Hi, and welcome to this webinar on beating the busy track. So first of all, thank you for, well, I was going to say making time, but really it's really about finding time, to be here and have a listen to this. And one assumes that you've, prioritised this time to actually be on this webinar to really find out a little bit more around this beating the busy trap.
So what do I mean by the busy trap? Well, the busy trap is very much that pervasive, invasive, persistent feeling that there's never enough time to get stuff done. There's always more to do.
There is an endless to do list that seems to follow you around at work. It keeps you on, on mind. And of course, what it also As it keeps you at work, you're obviously, you, you generally are reluctant to leave because there's still things to do.
You're leaving other people things to do. And even when you're at home, it might be that that's totally distracting and pulling you back into some sort of work mode. Maybe you wake up at night thinking about things.
Maybe there's just a lot. And this is the busy trap we find ourselves in, particularly in the veterinary profession, it seems to be a very insidious, thing we find. And of course this has its implications on your performance, your capability, your stress levels, and all other, bits and pieces.
So I wanna just delve into that a little bit. What the busy trap consists of. And from that, I really would like to see really how this issue is affecting you, a little bit of reflective thought on that, because one of the keys to change is self-reflection and awareness of where you are within that.
Read that impact and the implications of, your behaviour, the way you think, the way it works, the, the, the busy trap on you and others in the practise, and, of course, others at home as well. It's a very short, webinar, because there it is. We haven't got that much time.
But what I'd like to do is give you a few tips and around how you can, one, personally have a look at this, but also from an organisational practise side, what can we do put systems put in place to manage this. And what I'd really encourage you to do, and just see if you implement any of those strategies, what difference it makes to you. In terms of getting things done for sure, but more perhaps around the psychological impact of that in the weeks and months to come, because it's gonna be a persistent, response we get to.
So that's what we'd hope to have come from that. My premise, working with lots of veterinary practises, we have about 120 practises on our books, independent practise of all sizes, and the general trend I see in the UK and practises internationally that most vets, Are generally working far too hard and far too long, and far too little return in terms of time or money and energy, really due to the systemic nature of the inefficiency and frustrations and profitability in their businesses, that is driving this busy trap mentality. And I'm driving to that a bit more.
And so, This is the, what we're trying to solve, it's actually lifting ourselves out of it, and as I say, as good diagnosticians, we need to delve into this a little bit. As I said, there's probably 3 levels we need to be concerning us. One is the, systemic or the organisation or the business structure level of the way, Veterinary business is, is enacted and how it works.
There's an interpersonal level as well, how we work with each other and about expectations and how we actually communicate. And then there's a personal level of how we personally turn up at work, essentially, how we behave and how we look after ourselves into a state in which we can actually manage that limited time, limited space, priority. From the organ.
Organisational business level, I would suggest there's 4 key things we need to be aware of. And if you're a business owner or a manager or a clinical director, you probably have some responsibility or have some control over these things, more so than some of your employees. So it's worth looking into this.
One is, I find the big picture is often missing for many people. What's the vision? What's the purpose?
Why are we actually here? Why is this important? Because what that gives people is a, a sense of prioritisation.
They can actually start to think, Well, is this what I'm doing leading to that vision and purpose over time? So that's a discussion that needs to happen in practise in any business, but I don't see it happening very often in veterinary practises. And so they do, they do it very well, and it drives that discussion and engagement piece.
Then there's also this difficulty, and I think comes, is what I call commercialism. We're running a business, we have business outcomes, we have multiple business outcomes beyond just the clinical care of the animals. And there is a tendency to focus almost entirely, which is important, on the animal welfare and care and clinical outcomes, the medicine and surgery, but at the expense of the financial, the team harmony, the client, Experience, etc.
And so that imbalance, Causes a lot of problems in that it's those other things that actually give us some of that time and quality time back, I'll go into that a little bit more. From the individual level, it's, are there systems in place to support the mental and emotional resilience of individuals in the practise? Is the practise just a place of busyness overwhelmed, stress, or is it some way that there is a calmness can?
I'll grant you, veterinary business is highly, highly reactive in the way it's enacted. Things happen, people present stuff, people want stuff done. But Equally, we tend to respond in a highly reactive way as well.
And we believe that to be the way forward. We little bits of adrenaline junkies in terms of loving that cut and thrust of things. But of course, that is at the root of much of this problem.
It's the mindset, of that. When we are stressed due to the mental and emotional overload, we lack the ability to change. So we get locked into that is it is a key problem.
And then, as I say, as a business owner, as a business itself, Are we providing the resources, the human capital, the natural capital, the, you know, the, the human capital that allow and the capabilities and the skills and support to maintain people in a good, State for learning what I call the mutability of people, their flexibility and resilience in that, and that's a set of systems and resources in place. I'll sort of come back to those and say how can we can look at some of those things. Throw into that a global pandemic.
And then what we've seen as a practical situation that the demand for our service has gone up dramatically, the 3.5 million new puppies and kittens, the and then equally a reduction in the workforce due to all sorts of factors, starting with Brexit and lack of, other vets coming in and then just attrition from the Cre. And we see this massive lack of resources in the business.
