Good evening everybody. My name's Andy Mae from Veterinary Management Consulting. Welcome to this evening's practise management webinar.
And tonight it's my pleasure to introduce you to Alan Robinson. This talk is going to be sponsored by MWI Animal Health. I'm sure he needs absolutely no introduction whatsoever, but for those of you that don't know him, Alan has been a practising veterinary surgeon, owning a successful mixed practise for 15 years, and a business consultant for over 20 years working with more than 1000 practises.
He's director of Vet Dynamics, whose mission is to help independent practise owners to improve performance and quality of life in and out of practise. That dynamics provide tailored resources for practise, performance, business intelligence, leadership, and culture, and team engagement. And Alan is happy to take questions as we go.
So if you want to use the the chat box or the Q&A, I'll hand you over to Alan. Thank you very much. Andy, thanks very much.
Good evening and welcome, everybody. Welcome to this, practise management series webinar. It's great to be back on board again.
So maximising team performance, integrated business model, bit of a strange title. This is, Andy and I were just having a discussion before we came on a bound business consulting and, and really how it's working at the moment. And, I was just saying that we, we present a lot of information.
We know how business works and we give lots of good advice, but how much of it actually sticks in practise and how much of it actually makes a difference is, is the big sort of question for us. So what I've been Sort of thinking about more recently is really what's the underlying business model at work or actually deeper than that, what's the underlying human model at work that we as vets are engaged in that actually either enhances what we do, takes us forward and maximises our life and gives us the, the things we want, or what is it that actually works. Against us that brings us back, and keeps us out of the flow and out of the profit and out of the, all the things that veterinary medicine, veterinary practise should bring us.
And I'm a true believer that veterinary medicine, is possibly or should be one of the best jobs in the world in its inherent intrinsic motivators. So this is a bit of a walkthrough some of those. Models.
There's an awful lot of information here, so I apologise in advance for overloading you, from day one. Ask questions, please. Andy, we'll jump in if you've got any burning questions, but it's really is just for us to reflect on what is going on at the practise.
So, I'm going to get to the point we're at a crossroads of veterinary practise that we need to address. So let's move on. That dynamics, we're here, we, we truly believe that it is a good business to be in.
It's a good profession to be in, and it's, it's driven by purpose. It's, the reason for turning up is animal welfare and for our own benefit, the passion for what we do and then people that we work with. But to do that, we need a high-performing business, we need high-performing individuals, and we need high performing teams.
So that's our, our purpose to drive that stuff forward and get some benefit from that. I always start with this slide in that what are we trying to achieve? What's the outcome of being in practise?
And one of the paradoxes of the whole thing is that being in practise is a, is a hugely paradoxical situation. Same in business, but veterinary has a particular, couple of domains that are really interesting. At the core is the leadership.
What holds us together, what drives us, what, what holds that purpose and passion. Of course, it's a clinical resolution. We want to help animals, we want to help animal welfare, animal health, things get better.
So the cases we deal with day to day, we tend to be pretty good at that. We need financial viability. This is the bit where we as business consultants and your business owners step in, and obviously, without the financial viability, there's nothing, no framework to work with.
So we do need that. That's do struggle with that. There's a sort of an underlying myth at work on that, which I'll come to later.
On the other side, that we have to provide for our clients to client experience. And this is an interesting place because some of the more recent research, when you ask vets and nurses, what's the most difficult part of being in practise when you ask those questions, they often come up with client expectations, what the clients want from us. And there seems to be a mismatch within that.
And that drives, back into the business and often team harmony is disrupted, in that process. And so we have sort of have this left-hand side of hard measures, financial, clinical outcomes. They're easily measured and easily worked on.
We seem to be better at the softer stuff on the right hand, client and team harmony, it seems to be the harder part. Now, what I'm convinced that the model works from the inside out. So if you have good leadership, good culture, good, focus on what we're trying to do here, that will drive team harmony.
Well, often we see We ask for Team Harmony as a result of everything we've done. For me, Team Harmony is the core, and that's what you have to work on first. If you don't get that in the, as the core of your business, the rest of it falls apart because Team Harmony drives clinical resolution.
Good vets, good nurses, working digger, the good receptionist delivers a clinical resolution. And then, of course, the client has a good experience of that. The animal gets better, but the client enjoys it.
And of course, those two things will drive the financial viability of the business. It's an obviously good model. It seems to work and makes inherent sense and when we look at that.
So there's an inherent sense in the model, we've got to ask. Now, for me, work is a particular domain we end up in as individuals. OK.
So here's sort of the first model I'm gonna play around with. We are individuals, and we are individuals that regulate information and energy in our own selves. So, as individuals, we're a bundle of nerve fibres and neurochemistry and physiology and biology and neurology that actually work together to actually have our own personal experience in the world.
But of course, none of us can exist in isolation. Number one, we have a personal experience in our own environment. Now, that environment for this talk is about the practise, but that could equally be your home, it could be your play, it could be a football team, it could be a crochet club, it could be anything.
Whatever environment you put yourself into. Your own makeup as an individual will determine the experience you have. So it's your preset thresholds of experience that allow you to either have a positive experience in a certain environment or a negative experience in an environment or a neutral experience in a certain environment.
So we are embedded individuals in, in an environment. It gives a personal experience. The second part of it is we're also defined by the relationships we have, and that can be a marriage, it can be children, it can be with pets, it could be with clients, it could be any other interpersonal interaction we have that defines, and that happens from birth.
To to toddlerhood, through childhood, through adulthood. All those individual interactions with other people drive that at the work level, that's the team we work with. So those interpersonal experiences with the team define us and then we define the team.
Now, the third part of this is then the team and the practise derive the practise culture, that encompassing, environment we live in, that is derived, and that's the, how we, culture is how we see ourselves and how we act within that environment. Of course, then we, we have, we have the external environment of clients and client expectations, the economy, coronavirus, Brexits, demographics technology. And also the pervading social, beliefs about vets, vets are good people, vets are money grabbing people, vets are doing it for certain reasons, and some of those come in as altruism and social contract, etc.
Which I'll come to a little bit. So that's kind of my model of how we Create a work experience. Now, if we have well-performing individuals working in good, well structured teams with a good supportive practise environment, the model works exceptionally well, and we've got experience of that in practise, as we go.
What we have developed is this model of how do we actually drive health and performance and well-being to get that at the individual level, at the team level, and at the practise level. And there seems to be 5 stages of it. We employ people, but we want, we employ people not just to turn up 9 to 5.
