Maria Pirita, CVPM, joins Dr. Andy Roark to tackle a frustrating reality many veterinary leaders are facing right now, your clinic feels slammed every day, yet the appointment book is quietly shrinking. In this Uncharted crossover episode, Maria and Andy unpack why declining veterinary visits can hide behind busy schedules filled with same day appointments, and why that pattern can create serious problems for clinic planning, revenue stability, and patient care. They explore practical leadership strategies for veterinary practice managers, including how to identify leading and lagging metrics, avoid “rollercoaster marketing,” reactivate existing clients, and build real team buy in when the staff does not see the problem yet. If your team thinks an empty morning schedule means an easy day, but you know something deeper is happening, this conversation will help you reset your mindset and take action before small trends become big problems. Gang, let’s get into this episode!

ABOUT OUR GUEST

Maria Pirita is a Certified Veterinary Practice Manager, Elite Fear Free Certified Veterinary Professional and former hospital administrator. In her work with Uncharted Veterinary Conference and beyond, Maria has presented to veterinarians and teams across the US and Canada on topics including veterinary marketing, feedback, team building, and positive work culture. With over 10 years of experience in veterinary medicine and over 20 years in leadership, she's passionate helping leaders develop their skills. Maria loves any activity that involves creativity or learning something new. This leads to an abundance of hobbies including crafting, traveling, cooking and gardening.

Mentioned in this episode:

Uncharted Practice Manager's Summit

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Sign up for the Early Career Newsletter here!

Office Hours w/ Dr. Andy Roark

Inside the Uncharted Veterinary Community, Dr. Andy Roark hosts Office Hours where veterinary leaders can bring real-world challenges and get practical guidance from someone who understands the realities of practice life. These sessions give veterinarians, practice managers, and team leaders a chance to ask questions, workshop difficult situations, and gain perspective on issues like team dynamics, communication, burnout, and clinic operations. Instead of navigating leadership challenges alone, members get direct access to Andy’s insight along with the support of a community of veterinary professionals working through many of the same challenges.

Register for Office Hours here!

Learn more about Simparica Trio here!

Welcome everybody to the Cone

of Shame Veterinary podcast.

2

I am your host, Dr.

3

Andy work.

4

Guys, I got a crossover

episode for you today.

5

Sometimes I like to show you

what we're doing over at the

6

Uncharted Veterinary Podcast.

7

It's the other podcast that

I host and then I love.

8

. It's my first podcast, , but

I love 'em both the same.

9

Anyway, it's just different guys.

10

This is an episode of the

Uncharted Veterinary Podcast

11

that we got a lot of interest in.

12

It's, , from a mailbag question.

13

So when someone wrote in, she's a practice

manager, And they said, my clinic's

14

visits are dropping, but we're still busy

enough that the staff doesn't seem , to

15

realize that or to be excited about doing

anything about this, , unsettling trend.

16

that's what it is.

17

It's about when we're not booking out

far as far as we were, the numbers

18

are starting to go down, but the

staff is still busy and so they're

19

not really motivated to change

their behaviors or to be concerned.

20

The doctors are the same way.

21

I am hearing a lot of this, and I think

a lot of people are struggling with it.

22

So I wanted to take this and bring it over

to the Cone of Shame, , side of the house

23

and just put it out here, , in case it's

helpful to you guys that are listening.

24

Also, to kinda show you what

the Uncharted podcast is about.

25

If you've never heard Uncharted

before, you're about to hear one

26

of our episodes if you like it.

27

We've got about 300 episodes.

28

We go way back in the day.

29

We had just, we just answer

questions every week.

30

we answer questions at this point.

31

We've got a really.

32

Robust library of questions about

management and communication

33

in veterinary medicine.

34

So anyway, guys, I hope

you enjoy this episode.

35

Let's get into it.

36

Kelsey Beth Carpenter: This is your show.

37

We're glad you're here.

38

We want to help you in

your veterinary career.

39

Welcome to the Cone of Shame with Dr.

40

Andy Roark.

41

Andy: And we are back.

42

It's me, Dr.

43

Andy Rourke and my dear

friend Maria Purita.

44

How are you my friend?

45

Maria: I am good.

46

How are you, Andy?

47

Andy: I'm doing really well.

48

, , it's the start of the new year.

49

As we're recording this, I'm looking

out like, alright, we can do this.

50

, I've got, I have the most optimistic

eyes I think I've had in a

51

Maria: Ah, that's great.

52

Andy: whatever reason, I got

53

I started, I, I was sitting and sort of

reflecting at the end of the year, right?

54

And I always kind of think about like,

what was the last year and, you know,

55

I've kind of given up on resolutions,

but I do kinda like intentions and

56

I like reflections of like, what was

good about last year and what do I

57

wanna do more of this coming year.

58

And it was funny, I was talking with

my kids and I kind of looked at my

59

youngest daughter and I was like, oh man.

60

This is gonna be a big year for you.

61

And so, like my youngest daughter,

like, she's gonna get her braces off.

62

She, she's gonna, she's gonna

get her driver's permit.

63

She's going, you know what I mean?

64

Like she's, Her grandparents are taking

her to Iceland, , as like a trip.

65

I know.

66

Maria: That's cool.

67

Yeah.

68

That's very unique too.

69

Andy: like, that's my, my parents,

my parents like threw down on it.

70

They were like, we're going on a trip

and we'd like to take our granddaughter.

71

And, and and my older daughter's

like, going off to college.

72

And so like, but I started

looking at it, it's like, Maria,

73

it's gonna be a crazy year.

74

Like, I got a kid that's moving to

Pennsylvania, you know what I mean?

75

And it's just, she graduating

from high school and like I'm

76

looking at this stuff and I'm like.

77

Man, this is gonna be a huge year for me.