So any system. Overwhelmed with demand and under-resourced in terms of people and skills and time and energy, is going to break, is going to, to fracture. And of course, that's just exacerbated this problem massively, as we've gone on, we've had a post-pandemic boom at work.
I have a suspicion that's easing off and settling down. We still have a lack of resources in terms of people, in particular. I see that easing a little bit, but still critical in many, many cases.
And so we're right in the thick of it. So in that, it's really, really difficult to try and get some sense of how do we see our way through and out of this as we're going, and maintaining our people, and maintaining our business, etc. As we get through this, etc.
And then, like I said, there's a, there's a, a day to day experience of this, which I'm sure any of you on this call can, can give us testimony to in that, you know, we've got to get the work done. We've got to get through a list of things on a day consultation lists, diagnostic, surgical list, anaesthesia, and then manage the people, and then manage the clients, and then manage ourselves in that process. And how we do that, there's a personal, Response we need to bring to that and of course that's what we're looking for here.
In terms of the business, we're trying to achieve these things, and this comes back to a personal level, because this is what the business is trying to do. So that is sort of thrust onto us. There is a, financial viability that we need to deliver.
We need to make money, stay profitable, and put money in the, in the till. We need to have a clinical resolution of solving cases and get making animals better, improving welfare. And we need to have a client experience, that is good and the clients are.
Good to us, at least, and, and then tend to come back and, follow compliance and work through. But in amongst that, we need to maintain this team harmony of people working well, people working together, people cooperating, and people getting stuff done as a team and supporting each other as well. Of course this all comes back to leadership.
Now, that's fine in a little Model like this, but the reality of it, it produces massive paradoxes in the business and in ourselves and individually, because we're trying to manage those four conflicting outcomes. Keeping Team harmony, is difficult when you've got difficult clients to face. Keeping Team harmony together when you've got a massive overload of clinical work to get.
Done. The challenge of vets and nurses asking for money and clients wanting to pay money, the financial viability is at odds with all of this, and this is probably one of the biggest stresses we have in the consulting room, or developing estimates and in the business, is actually managing that paradox, that what I call the pet and profit paradox, trying to do the best. By the pet, but also trying to do the best by the business in terms of at least profitability.
So, there's massive paradoxes we're dealing with day in, day out. And I would say every 15 minutes of every consultation, that one of those paradoxes raises its head in some way, etc. So it's already putting us on the back foot for managing ourselves and our state in ourselves.
Remember, our, our management of this busy track is about time and energy, how we do that. Now, just aside, one of the things we do in Vett dynamics is we do a profiling tool called Contribution Compass. It, it's typical young G and 2x2 profile, where it looks at various ways people address work, contribute to work and come into it.
And if you've done any of the other Myers Briggs, disc, etc. You'll recognise a familiarity. But what we like about this one is it's, it's about people's ability to contribute where that contribution comes and equally how they interact with other members.
We've profiled hundreds and hundreds of vets and nurses, and this is the typical aggregated profile that we end up, this bottom left, energy, which is good and strong and what we call custodian cultivator energy. Let me explain what that means. This refining energy there is orderly, systems-orientated, good with eye for details, strong competing tasks, focused on how to get stuff done.
Very much a veterinary trait of getting things done in order and precisely and well, which is very important for surgical or diagnostic process, etc. Mixed with that is this, what we call sustaining energy, this compassionate, team player, reliable, Really keen to get stuff done, loves the process and love things done in order and accurately. They seek direction of us, and these are the positive attributes of these energy.
When they're working well, the people are focused on, good, strong work. And when vets are performing well, we see this energy that here's a list, here's stuff getting done, people compassionate and compassionate delivery, of, of a process of getting things done. When it's overwhelmed and under pressure, these things fall into negative traits of perfectionism, control freakishness, levels of, Withdrawing into one another and forming little fiefdoms, etc.
There's a couple of other energies out there. There's this activating energy, big ideas, energised, dynamic, wanting to do progress and coming up with stuff that, we can develop and want to be. This is your energy that puts you into, I want to be better at your, what's focused on your mastery, the future of the vet you're going to be, or the nurse you're going to be.
Focus on what we need to do. And then there's a inspiring energy, which is a passionate energy, but it's about team and team connection, how we develop people, how we develop ourselves, how we present ourselves, etc. And what we see is that inspiring energy is, is quite low, it sounds surprised quite low.
We're very compassionate individuals, but we're not, Team-based passionate people generally. We do see those people in passion. And equally, that, the activating energy is a little bit low.
Typically what happens when people are under, normal circumstances, these energies mix and merge, and, and they swell and, and they, they work well together. When people are under stress, People lock into their most dominant energy, so that compassion becomes control, that orderly becomes, fear of making mistakes, etc. And so we lock into some common traits we see a lot in the veterinary profession as we, work into this.
So there's nothing wrong with that. When it works well, it works well. It's a great trait to have.
And this is how we profile vets and nurses generally in the clinical environment, at least. There's other roles in that as well. What that leads to when under stress, these personal traits that come out look a little bit like this.
