary field. Dr. Josh outlines key strategies for integrating empathy into day-to-day consultations, reflective listening, addressing pain points, signposting, and effective use of empathy statements. The dialogue also addresses the benefits of a team-style approach, the impact of financial transparency, spectrum of care, and tips for navigating conversations with frustrated or rude clients. Emphasis is placed on self-awareness, taking a fear-free approach for everyone - pets, owners, and the veterinary team, and the overall positive impact of empathy-driven communication on client trust, veterinary well-being, and profitability and long-term success for veterinary practices.

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Welcome to the Life Boost with Amelia podcast where we're changing the narrative around what true health and success look like. They should give you energy, not drain it. I'm your host, Dr. Amelia multi-passionate integrative health and life coach, entrepreneur, and recovered burnout veterinarian. Together, we'll explore the science behind how your brain and body work, including the unconscious mind while also connecting with what your heart needs in order to stand up to the norm of feeling stuck on a hamster wheel-working hard yet feeling exhausted and not where you want to be- and instead live a life that makes you excited to get out of bed in the morning and in love with who you see when you look in the mirror. The reality is if you do what everyone else is doing, you're not going to feel good. Let's break the norm. Hi friend. When you think about having to deal with a frustrated client or having to talk about finances with a client that is complaining that vet med costs way too much or even needing to keep a client on track when you have a lot of rooms to see, and they're wanting it to be story time. Does that increase your stress level or make you feel drained? If, so you're really going to enjoy today's episode with Dr. Josh Rosen. By the end of this episode, you're going to have so many practical tips that you can start putting into practice immediately. So that those interactions that maybe used to be really stressful and draining may actually start to become your superpower and feel really empowering. My guest, Dr. Josh Rosen is a locum veterinarian serving pets and their families across New York city, long island and Northern Jersey. Known as@dogtorjosh on Instagram, he blends humor and education to connect with pet parents and veterinary professionals alike. As a relief veterinarian writer and speaker, Dr. Rosen is passionate about clinical empathy, effective communication and building trust in the exam room. Beyond patient care, he advocates for wellness and resilience within veterinary teams inspiring others to create positive change in vet med. His mission? Empowerment. By addressing the challenges and stereotypes in the profession with empathy and clarity dr. Rosen believes veterinary care can become truly unstoppable fun fact: he was a cheerleader in undergrad where he learned the importance of teamwork and lifting each other up a philosophy he brings to every team he works with today. Enjoy the episode.

amelia:

Hello and welcome, Dr. Josh. Thanks so much for taking the time to be here.

Dr. Josh:

It's my pleasure. Thanks so much for having me. I'm excited to talk about clinical empathy today.

amelia:

Yeah. Yeah. I've really enjoyed connecting with you on Instagram. I love your mission and message and really practical tips that you share for communicating. And I think you and I are so aligned in our mission and vision for what's possible in vet med. I know with, Your mission you shared like my work isn't just about treating pets. It's about supporting the humans who care for them including the pet parent and my team and that your mission is to make vet med a more inclusive, supportive, and sustainable profession and Just so much. Yes to that. I couldn't agree more. I think it's So important for us to acknowledge if we do want to provide the best care for our patients, we really need to be looking at the entire ecosystem that is our profession, right? Like the pet parent, the veterinary team, and our patients. And it's if we ignore or don't address the safety or well being of any one of those components, that's really when it becomes so frustrating or unsustainable for all of us. I love that you have such an emphasis on that and communication really is at the core of that so that we even understand how to support one another. so the plan today will start with covering some big picture concepts and tips, and then we can really spend some time diving into some of the specific scenarios that can be most stressful and draining in vet med so that people have, an approach that feels a little bit lighter and more energizing and empowering rather than draining.

Dr. Josh:

I love that. Let's get into it.

amelia:

All right. So to start things off, can you explain what is clinical empathy and why do you think it's so important that becomes the norm in vet med?

Dr. Josh:

Absolutely. When I talk about clinical empathy, I, mainly mean the idea of putting yourself in, the shoes of the pet parent, the pet guardian that's coming in the door with that patient, and really leaving your perspective behind, at least just for the beginning aspect of your intake, or when they're greeted and brought into your reception area. There, there's many different ways that this can be utilized, but the idea generally comes from the foundation of being able to put yourself in the shoes or the eyes of the pet guardian and breaking it down into three simple but still very big steps is starting off with being able to give space for the pet parent to be able to talk about what's going on with their pet. What is bothering them the most? And often it's going to start with the fact that their pet is sick. And I think that, sometimes I have conversations about this where it's obviously they're here because of X, Y, and Z. It says it in the presenting complaints. Yeah, that's why they're here. But. You don't know what about that. is actually, in addition to them being concerned about their pet what is also bothering them or creating an obstacle in their day to day ease of life? And sometimes it truly is that no, my pet's really sick right now and I can't focus on anything. Do my work, get up and think about anything aside from my pet getting better until I get that goal accomplished. And that's totally fair and you will absolutely find out if that's the case when you're having that initial conversation with the client. Sometimes it's because they stayed up all night Caring for their pet because they were worried about whether or not they were comfortable. Maybe they had to let them out several times. It's basically giving space so that you can listen to understand what pain points are present within their day to day dealing with that, that pet's concern. And the second step from that, and I just said it as being able to identify those pain points through reflective listening and being able to say, okay I'm not going to think about what my plan is persay Maybe I'll think about it a little bit, but I'm definitely going to give space so that I'm actually present for this conversation. And in doing so, communicating to the client that I am present, that I am hearing everything that they're saying, and communicating to them that I've seen their pain points. Wow, it really must have sucked to have to stay up all night caring for your pet or having to let them out over and over again. For hour after hour, or just simply having to worry about whether or not they were in pain. You can very easily communicate that in a minute or two, just by simply saying that really sounds unfortunate or it sounds frustrating. The last part of that step three is being able to say, okay I know what those pain points are. And again, I just said it again, but crafting empathy statements. So using that pain point to allow you to say, okay, I now know what I need to communicate to the client for them to know that I see them and what is most important to them aside from their pet getting better, because that is the given. We are going to assume that is the primary reason why they are there, but. If you show that client that you also care about how this is affecting them, they are going to trust you by default. And sometimes you have to, it's not always as straightforward as the situations I just, addressed, but that is the basic layout of it is giving space for them to talk about how the situation affects them being able to identify pain points and then crafting empathy statements from those pain points.

amelia:

I love all those tips so much and I like looking at things from a nervous system perspective and I love that what you're accomplishing is number one, acknowledging that these pet parents are probably walking in the door in a stressed out state, right? Like maybe they're not getting sleep. They're worried about their pet. Things have been hard. And by really listening to them and hearing their specific concerns and being able to speak to those, that's such a powerful way of just helping their nervous system to feel safe so that they are in a state where they not only are going to trust us, but they're also able to hear what we're saying, which I think is so important too.