78

Just like riding along, you know, I'm

gonna, I get to teach my younger daughter,

79

like she's gonna get her driver's

permit and it's wild to look ahead at

80

the year and think there are big things

that are going to happen this year.

81

That I'm like looking forward to.

82

I don't think I've ever like

looked forward to specific things

83

in the year ahead of time, but I

know you always like to do that.

84

You're always like booking trips

85

Maria: Oh,

86

Andy: a year to in advance and

87

Maria: The key to happiness

is making sure you always have

88

something more exciting coming up,

89

Andy: See, I love that.

90

I was like, I, I just, I

haven't ever done that.

91

I'm always like, we got to fight this

fire and then we gotta fight this fire.

92

And, this year, like there are, you know,

I'm not, I'm not happy my kid's gonna

93

move away to college, but I am excited

and I'm excited for her and I'm proud.

94

You know what I mean?

95

And I'm like, this is

going to be a big thing.

96

And so like, I don't think

I've ever looked at a year

97

like I'm looking this year.

98

And felt like there were landmarks up

ahead that I could see in the year.

99

And so like, do what, what do you, I

know you've got landmarks in your year.

100

Like what are you, what are you excited

101

Maria: I'm so excited for

so many different things.

102

Some of them professional, some of them

personal, but I mean, obviously we,

103

my husband and I, we like to travel.

104

So we, we have our year already of

travels kind of planned out, and so we're

105

gonna be going to Kenya and I'm pretty

excited about that 'cause I've never

106

been to any kind of, yeah, that's, that's

107

Andy: my wife desperately

wants to go to Africa.

108

Like,

109

Maria: that, that one's

just been a dream for us.

110

And so we're really looking

forward to that too.

111

You know what I also like about

the year,, I love Christmas, right?

112

And I look at things in

throughout the year as that's

113

going on the Christmas card.

114

I really do.

115

Yeah.

116

Andy: you really?

117

Maria: I, I'll be like, okay,

I know that Kenya's gonna go

118

on the Christmas card for sure.

119

But then as moments are happening, so

last year my niece graduated from high

120

school and she did a surprise speech.

121

Like we had no idea that she was

actually gonna be speaking at her

122

graduation, her commencement ceremony.

123

She said like she literally

won, went through this contest,

124

she won, and like she kept it a

secret from the entire family.

125

So she could surprise us.

126

And as that moment is happening, I'm like.

127

This is definitely going

on the Christmas card.

128

You know, so it happens not only like

ahead of time, but also like in the moment

129

when these, these great things happen.

130

So I was already thinking like her

graduation's probably gonna make

131

it to the Christmas card, but then

I was like, this is definitely

132

making it to the Christmas card.

133

Andy: I I love that you said it's

gonna make the Christmas card.

134

Okay.

135

You kind of blew my mind.

136

All right, so listen, so as at the end

of the year they always say, give gifts

137

that you would like to receive yourself.

138

And so I, my parents and my in-laws

both have those skylight frames, you

139

know, that you can, like, you email

photos to them and it like snatches

140

them out of the email and just.

141

And like puts them into the rotation.

142

Like so, so both my parents

have that, and I like those.

143

It reminds me when I, when I first

started in practice, , the practice I

144

worked at had an email address that pet

earners could email pictures of their

145

pets to, and then that's what they had

in the exam rooms like, and then in the

146

waiting room too, they just had that,

they just had like TV screens and it

147

just, they just, it was just slideshows.

148

They just cycled through slideshow of

the pet owners pets that they sent in.

149

And like it was.

150

It was awesome.

151

Like it's hypnotic.

152

You can just watch pictures of pets

go by and like, and then every now

153

and then, if like your pet shows up,

like these people would celebrate.

154

They'd be like, that's my boy.

155

I'm like, they, they would

forget that they sent it to us.

156

Like, like the only way we're

getting this is if you send it.

157

But they would be like,

there's our guy, you know?

158

, and so anyway, but like,

that, like cycling picture

159

thing, it's always like that.

160

We ally and I sort of decided

that we're gonna have sort of a

161

smaller Christmas for ourselves.

162

And so I, I really started to look

for something and I was like, I

163

would really wanna buy this anyway,

and I would want for us to have it.

164

And so I got it for Allie

as a Christmas gift.

165

And then, you know, I find that

if you give someone something with

166

technology, often it helps to go

ahead and set up for 'em, or else

167

it tends to just stay in the box.

168

And it's more like giving

them a, a to-do list.

169

And so I'm like, I'm gonna,

I'm gonna set this up.

170

And then I was like, I'll put some

pictures on it to get started.

171

Anyway, it has turned into a whole

thing where like, honestly, Maria, I

172

spend like an hour every night sitting

on the couch because I've got, I've

173

got like 20,000 photos on my phone.

174

Like it's, it's bananas.

175

It, it's like they go back to 2013 and

I've never sorted them and anything,

176

and like I've always been like,

like, I'll clean these up someday.

177

I'm doing it now, but I'm, but I'm

finding these photos and I'm sending

178

'em to the skylight frame and thin.

179

Because of the photo on my phone, it tells

me like the exact location, the pla, the

180

photo was taken, and also like the date.

181

And so I'm like, oh, we went

hiking on this trail in the

182

Smoky Mountains in 2021.

183

And like, and so the, the skylight frame,

unless you add like captions and stuff.

184

And so I've been like writing

captions and everything and so I like.

185

This is awesome.

186

I just watch it and my

family is blown away.

187

'cause I keep finding these photos and I'm

not taking the most picturesque photos.

188

Some of 'em are like slightly blurry.

189

Like my goal is not the

most beautiful portraits.

190

My goal is I'm gonna use

pictures of things that happened

191

in our life that we remember.

192

we were in LA as a family.

193

Recently, and we went to one of

those sushi restaurants that has the,

194

Maria: The train

195

Andy: the train.

196

Yeah, the

197

Maria: Yeah.

198

Andy: Yes.