It moves into high so that compassion moves to high emotional sensitivity. We actually feel everything quite acutely, any criticism, any demand, any overwhelm, etc. It really affects us personally.
There's a degree of what we call, from a psychological perspective, neuroticism, which isn't pejorative, it just means a hypervigilance, task focused, prone to anxiety, and we're looking for problems. We're looking for issues that are going to affect us. So that hypersensitive keeps us in a fight, flight situation, generally.
Again. And again, that has its impact of actually slowing our creativity and etc. We become risk averse.
Therefore, we have low thresholds for danger and insecurity. We're not willing to take risks and, and move through. And so this risk adverse becomes a, a cultural issue.
And with that, it becomes conflict adverse. So we, we don't take Criticism, we don't take advice, we don't take feedback particularly well, particularly from clients or from each other in the business. And of course, what we do then is sort of crave approval, self-worth is affected in a big way.
So, very broad brush, but you might recognise some of those traits being enacted in your own practise or seeing it in others, or in any state. It happens in families, it happens in any, organisational place, but it happens. But we see it quite clearly, and it's one of the factors affecting the veterinary profession in terms of burnout and stress, anxiety, etc.
With that. And so, like I said, it puts us in this fight, flight, what we call sympathetic autonomic state, which means we're defensive and Approach. And, but we're not flexible.
We're not curious. We're not driving collaboration. We're actually self-protecting ourselves.
Quite normally and naturally, it's nothing wrong with that. That is the perfectly natural response to do that in these circumstances. So it kind of points to the question, the circumstances seem to be part of this, but there's also another point.
Can we Adopt some strategies to see ourselves through that, become more aware of that and we work on that a little bit more. The other thing that adds to this is that there's a broader picture of the, the, paradigm or the state within which we enact veterinary practises and things to do. As individuals, as a profession, as vets and nurses, there is a drive towards generally altruism.
People do this job for the love of animals, for the love of getting better at what they do. They do it for lots of reasons, but one of those reasons is generally not for the money. It's what they.
The money's missing, people notice it. Now, that may be changing the generational shifts to a degree, but it's not a bad thing. But generally, there is this well-intentioned altruism.
Now that, in its normal. Is brilliant, makes us very good vets, makes us loved by the public. In a stress situation, it moves more into pathological altruism, and it develops this anti-commercial, only for the animals, state, which, which develops a problem for itself.
There's a social contract at play, because we are vets and because we have the licence to treat and, look after animals. Clients, there's an assumption that clients have a, a, a, a God-given right to us as veterinary surgeon. And if they're pet owners, they have a right to your time, and we need to treat them equally and fairly.
And therefore, the compassion that we naturally have is absorbed out of us very, very quickly under that contract. What we're not getting back is the reciprocal compassion back from the clients. And I wouldn't say all clients, but some clients drive that.
And therefore, there's a drive of compassion, fatigue, delivered through that process as well. In ourselves, we do strive for expertise, we do strive for perfectionism, we do see ourselves as high mastery individuals, because we've been drilled into us and it's our natural state that we need to do what's right. OK, we're very ethical and moral.
We need to do it right, butionist, OK? But also, there's this obligation, we've got to be all right while doing it. We can't show weakness or ask for help in those sorts of things as well.
It's a danger within this. Because you can see where all that leads, in terms of what we're doing. And then, This is where it comes down to it.
One of the things we do very well is keep ourselves very, very busy. Business seems to be an indicator of some form of success. So if I ask practise, I say, how are you doing?
How is business? And which I ask a lot of, a lot of the answers are, we, yeah, we're really busy. And I can't say, Well, that's not kind of what I asked.
Busyness is not an indicator of success. Business is just a pathway to stress and burnout and keeping yourself out a flow. So busyness may well be a response to all these other factors.
How do we actually avoid the awareness that we actually have an existential, busy that's keeping us going, a threat to us, this constant neurotic threat. Busyness is one way of avoiding even thinking about that. And there is a danger that that can happen in its own right.
So what we end up from the altruism, the social contract, the perfectionism, the busyness is these other traits kick in. Where is a, a fearfulness, a hypersensitivity. There's an obligation to clients and an enforced obligation by clients, but equally by ourselves, on ourselves, and from our peer group on each other as well.
It's endemic in the profession. There's a guilt if we don't deliver it. There's guilt if we fail.
There's a guilt if we don't get it quite right. And there's a guilt if we don't feel all right built into this. And we see imposter syndrome, and we see, burnout and stress from those factors as well.
And there's a massive, massive distraction. If we can actually keep ourselves distracted from this reality. We can carry on, and there's almost an addictive quality to it.
Now, it might be overpacing this massively for many of you, OK? But I, I see a, I see this in the profession a lot. I'm looking for it, perhaps as part of it.
And I'm guilty of it myself in many, many ways, OK? Is what we're trying to do. And I'm not saying that's bad.
I'm saying that this This is a perfectly natural, normal response to the environment we put ourselves in every day of our lives. It's what we've been trained to do. So it's no wonder we end up in this state.