We employ them to be engaged and bring energy to the business. So there's sort of the, the structure of employment, but there's the outcome of engagement and energy. We want people to perform at a certain level, but equally, we want people to develop, to get better at things to progress and become masters of their capability in, in also for ourselves, for our teams, and as the business will progress and grow as well.
We need to keep control of that mechanism because it's a highly, highly dynamic situation we're in continuously. So we need control of it, but equally, what we ask about people and what we complain about, we don't get it is why we want them to have autonomy and accountability, that we want them to make choices and make the right choice and then be accountable for that. So we've got this.
Constant paradoxes and dichotomies built into the process. Profit, yes, or clinical outcomes is probably more pertinent for some people, but equally, if we own a business or work in a business, we want to have some sense we're driving that as a, for a purpose. It's not just to make money, it's not just to deliver clinical work.
There's some longer term societal or cultural or, or deeper personal legacy and purpose in that. And the final bit is, we want to be busy, we want to carry things on, but we want, don't want to be stressed, burnt out, overwrought, and overwhelmed, which is kind of what we see. We need to be in a sense what we call flow, which is the, timeless experience of actually doing good work in a good environment with good people, and we want to work in a trusted environment.
And that's kind of the dichotomies we want. Sometimes it's a bit stressful and busy, but other times we want to shift and float. What I'm talking about here is this left and right orientation.
So the left is the hard, concrete stuff that we can measure and monitor and take control of. The right-hand stuff is the softer, more, ethereal stuff that we, that we, we focus on. And it's the combination of, so here's the integration piece, OK.
We can integrate these types of activity, these domains of activity, and it what it is, sometimes we're busy, sometimes it flows, sometimes, you know, we can maintain profit purpose. So it's that flow and ebb and flow that I'm talking about here. How do we get to that point or more the point, why have we not got that on a continuous basis?
So here's my integrated veterinary identity. Identity is about how we see ourselves and what we do, how we match what we, how we see ourselves and our actions in public and how we see. Driven by that is meaning.
People have need a sense of integrated mastery, autonomy, and purpose that gives us meaning in our lives. We need a mindset that is resilient. It's what we call a growth mindset.
We see challenge as an opportunity to learn and grow. And of course, within that in the dynamic environment, we need a flexibility of mindset. It's gonna be up, it's gonna be down, but we've got to see the ebb and flow of that.
Motivation is going to be driven by I guess clinical drivers because that's our central core of vets, but there needs to be a commercial balance to that. How do we manage that paradox? I think it's one of the hardest ones for vets to do.
And then with that, have we got the resources, the means of a safe engaged inspired community, environment, practise, and have we got the physiological and psychological Resources to manage the other four. That's for me is a perfectly rounded human being. Now, all this is in contingent on our genetics, on our, our upbringing, our childhood, our life experiences, and all sorts of things combined to do this.
So we're all living a set of adaptations. Around this, but generally, we should be able to work with its environment. That's, that's kind of a given we'd all hoped for.
And we, we look for that in ourselves, we look for that in our partners, we look for that in our work colleagues, and we wish that on other people. Now, the point is, studies recently done, and I don't know some of you might have seen these results for, this was a study done in 2008, end of 2018. Around motivation in the veterinary profession, it questions a lot of vets and a lot of nurses around how they really felt about themselves in the profession, and that whole identity piece.
And it's fairly shocking, responses here. We've got 30% thinking about leaving the profession at all, just don't want to do this anymore. And I put these sort of qualifiers a disconnection, a flight mechanism.
63% felt they were working too hard, a persistent struggle, a fight to manage on. Can't cope with the demands of the job. They weren't mastering what they were supposed to be doing.
So you can reflect in this, the the model of, of, of, integration that I just talked about. And the reality that we're seeing in practise is there's a distance between those two things and this whole burnt out disengagement, Vets feeling that their job isn't a purposeful or meaningful job, and, and, and that, that stuns me because veterinary has such profound intrinsic motivators of purpose and mastery or should have, but where's that gone in the process? People are finding the work boring and and unmotivating, etc.
And that's a pretty sad indictment on a profession. So how did we get to that point? If you look at work-life balance, there's autonomy doesn't seem to be in place.
Endless struggle for students just getting into the profession and then a real shock when they get into the profession of of the the work-life balance they're looking for and there's a, you perhaps you could talk about a millennial shift in that, but I think it's deeper than that. So this, it's this. Lack of engagement, lack of ambition, psychological exit and disengagement that it seems to be the core of, of going in, which it's according to this study anyway, is quite profound and that just leaves me at a, at a loss of thinking, where is the disconnect?
What have we actually lost? Now, it would be easy to point out things like corporates and competition and the economy and The university, we could blame a whole lot of things out there, but to be honest, most of this is an internalisation and a chronic, long term, perfect storm of activity. OK.
What we see in practise is a lack of profitability, a non-functional business. So this is working at the individual level. It's working at the team level and it's working at the practise level.
We seem to have a disconnected fraction. Atomized model at work here. OK.
And so those four outcomes that we'd love to integrate, hold together, is, is like I said, should be held together through leadership. Now, I'm giving clinical resolution a modest tip, but I have a deep-seated Concerned that the way we practise veterinary medicine is a bit like the way we practise human medicine. I think it's fractured and broken.
I don't really believe we're doing good stuff. We're doing good technical work, but I don't know if we're actually enhancing the health of pets generally. I think that's, that, but that's a personal thing as a way.
But I'll give a tick for that. The other stuff doesn't seem to be coming along. We don't seem to have that.
So where's this distraction? OK, what, and so I put in the middle rather than leader, a basic model of physiological shift in who we are and what we do. And I just want to explain that as we go on with this.
Read the press, you can see what else is going on there. Here's sort of the, the general drift and pick up any veterinary. Piece of, media and this kind of what we're faced with.
There's some good stuff as well, for sure. I don't want to make this too negative, but there is an underlying angst, and I think it goes deeper than we have. So let's summarise that.
What I think the key issues we face as veterinary pro consulting professionals working with businesses in veteran practise, a lack of general vision and purpose, that's not a long-term sense of. And you could even sort of pitch, well, there's an option here to sell out to corporates to move on. Give up on that and just take the money and run.
This could be one very deeply cynical way of viewing this. But where's the meaning in all this? And I'm, I hope the corporates are addressing this and taking some view of a sense of meaning beyond profitability and, and clinical excellence.
And and because that's also driven by this lack of commercialism in our basic understanding. We, we vets just don't accept that there is a commercial end to the business, etc. So that's a, a push back on three of the four elements of our outcomes, and that's a deep-seated piece, OK.