Dr. Josh:

That's absolutely right. And the flip side of it is that if you have a client that's coming in that wants to be able to share that, wants to be able to vent about how this is impacting their life because of how stressful it is, as you just said and we start to, Okay, but let me just get this question answered, or let me just fill in this box right here. Okay, so we're basically just here for diarrhea. I can just give you meds for that. That's not a big deal. Those are very easy things, because we're thinking about okay, how can I make this the fastest most efficient process for them and thinking that's the kindest thing that we can do for them, which it still is. It's just not the only way to accomplish that goal. The two are not mutually exclusive. You can empathize. And it actually has shown that we can be more efficient when we are practicing these approaches, specifically using other styles and skills with effective communication. But it, it really can be that easy to lose ground on trust because we aren't taking that step of saying, maybe let them just talk about what's going on for 30 to 45 seconds before I, I say, you know what, I really need these other questions answered. Or maybe just go through what their version of the history is and guide them and start with signposting so that they understand how long the consult is going to be entirely, and they can have that on the forefront in the beginning, but if they have the space to talk about what is going on, what's bothering their pet, what's bothering them, you can get those other questions answered in a matter of 30 seconds to a minute at the end of the consult when you're walking out even if it's just to say just really quick, one last thing, I need to know this, and this, what are we feeding? Are we still giving these same medications? Are we still on preventatives? Those are all still very important questions because clients don't always know what is medically relevant. We just don't always have to start there. So yeah it's so important.

amelia:

Yeah. I love that. And I love what you're doing too, is helping to prevent us from going in with assumptions and biases that may prevent us from really being able to speak to what truly is important to them, even if that's maybe not aligned with what we think is the top priority because if we're speaking to what we think or what we're assuming we're really probably gonna lose them So I love that

Dr. Josh:

Absolutely. And it's like a moment to say, did I mean to say, for that to sound like I uh, I'm thinking about these things, but every single thought that I have doesn't have to be communicated. In fact, we should be more mindful about the things that we're choosing to communicate versus what we're choosing to think about. But most importantly, also being present when they're talking. Because if all we're doing is thinking about the next thing we're supposed to say there's no way that you're gonna be present for what's bothering, what's going on with that client.

amelia:

Yeah, so true. And I know, like I've heard from pet parents that it can be, even if we are maybe just distracted, like typing notes, what an impact that has from the owner's perspective, they feel like we're not listening to them. And yeah, I love your emphasis on active listening and really being present with them because that alone, it's not just what we're saying, but certainly like our body language and our actions have such a powerful impact, for better or worse.

Dr. Josh:

Absolutely. And that's also why the team mentality in regards to this is so important. It's, certainly important for the veterinarian to have this approach, but it's just as important for our entire team to have this approach so that the client has this experience from the moment that they walk in the door. One other example is to say that, a common myth, for lack of a better term, is that. It takes longer if we're going to try to pursue these approaches, right? We're going to have to put more energy and more time into giving that space that you're recommending. And, I think that it's a logical way to think about it is if I'm already spending X amount of time and you're asking me to do more, then that has to mean that I'm going to spend more time. I think that it definitely has to do with the system that's in place at your hospital. I'm a relief veterinarian and I've worked in multiple settings where you have either a technician or a nurse or an assistant starting the appointment for the veterinarian or a veterinarian starting the consult themself. And it's to say, each system has its pros and cons, I'm not going to discuss those, but I can say that It speaks to the benefit of having a team style approach in this because what the issue in regards to, I think a lot of veterinarians have in approaching these consults is half of my consult time is already gone because the intake wasn't, I wasn't there for it. And it's to say if the efficiency for what you need to do in a day to day because you're accomplishing other tasks while you have that intake going on, then the most important thing is to make sure that your team pursues these approaches because if your team has already enacted this when they do the intake, then the client is already set to say, okay, this team isn't a mindset to hear me out and hear what's going on. So all you really need to do when you come into that consult is paraphrase from the assistant's perspective, what the client has already presented to you. Because if you start off after you obviously introduce yourself and, make sure you know their names is that, You are present in that you're not going to make them just say the entire five minute story over again. And make them get all into the emotions of it as well. When you take that approach you connect the empathy and trust that was built from the intake to now your physical and by continuing that same trend of communication, talking about your physical throughout the entire assessment, making sure that they know your physical exam findings, even if they're normal hearing it from you says that you're there and present in the moment and you're not thinking about something else while you're there with the them. And it's, it's very subtle. Like it's not to say anybody thinks that you're doing this on purpose or that you're truly having a malintent of the matter, but it's what you are communicating without realizing it in every interaction you have with a client. So on the flip side, if you as a veterinarian are starting the consult, then you have a lot more control over how much time is obviously going by in regards to where you want to land in starting your physical exam. But I don't think that there's one that's better than the other. It's just understanding how those systems work so that you can best pursue these skills and workflows of clinical empathy.

amelia:

yeah. I love that just self awareness, of how, what you're doing is really influencing the pet parents experience. And I also, I do love that emphasis on teamwork. That really is everything. And I love how, if it is that approach where an assistant or technician is getting the history and even starting from the front desk, what I love is that if everyone's adopting these tips that you're sharing. You are just continually giving this pet parent signals of safety and feeling trusted every step of the way. And what a powerful way to really create such a strong bond really with these pet parenTs.. And I love that of going in and being able to paraphrase what everybody else has already gathered. That is so comforting, I think, for the pet parent. I love that.

Dr. Josh:

And I think that it speaks like I've personally witnessed how having a team style approach helps in these situations from the client perspective. If you have a team that starts off the, intake by saying, Hi, my name is Josh and I'm going to be just taking a quick history for Dr. Rosen. I want to make sure that we have all of our medical history aligned with what we're coming here today for. After we go through the history and what medications we're on we're going to take a moment to do a physical exam with Dr. Rosen he's going to go through what his findings are and talk about recommendations based on those findings and the history that we've just discussed. And after we've gone through everything, including your questions we're going to go through a cost estimate or a treatment plan so that there's cost transparency in regards to the recommendations that we're making today and that there's no outstanding concerns that we need to address before pursuing these treatments. When I recently went to have my dog Molly treated for her mast cell tumor a very similar approach was pursued with regards to her intake for the exam. And, we're obviously going there for a very serious condition. It definitely helps knowing that they are, Taking this team style approach from that initial consultation or just simple intake to say this is what you should expect for the rest of the visit. And, when we talk about, when I've talked about signposting with some other colleagues, sometimes it's to say I'm already going in there halfway through the consult. Like, how am I going to signpost? And, okay, you can talk about where you're going to go from there, but the best thing would be that, your assistants or your technicians and nurses are very familiar with working with you and want to work as a team together and would probably have no problem setting the frame for the client to start the appointment because they are also looking for these visits to be efficient while also being thorough and providing the best care that we can for these patients.

amelia:

Yeah, I think that can go so far like our brains love predictability, right? And so it's like once again, what you're doing is really establishing that safety of taking away some of the unknown and just providing that clear structure of here's what you can expect. And I also really love how you mentioned the pricing too. I think that, finances can be one of the most frustrating and stressful components in vet med. And I think sometimes there can be a tendency to avoid talking about it because we're afraid that's going to cause issues. And in reality, the more transparent and proactive we can be in Speaking to finances and helping them to see like we're going to keep you updated on this. Make sure you're okay. That Can go so far instead of at the very end of the appointment this, unexpected bill and frustration

Dr. Josh:

Or even like before they end up paying to say that like you've gone through all of these recommendations, and then they find out that oh, I can't do these things, that okay, now we have to spend even more time talking about a different approach, where if we knew from the very beginning where these things were going to cost we would make different decisions and probably be able to pursue care more efficiently and effectively for that pet and with less frustration along the way. I absolutely agree. Yeah.

amelia:

yeah And so I know you've used the term signposting several times and I think that is a really important strategy, especially when it comes to so often we're short on time, right? And it's say you have this complicated case, then you have a lot that you need to explain to the owner. But the pet parent is also wanting to tell you like all of their stories and what else is happening in their life. Sign posting can be really helpful, right? For Helping to keep everybody on schedule and focused while also helping them to feel heard. Is that right?