We just kind of wonder how the profession ended up, is it? So how we change that is going to be really difficult because there's an innate thing we need to do. Oh, just summing that up and I'll get back into really what we can do about it.
What we see, some of the current business models out there, not all, many have overcome this and I'll show you some ways of doing that. We have what we call a low flow, as in people aren't feeling the best, doing their best, low trust. We're not working with each other, we're not working.
We're not trusting the clients. We're not. Stressed individuals, reduced, impoverished teams, constrained practise, resources, time, energy, money, etc.
Disrupted culture comes into this. And then we're trying to deal with A client base that is over-demanding, probably fearful and anxious in their own way when they come to you with a sick animal. They have high expectations of your altruism, of the social contract, of your expertise.
They want convenience, and they want financial security, etc. You can see the whole drama playing out the reception desk every day of practise. But equally, internally, we have a team then that we're working with that may also, be struggling with some of those aspects of fear and obligation, guilt.
But, and then these self-imposed, characteristics of altruism and our own expectations of the social contract, expertise, business, financial, etc. I said, some perhaps some demographic shifts in that, that we won't go into, particularly, but then all this is backed up by the media, online, social media, newspaper, the general expectation of, of people. And you can see there's a lot of, different.
Responses to the veterinary world from the media, etc. OK? And this is all playing into, into a market.
Now, that's the way it is. That seems to be happening out there, maybe getting a bit better, maybe getting a bit worse. What I'm gonna suggest is, what can you do in your practise that can alleviate some of this?
So there's a couple, like I said, there's, there's some organisational things, there's some interpersonal things, there's some personal things that you need to bring to the game equally as well. Again, we're trying to avoid that stress and anxiety and burnout as part of this process. The end point is, and what we're looking for, and what are the dangers of this, why this, I've, I've been through this background process, because as a business development consultant, my job is to help practises, make some more money, to practise good medicine, to practise good customer service, to look after each other on the team.
But while everyone is just so busy, distracted, fearful, guilty, and obligated, I haven't got a chance. So unless we solve this problem up front, or at least get some amelioration of this problem up front, there is no hope we're gonna do this. But this is really where the response comes.
Let's get further downstream to the problem and see what we can work out. Now, fortunately, some of the solutions we suggest. Work on this problem directly, or, or indirectly and actually give us a response.
So, like I said, busyness isn't profitable or good medicine or good customer service. Busy's just busy. Busy is just stress and out of flow.
It's a symptom of the deeper problem, as far as I can see it. OK. So, here's my suggestions, and like I said, I'm gonna be very broad brush.
I'm gonna be over this in, And not spend a won't be able to spend a lot of time on it. But there's 4 aspects of this that, that may become obvious as we walk through some of that stuff. To escape this busy trap, we're suggesting 4 broad approaches to this.
And you might want to think about this in your own practise. You might want to think about this in your own individual circumstances of how you might, apply these. So number one, simplifying your outcomes.
By that we mean just lower the cognitive load on you. In whatever role it is, and of course if it's in veterinary's proving, improving patient health is the primary thing, but we have a masses of information, masses of CPD masses of knowledge we're meant to know. Adopting some ways of actually curating that information and applying it, and, you know, filling our heads full of more and more and more stuff is not the answer here.
We've got to find ways and means of actually limiting that or curating information so we can deliver it at the time. OK. And there's some technology and there's some new, learning models out there that can do that.
But basically, think about all the stuff you think about. That might come down to your job. I'm a vet.
Therefore, what we gonna do? Well, most vets are probably looking after a long list of patient care. Then they've got a team they're go and work with, and then they've got to contribute to the business in some way.
And then they're probably looking after insurance forms and ordering and drugs and, compliance, and a whole load of other stuff. And I'm gonna make some suggestions how we may split that out equally with nurses or practise managers or admin people. Generally, most of us have 3 jobs.
Most of us have the job of Minding our back and making sure we stay in the game, doing the job we're asked to do, and there is another job we should be contributing, OK, and we should actually be watching how we do that. The systems and processes within which we work are massive. They're generally turgid and full of friction and difficult to enact, and things don't connect together, and we tend to have to recreate processes every time we do them.
There is not much efficiency in veterinary business, and there's lots and lots of friction. We've done an exercise where we've actually sat down and mapped out. Every process that needs to happen, and there's about 168 of them, basic ones in practise.
And then we graded them in terms of friction and efficiency, and not many really passed, muster. And then the question is, well, do we actually need to do all of these things, or actually, do I need to do all of these things? So again, that distribution responsibility.
We talked about cognitive load, the mental load of actually thinking about veterinary medicine, surgery and delivering clients. There's also an emotional load built into this of caring for the patients, which we find relatively easy, but there's also then this demand that we need to show compassion for clients, which we actually find quite difficult in many cases, particularly clients who don't reciprocate that compassion, as I've said. And so the demand on practises has always been high, and we, one way of measuring this is active clients per full-time equivalent vet.
And we measure that quite clearly, because we've seen a clear correlation between that number and the levels of stress, particularly emotional stress, within a practise and how that demand is. So finding some ways to manage that demand. But equally maintaining the client experience is, is an important thing we need to.