The evidence tends to suggest there's a low mental and emotional resilience in the ability to accept challenge and change, what we call a fixed mindset rather than a growth mindset. It's actually, it puts it, and there's conditions that make that happen. This isn't a blame.
I'm not saying, you know, this isn't pointing the fingers that we've all got to be better than this. There's reasons that we get in this state, we're in this state, OK? And what I want to do is get to this baseline.
So why is that so? Because we are bright. Normal human beings with normal everyday physiology that evolution has given us to survive and thrive.
We just seem not to be using it or worse still, it's being used against us, which is my concern. And then one of the underlying things, I don't think we actually have the understanding, which I'm trying to address here, the resources or the capability to maintain a suitable state for AI. Thriving and survive and going on from there and that's really the piece I want to talk about.
So, this is my crossroads, this is my critical point in the path, . And it's been a long time coming, and we sit there on what I call the right-hand journey is the journey of thriving, success, doing well in practise, managing ourselves well, managing our teams well, managing the business well, and really getting the intrinsic, rewards it's due to in a, in, whether you want to call it work-life balance or any other thing, but it, it's just normal human functioning that we were born to have. And then there's Culture.
Sorry, Andy, you, yeah, sorry, there's been a comment. I don't know if you want to, pick up on it. It's from Arthur.
When you've been a single-handed practise for many years and cannot attract anybody to help you with the workload, yet clients and staff expect you to perform at 100% and are disappointed when you get an occasional locum. Running a practise becomes like a life sentence you cannot escape from because one cannot think of letting people down, if you want to. That was after I mean that that's a, a brilliant summary of everything I've just said, we are at the whim of our businesses because we are say lock and the feeling you express there're locked in.
Client expectations driving your mood and everything else, controlling how you feel about life, this, this almost sentence delivered on you by, societal expectations, inability to get a locum, what is that because people don't work in that environment, etc. There's a, there's a whole encapsulation in what you've just said there, . Now some of that might be our own choice, some might be by default.
What I'd like to present, and this is a very short webinar, is how do we take back some control of that process? How do we, we, we recognise that and well done Arthur Thoraxy, . Verbalising that in that way, because it, it actually hits the core of, of, of what you're feeling, and that's really where, where the response has to get to, because that's a visceral sense that you've given us.
And, and if I can just hold that question that you've asked and carry on and just see if we can get a little bit further down the road, but thank you for, for that encapsulation. I hope that's OK, Andy. I'll just kick on.
So I said, and we can blame, and what I'm, what I don't want to do is say there's a blame to this. There's an external reason for this. What it is, it's an internal disintegration of our own sense of being.
And I think the veterinary world has exacerbated that exponentially to the point we've all been victimised to a degree, OK. Some of us should and will be capable of taking back some control, but some serious things have to change. So let me just carry on with that.
So perfect timing, Arthur, thank you very much. The big idea I'm going to suggest is life is better than ever. Technology, money, you know, living, living standards, no wars really to worry about.
We're all in a very good social, well to do environment, but we're feeling worse than ever. We're feeling locked in, stressed, we're feeling trapped, we're feeling like the world is impinging on us. When neurotic stress, unmotivated and it's killing us.
It is literally killing us, if you look at some of the statistics. What we need today is a really massive upgrade in how we approach performance, personal performance, team performance from a primary physiological and psychological model of self and then taking control of that model and that's optimising our brain. Our minds, our bodies, and getting us back to some level of, and this is an exceptional peak performance.
This is normal peak performance. What our evolution has granted us to survive. Otherwise, we wouldn't be here today.
We have an evolutionary model that works for us, but we have seemed to turn it on its head so it's working against us. And that's what I'm, I'm really I want to fix. OK, so my, my contention for the next half hour is personal engagement requires a high flow and high trust environment.
OK. We need to create that from our own internal resources. If we do that, we can start to co-regulate teams into an engagement.
Process and the more people get right and that will drive to practise success. What we do as consultants come in and start working on practise success without solving the team or the personal engagement. OK.
So if we don't work from the inside out, we'll have no success whatsoever, OK. So if that helps. So here's my definition of a self, very similar as you might see.
We have an embodied self, we have a, a, a, like I said, a baggage of Physiology, psychology, our brain neurology, our hormones, our neurotransmitters, all this, and evolutionary derived stuff that actually creates our experience of the world, who we are in the world, and that is then adapted and modified by life experience. And that life experience comes from our environment and from our relationships we have in that environment. So, our embodied self, and I haven't got a lot of time to talk about that, but I'll give you a quick explanation of that as we're going on.
Ourself in an embedded environment, be that work, home, play, whatever, and in or just our general life environment. I mean, living in the UK in the years 2020, it's not a bad environment. OK, it rains a bit, but it's not burnt down by bushfires, it's not under perennial floods, it's not World War 3 breaking out.
We are in a pretty good environment, but we're still neurotic and burnt out. What's going on there, OK. We have an interpersonal experience, we have an interperson with our parents, with our siblings, with our peers, with our, work colleagues, with our, you know, the people we marry, everyone else around that gives us another thing.
So there's a constant interaction and then that relational activity in the environment that the broader culture is the part of that dynamic. So we are an embodied. OK, working on physiology, psychology, and neurology as a we're embedded in environment.
And we were born to be relational. Relations and our interaction with other people define us and who we are and we define other people, OK, and that's really how it works. And in that, all we're trying to do is manage information and energy at a positive high salience, OK, not a negative, low salience.
We want activation and we want to be enjoying it is the basic thing. So when that model works, A well embodied, you know, person who is very aware of themselves, good, clear, positive emotion in a good environment, working with good people, well, it kind of works. OK.
So what's come apart? There's a lot of things, there's a lot in this. I'm going to talk about two of them.
Number one is a bit of brain lateralization. So you've heard the theory left brain's all about ration and reason, right brains all creative and soft and fluffy. OK, there's kind of some sense of that, but it's basically wrong in that.
This is how the brain works generally. We actually have two brains. We have a right hemisphere and we have a left hemisphere.
The right hemisphere is about our interaction with the world, OK? It's of the world. It's an open awareness.
It's where we take information in from the world, but also where we take in information from our bodies cause our bodies are the experiencing interface, OK. The, the right side is loves ambiguity, uncertainty, complexity, engagement, risk, connectedness, intuitive, volatility. It's contextual, it just loves the whole thing and that's how we take information.
We take in millions of megabytes of information in this format and the right brain more or less sorts it out, OK, because it's got a holistic context dependent, it's it. Loves unconditioned. It's not phased by anything.
It just takes it all in. But what it does, it's constantly scanning for, is this safe? Is it not safe, is absolutely number one.
