Like it or not you influence those around you – which makes you a leader & making decisions is a big part of that.
Whether you are a Practice owner, manager, team leader, associate veterinarian, nurse, receptionist or kennel hand, like it or not, you are a leader within your organization. You lead yourself and have an influence on those around you – so even if you are not currently in a formal leadership role within your veterinary practice please read on!
We spend so much of our lives making decisions…
Assuming we’re awake for 16 hours a day, Google estimates that we’ll all make a semi-conscious decision every 30 seconds!
This doesn’t include subconscious decisions such as getting out of bed, getting dressed and driving to work.
I see decision-making as a continuum where at one end it requires no thought at all – it’s entirely subconscious and at the other end, are highly complex issues that require significant effort and those decisions have big consequences.
Splitting hairs now, but at the far right of this continuum are complicated and complex decisions.
In my experience working with lots of Veterinarians, they are really good at making decisions around complicated problems but often will struggle (as would be expected) when dealing with complex problems.
The best example of this comparison I can think of is a Ferrari and The Amazon Rain Forest.
Given enough time and a detailed enough instruction book, we could all build a Ferrari from scratch.
It’s complicated but there is a relatively straight line between the problem (a pile of car parts) and the answer (a car). A top-down leadership approach in this case works as long as the leader knows something about cars!
The Amazon problem is not so easy.
Multiple integrated issues playing off against time and no ‘one solution fit all. Top-down leadership doesn’t work. No single person ever knows the complete solution because the problem is complex.
Having assembled the Ferrari and let’s agree the Amazon is a work in progress – I’d like to go back to the other end of this continuum and talk about the thousands of decisions that you’ll make today in your veterinary practice and mention a couple of tactics that might make your life just a bit easier.
Decision Fatigue
We know that we make better decisions in the morning – even grocery shopping is way more sensible when done in the morning rather than in the evening (yep, someone studied it!).
One way that the military teaches officers to move past decision fatigue is through the use of drills. Thinking too long about some things in a military setting may get you killed. This is one step removed from our natural flight response to jumping out of the way of a moving car.
You can create drills in your vet practice. A ‘hit by car’ comes in the front door and you swing into action. The dozens of decisions that you and your team make in the immediate triage assessment are based on experience and doing drills increases the odds of you saving your patient.
Your success at stabilizing your patient will come down to your team’s ‘training’ in these drills.
We can remove decision fatigue by practising these drills over and over and over and over again. You don’t need an HBC victim to practice the management of an HBC case.
I spent years in the military learning how to fight an imaginary enemy!
How far can we take drills?
Treatment Plan Templates (AKA pre-prepared and saved estimates) look like a great example of a drill to me.
You’ve completed your patient’s examination and are now ready to talk about it with your client – do you really need to now make a whole load of decisions on what to include in your treatment or diagnostic plan (estimate)?
Really? Why? You may be tired, probably a bit stressed – especially when the client gives you that strange look as the conversation transitions to cost and planning.
You are probably feeling a bit ‘under pressure’ to make sure that you’re not ‘giving stuff away’ – because you know how missed fees and charges are sadly rife in the vet industry and what a big impact this can have.
But at the same time, you can feel your client’s eyes burning into the back of your neck as you build your estimate on the computer and watch the dollar total grow out of the corner of your eye.
So, before you print out your treatment plan and step your client through it, one more decision to make…
Do you throw in a discount or mark down a fee line or two to make the conversation easier?
You are probably thinking “How can I get the total just below… your chosen comfort value threshold figure – it might be getting it under $1000 for example”?
To avoid missing fee lines or drugs in your plan and more importantly to avoid the temptation to reduce the total to your perceived client acceptable amount – create templates so that at a click of a button everything you need for your plan is pre-populated – then all you have to do is print it out and present it.
You need to make decisions about what to charge for that procedure is now alleviated.
Practising tricky client conversations – more role-playing – helps to remove decision fatigue
Also, practising tricky or stress-inducing client conversations in advance, where one of your team plays a “client with a bad attitude”, one plays “consulting vet” and one plays “observer” is a great way to remove decision fatigue because we all know that when under pressure, we don’t rise to the situation, we fall to our level of training.
Time spent training in your drills is never wasted because unless you’re jumping out of the way of a moving car, it’s unlikely that decisions that involve your Amygdala are going to be good ones.
What problem are you solving?
Einstein was onto something when he said that if he had an hour to save the world, he’d spend 55 minutes working out the problem and 5 minutes solving it.
What problem are you trying to solve in the consulting room when presented with a patient – and therefore what is the scope of decisions that need to be made?
My expectation as a pet-owning client is that my vet will work out either what is wrong with my dog and tell me how they recommend it should be treated or what tests should be performed to get to a diagnosis.
That’s the problem I expect them to solve.
When the vet is clear on this, they make more valued aligned decisions, don’t risk attempting to fall short on best practice medicine and give my dog the best chance of a speedy recovery and recommend the best drugs etc.
When the vet also tries to solve ‘my problem’ (how to pay), they usually do a really bad job – they don’t know all the inputs (how much I can afford or how I wish to prioritise my spending) and if the Vet Board / Council (NZ) statistics are anything to go by, with 90% of complaints associated with under servicing – they’re at risk of just being another statistic if they try to keep what I have to pay to a minimum.
So, what to do – solve the problem that you’re there to solve and let me solve my problem.
If, you haven’t practised not filling that awkward silence that crops up after you tell the client what your plan is going to cost them and instead start immediately working out how to reduce the cost without compromising the level of care – then do drills – practice this with your colleagues.
Also, how do you respond to a client who stands up and yells at you and says you’re a rip-off?
Again, if you haven’t practised this in a safe environment – and the first time you experience this is in a live situation… Let me just say that we’d be in a lot of trouble if the military took that approach. Do your drills and practice with your colleagues so that you are prepared.
Acknowledge that not all decisions are the same.
From the subconscious to the complex – try these two simple approaches;
- Reduce decision fatigue by bringing the decision-making process forward (create templates) and,
- Practice various difficult client scenarios – drills.
Secondly, get really clear on what problem you are there to solve and get really good at doing that:
- Complete a thorough diagnosis,
- Present your findings and recommendations in a compelling way – and then,
- Know how to respond when you get pushback.
We all have a lot of decisions to make today, let’s not make them harder than they need to be!