But it does demand some compromises, unfortunately. It does demand some decision being made for the benefit of the team or the business, etc. And in the past, we've also, the client is always right, the client gets everything.
Our compassion is driven, a very client-centric experience, which is good, but it may have had its cost, and we may need to readdress that. My suggestion is if we do some of those, or those things above the, the simplify the outcomes low, that cognitive load, improve many of the systems, or even eliminate or automate or delegate many of those, difficult systems to people who can do it better, essentially, and then reduce the overall demand on the system, what we will naturally see. Is an increase in resilience, well-being, and performance.
The busyness factor, the demand for that will reduce. It will actually become easier. There is still work to be done with individuals and teams to develop the skills of resilience and well-being and performance within that environment.
So it's not something we're used to. We've never, or very rarely been in a state where we can perform and perform well. So we need to learn those skills as well, and I'll, I'll discuss that as we go.
So that's the framework. This is kind of a simplified version of that, if you, if you want to sort of understand it better. On the left-hand side, it's actually looking, what's the work we've got to do?
What do I actually have to do? What counts, and what is my role in that? What's my cognitive load that I need to address?
And equally, what systems and processes are there to support me? Are they efficient, effective systems? Do they work?
Are they the best systems I could be using? Or can technology, automation, and other processes, work to improve that? And just improving that.
On the right-hand side is the emotional stuff, more so. OK, the demand on us, particularly from clients, not necessarily pets, but clients, on the system that bring the emotional load, the compassion fatigue that drives that. And that's a matter of qualitative and quantitatively, looking at that load, client numbers, essentially.
And then, The, how do we improve well-being? How do we lease the talent that is innate in the people in your building that are probably working at 30, 40, at, at best, 50% capacity, not work-wise, but actually their ability to bring to the, the team. How can we release that talent, increase their well-being and improve that?
Well, there's a degree of natural response. And then there's an enhancement of that. We can actually do some things that Accelerate that to a far greater way.
All this comes back to leadership and culture, OK? The leadership will drive this, the culture of the business will provide this, but it does ask some radical shifts and changes in the way we work, is what I'm suggesting as we go. So, Let's drill into that a little bit and see what we've got.
That cognitive load, improved patient care, again, as I said, what's the, what's, what is your job that you need to do, what's your primary job? There's a thing, a kind of you can look at your, your job, and as vets we are. Multi, multicompetent.
We can do lots and lots of things there, but we can do anything, but we've got to believe we don't have to do everything. But there is this, omnicompetence thing that we're driven, not just species-wide, but I mean, in, in any sort of work that we do. What I suggest you do is map out what your roles and jobs are.
In detail, I've got to do consulting, I've got to do operating, I've got a surgery, I've got to do anaesthetics, I've got to do drug ordering, I've got to do, ringing clients, I've got to interpret lab results, there's a whole raft of stuff you gotta do. Start to think 8020, so it's OK, what's the 20% of the stuff I do. That, that really adds value to the business that I bring to bear on this business that really I can only I can do and actually only I enjoy in many ways, and that'll be different things.
Now I'm not saying those other things aren't get done, but you maybe want to find, say, the ways of looking at the other things as well, do I have to do. This is there someone else who could do this better? Is there a process that, obviates this so we don't have to do it?
Is there an automated process? Is there a technological solution to this? And you might, this could be a group-wide thing.
Equally, as nurses, you can have that same discussion. And you start to bring, and it might sound selfish, well, I'm, and it's not following your arm, saying, it's not my job. It's about, it's it's about saying, opening your arm, saying, actually, give me more of this, because this is what I can do for you.
And actually, it's what I can do for me as well. So, that cognitive load piece, I'll, I'll jump into some examples of, of, of how we can do that. In a broader sense, we also need to look at What is the business focused on, because businesses tend to butterfly around or ricochet about around, try this or do this or someone goes on CBD and they, there's another initiative and the endless tried that, yeah, it didn't work, so let's not do that, let's try something else and all those sort of things.
So having a clear set of plans is important. Reduce, distraction in business. So this is the focus bit.
Having a plan to focus on is really important, part of this. And that's a, a strategic business organisational process. That's something that business should organise and then philtre it down to the individuals in the business.
Everyone should have a say in it, but everyone should be engaged in it as well. Training, capability, mastery, people getting better at stuff. What skills do people need to do their job?
Not these skills that are nice to have, or that's interesting, let's go and do that, but actually focusing your resource capability on the jobs that need to be done and giving people a sense of, Something I'll mention that is a sense of mastery, getting better at something that's important, OK, and then from an individual perspective, How do you focus on yourself, how do you actually get into flow, perform well, and then how do you step out of flow and decompress out of that, actually take the down time to actually get an improved ah. Sense of being, so you actually turn up to work better, turn up to home better, be a better human being. And I'll touch on that towards the end.
OK. So this overwhelming disorganisation is everything's coming out, that's off the field. So that's kind of the essence of the busy track.
Basically, Overwhelm disorganisation. Stress and burnout is sort of follow on from that. They're sort of a progression of the same problems.