Is this relevant? Is this not relevant? Should I take note of this or should I?
So it philtres all this massive amount of it, which is why I can look in the fridge and still not see the milk. I mean, that's kind of how the right brain works. That's, that's how life works in that way.
So it's a filtering information. Now, that's an important way to engage with the world, OK, and it's got its philtres and it's danger signals, all that. The left brain is the brain that actually looks after our internal sense of self, of who we are.
So it takes that information and it wants to categorise it, simplify it, control it, organise it, plan it, manipulate it. Into some sort of sense and order, OK, it's the ordered, accurate factual evidence, so it's focused on minutiae and detail. OK, it's very selective, reductive, categorical, etc.
OK. And that's another sort of way of working with the world. So it's about who we are.
So it actually comes up with very black and white. Right or wrong assumptions about the world, etc. So the way that works, and we need both parts of that brain, because if we didn't, we couldn't survive in the world successfully, and that's the, that's the integration part of it, OK.
So information comes in from our body, through our autonomic systems, through our somatic systems, through touch, feel, etc. It comes from outside, from what we see and feel and touch and taste and smell. OK, so the information coming in, masses of it.
The right brain is processing that, putting it through these philtres, putting this through one, number one, is it dangerous? No, it's not. OK, is it relevant?
Yes, it is. OK, is it, is it something I need to be aware of? Yes or no?
Is it something known or unknown? Boom. And what it does is it processes around that.
What it then does, once it's filtered it down to a manageable level, it says, Hey, left brain, I've got this new novel, interesting stuff. Can you actually just file this away somewhere useful because it will need it for later. So the left brain says, Sure, right brain, no problem.
And it starts to run it through its library system. It actually puts a code on it, puts it in a certain place, matches it to stuff it already knows, well, it's a, it's a fair. Thing that barks, it looks like a dog.
Therefore it must be a dog. It, it quacks, it, it looks like a duck smells like a duck, it must be a duck. It puts it into a category and puts it away, OK, and tells us what to do with it, OK?
And it runs it up and down that several times. And then it says, Hey, right brain, this is what I've done with it. What do you think of that?
And the right brain says, Cool, mate, that's good. Let's put it away. Actually, I've got a whole load of new stuff coming in here, take this, and off we go again.
That's a normal functioning human brain, OK. Open awareness, focused attention, flip flop between the two running together and that's life being sorted out in a fairly normal way. If danger comes in, we've got ways and means of dealing with that I'll come to that in a minute.
OK. Now what's happened through history, and this is a long genesis of this stuff. Really going back to Aristotle, he sort of divided the brain, the mind from the body.
Obviously, Rene Descars with his, I think therefore I am, created dualism, and of course that's where the separation of medicine and philosophy happened and which ended up between medicine and psychology. The mind has nothing to do with the body, the body has nothing to do with mind. That's kind of driven Western philosophy and Western medicine for a long time.
In that, we've now dealt with a mind separate from the body, so the sensory system in the body has become sensory, I can feel, touch it, see it, or autonomic. I can't see, feel it, touch it, but I can feel it, do I trust that? So there was a lack of trust in that.
The, the body was divided up into functional systems. So this is where medicine actually evolved into cardiac people, respiratory people, GI people. We even our, our curriculum teaches these separations where there's not really a separation because these things are inter function.
Our brain has been split into Through the old reptilian brain stem, who needs that? That's his body system, very boring limbic, OK, we can blame that. That's the chimp in the process that we all talk about.
OK. And then there's the cortical, prefrontal cortex, and that's, that's the obviously the ruler room. We're given that preeminence, etc.
Now, there's some sense to that, and that's how phylogentically our brains actually developed. But to separate them into three discrete functions is where we went terribly wrong because they are all intimately interlinked through networks, etc. Autonomic, we're put into a, a competing sympathetic or parasympathetic and antagonistic system where again, and it said, well, there's a sympathetic system #1 or a parasympathetic number system 2, there's actually 4 systems at play here and we've left out several of them that are really important.
And then of course, we've separated thought from emotion, reason. Well, that's the obviously higher power. We don't trust all that passion stuff because it leads us astray.
And emotion is something to be ignored, suppressed, or put away or controlled, and thought is perhaps again, massively wrong way of or a very good way of disembodying ourselves from our real lived experience. And then like I said, this leads to this left and right. Logic versus creative, which is a false dichotomy in its own right.
So there's a long history. So it's not that this veterinary medicines, this is part of it, but then we're taught in this manner. And of course, what you can see here is the left brain reinforcing left brain thinking by coming up with all this division.
It categorised our bodies apart, is what happened. So here's what's happened to our thinking in the Western world at least, OK. No longer has our right brain got, got, a full awareness, OK.
So the information is still coming in regardless. We can't stop it. It is still coming in.
However, it's not getting passed across because the left brain is actually blocking it. 80 to 90% of the fibres in the corpus callosum are inhibitory, and we've actually expanded that inhibitory function and the, the, the, the neurotransmitter at work is GABA, gamma, I can't remember what the term is, but it's an inhibitory one as well. So there's nothing getting across.
What's happening, the left brain is now autonomous in its own right, but it's only Serving itself. It's not taking new information, it's just reiterating the information already has. So it knows what's right, it's telling what's what's right.
It's living on the certainty and the simplicity, but it's endlessly self-reference, endlessly intuitive of its own information. It's not passing anything back to the right that will give it a sense of meaning. It's got a self-forming sense of me.
Now, if this isn't making much sense, I apologise, but what a basic say the left brain has taken over or the left hemisphere and it keeps us in a A state where we don't take in new information and we don't process new information. We just keep repeating what we've already done and know. It knows what's right.
Now, if there's a feature of veterinary surgeons, our need to be right is very deeply ingrained. We're taught that we are experts in our field and we don't like the challenge of Dr. Google or anything else.
This is kind of symptomatic. So this is where we've left, so a left brain attention to all this, and this has given us a bias in the way we think, work and act. Now, all that information is still coming into the right brain, it's got nowhere to go except back into the system and that's the critical point about this, OK.
Equally, the way we manage the world is very left brain approach. Now we can see this in the current economic, political, social environment in that the key problems we're trying to deal with are certainly economic demographic, and in our world, corporatization and competition and technology, and we're hoping there's a simple linear, simple answer to this. What, what, yeah, there should be a right and wrong answer.
The reality is the problems we're facing, like Brexit, like coronavirus, like, global warming, like any of the other big issues that we are facing, there absolutely is no simple answer. It's a polarity that needs to be managed. It's a volatile and uncertain, complex world.