199

It like the sushi's just coming by.

200

And my oldest daughter was like, Ooh.

201

And she's just, she's just popping

those things open and grabbing 'em.

202

And like, and like it was white and

like, I have a crappy selfie of us at

203

the table with the sushi train going by.

204

it's not a good picture

of our family necessarily.

205

But man that's going in there

because that was so fun.

206

And I wrote like Little Tokyo, you know,

20, 25 anyway, all that to come around

207

to say, having that stupid frame, like

I set it up vertically so that like

208

selfies, like work really well on it.

209

And I'm like, dude, I'm looking

for from now on when events

210

happen, I'm doing selfies.

211

Just so that I can put them into the

frame and add them to like this life

212

collage that keeps going, but like it won.

213

It, it makes me grateful

every time I look at it.

214

I look back at all of these moments I

had with my family, with my friends, you

215

know, with the uncharted team is in there

and stuff, and just, just from like some

216

of our previous events and things, and

I'm like, I remember when those things

217

happened, and it just makes me feel

deeply grateful for all of these things.

218

And so it's just been this

really beautiful thing.

219

This episode, by the

way, is brought to you by

220

Maria: I was gonna say,

221

Andy: frames.

222

It's not,

223

Maria: if anyone from Skylight

is listening, you we're open for

224

Andy: we're, yeah, we're

225

Maria: so feel free to

call us, let us know.

226

we'll see who can sponsor this episode.

227

In the meantime, we have

an excellent mailbag.

228

Andy: let's do some actual work here.

229

I'm really excited about this Mailba.

230

I think this is a great one.

231

I think a lot of people are

gonna really like feel this.

232

It's just, there's so much here.

233

I love, do you wanna go ahead

and lay down our mail back?

234

Maria: Yeah.

235

I'm actually gonna read

it because it's so good

236

Andy: Do it.

237

It's, it's good.

238

And the details matter.

239

Yeah.

240

Maria: So they said our visits

are down and I'm freaking out.

241

Last year we were booked out two weeks.

242

Now we're lucky if the

morning has anything to.

243

Scheduled at all.

244

The only reason we hit capacity by

the end of the day is because we get

245

slammed with same day appointments.

246

But my train treat treats the

same day feels like a good thing.

247

And they're excited when the

morning looks empty because they

248

think it means it's an easy day.

249

But I

250

Andy: Easy day.

251

We got it, guys.

252

Maria: That resonated so hard.

253

I was like, oh, I remember that.

254

Yes.

255

, but I know the pattern we're in is not

sustainable for revenue or planning.

256

When I try to talk to the team

about outreach or marketing,

257

they tell me they don't have the

bandwidth for anything extra.

258

I suggested an open house or

community event as a way to

259

draw in new clients and the team

practically stage a muti knees you

260

Andy: I thought that

261

Maria: Um,, I was like,

that's pretty funny.

262

A mutiny.

263

they don't wanna come in on their day off.

264

And I'm not in the place to push

morale or any lower, but I'm scared

265

that if we don't start doing something

proactive, we're gonna be in trouble.

266

What do I do when the team

refuses to engage in anything

267

that helps build the schedule?

268

Andy: Alright, , I really like this.

269

I think this is really common.

270

I think that there's a lot of, I mean,

I think, , across the country we're

271

seeing visits go down, like, you know,

that's been going on for a while.

272

, Matt Sooy, , the Economist was on the K

of Shame podcast with me not long ago, and

273

he says as of the end of, , 2025, we are

definitely in a recession in our industry.

274

And so, he's optimistic that

275

We are seeing recessionary,

forces at, play and we are seeing

276

declining visits as a industry.

277

And so anyway, , there's a lot of

people, I think, who are seeing more

278

open appointment slots than they

used to, and the team is still tired

279

and they still got plenty to do.

280

And, , you know, and they're

like, this is fine, this is nice.

281

Things are good.

282

And so anyway, I just, I love that sort

of, that di that sort of dichotomy.

283

,

Maria: I wanna jump on that first for a moment because I have this

284

in my head space, and I think

this is really, really important.

285

Right now, we are seeing this shift,

this recession, this , lower visits,

286

I want you to know that the reason why

this is happening is actually kind of

287

irrelevant to you as a practice manager.

288

Practice owner.

289

You will be in these seasons no matter

what, whether it's a recession, whether

290

it's a pandemic, whether it is, you know,

the economy, an election, what have you.

291

It's going to be an issue in the

future just as much as it is right now.

292

And so I think that the most dangerous

head space to get into is there's

293

nothing that we can do about this.

294

Andy: Yeah, so I agree with

295

Maria: that's why I think it's important

that we mention that is I don't say

296

that this is normal and to tell you

like, oh, just kind of go through it.

297

It is normal.

298

You're gonna be here in the future.

299

Don't feel like a failure.

300

But at the same time, know that there

are things that we can do about it.

301

And I'm sure we'll get to

those in the action steps, but

302

Andy: I think there's

two dangerous headspace.

303

One is there's nothing we can do about it,

and the other is this is terrible and all

304

is lost, and like we're gonna live in the

street when they shut this building down.

305

It's probably gonna turn into a Spirit

Halloween shop in a couple of months.

306

Like that's what's gonna

be in this vet clinic.

307

It's like it's

complete, , catastrophizing.

308

But again, you're right.

309

Maria: right?

310

Like

311

Andy: Well, it, it is.

312

And so business is cyclical.

313

It is cyclical.

314

We have good times and we have

down times and lean times.

315

And that is just what it means to

run a business over the long term.

316

And so you're not doing anything wrong.

317

You're not failing, this

is the way that it goes.

318

We are riding on a tide that's

much bigger than ourselves.

319

Alright, so, so my first thing

in Headspace is whenever you

320

get to something like this.

321

We need to focus on the actual problem.

322

And I know that I am not the only

one who looks at a, trend like this

323

and then projects down the road.