So, there are systems and processes you can learn to cope with that overwhelming disorganisation. It's, it's a time management type of skill that we need to. Now, I'm not gonna go into it now, but in, in our vet dynamics courses, we do teach that, and it is hugely effective.
People actually freeing people's, time out of these things, etc. It basically works on this idea of a circle of energy, so it's not time management, it's energy management. And it takes a basic process of you've got ideas and projects and a million things to do.
Where are they all? Where are they sitting? Who's got them, who understands them?
Are they just an idea, or actually, are they a defined project? We collect and curate that stuff, we've got to have a process of prioritising next actions, what needs to be done, individuals, so who can do this is the thing, not what do we have to do, or not how do we do it. Getting stuff written down, getting stuff into systems, rather than just floating around stuff in your head, that works at a personal level.
Most of us, the busyness we experience is purely a cognitive overload in our heads, because we're trying to remember stuff. Key trick, write stuff down. Everything I do, I put into one of my folders and I write it down, it's captured.
I don't have to walk around with a head full of stuff, OK? And then there's getting it done, OK? And there's systems and processes down to it, to the point of completion.
Even getting stuff done, we say, Right, that's done, move on. Unless you do a reflective process of learning from what worked, what didn't work, you actually leave what's called an open loop. That loop is never quite shut until you've done the review and feedback process.
And it's the thing that's missing most of the time from these reviews. So in some of your meetings, you might just have that, Let's look at the, where we've come from, let's look at what we've done before we move on to what we haven't done, OK? What that closing the loop does is releases a huge amount of creative energy that we can start to put into the next ideas and the next projects, etc.
OK. Very brief run through. That's really a two-day time management project course that we, we do.
But there is a sense of understanding that if you want a reference for that, Book called Getting Things Done by David Allen, A L L E N. David Allen, Getting Things Done is the reference for this, and it's hugely adaptable to the veterinary, process and for your individual process from doing that. So what we do with that process, we overcome the overwhelmed.
We, we remove the distraction by prioritisation. We organise stuff, minimise. Some of us are not very organised, OK, but other people are.
We release the energy from the feedback and learning loops, and then we develop the motivation for the next thing. Of course, motivation is the antithesis of the busy track. This is actually, we're still getting stuff done.
We're still busy, but it's a positive, busy busyness of action that we move into. What can the business do as a business owner, what we suggest and what our clients that we put them through a planning process, again, I'll run through this reasonably quickly. It develops from business planning down to personal planning.
There's a link up to this, and then you apply your own personal management skills to get stuff done. We do a thing called a 3-year orbit. It's a very simple graphical thing.
We decide, not as necessarily complicated as this. It might be 6 or 8 parameters. We pick the key things on the left-hand side.
There are things we want to achieve, or their KPIs or their measures of success that we've decided on for now, cause they do change, they're different, etc. This one's quite common. Comprehensive.
We map out in the middle where we are now, we map out on the outside parameter, perimeter, where do we want to be in 3 years' time, I mean, that can be a huge stretch goal. That could be really quite extensive. And then what we've got to figure out, OK, to get to there, what do we have to do next year and the year after and the year after, and we actually get this planning process.
Every plan fails. Every plan fails at the point of contact, but planning is still very important because it sets a marker in the ground for the future. It gives you a milestone to aim for.
It actually is your compass rather than your map. OK, it gives you the direction you're aiming for, and it presets stuff. So that's a a half a day process with your leadership team or your development team, it could involve others as well, but we generally find the leadership team can be very good at helping you put that stuff together over time.
What we need to do is take that information and then just don't worry about the 3 years or 5 years from now. That's way ahead. Take 1 year.
What are we gonna do in this next 12 months that's gonna move us closer to those targets? And what I would suggest you prioritise that down to 3 key projects. If you go for 6, too many, never get it done.
If you only do 1, not enough to energise you. OK? 3 or 3 projects or so at most, and you can break that down.
And what we say, what is the smart goal here? And one of our projects say team development, or we're gonna review our pricing, or we're gonna sort out payment and debt problem, whatever it is. It doesn't matter.
OK. It's a business critical operation that you've decided what to do. Then we break it down to who and how's, when and where's.
How do we break this through? So it's a broad brush map. This has to be broken down a little bit further, but this is the broad brush.
If we need a reminder, if we need a, a choice criteria, this is it. What are we gonna do? OK.
What we do know is 12 months is still too long from a planning perspective. What we need to do, the peak planning, energy, focus, fast growth momentum is driven by 90 days, quarterly planning. So take that 3 month plan.
Break it into an, that 1 year plan into 390 day plans, 490-day plans, do the next 90 days, etc. And we have another template for that. And again, focus on 3.
In our business, every member of the team has a 90 day plan. They have their own personal 90 day plan as contribution to the group 90 day plan as contribution to the 1-year plan. And as a contribution to the 3-year plan.
And that's what keeps things visible and shared, and the working document also actually gets people focused on what they need to do. So here's the cadence of that. Every year, the leadership team should think about what's, what's the update on the 3-year plan?
Where are we going, what are we trying to do, what's, what's 3 years look like, take some outside advice. Develop a 1-year plan. What are the 3 priorities really would make this year successful?