That doesn't respond to left brain linear thinking. We need to reconnect and reintegrate our right side of our activity. And to be honest, our veterinary training has actually decreased that possibility massively.
OK, so as a culture in the veterinary world, we're suffering from that deeply. Now I see that here's my business model for vets, OK, you do a startup, you take through the systems, you improve your pricing, you get more clients, you get into a leadership role, you build a team, it becomes a successful business. 80% of its caught up on this side of it, worrying about the pricing, worry about the invoicing, worrying about the performance, worrying about their time, worrying about their money as our.
The question I asked earlier, trapped in a situation they can see no way out of because they're looking at it in a basically linear way. That's not their fault, that's what we've been trained to do and what our clients expect us to do and therefore that's what we expect ourselves to do. We have self-trapped ourselves, OK.
There's a whole another part of the world we should be engaging in. That is driven by other things that we're not getting to. OK.
So second thing here. So that was sort of the first thing. The second is a physiological dysregulation.
Now, what I'm talking about is below the neck stuff. So we've sliced our brains in half, so we're only using half our brain anyway. Now, the rest of our neurological capability is embedded in the rest of our body.
And to be honest, we've sliced that off as well. So we're actually working down to less than A 25 or 10% of what we're doing. Now, the embodied nervous system has 3 functions.
It, and this is evolutionary driven. I mean, this is the same for everybody, every malean species and every species on the planet. We are built to survive, we are built to grow, and if we grow, We can then reproduce.
That's it. That's all evolution and our genes ask of us. OK, do that.
Avoid danger, stay safe, socially engaged, meet someone, reproduce. That's kind of all it wants to do. After that, do it like, now we're a species that live beyond reproducing age, so there's some purpose behind that as well.
But just at this basic evolutionary level, we have a system in place that says, let's survive, because if you can survive, then we need to gather energy to grow, and then we need to actually interact with other. Others of our species, so we can reproduce, and then we need to nurture and develop them beyond the age of survival, so they can do the same thing and that's really the rein through cycle. Now, you'll be familiar with these models quite easy.
There's a normal autonomic automatic, adaptive survival behaviours in the face of danger. And this is the most pertinent, most available one because if we don't survive, we're out of the game, end of, OK. And you'll understand there's a fight flight behaviour and there's also a vertical behaviour of actually activation, mobilisation at the top, fight or flight, that's mobilising or immobilisation, shut down and hide away until the danger goes away.
Now that last one, the shutdown is a very ancient. Way of dealing things. So it's developed in the reptilian and the elonian world because that's what's simple.
But these things developed in a timeline. OK, so what happened first is the reptiles, pre, pre-human, pre-mammalian. Evolution, they developed a parasympathetic vagal nerve that came from the brain stem on the dorsal side, unmyelinated and it attached to the heart and the lungs and and the intestines.
And what it was is an instant shutdown button. So if there was threat of death, predator, change, whatever, that would hit this button and the reptile was capable of shutting down the whole system, OK. Threat of death, inability to escape, shut the system down, and they would sink to the bottom of the swamp and sit there for 3 days, and that was the response.
And if the danger passed, they could rise to the top and start breathing again. Now, that works well for reptiles, not so well for mammals, OK? But we still have the that vestigial system in the process.
This is our last chance of survival. How it's enacted for us as Higher human beings. So for turtle, tortoises, modern reptiles, etc.
They still do that. They go into bradycardia, they go to reduce respiration, metabolic shut down, use no oxy and they can shut down that process. Mammals cannot.
OK, now in this picture, we're not looking at the cat, we're looking at the mouse. This mouse is not dead. It's been picked up by the cat and It has gone to a dorsal vagal syncope.
It is collapsed and gone into a feigned death. This is a primitive reptilian passive defence mechanism that some small mammals still have. OK.
We see it in humans in the human dive reflex, so young babies below a certain age, drop them into water. I suggest you don't try this at home. They will actually do exactly that, bradycardia we just hold their breath, metabolic slow down, but you can't hold them forever because mammals have a need for oxygen over a certain period of time.
OK, but it's an immobilisation process, rarely used, but it's actually happens more often than not. The reality is, because it is so dangerous to animals, we can't adapt to the original, so we go to a different one. When we cannot escape.
When we're under a perceived threat of death, and that usually happens when we cannot fight or cannot fight, we go into a, an emotional shutdown process and we call that dissociation, shame, depression, hopelessness, helplessness, etc. It's a post-traumatic response to a prolonged Physiological condition. Now, you can recognise this as depression, you can recognise this as all sorts of things, and we all do it all the time to some level, OK?
And it's just a shutdown system. And what it's saying, there's no more energy, shut down, stop using it. Let's just go.
And this is where we and some people get into a chronic state of that, which is certainly not healthy for them, OK. So that's one, that's the earliest we do. So that's the first one we choose.
Second one is a fight fight. Now this is our normal sympathetic defence mechanisms. This is a mobilised system, really ruled by amygdala, taking information from our brain stem.
It's hypervigilant to danger from the environment. External events, people or our our internal thoughts or internal bodily conditions. It's always on, never off, OK, so it's because if it ever turned off, we're, we're, we're prone to danger and we get it.
So this is absolutely essential, but it is designed for very short term survival because it's very resource heavy on our system. OK, for short duration only. Fight until you're out of danger or flight until you're out of danger, but don't stay and then return to normal physiological state, which is what I'll explain next, OK.
If we stay in a permanent hypervigilant, a sympathetic state, we end up with the symptoms of worry, frustration, anxiety, fear, anger, anger, panic attacks, rage, etc. OK, is the trouble, from a chronic state, so that's the important part. Really important we have a sympathetic system, OK, but it's really important we only use it when necessary, OK, and what the trouble with the modern world is we don't know when that necessity is.
The third system is then when there is no danger, our body is detected, sent out the the probes, no, no danger out, they were perfectly OK. So it's scanning your body and the environment through the peripheral perception, through your hearing, smell, taste, vision, etc. It's focusing on your mental state, so is there anything that you perceive even from a mental?
So of course, if you've got Flashbacks or traumatic memories or deep-seated other anxieties, they can be just purely mental. They are just trapped memories that are you being brought to the present. But if you haven't got those and your beliefs are OK, you, this is where psychology kicked in starting to manage all that.
And then we have an internal interception, OK, it's measuring your heart rate, your CO2 levels, your 02 levels in your gut, your microbiome is actually sending about 80% of its signal is upward to this and saying, yeah, that's all functioning OK. There's no sense of danger. If we got that, boom.
Am I safe? I am. We kick in the parasympathetic, homeostatic positive body budget system.