324

If this decrease in appointments

continues, we will have negative

325

appointments in three years.

326

Like we will literally be like, we will

have to, we will do appointments ourselves

327

just to make appointments happen.

328

It's like, that's not gonna happen.

329

If there's a great change from

where you are now, you will

330

address that change when it's real.

331

Now that doesn't mean don't pay

attention to what's going on, but, , I

332

have sort of a mantra where I say

I don't have the answer right now

333

because I don't have the real problem.

334

When I get the real problem,

the answer will come with it.

335

And what that means is it doesn't help us.

336

You should be worried about the

pattern here, and it should worry you

337

enough to motivate you to take action

based on where you are right now, but

338

you don't know what the situation's

going to be like in a year from now.

339

And.

340

Don't spend a ton of time thinking

about what catastrophic, decisions

341

you're going to have to make

a year and a half from now.

342

'cause that's not where you are.

343

You don't have the context,

you don't know what's going on.

344

Like you will have a lot more

clarity when you get there.

345

And you have to trust future you to be

able to make those choices when they have

346

all the information that you don't have.

347

And so.

348

There is a pattern here.

349

Our appointments are going down.

350

Let's not panic.

351

Let's look at where we are and let's

make adjustments right now without

352

spending a lot of time, , panicking.

353

And so I say this just because the first

line of the mailbag was our appointments

354

are going down and I'm starting to panic.

355

I get it.

356

We should be worried and we should

be motivated to action, but we,

357

we don't need to be, we don't

need to be more upset than that.

358

Or thinking about where this might go

or what it might mean in the future.

359

Let's just, let's play the hand that we're

holding right now and play it really well.

360

Maria: Yeah, I'm a big fan of that.

361

I think you said something that's

super important too, which is

362

basically, let's look at where we are.

363

And so I think that this is a good

time to think about, also the fact

364

that a lot of times when we apply,

think about marketing and they

365

didn't really give us specifics on.

366

What kind of clinic we're looking

at, but just in general, when we look

367

at marketing, a lot of us practice

managers are guilty of doing what

368

I call rollercoaster marketing.

369

Have you

370

Andy: Okay.

371

I like this.

372

No, I haven't heard that term, but I,

373

Maria: Essentially rollercoaster

marketing is where we tend to only

374

look at our marketing efforts when we

have a low point in our services and

375

our revenue and our patient visits.

376

And so then we start increasing

marketing and we put in more

377

marketing efforts and we start to

rise up and we start to rise up.

378

But then next thing you know, we're.

379

So busy as practice managers,

as technicians, as veterinary

380

assistants, as practice owners

we let our marketing fall down.

381

And so then all slowly but surely,

we start seeing a decrease in patient

382

visits and revenue and revenue.

383

And now we're back here again

where we're, there's time to do the

384

marketing, and so we start doing it.

385

And so your revenue or your patient visits

or anything starts to kind of look like

386

a roller rollercoaster because it's just

going up and down, up and down because

387

we don't have consistent marketing.

388

And so.

389

As we're track looking at our things,

we need to ask ourselves, is this trend

390

happening because of the ,economy,

because of things that are happening?

391

Or is this happening?

392

Is this a regular trend

from the winter visits?

393

And if so, we need to be more proactive

next year about preventing it.

394

And so , that's part of kind of looking

at where you're at, is, , try to

395

avoid doing rollercoaster marketing.

396

The other one is what I call

vibes only marketing, which.

397

Is essentially where we throw

a lot of marketing out there.

398

And I, the reason I mention this

is because the practice, , owner

399

or leader , who submitted this

kind of gave us some ideas of, of

400

marketing that they wanna implement.

401

When we just threw marketing, but we

don't know what's actually working.

402

We're spending a lot of money on

effort and time and money on efforts

403

that may not be coming back to us.

404

So vibes only.

405

Marketing means when you don't,

you're not really sure what's

406

working, but you're like, well, some

clients have mentioned referrals,

407

some have mentioned Facebook posts.

408

So I think we're gonna do more of those.

409

Right?

410

But we actually don't know, and this

actually happened in my practice when

411

I took over marketing in like 2015.

412

I remember.

413

They, we were tracking where

new clients were coming from.

414

, we were tracking it, so we were

asking, but nobody was actually

415

looking and reviewing it.

416

And so I noticed that like none of the

clients had ever said that they got to

417

us from the phone book, the Yellow Pages.

418

However, we were still paying for

Yellow Pages ad or like to be in them.

419

And so that's where, that's where

your efforts will become wasted is

420

not only do you have to track 'em,

you do need to be reviewing them so

421

that you can make smart adjustments.

422

Before you're in the situation, and so

I call those two out because I think

423

that they're super important when

it comes to looking at where you are

424

at currently within your practice.

425

Andy: I like that a lot.

426

I, I think that, that's good.

427

I think the last part of Headspace

for me is about making a little bit

428

of peace with where the staff is now

we're gonna work on this, like, we're

429

gonna, we're gonna fix this and we need

their help to get this up and going.

430

so one I just wanna throw out like,

431

. I don't think the staff is ever

gonna be fired up about coming in on

432

their day off to do an open house.

433

Like I, I don't think that's

ever gonna motivate 'em.

434

I, I think that you have to go ahead and

if the clinic wants to invest in this as

435

a marketing push, I think you're gonna

have to probably pay these people to be I

436

Maria: I'm so glad you said that, Andy.

437

'cause that is something that

I see so often in the sense of

438

like, let's have an open house,

but everybody, it is voluntary.

439

So if you can please come by and I will

tell you right now, I am with you on that.

440

Don't make it voluntary and

expect people to be excited about

441

Andy: Yeah, it's just not gonna happen.

442

I, I agree with that.

443

And so that, that's not, they're not bad.

444

Like, that's just like, that's

just, that's just how people feel.