Break that down. Meetings, full team meetings every quarter to discuss where we're going, what we're doing. We've just had that in our business.
And then everyone ends up with a monthly 90 day plan that they're working on, that you're coaching, you're reviewing, you're giving feedback on, and that's between weekly and monthly, however that needs to be. We suggest the teams review it monthly, individuals, Within the teams weekly, and that's through your teams and your meeting structures, etc. So that's just a quick overview of that.
Reviewing strips, and now this is a huge, huge project, it's a huge, huge subject, but it's basically we, we're using some systems that business design processes that, and these are there to eliminate, get rid of, automate, put it into a system, delegate, get someone else to do it or outsource it, or if we choose to do it ourselves, do. It stonkingly well, is what we're doing. Now, we're using systems like Lean, LEAN, or we're using, 6 Sigma, if you're aware of those sorts of things, but they are sort of design processes that actually help you do this, and there's people that can help you do it.
What we're trying to do, it also brings in technology as well. Utilising, integrating. Not technology for technology's sake, but appropriate technology that will give you those advantages.
Unfortunately, in the veterinary world, the technology is a bit distracted and not very joined up, but that's getting better. The key thing is automate as much as possible at the moment, as much as you can in any shape or form. But equally, there's outsourcing triage systems, there's outsourcing telephone systems, there's outsourcing financial systems.
So there's a whole range of stuff that we can do. There is a, a, a, a process called the 8 waste that comes from, lean and 6 Sigma. It's well worth a look at.
That's what it looks like here. This is our veterinary adaptation of that. Again, I'm not gonna go through this particularly, but it looks at the key areas time, energy, money, resources are wasted.
And in veterinary practise, time is your biggest, biggest, most valuable asset. And so much of that time. Is either wasted or not charged for appropriately is the key things that we need to work for.
And that's because things are broken, don't work well, cause we overproduce and do too much of something and, and it's wasted, too much waiting time, non-utilized talent, massively. Moving things around. A typical example, I, I want to look down the dog's ear.
I'm in the consult room. I open the drawer, no ophthalmoscope. I've got to go looking for the ophthalmoscope, OK?
I want to print a receipt. The printer is in the reception. I've got to go out to reception to get the receipt or the information or the, you know.
Form that needs filling in, etc. These sorts of things, we live with, because they're just normal, OK? But if you actually sit down and think about it, or get your team to actually mention, you'll be amazed of how massively inefficient things are on that.
So, if you want to, again, a reference, you want to Google, 8 wastes, you'll get these sorts of diagrams and this sort of thinking to, to bring this up. Mention about the reduced demand on the system, this is critical because at the moment, the demand on veterinary practise is huge through the excessive amounts of pets and dogs and cats. Out there, a large proportion of clients are not able to access veterinary care at the moment, they're the ones that do are finding it massively expensive, etc.
So it's raising that emotional and psychological load on practises. Some, you know, some are, having price increases dictate upon them. Others are necessarily having to do it to actually cover the rising cost of living, the cost of, resources, the cost of wages, etc.
So all those are, are dynamics at the moment, that is improving. Key thing with this, we would say is that you probably need to be quite selective. On your client numbers and your client-client quality.
OK? Cause the stress comes from the complaints, from the difficult clients, from the lack of money, from a whole load of things. And I'm not saying you'd become exclusive and reductive and, talk about, but by putting in systems and processes, you can optimise the clients who do come into the practise and work with you, because you can Do better work for them.
It's just an equal swap of of capability. Triage systems, case load, selection, appropriate to levels. And obviously, you've got to watch your own skill level and practise.
We're seeing a lot of practises being de-skilled by losing, practitioners and, and nurses from the team, and therefore can't do as much. Therefore, you need to manage that client expectation as well. I mentioned active clients per vet for full-time vet, and that is dependent on your consultation length.
Now if you're doing 10 minute consultations, number one, don't do do longer ones, but if you are, you can probably handle 1, 1200, 1500 active clients, but it is. Is very much a churn them through, get them through. If you're doing 15 minute consultations, we're suggesting you should be between 850 to 1000, maybe.
000's a bit high, but 850 active clients per full-time equivalent. That would be a for reasonable number. If you're at 20-minute consultations, that comes down even lower.
You should be looking at something like 650, 750 active clients per vet. You can cope with that, you are doing less numbers, but higher. Input, working more with those clients, your pricing can be higher as well.
We've got some practise now at 30-minute consultation. They're working at 500 to 600 active clients per event. Now, believe you, that makes a huge difference to the load on the system, but it does change the dynamic that you need to work with those clients in a much more, 1 to 1 manner, etc.
The other thing that is the biggest stressor for all of us out there is the fact that we're charging for what we do, this money. Question is the biggest stressor. Pet health clubs, insurance, and other such things can help to reduce that, load conversation and contention that goes with the money discussion.
We are looking at systems where full subscription models may well come in, and we're looking at those, in various aspects. And we see that as a real game changer for the profession if we can actually make that work. How that works in reality is in your care team.