We start pumping energy. The lights come on, the hair conditioning comes on, the heating comes on. We start to generate and we actually turn into a developing, growing, healthy human being.
And we're repairing stuff. We're actually improving our immunity. We're actually fighting cancer cells, we're actually digesting our food, we're actually removing waste.
We're clearing plaques from our brain. We're doing all sorts of stuff in this state. So this is the primary state where we rest, digest, grow and get positive.
This is where we have to be as much as possible for long-term health and resilience. OK. And this is a state we can measure and monitor and detect, but most of us are completely blind to our physiological state most of the time.
For those of you who meditate, for those of you who do exercise, you will be aware of it, but maybe you haven't framed it in this way. Now, that's really important we get to that. So there's ways and means of getting there, which I'll come to in a minute.
There's a 4th level, and this is where it's really important to get your team. The body budget's a bit like your electric car. What it's saying is you've got 14 miles left before you run out.
You've got, you know, 1 hour and 47 minutes. You've, this is your charge. You now need to either go and recharge, so the body will tell us when we need to do something about it.
But if we stay at work, stay stressed, stay chronically out of, out of flow, we're just draining the system, and when we run out, boom, we're going to shut down, OK. So we fluctuate. Now, I'd rather work from a half full system and keep topping it up rather than a half than the bottom half and just topping it up to halfway all the time.
So the choice is where was our baseline before we detect, which is why I call the, the sympathetic threshold, OK, is what we do. So, summary, parasympathetic is positive, putting energy into the system, building us up from From empty to full or half empty to completely full, sympathetic is draining the system. It's taking energy out on a continuous and dorsal shutdown is when we've run out of energy, boom, crash and burn, nothing left.
OK, running on empty on that one. OK. Now the 4th 1, if we're in a good physiological parasymbolic state, we then can engage a further set of neurons called the social engagement system.
These are cranial nerves combined with the vagust, because the vagus is a cranial nerve. It's cranial nerve 10, and there's actually 12 cranial nerves. So what the social engagement system, and the reason I've got this picture here, it's what we were born with to drive nurture and survival as insufficient human beings, OK?
It's the parasympathetic activation. And it's an interaction with other mammals, your mother or your carer, and we're using cranial nerves 3579, and 11, OK, plus 10, the vagus, OK. So, 3 is about an ocular motor nerves.
So that controls eye move. You look at babies, they have very good control of their eye movement. They're looking for the carer all the time.
The row on earth 5, the trigeminal, it controls your lower face, OK, it gives you facial expression, it makes you smile, OK, facial nerve 7 is 7 cra, that's about taste like, but it gives you your upper facial eye squint, the squinting in your eyes. You've heard about the Duchesmile, the smile that's not sincere doesn't have upper facial movement, OK, and that's social engagement. The glossopharyngeal, OK, that's the back of your throat, but it also controls the tensor tympani and the stapedius muscle in your middle ear, which tunes your ear frequency to hear your mother's voice, and it tunes your mother's ear muscles to hear the baby's voice.
And it's, it's when you're in a, a, a loud public place, you can actually tune into a conversation. It's part of our social engagement. System.
It's what we were born with as babies. And then there's the accessory, which is your trapezius and your cleidomastoid muscles, which actually manage head orientation. A baby will move its head again, looking for orientation to find a carer.
I go all the time. And of course in the vagal nerve. So this is the social engagement system.
We're born with it, and we, and we maintain it and we grow it through life. These are the most important parts of team empathy, compassion, etc. So it's this parasympathetic plus kind of forms this social engagement system because as adults, it uses us and what it engages for adults is play, connection, empathy, nurture, compassion, social bonds, intimacy.
But don't forget, this is a mammalian structure. It's not just human, so it's what other mammals do, particularly the higher apes. It's why we engage with dogs.
Ever seen two dogs playing? They will chase each other. One will bite the dog's back leg.
They'll have a big tumble. They'll look at each other, re-engage social engagement, and then the other one will run off and they'll chase it the other way. Footballers do exactly the same thing.
If they don't, they get a punch up. If they do, they get a slap on the back of a hand up. It's social engagement work all the time.
It all happens a lot of from the neck up, a lot of body language appears that way, OK. So the other thing, once we're in social engagement, it actually inhibits the sympathetic and parasympathetic defence mix. It destresses us.
It improves our immunity. It lowers our heart rate, it improves our circulatory system. It detoxifies our.
It clears out plaque from our brain. This is the perfect cleansing situation that we need to be in. It's good when it's parasympathetic, but it's superpowered when it's in its social engagement.
And this is the skill we need to learn. You can learn how to do this yourself. So here's the hierarchy.
Social engagement. We turn on first. That's what we want to have because that's the highest level of, of human existence, OK?
If we have a sense of danger, we might drop the parasympathetic, we'll retreat into ourselves, but if there is danger, boom, we'll smack straight into sympathetic override. And then if we actually get caught up and stay in there, we will drop down the ladder into this immobilised state, OK, and then we're down there. So I'm going to give you a couple of models.
Don't worry too much of these. They're a bit complicated, but it's just me trying to think this stuff out, OK. We've got the sympathetic trigger point.
This is where we start, these are our adaptions in life as a human being. It depends on our upbringing, our genetics, our Primary experiences as children and as babies and, and then further things has happened. So if your mother was a, a drugged crack addict, or alcoholic, your foetal little body was probably awash with cortisone and adrenaline throughout a long time of its life.
So your threshold point's going to be much lower. If you had a happy, healthy, loving mother and good attachment, Your threshold point's going to be much higher. If you've had traumatic experience through your life, it's gonna drop that point.
If you've had therapy, you've been able to lift that point. All this stuff is individual. OK.
But when we hit that trigger point, the sympathetic system kicks in, fear, panic, rage, etc. OK? We sense danger differently from everybody else, but to us, it's still the same system, OK?
If we stay in that state, we can end up in complete freeze, dorsal vagal shutdown, OK, and then we go into shame and hopelessness and hopelessness and and trapped. And I can't get out of this and we blame the world and we go into victimhood and all other such things come out of that, OK. However, if we, if we actually figure out where our sympathetic threshold points are in different situations and we do things to drive our physical, psychological and physiological safety, and gauge our full parasympathetic system, which you can measure and monitor.
And then you actually engage with other people and do stuff for other people. Now you've heard all this wisdom before, but here's the science behind it. We connect in a safe environment, empathy and compassion and curiosity kick in.
We become normal human beings acting in the way that evolution designed us to be. Our biology works for us, not against us, and that's A great place to live. OK.