445

And like that's honestly in a

profession that really needs, , to

446

keep working on its boundaries,

that's probably a good thing.

447

So, so I think that's true.

448

The other thing is to understand is

this, and like you have to kinda put

449

yourself in the shoes of the staff.

450

They are looking at what they

see in the practice and their

451

days seem to be full, right?

452

They don't understand the difference

really between someone who makes

453

an appointment and comes in versus

someone who walks in the same day.

454

To them, they're like, Hey,

we're staying busy enough.

455

Let's keep going.

456

As a manager, you know, you do see the

difference in someone who's made an

457

appointment versus somebody walks in

and, and like what that means about

458

sort of the health of our business

and people's intentions to come in and

459

like generating long-term, reliable

appointments and things like that.

460

And so they're kind of living in

the moment on the floor, you see.

461

The pattern that is going on here.

462

They don't see a pattern.

463

They've been busy and they're still

busy, and so that's not make them bad.

464

It's not that they don't care, they

just, they don't see the why yet.

465

And so part of it for Headspace

is we're gonna have to do that.

466

Maria: They also haven't

been trained on that.

467

Like they don't understand leading

and lagging metrics, which is

468

essentially what this practice owner

or practice manager is looking at

469

because your, scheduled visits, it's.

470

It's a leading metric, right?

471

And so you are trained as a practice

owner, a practice manager, to

472

look at that and think, this is

gonna bring us trouble later on.

473

But your team is not trained to

look at leading and lagging metrics.

474

They're looking at it as, hey, well

this probably has just happened and next

475

week it's just gonna be just as busy.

476

And so I think that getting into

that mind space helps to protect

477

where the team is coming from.

478

It's not that they're lazy, it's

not that they don't wanna work, it's

479

Andy: it helps you empathize with them,

and we want to empathize with them so

480

that we can work effectively with them.

481

But if you don't empathize with

'em, I think this is gonna be

482

a, a hard thing to, to get done.

483

So anyway, I am, I'm

with our writer on this.

484

These are concerning signals.

485

I, I love your, call out

of like a leading indicator.

486

This is definitely a leading indicator.

487

, there's alarm bells

going off for me as well.

488

We've got to, We've gotta focus on

not where this goes, but we need to be

489

serious about what we're doing right

now , and what changes we can make.

490

And we've gotta empathize with

the team and also use that empathy

491

to motivate them to take action.

492

And so anyway, , let's take a break

and then we'll come back and do that.

493

Maria: Okay.

494

Andy: right.

495

, let's talk about some action steps here.

496

I think the first action steps

happen in secret, and I don't mean

497

secret, like don't tell anybody, but.

498

This person's trying to do a

couple things at at once, right?

499

, first we need, like, we, we have to create

a plan of like, what are we trying to do?

500

And then we have to get team buy-in.

501

And what I've found is sometimes

people kind of panic and they,

502

freak out and they're like, let's

get the team and make a plan.

503

And I'm like, if the team

is not excited about.

504

If the team is not on board and you

try to recruit them into the planning,

505

a lot of times that's really hard.

506

I want them to have a voice in the

planning and I definitely want them

507

to take ownership as we start to do

this and I wanna support their ideas.

508

But I think that you need to go

into stealth mode and start to

509

do some your homework and your

research, and you need to figure out.

510

What really needs to happen here,

because just like you said before,

511

Marie, like they don't have the

training or the visibility on

512

leading and lagging indicators.

513

They also don't know what we're

able to do in terms of marketing.

514

What has worked in the past,

what hasn't worked in the past.

515

They really don't know what

initiatives or things that we

516

do lead to clients coming in.

517

Like they don't, that's not their job.

518

Like their job is to take care

of the patient and the client.

519

And so , they're not really thinking

about where do our appointments come

520

from, and so that, that's your job.

521

And so go ahead and just, On your own.

522

I think that's the better way to work

on a lot of these things is go ahead and

523

get your head straight about what are

you looking, what are you looking at?

524

Where is this pattern coming from?

525

Can we do some root cause analysis?

526

Are there any things that have changed?

527

Like you said, you've got these things

where we do roller coaster marketing.

528

did we get excited and

start doing something?

529

And we've kind of fallen off on that.

530

I mean.

531

, the classic thing that

happens to vet clinics.

532

I don't know if this even happens

anymore with everything being as

533

automated it is now, but , I know

you've heard stories of the clinics

534

that their reminder system would get

turned off and then all of a sudden,

535

like, like it takes a little while,

but people stop booking appointments

536

and they're like, ah, I'm going down.

537

It's like, well turn your reminder

sister back on and let's start

538

getting these people back in.

539

I'm not saying that's what's

happening here, but that is an

540

example of the type of just.

541

Basic processes that we should be

running in the background all the time.

542

But when those processes get dropped,

, people stop making appointments.

543

And so anyway, it's time to do an audit.

544

Maria: That actually

happened in my practice.

545

But with, The reminder postcards and so

546

Andy: back in the day.

547

Yeah.

548

Maria: yeah, it was back in the day,

so postcards were a lot more popular.

549

But the postcards essentially, we

had not submitted an updated address

550

list to them in like three years

or something when I took over.

551

And so we noticed a deep drop after a

certain amount of time and they were like,

552

well, how come there's, you know, like

reviewing the numbers was like, how come

553

there's significantly less postcards?

554

And that's when.

555

This is why I think taking care and

overseeing the marketing still takes time,

556

I think as a practice manager, because

at the time I was a marketing manager

557

and I was kind of just taking over the

marketing, and that's when they said,

558

oh, nobody has submitted in one of those

updated lists in, like two, three years.

559

And therefore you slowly drop off lists

at, you know, off the list if people

560

move, if you know, addresses change.

561

And so it turned out to

be that we put that in.

562

And the only reason we saw it is

because again, we were good at.

563

You know, looking at our leading metrics.