Dr. Josh:

Absolutely. And, it really there's different styles of how to accomplish this goal, but essentially what it is, is creating a roadmap of expectations for that client or pet guardian to be able to have expectations from the moment that they're walking in the door. How can you signpost as a receptionist? After they check in aside from saying, good morning, how are we doing today? How's fluffy? Being able to note and see what they're there for, Oh we're here for vaccines today. That's great. The team will be with you shortly. Do you mind taking a seat over there? We have some water available if you'd like, some coffee. It'll probably be not but another two or three minutes before we start the appointment. Versus, good morning, the check in sheet's over here. We'll let you know when we're ready.

amelia:

So much

Dr. Josh:

Know, when So much unknown. And, I think that the reality of the situation is when we compare those two, it sounds like one is very right and very wrong. And that is not the goal of comparing them. I think that the reason why the second situation exists has to do with a very fast paced, high volume environment. And that is important to note. It's also significant to note that Again, it's not something that's necessarily going to slow you down. It probably is going to make the process more smooth to have that involvement from the start. And we, we'll talk about this a little bit more later too probably, but We feel more fulfilled when we have this approach, when we're not just going through the motions. I'm here for a reason. There's a reason why we picked vet med and not human med, right? This is what we're passionate about. This is what we want to do every day. And being able to lean into that side and trying to see the other side as not, Wrong. Just Oh that's where I don't want to be. That's not why I got into this. I think that going from there to say even further being able to roadmap the rest of that appointment, like I was describing before, when they come into that visit a lot of colleagues, that I know are afraid of how long appointments time appointment times take in general. Know that the client is coming in with multiple concerns, this is something that is going to help you significantly. Because you may try to handle all of those concerns at once, maybe they are truly all urgently that you need to handle all at once, but maybe you can take things step by step and handle the most urgent ones and have them follow up in a week to start the process of handling the next. Just for the simplicity of making things efficient and not taking care of it in time away from other pet guardians and patients you plan to see this is a relatively, humorous situation that actually happened to me this week was a a pet that presented to me. Teddy had been really itchy, and we were really itchy all over our body, but most itchy by the rear end and the ears. We weren't on flea and tick prevention, and there wasn't really any rashes or anything like that, any skin lesions that I could see, but it was very clear that we had been chewing very much by the rear end and maybe some evidence of an ear infection. But the interesting part of the history was that they were also concerned about seizures. And that was brought up very casually at the end of the consultation because they really were there for the itchiness. They also brought up sneezing, nasal discharge. They wanted to talk about how much they should be feeding. And the intake, said further questions from there which is fair. I think that these clients were new pet parents. They were coming in to consult about multiple concerns because they had probably been waiting a little while to feel like they were going to get as much as they could out of consulting with the doctor about their pet. In the beginning of talking about all of these concerns, the way that I approach this is saying, I definitely want to address the itchiness. It certainly sounds like that is what we feel is most uncomfortable for Teddy. But I also just need to touch base really quickly on part of the history that is a little bit if we're having seizures we certainly need to address that as well. We may be able to do both today, but let's just talk about that a little bit more. What are we seeing at home? And they went on to describe that Teddy has these Episodes where he's rubbing his entire body on the floor and they think that he's, flipping his body back and forth right? And that's the seizure because he's also shaking his legs when he's scratching. And they've never seen this behavior before, right? Like, why on earth would they know if they've never seen seizures before and they've never seen a really itchy dog before?

amelia:

Yeah.

Dr. Josh:

how would they know if it's a seizure or not, right? So the the first question that I had after that was like, okay, that definitely helps a lot. I appreciate that information. I have to imagine that when you found Teddy doing this, that you immediately had to be like, Oh my gosh, Teddy what's going on? And maybe even pick Teddy up. Do you interrupt Teddy? And they're like yeah, as soon as we pick him up, he stops. And it's okay. That's also extremely helpful. I am, I'm very happy to report that Teddy is not having seizures. I certainly want you to record what you're seeing at home so I can know for sure, but I'm fairly confident that what's happening, that you're describing is from the really itchy nature that you're actually here presenting for initially. And. It was interesting how just by having that conversation, we were able to shorten the concern list and not have to do multiple concern workups, right? But I also had planned in that moment to basically say to them, listen, I know we're here for the itchiness, but we may have to just start with medicated bathing and a flea preventative for that and start with a workup for the seizures, depending on how often it's happening, right? Because that's at least conservative management for the concern that's not life threatening. And we can make sure that we have what we need based on the severity of the history regarding the seizures. But it turned out so much better than that, obviously.

amelia:

Yeah, I love that. I think there are two really powerful things in what you shared. One is prioritizing and it's both like acknowledging what the pet parent's priorities are and thinking about what your priorities are and then looking at how can those Combine in order to come up with a plan. And then I also really love how you were talking about curiosity, right? And getting curious okay, what specifically did that seizure look like? And even before that, when you were talking about, when we compare what the ideal communication looks like to not ideal communication. I think it's important for us to not put so much pressure to be perfect and to do this right, but I think that any time we do have one of those encounters or situations with owners when it just doesn't go well or as planned, Afterwards, getting curious and using all these tips that you're sharing to think okay what maybe was missing and now what can I use to, to come up with a plan that works better?

Dr. Josh:

Absolutely. Absolutely. And I think that's a really important point in the process of trying to add these skills to your tool belt, right? It's so much different than other skills that we have clinically in veterinary medicine is this idea of soft skill development. And how can we do better at this if we are currently struggling and don't understand why? I think that there is obviously a reflection, period involved, but we have a tendency in veterinary medicine to need perfection, to, okay, if I want to do this, then I can't make any mistakes, and it's Unfortunately the only way to do better at this is to make a few mistakes along the way and the reason is because it is it like you will never forget the moment that you make a communication error and you reflect on it like you will make the error and it's to say you don't do it on purpose, right? Yeah, of course Like it's all part of the learning process. And unfortunately that, there's no catheter lab or, clinical skills lab that you can go in and be able to practice the skills for 45 minutes a day. But, I'll tell you what you definitely are probably already doing is practicing communication efforts every single day if you're in clinical practice, and those are your opportunities to put some of these skills into action, and, it's as simple as picking one thing to do differently every day or say this month I'm going to try to do this thing the majority of days that I'm working. Understanding that you're still not going to be perfect even if you're just choosing one thing to do better at, and as time goes on you'll realize oh wow I can do this now, like I'm going to add one more and I'm going to keep learning about this because these things really do help. And I see how much more willing clients are to connect with me and provide trust in the recommendations I make. And to also have a lot less frustration along the way in regards to declined treatment plans secondary to poor trust. There's always going to be situations where clients need a spectrum of care approach. But I've also had clients that are very involved with their pets that, always do the full workup that's recommended when their pets are sick they end up going to an emergency room and, maybe they end up pursuing supportive or conservative symptomatic care because they don't necessarily want to pursue the diagnostic workup where they don't have the connection and It's not anything about the individual that they work with there It's all about how much of a relationship they already have developed To the point where you can see how much it has the potential to benefit the care that you provide. I think that there's also myths around whether or not this can you know lead to emotional overwhelm or compassion fatigue, even burnout. And aside from feeling fulfilled from pursuing these skills, I think that the thing people fear when they say things like that or feel that way is the idea of the energy that it takes to be emotionally present. And, it's a very common thing that, that's on my mind when I think about empathy is this idea of, what's the difference between sympathy and empathy, or just simply the idea of is empathy an all encompassing term regarding, clinical empathy? No we're talking about something specific, something known as cognitive empathy or affective empathy with an A. If somebody is in trouble and they're trapped underneath a car and you're walking past them on a street, that they're struggling so much you know that they need help because you empathize with what situation they are in. You could not understand that they need help without empathizing that they are under a car, and that has the potential to kill them. If you decide that you are also, in order to know what level of urgency this is, that you also tap into feeling, What it's like to be underneath a car, because you're like do I really know if being underneath a car is life threatening? Let me just tap into what that feeling is, and it's obviously not a conscious decision. The idea being that, okay, if I decide, okay, I'm going to also feel like that, we're both going to get crushed by the car and then nobody gets help, right? Another very common way to say that is you have to put your own oxygen mask on first, right? You have to. to be able to take care of yourself before you take care of others. Most importantly, our patients, but also their pet guardians. And if we aren't doing those things, if we aren't moving forward with appropriate means of self care and what that means to you, or another way to say self care is self empathy the idea of truly caring and understanding your needs. So that you can function to be the best person that you are. To be cliche about it, but that's absolutely true.

amelia:

Yes. Whew. Okay. You have so many good points in there that I want to unpack. So I love what you were just saying. So much yes to we need to be putting our oxygen mask on first. And I think that we've. Really been selected and rewarded in some ways for that willingness to self sacrifice, right? And it goes back to talking about the perfectionism. I think that's a big issue too, like in getting into vet school or just in this profession. I think we do select and reward for a certain type of person who has been very high achieving is used to doing things perfectly and is willing to self sacrifice to take care of someone else and that really isn't sustainable, right? Because we really do need to be prioritizing our energy so that we keep having the energy to come back every day. And. I think it is great what you were mentioning of this kind of communication and like having a little bit of empathy it really does help to connect on a really important level and that becomes Energizing, right? Like when we are able to see how these methods of communicating help to create so much more teamwork between us and the pet parent, and help to lead to more successful outcomes, with whatever that is and whatever kind of spectrum of care they're able to do. That is so motivating, right? And so it's like something that used to be so draining and stressful and frustrating can switch just by a little bit of a different approach can turn into one of the most rewarding parts of the profession. So that's so powerful. And I think it's so important to emphasize how worthwhile Adopting and playing around with these approaches are because it's so important for this career to feel fulfilling and sustainable

Dr. Josh:

So important. So important.

amelia:

And I love your idea of One focus as well Like it can be overwhelming right to listen to a whole podcast and to hear all of these Ideas and it's so helpful to just think, I do that with coaching too. I'm always asking my clients like, okay What's the one thing you really want to Focus on? And just adopting that growth mindset, right? Of trying it. If it doesn't work, that's also really valuable information to go back and just get curious. Okay. What did I learn from that? What do I want to change so that next time I can try something different? And I know when I experienced burnout and I was recovering, having one focus and something that I was excited about really was important to me, it was like, Early in COVID to me, connection is so important, having a good connection with owners. And during that time, I felt very disconnected. They were in their cars, we were on the phone. And when I started prioritizing, okay, I'm going to challenge myself. Like even on the phone, I'm going to see how can I feel like a real connection, help this owner to feel heard that changed so much. And I started to feel much more energized. even though it was the same situation. I love the tips that you're sharing, because I think it's so important.

Dr. Josh:

I think that's really fascinating because coming from and I agree with that sentiment and it was part of the process in recognizing how, visually involved and just the aspect of being present for the exam, how much of an impact that truly can make, what tools you're missing when you can't do that to be able to say how much potential you have when you start to incorporate that into your consults. After COVID, Once we started letting clients and pet guardians back into the exam rooms in the various clinics that I worked at aside from being present for the physical, something that really Became clear to me and just helping associate veterinarians when I was a medical director why can't I get a client to approve a fluorescein stain? Why can't I get a client to approve this ear cytology? And, I'm not talking about the one off situations. There's again, always going to be, I have clients that don't want to do things and it's because of their decisions and what their history and experience and trust with veterinarians are whatever the X, Y, and Z is, it's not me, but I still care and I'm passionate about this so much because of how much I see it work. When I'm in an exam room. If I know I'm going to do a corneal stain as well as to say, Schirmer tear test or pressures I want to do that in front of the client and I'm still going to give them the price of it. But I'm gonna say to them, listen, I need to do these tests, and I really want to see whether or not there's a scratch on the eye. If I find it, I'll show it to you and you're gonna be here, and you're gonna see the whole process, given the patient is compliant and, isn't very fearful right, that this can be successful. But when they see okay. I understand that this was necessary Oh wow, this is really fascinating that we can find this out this way and I get an answer immediately. Or maybe, we recommend a skin cytology and we're not getting the yes on that a lot. We're just recommending it and putting it on the treatment plan and leaving the room. Like, when I take a piece of tape or a slide and I press it against the skin, and I show them what came off and what, how I'm gonna look at it under a microscope and see what's there and treat based off what I find, The only time that they say no is, is when they have financial concerns and then I can feel confident that we're okay. We're gonna take a spectrum of care approach. Here are some other options for you and we're moving on because I don't doubt. That there's trust after they said to me, Wow, that's, that's really cool, or Ooh, gross yeah, I would really like it for you to look at it. And then when I show them the price, they're like, Actually, I can't. Like, There's only one reason why that happens, right? If they were so for it initially, I'm not gonna bother that. Okay, that's totally fine. Let's move on to what the next option is. But when they see you do it, It means so much to them. And it's not like a, Oh, I love this so much I want to go back to the vet to see it happen again. It's just the idea of understanding what we're doing. And not being in the dark as to what it is we're trying to find out for their pet. I think that a lot of times people don't say yes when they probably would otherwise is because they simply just don't understand the why.

amelia:

Yeah. So true. I think it's so easy for us because from our perspectives, it makes total sense. We know we're doing this all day, but for a pet parent, it just seems like something else on the bill and they're not really understanding what's the difference between if you do it and if you don't. And yeah, I think that can be so helpful of just covering both okay, here is the benefit. This is specifically what we're going to find. We're going to see maybe if there is a specific, yeast infection or bacteria that we need to treat, or maybe this is just inflammation and we'll treat it this way. And we won't be able to compare on recheck, if we don't know what our starting point is. So to confirm say you have an allergy appointment and you're recommending doing an ear cytology and a skin cytology and initially the owner is saying, no, I I just want some antibiotics for that, so how would you specifically what communication tips would you use for that case?