Now, sometimes when danger happens, we're going to jump into here, but we don't stay there long. Sometimes circumstances push it into dorsal Bay and we go into a meltdown and sometimes we have to stay under the duvet for a day. Fair enough.
But you need strategies to get out of there and back to a good system. So we need a good baseline, OK? Now, I'm gonna skip this because there's a whole load of neurochemistry with serotonin and dopamine and oxytocin.
And I mean, what the medical profession does is chuck you a load of serotonin in uptake inhibitors, so you're swamped with serotonin, just buggers up the system completely. OK, we've just poured the wrong all into the system. But basically, we want to be in this high social engagement.
Situation, driven by certainly serotonin and Nandamides, dopamine and oxytocin. That's the key areas. We want to stay away from the from the cortisol adrenaline system.
OK. So why is that so, so badly off this? Why is there such a difficulty?
Let's have a couple of traits they bring to bear with this, OK? We're highly emotional beings, OK. That's part of our traitness.
So we actually tend to have lower social thresh or sympathetic thresholds, OK? And, but we don't have good emotional control because we've gave that up in our training of our left brain because all that happens in the right brain. Our training, our selection, our way of working and the way of, of actually interacting with all is left brain trained, we gave up that.
We are conflict adverse, which is again a right-brained activity. We can manage conflict and uncertainty in the right brain, we've given that up. We're risk averse, we have a low threshold for safety and security, therefore, our, our, our sympathetic systems kick in so much quicker and easier.
And therefore we remain in this what we call neurotic hyper vigilant state, expecting trouble when there is none, OK, or seeing trouble when there is none, and that's really part of the whole genesis of how we build a veterinary activity. Add to that what Arthur was probably talking about earlier, what's the social myths that we live under? I do the job for the animals, not for the money.
The clients have a right to me and I've got to be at my best all the time, OK, that's what's expected of. Despite our lives. And then they don't care what goes on in our lives.
That's what they expect of it and we've driven that, we've provided that, OK. We've, we've sold ourselves the expertise, experts and perfectionists in the whole process and we're always right. We cannot tolerate being wrong and people can't tolerate us being wrong.
Therefore, there's forgiveness. And so we bury ourselves in busyness. We bury ourselves in not helping ourselves, but just getting busy.
Now, I don't know if this is resonating with anyone, but like, I spent half my life doing all these things, and I did it really well. OK. The second half has been a lot better.
Business is no relation to profit or success or lifestyle or anything. It's just means you're busy and it probably means you're stressed and out of flow, OK, and that's the one thing we have to give up more than anything else. So where we step in as consultants, we look at leadership and vision and team engagement and marketing and systems, and we talk about your pricing and your invoicing you should charge properly.
All that's symptomatic. All this stems back to if you're not in a good physiological state, you will not take this stuff in, you will not change, you will not learn, etc. And so we get threatened by our clients, that's getting danger, we kick into sympathetic state, .
Now think that in terms of this, if that's, that we actually do this through the 5 years of veterinary training, so a new graduate stepping into your practise on day one experiences all these things. Now if their threshold level is particularly low, or that, not even if they had any adverse childhood experiences, even if they're just normal people, their training would have actually told them that these things are threats to their expertise, to their left brain rightness, etc. And therefore they will live in a world of frustration, anger, insecurity, OK, and that will create an environment.
That really is not suitable. So we get into this vicious cycle. Now, I might be overtalking this, but this is my experience of working with a lot of practises and I'm really trying to get back to grassroots here.
So, We have a system and process in veterinary medicine that creates a very disintegrated veterinary identity of poor meaning, poor fixed mindset, lack of means of actually interpersonally and personally understanding this stuff, and we, we, we bury ourselves back into clinical business as a response to that. It's a, it's an avoidance mechanism, more than anything else, in that. These are some of the recommendations that come out of that original survey, make people feel valued, make them feel fit in, give them role models, make them work less.
It's, that won't do any difference unless you make people feel safe in that environment. OK, this is just people screaming out saying, make me safe, Give me, but we've got to teach people the basic skills to do that, OK, so. Where we don't want to be is a cortisol, adrenaline, right-brained, out of action.
Disembodied self, therefore we have very self dysregulation. We can't get ourselves into a state. We're stuck in this chronic state.
We're in social shutdown generally, although we, you know, we integrate into talk with clients, but we see clients as the enemy at, at work, most of us, and therefore we can't co-regulate. We see people as competition and conflict, OK. We view the world very differently from this perspective, OK.
So all my problems as a as a consultant, all your problems as vets, not all but some, around this sympathetic state of no flow, fear, obligation, guilt, how we want to do it. How can we, and this might be the subject of another webinar, get into this state. So I want people.
Embodied, self-regulating, socially engaged and co-regulating others as a team, OK, and that's a hormonal mix. We can do that through different ways, OK. So it's embodied relational and safety environment that we're looking for flow and trust.
And this is what we're, we're, we're now moving to in our teachings and how we help practises do. We take them to this level first and bring them up from there. Now, you've heard all this stuff before, but there's a basic responsibility for every one of you to take personal responsibility for your personal flow.
Sleep 7 or 8 hours. Don't eat rubbish, OK? Don't eat sugar.
It creates inflammation, and creates depressive effect. Do some exercise. Spend some focused time on a hobby or something you enjoy.
Spend some time in your head, figure out what this is about and Meditate. Take some time out and do nothing. Play with other people, play games, play with the dog, play with the kids, and connect back to other people, OK?
This is your baseline activities. If you're not putting time into these, if you're not prioritising these 100%, you will fall in the trap. The pernicious trap of veterinary medicine is too strong.
The gravitational pull will suck you in and spit you out, OK? So where this happens, where do we get that? Where do we get this now team effort?
It happens in community where you have a trusted safe environment of people sitting together, discussing these issues, making sense of it and have a basic understanding of how this works, OK. Then the model works. It's not trapped in one side, the model we get much improvement.
We get in those community building in practise, we have profitability, we have teams, we have people moving through. The question of do I, is this too much? I'll just sell up and get out.
OK, is one option and this is the other thing, OK. This is the natural response to the problem I've outlined as much as I can see it. OK.
We opt out, abdicate from our own personal response, but believe me, jumping into that changes nothing unless you change your basic philosophy around things. So I'm going to finish there, Andy, but what I would say that's of the interest of people. What we're going to do, we're having a boot camp in a couple of weeks, 2 21st of March, which is only 2 weeks away, one in Manchester, another one in Gatwick in May.
This is the stuff we're gonna work on. We're gonna help you find success in your business, success in your teams. We're gonna give you some tools to work on your own flow.
