Discharge Notes columnist Dr. Andy Roark is a practicing veterinarian, international speaker and author. He founded the Uncharted Veterinary Conference. His Facebook page, podcast, website and YouTube show reach millions of people every month. Dr. Roark is a three-time winner of the NAVC Practice Management Speaker of the Year Award. Learn more at drandyroark.comRead Articles Written by Andy Roark
Jessica wonders if she’s a “real vet” because she works only one day a week in the clinic, seeing 15 appointments. Amari stresses about starting practice after graduation from veterinary school because his GPA puts him in the bottom half of his class. Michelle gets angry whenever someone she hasn’t seen since high school texts her for pet advice. (She feels obligated to answer.) Erica believes she is unappreciated by her employer because all management wants to discuss with her is how her average client transaction could be higher.
Those anecdotes might sound like a pile of different problems, but they’re all basically the same at their core. I call those struggles “ruler selection problems” because each is rooted in the challenge of deciding how we measure ourselves and what is important.
Veterinarians are notorious data wonks. As a group, we’re constantly on the lookout for test results. We want to know what the numbers say and where they fall on a scoreboard, reference range or grade scale. We question whether the numbers make us worthy of a pat on the head, will impress our fellow doctors or are “exceptional.”
I think we come by this desire honestly. Numbers, after all, carry inherent weight. They are straightforward, precise and feel quite objective. If we take an examination and answer 49 out of 50 questions correctly, we have tangible evidence that we know the material and can move on to the next subject. If an appraiser tells us our practice is worth $5 million, we can sleep soundly with numerical support for the idea that we run a highly successful business. If a patient’s HCT is 12%, we have a clear green light to take aggressive medical action.
The problem with numbers is that some are vital, some are meaningless and most fall somewhere in between. We also struggle to know which ones go where. Numbers also mean different things to different people. Just because someone tells you a number is critically important, or critically important to them, doesn’t necessarily mean it’s true for you. If you’ve ever spent time with someone obsessed with the number of Instagram likes their last post received, you know what I mean.
Picking Our Rulers
I once read a story of a young man who got a summer internship at a car manufacturing plant. The point of the internship, it seems, was for interns to simply spend time on the factory floor among the line workers, moving from station to station. Intern performance was thus measured with a pedometer.
At the end of each day, the interns turned in their pedometers and step counts were recorded. After a few weeks, it became known that 10,000 was the minimum daily steps that would keep you in the program. Achieving 15,000 would get you a letter of recommendation at the end of the summer, and 20,000 would get you a full-time job when you graduated.
Well, it didn’t take long for an industrious intern to realize that if he put his pedometer on top of a specific piece of vibrating machinery, he could run his step count quickly to whatever number he wanted. The shortcut would free him to goof off for the rest of the day. As an aspiring entrepreneur, he also saw an opportunity to offer the service to the other interns at an affordable price.
The plan went swimmingly for several weeks until the intern running the side program got called away from the pedometers sitting on the machine. At the end of the day, multiple interns turned in step counts in the six-figure range, and the entire enterprise collapsed.
I love the story because it highlights the dangers of choosing the measurements we focus on. Steps around a factory don’t measure leadership or compassion, but they were concrete and easy to count, so they were considered important.
Some of the most significant challenges veterinarians face are tied up in the measurements we choose to use. They are the rulers we hold up to our lives and careers to generate the numbers we believe will tell us how we are doing. The problem is that veterinarians have a terrible habit of simply accepting rulers handed to us. We’re like managers who are told the interns are doing great because of their pedometer step counts. And we believe it.
When we consider where the rulers we seem most likely to use come from, I think there are three obvious places.
The Ruler of Academic Excellence
Think about the metrics presented as “keys to success” before we become veterinarians. They’re measurements like grade-point average, SAT scores, class rank, resume-worthy extracurricular participation, and hours spent in and around veterinary clinics.
I’m not saying any of those rulers are unimportant in measuring our ability to practice medicine. The problem is that they, like the pedometers, do not directly capture our abilities to make a meaningful impact. Also, we’re measured by these specific metrics for so long and in such a critical way that many of us assume value in them far beyond what is warranted. We keep using (or searching for) rulers that feel like those scholarly metrics long after our academic careers are over.