Dr. Josh:

That's a really great question. I think that, part of this is, it depends, a typical answer, right? But the severity is the depending factor, right? If it's a mild case that's presenting for both skin and ear concerns, and I know that, It's safe to start conservative management in regards to a medicated ear cleaner, a medicated shampoo, a medicated mousse. Um, Make sure that their flea and tick preventative is up to date. These are all things that I'm thinking about before starting my communication, right? Okay. We don't have an interest in pursuing this diagnostic workup regarding the skin cytology and the ear cytology. I just want to make sure that you understand the why behind these recommendations before we move forward to some other options, because it's important to me and it's part of my job to make sure that you're informed. So when we talk about the ear and skin cytology, That's going to tell me whether or not there's any bacteria present. Bacteria, we can both agree, is really the only reason why we would use an antibiotic, right? Yeast is a fungus. We know that an antibiotic is not going to help treat a fungus. It may even help them overgrow, right? To what we, maybe apply from humans. I'm not going to prescribe an antibiotic today without having the results of these antibiotics. Again, we're talking about a mild case. And I want you to understand that it's because they may not be necessary, and without definitive proof for the necessity, I don't want to make this case any worse than you're presenting for. I would really love to see you come back in 10 to 14 days and this be at least 70 to 80 percent better than it is when you came here today. If you want to be a little bit more aggressive than that, because you're used to, Pursuing antibiotics for your pet and these skin conditions. We can also talk about some anti inflammatory therapy or monoclonal antibody treatments specific for allergies. But I would really prefer we start with the skin cytology because even if we decide that the antibiotics are needed, we can wait a little bit before starting them and start the topical therapies. And not have as much of a negative effect compared to starting the antibiotic and maybe they're not necessary. On the flip side to it is that if there's a very severe case I probably will approach the conversation a little bit differently. Still thinking about all of those same things that discussed before. Yeah. Are we on flea and tick prevention? What is the medical history in regards to how we got here? Is there a history of allergies? Are we on any allergy medications already? If they are declining it, I would start off by saying, Listen, I want you to understand that this information is so helpful in getting to the appropriate treatment that we need in the situation. I'm not telling you that antibiotics aren't indicated. I don't know. And I really want to know. If you were to tell me that the cost of these cytologies is going to get in the way of groceries, is going to get in the way of rent. I will tell you right now, I understand. Let's take a conservative approach and see what happens. But, I need you to leave here knowing that this test is really helpful because it's going to tell me exactly how I should treat. And probably also talk a little bit more about how I would want them to go home with the anti inflammatory therapy or start cytopoint treatment. It's to say cytopoint versus Apoquel especially if we're taking things conservatively and then discuss that at least we can start conservatively reassess in a week. And if we're not doing much better, you know exactly what we're going to talk about as a next step. And maybe we have had a little bit more time to prepare for that cost.

amelia:

Yeah. Yeah. I think that's such a great approach and I love how there is some signposting, I guess you would say and helping them to see what the future looks like down both of those paths and really setting expectations at that point of okay, if we don't do the cytology and stuff. Here's what we might be looking at, in a couple of weeks versus if we are doing antibiotics, this is the benefit. This is how it's going to hopefully make your life easier. Save money. I always like speaking to that too, of I don't want you coming back in a couple of weeks and, being frustrated because we aren't making any progress. Like I want to make sure we're having the most specific approach. Now to make your life easier, and sometimes I think it can also be helpful if they're just like, Oh, I just want antibiotics also speaking to we want to avoid you having to deal with diarrhea, which is a common side effect. we want

Dr. Josh:

Good point.. Yep. That's

amelia:

And I like how you also included a because in your explanation too. And I think our, all of our brains-there are such interesting studies of how we really like, even if the because isn't even a very good reason, if we hear a suggestion or a request followed by, because we're so much more likely to adopt it. So I think that's helpful. Understanding the why.

Dr. Josh:

absolutely and, I think that what you were saying before in regards to avoiding, follow up visits, it's a very common approach that I have when I'm suspecting fleas or parasites, right? I Think this is fleas so much that I really don't want you to have to come back for this. Let's do three months of prevention so that we don't come back in a month for the same issue. And, trying to help them understand that we're on the same team here. We're not doing a good job if you come back with the same exact concern, right? Like that, that, Reflects a little bit on, on whether or not we're looking at the right thing. So hear me say that I think this is fleas, please. It's to say that's obviously not as direct as I am, but the thoughts of where that's coming from is important because part of communication is being able to help the other person understand what it is you're feeling. Even if it's, even if it's positive, even if it's negative, it's simply being able to process and deliver the information that's coming from that.

amelia:

Yeah. Yeah. And I think it's so helpful when it can, cause the owners, so often that the mindset can be, Oh, you're just trying to rack up the bill. But I think when we can really speak to why this is so important and what our common goal is of saving them money in the long run, helping them to not be stressed out with their pet and helping to support their pet and really showing the value. I think that goes such a long way.

Dr. Josh:

Absolutely. Absolutely. We've been on antibiotics four or five times this year. I'm sure that it was very helpful when it was given, but I think that we should try to get that four or five times down to maybe two for the following year. And what do you think about that?

amelia:

Yeah. Yeah. Hard to say no to that.

Dr. Josh:

absolutely.

amelia:

So I'd love to cover some other scenarios that can be stressful. So I think we have this is along the same lines with money, but one person submitted this question, it was when a client is not happy with the cost and they go on to say, I have to if that's what their pet needs, but they then go on to complain about like how absolutely ridiculous it is that everything costs so much. So what would your approach be when that

Dr. Josh:

I definitely appreciate this scenario because it is a common one. I think that it's to say I'm in the New York City area and New Yorkers are definitely direct in regards to how they're feeling in day to day. And that also means that I, to a certain level, expect it. I think that it's frustrating because our jobs are not easy, right? So we went through this entire consult. We talked about what the costs are going to be. They agreed to what the costs are going to be, and maybe they agreed and they're like, mumbling under their breath as they're signing the estimate, or they're just simply like scoffing at every line item that's listed. I think that. There are times where that is because there was something missed and because they are the type of client that is, I'm just going to do whatever you tell me to do. I don't want to be given options. I want you to tell me what you think is the best thing to do here. They sometimes run into issues because they aren't necessarily communicating exactly how they feel. And that may be a red flag right there in the moment to say, hold on You know that you don't have to do this. There's a world where there's other options. And the reason why we're presenting this plan to you is actually because we don't want you to pursue any treatments or recommendations that you are not on board with. I just want to make sure that you don't have any questions about that because I would also be quite frustrated if I felt like I was paying for things that I didn't understand. And that, that's one moment where I feel as though the clients that are trying to communicate in a subtle and maybe shy manner that they're uncomfortable and that they would like other options that they will then say, Oh yeah, I didn't realize that there were other options. Do you mind if we discuss those? And, that's the key point where you're going to avoid a negative review, maybe where they leave and they approved everything and then they get home and they're like, this place is so expensive. They made me pay so much money. Even though you had them sign a treatment plan, like there are situations where clients and pet guardians don't understand that We're not just getting their consent. We're actually doing this so that there's complete transparency. We don't want to do anything that they don't want to do.

amelia:

Yeah.