That these 4 outcomes do. Clinical care is a veterinary responsibility. Making clinical decisions, treatments, recommendations, procedures, etc.
That's narrowing the cognitive, the emotional, the process load. That's the the systems that, that should be managing that. Compliance is very much a nurse.
Inpatient care and care point of view. So the patient is at home, it's a, a nurse can deal with that. If it's an inpatient, a nurse can deal with that.
It's managing that compliance. Again, lowering the cognitive load. What do you need to deal with compliance, how that works.
Deal with the animal in front of you, put the systems and processes behind that to That work, communication systems, etc. There's a compassion need, and that's your client care operatives. Now, we call them receptionists, but I think that should be a broader, more comprehensive turn of actually managing the compassion between the practise and the client out there in, in a much more proactive way.
Care. Operatives or, client care, etc. And then, like I said, if we could take cost out of the consulting room and put that into some sort of subscription model, much as you do with your healthcare schemes and, and perhaps to a degree with insurance, that can work, then within your consultation, those other aspects can kick in.
You've actually improvements in technology, improvements in, Systems and processes, you're narrowing down of your skill of not your skill set, of your responsibility set within your skills, then enhance your skills within that can work very well. And we're trialling these, these systems out as we speak, which should make a huge difference to this load, etc. Because what I'm saying is that the basic veterinary model at the moment does not work, particularly or at all, for that matter.
And then you can actually plug a student or a new graduate into that, and then the learning opportunities for everybody massively improves as well. So we actually get that, this extension of this, we get actually a massive improvement in learning and capability. Technology can kick in, and again, everywhere around the team, we've got technology available right now.
That mostly works, needs some more integration, needs to be aware of your practise management system and, and integrations that way. But online booking and reminder systems using digital forms and patient workflow systems, can all help the team, client apps for communications, outsourcing and insourcing digital triage through your, communication apps, etc. Collaboration tools.
For internal communication and your intranet, etc. We're using veterinary IT services, providing a lot of this, and if, if you need some help, I would recommend that they would be people you can, call on for this. But again, this is actually enhancing all those slowing cognitive load, improving systems, and, emotional, but releasing the talent, because these people don't have to be doing all this stuff.
So just to finish off, that leaves us with this opportunity then that innate talent will be released, the well-being will improve, performance will improve. It is dependent on a couple of things and there's some key intrinsic motivators that need to be in place. Sense of purpose, we talked about with your planning, sense of mastery, get people improve and measuring that improvement and seeing that autonomy and choice and volition and what they do by freeing people up into their key skill sets.
And of course, that's within a community of vets, nurses, receptionists, and clients and students that work together. Removing as much hierarchy from the system as possible. Now that's, again, a broad subject there, but actually, we, tend to be have this high pyremeal, vets at the top and everyone else at the bottom system that can shift and change, and these systems are based on that.
People need the basic provisions. It shouldn't be said, but everyone needs to be paid well, people need to have time off, people need to go home when they need to get home. People need to have their lives basically under control for the rest of it.
And some security of tenure, etc. As well. And then internally, this physiological and psychologically safe or psychologically informed organisation that actually puts people at the centre of the process to say, Guys, you are important.
This will work. And not just The virtue signalling of throwing a few yoga mats in the back room, but actually doing something consciously around people and, the process works. This shifts the model from the right hands, the business, the burnout, you know, focused on clinical cash, command and control, boredom, disengagement, which we've seen massively throughout the profession.
And it starts shifting it across to the left-hand side, this flow and trust, and all these things I've mentioned already, legacy and purpose, the autonomy and accountability. That then is a business that is a positive, virtuous circle of production, collaboration, positivity, creativity, curiosity that gets, things done in a positive way, becomes a place you might want to work and you're seeking it out rather than fearing every day going to work in that way. I'm just gonna finish with this one.
There is a personal obligation, I would say to all of you, that you need to look after yourselves, and that needs saying there is, you know, it's very clear in the literature that we need to have a proper sleep, we need to eat. Proper food on that mean less industrially produced stuff and fresh fruit and vegetables and hydrate, do some exercise, spend some time on other activities, some enjoyment, a focused time. Spend some time reflective, be that meditating, Pilates or, you know, whatever it takes, breathing techniques.
Have the time to take time out. So these are all time-related activities that have been subsumed, stolen, taken from us, and robbed of us, the busy trap have taken all these back. And I would suggest we need to find ways to Activate those.
In the centre of that circle, this is a neurobiological activity. This is actually doing things that give you the reward of dopamine, gives you the connection of oxidation, giving you the well-being of serotonin and the performance of testosterone, is what we're doing. And these are fairly well known.
Activities, taking this forward. So that's what I'd charge you with. I'd like to give you so much more that you could spend time on, but, we've run out of time.
So, I'd like to say thank you. I hope your flow and you go, are well and that you can take some, Some challenge from that for number one, but also some hope from that that that things can get better. If people are interested, the Platinum Academy through that dynamics is our, way of building that, capability in teams and people and practises.
If you have any questions, please feel free to contact me at vet, Alan Robinson at, or Alan at vetdynamics.co.uk.
So thank you very much, and, we'll speak again soon.