564

So we saw it ahead of time and

we kind of started to question

565

like, how come this has been down?

566

But that does happen, Andy, and

I love that you mentioned it,

567

because what we do in this state,

in this moment is really important.

568

And the mailbag, submitter pretty

much said that they're interested

569

in putting together these events

to kind of hire new clients.

570

Remember?

571

That it actually costs you more

money to find a new client than it

572

is to activate an existing client.

573

And so what you are talking about is super

smart because you're reactivating current

574

clients, and that is gonna be easier for

you to fill the book with than to actually

575

go in and, bring in a new client.

576

Not that you shouldn't focus on

that because that is important,

577

Andy: But you, you're

so, you're so spot on.

578

Like looking at like getting current

clients to make appointments is so

579

much easier than getting new clients.

580

We should be doing both like

there, because we're gonna have

581

turnover of clients no matter what.

582

Like you always have clients that

leaving, they're moving away.

583

They are no longer pen owners.

584

You know, things like that,

585

Maria: we did an episode actually not

that long ago on how to convince, our

586

team for the need of new clients that

people could also listen to if they want

587

to talk specifically about new clients.

588

But I think the missed opportunity here

is definitely the deactivated clients.

589

Andy: Yeah, when I look at problems

like this and I'm thinking

590

about like, what am I gonna do?

591

I do put.

592

Possible action steps into two buckets.

593

And so I like to look at things and

say, what can I do with zero buy-in?

594

And then what do I need the

team's help for to get done?

595

And so things like this of doing,

doing a quick audit, looking at your

596

reminder systems, looking at, what

kind of automated, , follow ups do we

597

have, you know, what kind of, , what

kind of, yeah, what kind of reminders

598

do we have to get people to come in?

599

A lot of times if you're

the practice manager.

600

You don't need the team to even

know that you're doing that stuff.

601

And so it's not that I'm saying do

things that don't involve the team.

602

I'm saying you can get to work

immediately on the things that don't

603

involve the team, and you don't

have to ask for anybody's help.

604

And those things are a hundred

percent within your control.

605

And so just going ahead and starting

to work on those things, that's

606

something productive and positive

that you can be doing right now.

607

And we're gonna work on the team.

608

We will.

609

But what can we do without the team

, that can be automated, especially

610

that can run in the background?

611

I like to look at those things

and say, I don't need anybody's

612

help to get these things done,

so I'm just gonna get 'em done.

613

, Maria: I absolutely love that

and I think that this is a

614

really good point to make too.

615

When it comes to like, what can we

actually do within the buckets of the

616

reminders and bringing it and activating

new clients, there is something that we

617

forget that is really powerful and it is

the simple either, A lot of people will

618

call this like treatment phone calls,

treatment plans, or activation phone

619

calls, but it's simply where we can call

up our clients that are either have.

620

You know, not been in within the, the

current year but are coming up due or

621

that they have pending treatment plans.

622

And so these things really do help

our, our practice to fill our books.

623

The team doesn't generally love doing

these, especially if you frame it

624

around, Hey, we need to fill the book.

625

we need to get appointments in.

626

Right?

627

And so , when you do start to look into.

628

The things that you know, are gonna

require the team buy-in, whether

629

it's these kinds of phone calls.

630

And They're very powerful and you can use

them to fill your books when you need to.

631

And they're not that hard.

632

The main thing is.

633

You have to frame those from

advocacy for the patients.

634

That's what it is.

635

And you have to make sure that we,

we understand as we're explaining

636

these to the teams and we're

getting their buy-in, they don't

637

get excited about filling the book.

638

They do get excited about being advocates,

and that's what we're doing, right?

639

Whenever there's a, a patient that has

not received the dental or have not

640

received a spay, or if there's patients

that are coming up due and they're not.

641

, in the schedule.

642

Yet you are advocating for the wellbeing,

the preventative care of that patient.

643

And so training your team to be able

to do that over the phone and kind of

644

make these phone calls is a good way

to start getting that book filled.

645

Especially because I think a lot

of us practice managers, we see

646

an empty schedule and the first

thing we wanna do is cut hours.

647

We're like, alright, who wants to go home?

648

Which is a good way to , cut costs.

649

But at the same time, there are some

productive things that you can do to set

650

yourself up for the future because those

visits aren't gonna schedule themselves.

651

Andy: One of my big things too

is I think people panic and

652

they're like, we gotta cut hours.

653

My thought is, alright, we need

to think about what was gonna

654

help address the problem, and

then think about how we can push.

655

To make that change and

you can cut hours later.

656

But it's sort of like, sometimes I

think we go into defense mode too early.

657

I think that there are definitely

something, , even if you said, look

658

guys, we're gonna do this initiative.

659

We're gonna do a real push for

clients for two weeks and we're

660

gonna see how it goes and either.

661

We're starting to see some traction or

we have put some processes and systems

662

into place, and now if we have to cut

hours, we've already at least made

663

this push and started to try to have

a re-engagement campaign to get our

664

clients back in and things like that.

665

But we have done some things to try to.

666

Get clients coming in before we've

tried to like trim down our hours.

667

Ideally, we're gonna make a push, we're

gonna start to see people coming back in.

668

We're not gonna need to cut hours.

669

But I think sometimes people go

straight to cutting hours and because

670

I get it and like, trust me, I get it.

671

Payroll is scary.

672

It keeps coming, it keeps like,

673

Maria: your biggest expense.

674

Usually

675

Andy: the biggest expense and it

does not stop and it does not waiver.

676

It just keeps coming.

677

And people are like, we gotta

get that number down sometimes.

678

Using the labor that we have in a

smart, focused way , is a better

679

move than cutting that labor.

680

And the worst is sometimes we can

use it in a smart, focused way right

681

now, and then cut it later if we

need, if we still need to, and we'll

682

still be in a better place than

if we go straight to cutting it.