Dr. Josh:

On the flip side, I do feel like I'll have that situation happen. I'll approach it in the way I mentioned and, they'll say No, it's fine. It's fine. It's just a lot. And half of those people, I think, are just maybe going to be a little bit frustrated no matter what. And, there very well could be a valid reason for that from their perspective. But from ours, we don't need to know. We don't need to solve every problem. And it is okay sometimes to let people decide how they want to feel. After a given situation where you've done everything that you can to present the best plan for them. There are definitely situations where a client will leave unhappy and that there's nothing that you can do about it. There's nothing that you could do about it. You can think about the situation and think about different things that you could have done. But the reality is that it still may not have worked and you may have to take those approaches to a different individual because that wasn't a problem you were solving that day. But, the other situation too is that they maybe had the opportunity earlier on in, in the visit to be able to see that, the client maybe was looking for different options along the way and through no fault of our own, we just wanted to be able to get our recommendations out. We missed the, we're sitting with our arms crossed and maybe not making eye contact and, if you were to ask them what did I just say to you that they probably would be like you were definitely talking I think that there's many different ways that you can approach this issue. I think that I most commonly run into it when I've gone over my recommendations and then I leave the room for my assistant or technician or nurse to go over the treatment plan. And they end up telling me that the client is, pretty upset with all the costs and they don't want to proceed with what we talked about. That I end up going back in and having another conversation, right? And often in those situations, I do feel like I'm going back in there again because I must have missed something along the way that would have communicated that to me. And I may never know, right? But it's just the awareness. It's how you think about those moments. It's not thinking that you're always going to find an answer.

amelia:

Yeah, so many great examples of how to navigate that. And I love looking at things from a nervous system perspective. I really feel as a profession, if we adopt a fear free approach for people, it's going to be really helpful.

Dr. Josh:

I love

amelia:

that. Thank you. And I think in these situations, when there is that frustrated owner, all we really know is that as an owner in that fight stress response, and it could be that there are just things outside of the hospital that are going on in their life, that's just putting them in that state. And it's not at all about what's happening in the exam room. Also noticing that it's not something personal, it's their individual experience that something's feeling like a lot. And then I really loved your approach for that owner who is saying fine, but they're also clearly stating that it's making them angry and how, like by acknowledging both of those, right? Cause it's really, this person is feeling stressed because they are feeling pulled between two desires. There's that desire to do what's best for their pet. And there's probably, Fear or stress around finances. And I think that's so powerful. If you can acknowledge and speak to that and helping them to feel seen and just reestablishing, Hey, we're on the same team. Like you are in control. There's no judgment. Let's figure out like

Dr. Josh:

Yeah.

amelia:

what path feels right. Or maybe we can come to some kind of compromise. That's so powerful and that can be the difference between that horrible review and one that's actually positive because they felt seen.

Dr. Josh:

Absolutely right. Absolutely right. I think that we sometimes analyze these situations as putting them in a box, right? So that anytime, and it's to say it's the same nervous system style approach where, oh, This situation has made me feel very uncomfortable before. I'm gonna put all of my defenses up and we may end up escalating the situation more, not because we say anything, but because body language wise, we're now in a defensive state of mind and it's not going to further that bridge of trust that we need in that situation where it's not every situation in a box. We need to accept that there are some, people that have something going on that we are not involved with and we can't solve for them. But aside from that, there is a reason just like you need to explain the why behind your recommendations. If you're leaving that appointment thinking like, Oh, that person was really standoffish. It's not because they think you're a bad person. That's the least likely of the situation and you are actually identifying a red flag and you don't realize it. You don't realize it in the moment that you think that it has to be about you and in reality it's the best opportunity to pause and say, oh. Yeah that seems like you, you might have some questions, actually, before we move forward, or is are there other options that you might be interested in pursuing I'd want to make sure you leave here feeling like we're providing the best care for you and Fluffy.

amelia:

Yeah. Yeah. And that kind of defense mechanism that we have is so important. Like you highlighted that kind of fear free approach and self awareness really starts with ourselves too. And recognizing when our initial reaction is also to go into that fight response or maybe the fawn response of wanting to say whatever is going to make them happy. And I think having compassion for ourselves, that that's a very normal reaction, like automatic before our conscious brain is even online. If someone is yelling or frustrated with us, of course, our initial reaction is going to be probably to be defensive. But if we, can at least notice, Oh, I'm going to fight mode because I'm, this is feeling like personal and just, Observing that alone can help to shift back out of that state. And this is where curiosity again, is so powerful. Of just being like Hmm, I wonder what is feeling overwhelming in this person's life and whether or not we're going to figure out what is causing that stress for them, may not be possible. But at least having that separation and not absorbing that negative energy, really, which then we can take. And, or you go out back and you're like, oh, that person just didn't care. It was so frustrating. And that was just off this horrible domino effect of negativity,

Dr. Josh:

Couldn't have said it better myself. That, that absolutely reflects it exactly. I think that it also segway into the idea of dealing with rude clients that same idea that, you may not actually, You may not actually find out why they're upset. There are clients out there that, it's people, right? It's not specific to veterinary medicine. We're all guilty of it. We're human beings. This is how human beings behave when they're not at their best. It, it's not our responsibility to find out the why when it's not relating to them and their pet's health and their pet's care. But it does help significantly when you're in a situation and a client says to you of course the bill's over 800 because I'm at the vet today or something like that. That is definitely not about us. There's, you can. It's so clear that there's something else going on there and it very well could be that they're trying to say that they are financially constrained. You need to have a little bit more of a conversation to find out. But, if you immediately get defensive and start to try to explain why veterinary medicine costs as much as it costs when, They definitely don't care. It's just going to lead to escalation because you're bringing into the equation, what you care about, right? That's how you're trying to handle the complaint or the conflict. And in reality, Curiosity, like you said is the key being able to see, even being able to say if you really feel frustrated in that moment and you have to say something that at least demonstrates that you felt uncomfortable with what was just said to you I said it before, but this is one of my favorite phrases that I heard recently. Did you mean for that to sound right? Or just simply waiting 10 seconds. And you don't have to stare at them, you can look into the sky, you can look out the window, maybe look at your computer for a few seconds, but I guarantee you That 10 seconds will be in an eternity to that individual that just tried to escalate a situation when they could have communicated how they were feeling instead. And I, I see so many situations where you give that 10 seconds, You don't even have to say anything else. And they apologize. And they say I'm really sorry. It's been a stressful week. I'm alone with the kids this weekend. Or I, I just had a situation where I had to hospitalize my other dog last week. Like whatever the case is, they're probably going to dump it on you in that moment. And that's okay because that's deescalating, right? That's how you get out of the conflict and you get to where the source of the problem is. And, I've had conversations in that moment where it's to say I've spent all of this money because I was recently in the hospital or my pet was recently in the hospital or whatever the case is that they don't have the cash available to be able to pursue the care that they want to, or at least want to know it's definitely necessary that I still say to them, listen we're talking about shock and your pet is definitely unstable. We, we need to pursue these interventions right now for the sake of their life and, they move forward with it because they understand that's the case and that's how they want to prioritize. But if all we did was let that situation escalate. The pet wouldn't get the care that they needed or at the very least it would be delayed probably would end up pursuing care at another hospital or something along those lines and probably would leave a very poor taste of veterinary medicine in that person's life. Which is not, again, something that we need to feel like we're responsible for entirely. But it is something that you play a role in every day. And you don't leave work feeling as good after having to feel like you have to defend yourself, in comparison to feeling like you just de escalated a conflict that you felt could have gotten to that point. There's a very big difference in the joy and the sadness that you leave with, right?