Consider the best veterinarians with whom you have ever worked. Do you know their SAT score, class rank or GPA? Do you know how they score on their online CE tests? Does it matter to you whether they did an internship? I’m guessing your answer to those questions is no.
At the same time, I suspect that many who read this are still looking for a test to take or a certificate to achieve that will make them feel successful. They’re seeking the grade at the top of the test to tell them their work is paying off. That ruler has outlived its usefulness, yet many of us continue to try to apply it to our lives.
The Ruler of Key Performance Indicators
Some of the more business-inclined (or business-trapped) veterinarians have come to realize that key performance indicators feel a lot like the measurements of academic performance we’re used to. Statistics like average client transactions, number of transactions, number of appointments, customer satisfaction score and net promoter score are clear and precise and make fancy stand-ins for pedometers.
As a business consultant, I fully understand the importance of metrics in running a profitable and efficient hospital. I know the measurements are key in giving people clear feedback on how they’re doing in areas vital for hospital success and viability. Such excellent tools help people recognize their weaknesses relative to other employees, and they motivate personal improvement.
At the same time, they should not be the only rulers we use to measure our worth as professionals or our impact on pets, our coworkers or our community. Unfortunately, many of us receive messages that these are the only values that matter, or we simply assume that’s the case.
When we pick up KPIs as the exclusive tool for measuring our careers, we send ourselves down a path devoid of the heart and humanity that make our profession special. We’re not widget salesmen, nor are we robots turning out doodads. To measure ourselves using only numbers that drive revenue generation is to tie our view of ourselves to an outcome that most of us do not find entirely motivating.
The Ruler of Self-Worth
The last of the rulers I see veterinarians commonly picking up is the ruler of self-worth.
I recently went down a philosophical rabbit hole of thinking about what makes someone or something worthy of love. Must basic requirements be met for someone to be worth caring about What are the minimum standards?
The best answer I found to what makes someone worthy of love is this: Love, by definition, doesn’t come with strings attached. If it does, then it’s not love. Therefore, asking what makes someone worthy of love shows a lack of understanding of what love is.
I think that is an essential concept to put forward here because so many of us were raised with the idea that we must provide value to others in some way. A good number of us think we must show up and perform every single day. I am certain I’m not the only person who has felt an obligation to achieve so that I can feel good about myself and worthy of the respect, consideration or love of others.
How many of us secretly wonder whether we worked hard enough today, sacrificed enough or were smart enough to feel good about ourselves? We wonder if we are worthy, and we seek rulers and measurements to give us the answer.
When we choose to give our attention to our work instead of our family, is it because we want to pick up that extra shift or because the sacrifice is how we measure ourselves? When a friend you haven’t seen in 10 years texts for pet advice, do you stop what you are doing and respond because you derive satisfaction from helping or because you feel you must continually earn your place in the world?
Choosing Rulers Wisely
Writing about how we measure ourselves is always dicey because people might think you’re telling them that what they care deeply about (or believe they care about) is unimportant. I certainly don’t want to do that here. I do, however, want to stress that it’s easy to get caught up in the misconception that fairly arbitrary metrics determine the quality of our lives and careers.
If you think you might measure your life in a way that doesn’t reflect where you’re trying to go or who you’re trying to be, I invite you to step back for a moment. You don’t have to dump rulers that have served you well or that you know others will use to measure your performance. You can, however, decide to hold the rulers looser and add others more representative of what you believe is truly important
Maybe it’s time to track how many really good things happen to you each day, how many times you laugh or how many people you help. Perhaps you’d get some healthy perspective to log your hours doing a hobby, count your dates with your significant other or collect the ticket stubs from events you attend.
Regardless of the rulers you choose to apply to your life, make sure they make sense. Be certain you’re not the executive at the factory who accepts that putting pedometers on interns tells an important story. Remember that you don’t have to prove yourself worthy every single day by providing value that others can see or measure.