683

So anyway, I wanna, , so big, the

biggest action step for me I wanna

684

talk about is talking to the team.

685

, and so,

686

Maria: that's the biggest one.

687

It's team buy-in is hard.

688

Andy: Team Buyin is hard.

689

, one we already said, you know, I, I don't

think the team's ever gonna be excited

690

about coming in on their day off to

do, open house and things like that.

691

I just, I would take

that outta the playbook.

692

, if you're serious about it, I

think we need to pay people.

693

But here's the other thing

too, if you pay them.

694

You expect 'em to be there.

695

You expect them to have a

big smile on their face.

696

You like, give them some guidance.

697

Not, I want you guys to be here.

698

No, we're doing open house.

699

You're on the radiograph station.

700

You know, like, you're gonna make

a, you're gonna make a little

701

presentation that you're gonna do

for people as they come through.

702

You're gonna find some good cases to have.

703

Like, let's have those ready to go.

704

Like, I want, I wanna see cool stuff here.

705

You know?

706

And , think about what

you want these guys to do.

707

I'm not saying.

708

Pay 'em to stand around with a smile.

709

I think that's a bad use of your funds.

710

Also, I think it's unfair to

ask them to come on their day

711

off and, make any sense either.

712

I think the right play is to figure

out what an awesome open house looks

713

like for you, and then to, to make some

chop descriptions for that open house.

714

Really put a little thought at this and

then you're gonna have to compensate 'em,

715

but go hard in the paint and really try

to make this into something that matters.

716

And so, so I think that,

717

Maria: I so agree with you on that.

718

And also the fact that like when

we talked about doing it, you know,

719

framing this from an advocacy point,

you can frame this also this open house

720

from that point and be like, what are

you excited about to teach clients?

721

Like what would you like to talk about?

722

Is it dental, is it fear free?

723

And then they can create

their own presentations.

724

One thing to add on that, because if

you are gonna do an open house still, if

725

you're, you're like, I definitely wanna

do this, make sure you have a funnel.

726

Because a lot of times I feel like people

like to put together these events and

727

they'll go and they'll, I handed so many

business cards, I did so many things.

728

But it doesn't work if you can't

market to them later on also.

729

And so you wanna be collecting

those email addresses.

730

You want a reason for them to

give you that email address.

731

And you wanna know, and again, it goes

back to what makes this successful.

732

Do we want a goal of how many

people, you know, how many

733

impressions of people that we made?

734

You know, and things like that.

735

So I think that that's all

part in making it successful.

736

But I agree with you, whatever idea the

team has is gonna be a lot more successful

737

than whatever team idea you try to push

738

Andy: That's such a great, such a

great call having a funnel ready.

739

Like these people, , they're

gonna show up with their kids.

740

'cause , honestly, it's a

fun thing to do with kids.

741

And if you've marketed it correctly, then

people are gonna come with their kids to

742

see what's going on and they're gonna,

they're not like, Ooh, I'm gonna come and

743

get a new vet and set up an appointment.

744

They're coming to literally look

at what surgery looks like and to

745

see some, you know, some x-rays.

746

That's what they're coming for.

747

You have gotta have a plan.

748

That is graceful and that walks people

from attending the open house into

749

bringing their pet in for you to examine,

like you gotta build that pathway.

750

That's the funnel.

751

But you need to think

about what that looks like.

752

What do you give to them?

753

What do you get them to sign up for?

754

How do you get them to give

, your email address or their.

755

Phone number so you can text them.

756

And then what does a

graceful follow up look like?

757

That doesn't look slimy, that doesn't

look salesy, but that encourages

758

them to come back with their

pet and to give you guys a try.

759

Do you wanna give 'em swag?

760

Do you wanna have, do you wanna have

balloons, do you want to have, fans,

761

do you wanna have bumper stickers?

762

Do you have t-shirts?

763

What do you want?

764

Like, what is, what do

we take away with this?

765

I think a lot of times people say,

we're gonna have an open house and

766

we're gonna get new clients, and I'm

like, buddy, the distance between

767

having an open house and getting new

clients, think about that for a second.

768

Those are not the same thing, and

there is some distance between them.

769

How are you going to gracefully support

people in making the transition from

770

someone who is an impressed open

house visitor to they are act, they

771

have actually booked an appointment.

772

And that does not mean put on the

hard sale, but it does mean just be

773

intentional about what would make

them after they're impressed by your

774

open house, what is the most graceful,

supportive way to get them to come

775

back to, to meet you with their pet?

776

What does that look like?

777

And so anyway, I love what you said

here, Maria, about the funnel, and

778

I love that what you said about.

779

What the team is excited about is what

they're gonna work the hardest on.

780

And so this goes back to the buying team.

781

The big buy-in for, for me, for the

team is this, the why really matters.

782

And so when our writer says, guys, the

appointments are going down and we've

783

gotta do something, the appointments

schedule are going down and the day

784

filling up with walk-ins, that is not a

compelling why for them to take action.

785

They're like, I don't see a problem here.

786

We are still busy, and if we're

not busy, we've been busy since

787

the Global Pandemic in 2020.

788

It's a little bit nice

to catch our breath.

789

, that's what they see.

790

You are seeing the pattern and you, you

are worried about where this pattern

791

goes, but they don't see that, they're

looking at today in the clinic and so

792

you have got to engage them on the why.

793

And so you say, but what is the why, Andy?

794

I would say, well, the why is very

specific to your situation and

795

it's very specific to your team.

796

So in terms of what is your

specific, what is your situation?

797

What I would say is, remember when I said

don't worry about the future so much and

798

don't catastrophize, put a pin in that.

799

For right now, I want you to go back,

I want you to worry about the future.

800

I want you to catastrophize.

801

If this downward trend continues,

what does that mean for you?

802

What does that mean for your patients?

803

And that's important.

804

, think about that first.