amelia:

Oh my gosh. Yeah. And I do think it's really eye opening and powerful just observing the interactions that do boost your energy and make you feel really empowered versus the ones that do feel really draining. And I love that you mentioned the pause because I think there's so much power in the pause and it can feel a little uncomfortable, but just like 10 seconds really can change everything. So I love that you shared that. And I think it's also important to circle back to the fact that the more that you are doing all of these things, and when a team is adopting this, The less and less you're even going to be having these situations, right? Because it's from the moment they walk in the door, they are getting these signals of feeling supported and seen, and they have a clear understanding of what to expect and they feel heard, then it's less, so much less likely that you're going to be having those times when they are really frustrated, right?

Dr. Josh:

You naturally form good assumptions towards the people that you trust, right? And that makes so much sense, but it is also so much of why, we have to have this self awareness to how the external biases impact how we decide to communicate on a day to day basis.

amelia:

Yeah, absolutely. And also just going back to this, emphasizing that this really does save time and money and energy and leads to sustainable success because it's like when we don't take the time and it really doesn't have to take more time, it's just a different approach. And I think it can be easy. Vet med tends to be operating in this survival mode of just in the moment, what needs to happen in order to just get through this and to get through the day and not noticing wow, when we take a little bit of time to help this owner to feel really supported, to acknowledge their concerns, how that can result in, a great, Client customer who wants to tell everybody about you, how you're, avoiding miscommunication and mistakes. And they probably are more likely to invest in the care that they can because they understand the why behind it and they trust you.

Dr. Josh:

Absolutely. Absolutely. It is so refreshing as a relief veterinarian to go to some of these clinics that I travel to and see in the schedule that these pet guardians have specifically asked for when I'm going to be back in the hospital to schedule their appointments with me. And I tell them during the consults, especially if they're sick like You have to follow up with the doctor that's here next if you're, if your pet's not doing well and we're monitoring the improvement, but talking about for wellness visits and things like that, it is the most refreshing thing for me because it just reinforces so much what I'm passionate about, it speaks volumes to why I feel like these approaches and skills are so beneficial, give you so much potential to provide the best care that you want to for these pets.

amelia:

Yeah, I can, I do relief as well, so I can really relate. That really is the best compliment, isn't it, when, yeah, a client wants to stick with you. And I'm curious, have you always been just a communication rock star, or what helped you to get into this?

Dr. Josh:

Definitely spent a lot of time as a medical director trying to determine different ways to motivate associate veterinarians to have better interactions with clients and pet guardians to lead to more Approved recommendations to better care for pets and and, through curiosity and shadowing different veterinarians I noticed that I definitely had a style of approaching these consultations that was very different. And the way that it's different, to start is that it's certainly less structured. And I think that's where a lot of the discomfort comes from is this idea of letting clients and pet guardians just talk about what's going on with their pet and how they feel about it and giving them the space to do those things that there's a lot of angst that can develop around the idea but like how much time is that going to take but i get all of these pet guardians to pursue the care that i think is best for their pets and eventually you know, started to research this idea of using empathy and communication, finding, many different sources out there that talked about specifically clinical empathy and its impact in human medicine. There are many studies out there, reviewing this as well as the different techniques that you pursue in approaching that way. There are also a few studies in veterinary medicine now, which is to say they're few, like a count on one hand type of thing, but they will come more with time. And the reason being is that it's definitely going to be supported by the data. We're talking about the same style of communication. And it's it's so important in regards to involving it in your day to day consultations. I was I was working in urgent care when I first started to appreciate and connect the dots on that style of communication. And I realized that a lot of a lot of times when people weren't connecting with clients, weren't getting diagnostic workups approved when the pet really needed them based on their presentation. It was very matter of fact when I was in those consults, you can't say anything or give feedback about the medicine. You can't say that, you're talking about poor medicine and a poor style of practice, but we definitely didn't explain why these recommendations were needed aside from I want to rule out X, Y, and Z. And I think that's important because of the risks to your pet from that disease and not really giving them any space to talk about how tough the day has been, the past weeks have been. And it's to say this isn't negative feedback to say that they're doing something wrong. Or that it's, or that it's malicious or malintent it's truly just the idea of, wow, this is a noticeable difference that I'm seeing and it actually shows a relationship with whether or not clients are moving forward with these recommendations. And so starting to teach, What day to day changes can you make as a veterinarian, talking about eye contact, talking about using the client's name, using the client's name multiple times in the visit. It doesn't just help the client. It helps you. You train yourself to treat them as more than a number and it's to say like nobody should naturally get into that mindset, but when there is a high volume environment, It is a natural flow of energy to go that direction and you have to be able to be aware of it so that you can work against it. I think that when these skills were pursued, I immediately saw in months following that a lot of these associate veterinarians would lead to a better conversion on their treatment recommendations. After just starting a few of these, changes and they also note that they feel better like it makes the day more fulfilling to be present to Imagine that oh, what if I was like this client walking in the door with this concern? Like how would I want my doctor to approach this situation? Would I want them to just spell out all of the jargon and tell me? You gotta do this, otherwise we're not doing what's right for your pet. I'd probably feel relatively uncomfortable with it and feel like it's a little bit salesy. And that's nothing to do with veterinary medicine. That has to do with other experiences that I've had where people are trying to make recommendations to me. And that's the same position that every client's going to have when they come in the door.

amelia:

Yeah, it's so true that it can be easy to just go into that automatic, survival mode or strategies that are not maybe as effective long term and that self awareness and choosing and having that focus does make such a difference. And one thing I'm doing now is this workplace satisfaction and wellbeing survey that hospitals can take. And the goal is they can get a baseline with how they're doing, like how's their team's energy, their wellbeing, and then they can make a change. For example, taking any of the tips in this podcast, put it into practice and then re take that survey, because I bet it would be so exciting to see just how much happier and more fulfilled everybody, the whole team was in adopting just these little strategies. I think the more we can collect data about how these really do help with not just wellbeing, but even the numbers and long term success. I think the better.