And where your own, capability. We're can actually put you in a safe community. It's over two days going to work with people, OK.
It's a really good deal, 497 plus that, it's probably the best money you're going to spend to actually get your life back. So Arthur, I invite you personally, if you ring me up, I'll give you a special deal, if you can get away from the practise. Andy, that's me done.
Thank you very much. Perfect. Thank you very much, Alan, for that fascinating tour de force that we've had.
We have had a comment back from Arthur actually. He say, saying his brother's been trying to get him into therapy for years and it's good to see the science that has convinced me that he, I need it. So maybe you don't need the therapy just yet.
Maybe try out one of these boot camps or consider getting yourself a, a coach or something. Boot camp isn't therapy, but it can edge on that. Arthur, if you, I'm happy, if you want to give me a call sometime, ring me.
I've got a few suggestions that might help. Brilliant. Any other questions, please, type them in the chat box.
I've got a couple for you, Alan, just to kick kick you off. You talked very early on about those studies showing the issues around disengagement, etc. In the practises you're working with, is that a key issue that you're dealing with on a daily basis or what, you know, I, obviously, you're helping them get successful to make more money to be less busy, etc.
But do you see those types of issues regularly? If I, if I put a marketing activity out and says you're all disengaged, burned out, and stressed out, they'd always say, yeah, yeah, we know that what's new, and, but they're not going to come and pay me any money to help them. But if I say I can earn you £50,000 extra profit per vet, would you be interested?
And I get them turning up quite nicely in that. So I've got to sell them what they want, but yes, what we start to work on immediately is personal, from the leadership point of view, personal leadership, conscious what I call conscious leadership. Are they aware of this stuff?
Where are they? Cause their business is only as good as they are. If we can get them through that, we want to then build a leadership team, so we want to engage the, the first few people into that engagement.
Yeah, and the answer to the question is yes. There generally is a level of disengagement. Something I think Gallop suggested something like 76% of practise of workers are disengaged from their business in some shape or form.
So yeah, but we don't overtly sell that if you see what I mean, but that is certainly the primary problem we work on when we're in practises. The, the paradoxical thing, if we can get some of that even by a few percentage points, it immediately reflects on the bottom line. It's immediately a profitable response because engagement drives performance, and performance drives profit.
Yeah, absolutely, as we were discussing before, isn't it? It's amazing people spend a fortune on clinical CPD but not on the business CPD side, which, slightly, which is symptomatic, do more, do more, do more. But like I said, that's an avoidance mechanism.
Yeah. Another thing that I know you're a fan of, personality assessments. I think you do the HPDI don't you?
Is that still right? Well, we, we've done that in the past. We currently use one called Talent Dynamics, but this, this will be a future webinar.
We're just moving on to one called Contribution Compass, which is dramatically dramatically good around team engagement. And team, and it, it drives this flow factor thing as well. So what it does is it describes the domain where you perform best, where you're most likely to get into a good parasympathetic state.
For example, if, if you really melt down at the side of a spreadsheet, figures, facts, etc. Well, maybe that's not the best domain to spend a lot of time in because it will, you'll find it stressful. There are other domains where you can be more several, but at some point, when you build up resilience, then go back and deal with the spreadsheet if you see what I mean.
And this is what this tool does, it helps us define that and the boot camp we're doing a whole session on that. Brilliant. I think you've answered my next question, which was, so can you link that to what you're talking about, which obviously, yes, you can.
So you talked again about, about students coming through. They're almost like, pre-selected to be like this. Do you think there's anything universities can do in terms of their selection process, nip it in the bud early?
You, I mean, the trouble is the curriculum is chock a block full. It's, it's such a hefty curriculum, the way it's worked. Some of the universities are looking at this.
They're sort of putting in stop gaps. I know RVC they've given 3rd year students a sort of easy option if they get to 3rd year and say actually this isn't for me, they've been given an easy pathway out of veterinary into other science courses without shame, basically, or a sense of failure. I know some of the newer veterinary schools are spending a lot more on this, and I think they're, they're adjusting their selection criteria.
Whether that's successful or not, I don't know yet. It's too early to tell. But I think it's a hard job for them.
Part of it is actually pre-college because, ask anyone in this audience if they're veterinary surgeons or what age did they decide to be a vets. The vast majority would say probably before the age of 10. So they've pre-selected themselves, put them into a pathway, and adopted the social myths of vets, which is work hard, be loved, save animals, but never mention the money.
So we actually create some of that ourselves in our own minds. So until the social myth changes, I'm not sure a lot of that is gonna change. And the biggest shock is, as you say, when, when they go, and course then they're cosseted for 5 or 6 years in an academic environment which is totally non-commercial, being taught by people who possibly have not had a commercial background.
And then they step into a veterinary practise and they say, guys, you got to make some money. Where'd that come from? So I don't know.
Yeah, no, it's an interesting conundrum, isn't it? I'm still waiting on anybody else to some questions. So just a couple of comments really.
Obviously the, the ultimate bad side of this, and there's some work being done by a colleague of mine at the business school in Manchester, Eleanor O'Connor, who's looked at the linking perfectionism to suicide. And that's one of the big, you know, causes of, of suicide, and, and it's, you know, it's, I think people need to be more aware of that link, and sort of pull back on their perfectionism. Hm.
Yeah, very much so, because it sets you up for failure immediately because that's what we don't cope with very well. Yeah, another just interesting observation. I was actually watching a TED Talk today on drug addiction, and they were saying that in, I think it was Portugal, they did a study where they actually looked at decriminalising everything and putting the money that they were spending on putting people in prison and what have you, into building communities, giving them paid work.
And this goes back to your point about, you know, get that community, get that team together. So, so maybe our addiction is to hard work and, and being perfectionist, and we need to get over that and, and work more on that community side. So just an observation there.
And very, very nice one. Thank you. Right, .
Yeah, I don't think there's any more questions coming through. So thanks again, Alan, for that very engaging. And then lightening talk and just finally to thank our sponsors again, MWI Healthcare.
OK, I will just say if that's raised any issues for people that they don't want to raise on this and they feel they want to contact me to discuss that 1 to 1, I'm happy to, for that as well. I know it's a bit of a contentious topic. No, that's brilliant.
Thank you. And again, just to reiterate what you, you've got the slide up there, but, I would strongly recommend people invest in business CPD and, and as Alan said, That's a fantastic deal you're getting a couple of days of brilliant CPD at a very good rate in a nice place, so thoroughly recommend it. Thank you very much.
No problem. So thank you everybody for attending and look forward to speaking to you again on the next practise management webinar. Thanks again.
Good night, Andy. Good night.