805

What does it mean for the patients?

806

If this continues?

807

What does it mean for the

clients if this continues?

808

And then what does it mean for

the team if this continues?

809

And that is a compelling why

to your specific scenario.

810

If you are like, if this continues,

we are not going to be able to,

811

we're not gonna be able to stay

open, every day of the week.

812

We're, or we're gonna have to, we're

gonna have to reduce our hours.

813

We're not gonna be able to.

814

Be here to provide services.

815

We're not gonna be able to give

you guys the hours that you want.

816

it really is depending on,

on your situation of, of

817

what we'd have to give up.

818

, but what are you worried about?

819

And again, I don't wanna scare

people or threaten 'em, but honestly

820

that's part of a compelling why.

821

The other part I said that's

specific to your situation.

822

It's also specific to your team.

823

What does your team care about?

824

And one of the things I always think of

when I think about the team is, people

825

in veterinary medicine, especially

veterinarians, but honestly the whole

826

team, one of my mentors told me they,

they tend to care about three things.

827

They care about patients, they care

about people, meaning clients, and they

828

care about the practice in that order.

829

And so they care about pets, they

care about people, and they care

830

about the practice in that order.

831

And so oftentimes when I say what is

a compelling why, I would say, how

832

does this trend affect the patients?

833

. How does it affect the clients and

then how does it affect , the team or

834

our ability, , to support our staff?

835

Those things often are

what the team cares about.

836

If you have core values for your

team, if your team cares about serving

837

the community, if they care about

lifelong learning, if they care about

838

being fear free, like all that stuff.

839

Requires a steady income stream and

the ability to budget and plan, and to

840

support initiatives around those things.

841

Don't talk to them about

we need to fill the books.

842

That doesn't motivate them.

843

Talk to them about our

ability to keep practicing.

844

Fear-free medicine to keep up our low

stress handling certifications and our

845

ongoing training, our ability to be

here for our patients when they need

846

them, the ability to have extra support.

847

A lot of times the team cares about,

they don't like working shorthanded, and

848

you say, guys, I don't want you to work

shorthanded, but we are not gonna be able

849

to keep this much help around if we don't

have like steady appointments coming in

850

and they don't wanna be shorthanded again.

851

And so I understand.

852

That they say, boy, we've been tired,

and so we don't want to do these things.

853

And I think they need to understand

that not taking action now is

854

not gonna lead to restful days.

855

It's gonna lead to them being

more shorthanded in the future.

856

Again, that's sort of about

framing up that compelling why I

857

don't wanna scare them with this.

858

I'm not trying to be negative, but also

they need to understand the consequences

859

of what happens if we don't do this and.

860

The benefits, if we do do

it, what's good that happens?

861

If we're successful, if we pull this

off, if we can start to build these

862

appointments back up, what is,

what does that mean in a good way?

863

, what can we do to make the world better?

864

How is this gonna help the team?

865

How is this gonna help the

patient care and the doctors?

866

How are they going to feel if

we're able to get this stability?

867

What's in it for them?

868

And again, between those things of.

869

We want to avoid this, but this

is also what we're trying to get

870

to or what success looks like.

871

I need to be able to figure out how

to make a compelling why for them so

872

that, so that they'll get on board.

873

Maria: I'm so on board with that and

I would tell you that I think the why

874

that I would go with here, and it does

depend on your clinic, and it does depend

875

on, you know, what you've got going on.

876

But the truth of it all is that

the economy is tough on people and

877

that visits are down because they

can't afford it, and it is still our

878

responsibility to advocate for the pets.

879

And so, even though like

the economy is down.

880

One of the first things that goes

is gonna be the preventative care.

881

And I worry about the patients who aren't

receiving their vaccines who might get

882

into trouble because they go past due.

883

I worry about the patients who,

you know, might skip the heartworm

884

test because of, of finances.

885

And so can we call these clients up

and ask them, you know, what, you

886

know what, where we can help them?

887

Whether it's splitting up the services,

maybe they come in for the rabies vaccine

888

and the heartworm test during the visit,

but we do the rest of the vaccines with

889

technicians because we can, in our state.

890

That's really important, but also

just like advocating for the patient,

891

but also framing it from a, you

know, we wanna try and help the

892

clients during these situations and

like, what can we do to help them?

893

And so that might be one of the areas.

894

And the same thing, like coming from

the place of like, you know, this is

895

a lot of unprotected pets essentially.

896

and it's our job to advocate so

that they at least know that , the

897

risk that they're taking in, not

coming in for those vaccines.

898

Andy: I hope that that's helpful.

899

I think that there's a lot of

things that we can do here.

900

I think this person's got

their head on straight.

901

, I think that crafting that compelling

why for the team is gonna be really key.

902

And then I think getting

really intentional about.

903

Doing an audit on what are we doing and

what are we not doing that can, yeah.

904

Get new clients, but also that can

really, reengage our current clients and

905

start to start to build out that way.

906

Maria: Yeah,

907

Andy: Maria, thanks

for being here at guys.

908

Thanks for listening everybody.

909

Guys.

910

Thanks again for being here.

911

We'll be back with a regular cone

of Shame episode, , next week.

912

In fact, next week we are bringing back

my good friend, the original anesthesia

913

nerd, Tasha McNerney, and we are talking

about quick sedations in dogs and cats.

914

Boy, super valuable, super useful.

915

, Tasha is so amazing.

916

She just, she just pours knowledge,

pearls out onto the table.

917

Get as many as you can.

918

It's like hungry, hungry hippo over here.

919

I'm just grabbing 'em as fast as I can

and pulling back the know the knowledge

920

pearls and putting 'em into my pocket

so I can take 'em to the clinic.

921

And this is another example

of that in this episode.

922

You guys are gonna love it next week,

, coming out on the regular day and the

923

regular time and I'll see you there.

924

Take care everybody.

925

See you later.

926

I.