Dr. Josh:

I absolutely agree. And I think that it's awesome that you're looking into that because we need more data to support, this style. And I absolutely agree. I have no doubt that it will show exactly that. We're not just talking about this because it leads to better care. We're talking about this because it leads to more fulfillment. You feel more like the reason why you got into this field. The passion that veterinary professionals have is so intense. It is rare that somebody gets into this field without that passion. And this is what fuels it. This is the medicine that keeps that going forever.

amelia:

Completely. Yeah. And I think these communication skills apply to all aspects of life and it's also not just with pet parents, but there can be a lot of challenges, even among colleagues and bullying. And I think as a profession, we could all be more supportive too. And so I want to be respectful of your time, but I wish maybe we can do a part two in the future, because I feel like there's so much in terms of how we can be really helping assistants and techs and our support staff to feel really valued and respected, like in such an important part of this communication and the success of our practices and, a diving into more examples. That would be ideal.

Dr. Josh:

I would love to, and I think that it's an awesome topic to discuss in general because, You can't accomplish this alone. If you go into a clinic where the energy is the opposite of what you want to accomplish here, it really doesn't function well. All that's to say is that it's so important for us to be able to take a team style approach when we're dealing with empathy because we need to be able to take the burden that is veterinary medicine and hold it up together rather than putting it on any individual to take on the entire load by themselves at any given point in time.

amelia:

Absolutely. Yeah. It's been interesting with the surveys consistently I see like patient care and clients are the perceived priority and then it's vets and then it's support staff. And it's like, how can we get all of those even, how can they all be seen as a priority so we can really create a sustainable profession?

Dr. Josh:

Absolutely. Absolutely. And how do we do that without making others feel like anything's being taken away?

amelia:

Absolutely. Yeah, which is totally, it's totally possible. We all thrive, right? It's not

Dr. Josh:

100%. Yup. Oh, it's definitely possible. It's definitely possible. It's just it's the question that we all want to reach that perfect solution for, right?

And popping in to share that while there is no one size fits all perfect solution, there are some basic requirements in order for vet med to feel fulfilling and sustainable. One, there needs to be a foundation of safety and mutual respect. And two, there need to be more things that are supporting your energy and sanity versus draining them. Otherwise it's a recipe for burnout. That's why my resources and coaching programs for you and your vet practice, some race approved for CE, help you to get to the root of what's keeping you stuck in survival mode and provide support in shifting out so that you go to work feeling content and supported instead of dreading the day. To learn more, check out the links in the show notes or better yet reach out to me on Instagram or by email. So that I can point you to the resource, I think will be most helpful for you.

amelia:

So I have a couple quick closing questions before we go. One question I like to ask everyone is when do you feel most alive? Because I feel like this is what it really all boils down to, right? Yeah.

Dr. Josh:

When do I feel most alive? I think that I feel most alive when I'm traveling to a new place and experiencing everything for the first time. Even if it's the same country that I've been to before, but it's a new place within that country, whatever the case is, I love feeling new experiences occur. It makes me definitely feel alive for sure.

amelia:

Oh, great answer. I love traveling too. One of my core values is adventure, so I love traveling. And I'm curious, I found that's also something I loved about relief work was because it was like an adventure of going somewhere new. So I wonder, do you feel a little sense of that when you go to a hospital?

Dr. Josh:

Absolutely. Absolutely. And I I talked to friends in the field about it too, in regards to it's stimulating, right? Oh, I get to meet a bunch of new people today and make new friends, right? Like there, there's an aspect to it that definitely brings joy because you get to experience something new. The added benefit also, just being able to see how veterinary medicine truly is an example of how there are so many different ways to cook, right?

amelia:

Oh endless possibilities. So true.

Dr. Josh:

Yeah.

amelia:

And finally, where can people find you? How can they connect? Cause I'm sure they're going to love everything you've shared and want more.

Dr. Josh:

I appreciate that and I've loved being here today. Definitely looking forward to talking more in the future. You guys can find me at@dogtorjosh on Instagram as well as TikTok. That's D O G T O R J O S H. You can also reach out to me at josh@dogtorjosh.Com. I love hearing different examples of how, we, we are using clinical empathy and having success with it. I love to talk about, maybe different client scenarios that we struggle with or scenarios where there's a certain chief complaint that we have a lot of trouble getting clients to say yes to. Whatever the case is, if it's clinical empathy, if it's effective communication, I'm here to talk about it. Reach out to me anytime.

amelia:

I love it. Thank you so much. Appreciate all that you shared.

Dr. Josh:

My pleasure.

I hope you enjoyed today's episode. We covered a lot today. So choose one thing that really stood out and excited you that you want to focus on for this next week. And as a reminder, the three things to keep in mind for every appointment. Number one, giving them some space just to talk about what's going on and, and really listening to that. Two. Identifying their pain points, their pain points- what really matters to them, not what you think their pain points may be, and really being present with them and using reflective listening to help them to feel heard. And then having an empathetic response to their pain points to really help them to feel supported. Sometimes it can be really easy for us to dismiss something that doesn't seem that important to us. Right. Like feeling like they really need the nails trimmed, but maybe they're elderly and they're really worried that it's going to be breaking their skin, or maybe it's that constant noise of long nails on the floor that's just driving them crazy. Trying to understand from their perspective, And acknowledging what maybe stressful or frustrating for them goes such a long way. And then other things to keep in mind, signposting really helps them to know what to expect and to keep everybody on track. Teamwork is so powerful, so if you can get the entire hospital and every team member involved in this kind of communicating. It is just going to have such a powerful, positive impact on the hospital. Prioritizing as well, if a client has a million different things, they don't all necessarily have to be addressed in one short appointment and comparing your priorities to their priorities and being able to come up with a game plan. And showing the value of things, right? Like we know the value, but they don't always. And so doing something like showing them the fluorescein stain, I know clients always think that's so cool when I show them. Or sometimes I'll even take a photo of the microscope if there's just a ton of yeast or bacteria, or I love it when the white blood cells are eating the bacteria. I love to show the clients and just really get them involved. And it always boils down to the three life boost CS. Compassion, curiosity and connection. Right? So compassion. It has to start with you putting your oxygen mask on first. And recognizing that this clinical empathy is not at all about people pleasing or giving more than you have. This is actually a way for these interactions that may have previously been really stressful and draining to start to become more fulfilling and rewarding. This is really about protecting your energy, preventing you from absorbing any negative energy, and instead having a strategy to navigate and strengthen relationships with pet parents. And this also helps with having compassion for the pet owner in that you are using so many strategies to help them to feel safe. And when we all feel safe, we are able to connect so much better and to communicate and to support our patients. And curiosity, not going into these appointments with biases or judgements instead, really getting curious about what is important to them? What needs to happen to make your positive intentions clear. What are their pain points? And if you're trying some of these strategies and it doesn't go as planned it's okay. Just get curious what maybe didn't work. What did you learn and what do you want to change in the future that might work better? And then connection. If we zoom out and look at the long-term impact of these communication skills. It's huge, right? These skills help us to really create more genuine trusting connections and relationships with our pet parents. And it also is going to result in less mistakes, less communication errors, less upset clients, better compliance, better patient care, and most of all, happier and more fulfilled veterinary professionals. So, think about what, one thing you're going to focus on today and we are going to be having a part two. This is going to come out in December, probably in late January part two will be coming out. So if you are listening to this and there are specific scenarios that you would like us to cover, we are going to dive into that even more in the next episode. So feel free to message me on Instagram. Send me an email. And we will try to address as many as we can. cheers your inevitable health happiness and success