• NAVC Brands
Community, Leadership

The Four P’s of Positive Leadership

Learn to create an environment in which people motivate themselves enthusiastically.

The Four P’s of Positive Leadership
Everyone in the veterinary profession deserves better. Positive leadership is the catalyst to get us there.

Her tears — and the pain and distress behind them — stung somewhere deep in my heart. It was the early years of my veterinary adventure, and I was a trained-off-the-streets technician with little more than two years of experience. I was leaning against the wall in the corner of the clinic’s exam room as the doctor, our chief medical officer, reviewed a cat’s condition with the young woman standing before him. She couldn’t have been more than 18 or 19 years old, a student at the large university in our city. The love she shared with her cat was palpable. Having moved away from home for the first time, she sought companionship at the local humane society.

That is how Graybeard entered her life. He was a middle-aged cat with a soft demeanor and long, wavy hair that made him appear twice his actual weight. Yet, he was more than a pet to her. He was a source of strength and courage in a chapter of her life when she needed those qualities.

So, when Graybeard stopped using one of his back legs, she was nearly frantic to get him the help he needed. That’s what friends do.

After the diagnostics, the doctor’s explanation must have felt ominous to her. Graybeard needed hip surgery, and having a specialist perform the procedure likely would cost thousands of dollars. She muttered, “I just can’t afford that,” and broke down as her boyfriend put his arm around her, helplessness filling his eyes. The veterinarian sank a bit and then stood up tall and said, “Well, maybe I can help.”

He explained his interest in growing his orthopedic surgical skills and was transparent about the status of those abilities. That is, he had never done the procedure.

“I’ll tell you what,” he said, “so long as you understand that this will be my first time doing this surgery and that I am not a specialist, if you let us keep Graybeard until tomorrow, I’ll do my best to fix his hip for $200.”

In an instant, the air in the room shifted and warmed. Graybeard’s owner lit up and eagerly agreed.

Safe, Needed, Empowered, Connected

The surgery schedule was packed, so we decided to help Graybeard after-hours. I went home for dinner. I returned to find the doctor nose-deep in a medical text, reading through the details of the surgery we were about to perform. He looked up and explained all he had done to prepare. Then he asked, “What am I missing, Josh?”

Thinking about the sterile environment of the operating room, I imagined a scenario in which we’d need to refer to the textbook and, being thoroughly scrubbed in, how unfeasible that action would be.

“Why don’t we make photocopies of this chapter in the textbook and tape it up in the OR?” That’s what we did.

During the procedure, I noticed the doctor doing something different from what I had seen in the text, so I spoke up. He paused, considered the situation and then chuckled.

“Oh, yeah, this is how I’d do it for a dog, not a cat. Thanks, Josh!”

At one point, as I monitored the patient’s vitals and followed along on the procedure, he stopped and asked how I was doing and what I needed.

Afterward, we recovered Graybeard together and made sure he was comfortable and cozy in his kennel. We waited long enough to give him a small meal, and then I left for home, the doctor still sitting in treatment alongside our patient.

The next morning, I came into work to an elated veterinarian. “Come look, Josh!” Though gingerly and at a slow pace, Graybeard was walking on his newly repaired leg. “You helped with this, Josh. It’s as much your win as mine. And the impact this is going to have on that college kid and her boyfriend. … Well, that’s why we do what we do, right?”

Positive Leadership

Veterinary leaders almost universally share a worthy mission. They seek to energize their teams and help everybody find the fulfillment they deserve in their work. However, the problem as I see it is that we rarely receive the training we need to learn, master and embody our leadership skills.

Do not be fooled — leadership is not a personality trait we are born with or without. Instead, leadership is a set of skills, behaviors and actions we can acquire. Positive leadership, from my perspective, is a special kind of approach we need in the veterinary profession.

You all know the statistics about our community’s well-being challenges, so I won’t regurgitate them here. Everyone in this profession deserves better. We deserve to be sustainably fulfilled in and by our work, not depleted by it. Positive leadership is the catalyst to get us there.

As a leadership consultant and coach, I am routinely asked, “How do I motivate my people?” Besides the fact that they aren’t your people, I don’t think that is really the question for which leaders seek answers.

Screaming can motivate people. Throwing large solid objects might work as well. Threatening employees with punishment — even termination — might get their engines started. But none of those tactics motivate people in a sustainable, energetic way.

What leaders really want to know is how to instill energetic enthusiasm in the teams around them.

Drs. Richard Ryan and Edward Deci have spent decades researching human motivation. In particular, they’re interested in the motivation that elicits what psychologists call “subjective vitality.”

So, imagine a kid who spent the night tossing and turning, unable to sleep in anticipation of what Santa’s bringing this year. She dozes off at 4 a.m. Then, an hour later, her brother shakes her awake. Physically, she is exhausted, but the moment she realizes it’s Christmas morning, her body comes alive, and she bolts down the stairs to the waiting pile of holiday joy.

That is what subjective vitality feels like. We all have the capacity to experience it, even in the face of physical exhaustion.

The research of Drs. Ryan and Deci shows that when people have a meaningful sense of control over their activities, experience some level of connectedness and can relate the activity to a contribution or connection, and enjoy the level of competence and resources needed to take on the task, they tend to internalize motivation.

Positive leaders don’t motivate people. Instead, they create an environment in which people are far more likely to motivate themselves enthusiastically. The science suggests that positive leaders do this by ensuring that four qualities are nurtured in the work environment: psychological safety, purpose, path and progress.

You might think of these as the 4 P’s of positive leadership.

1. Psychological Safety

We have all experienced this in different ways. Maybe it was while assisting a veterinarian in an exam room. She suggested the wrong nutritional supplement, but you didn’t say anything. Or it was the idea you had to improve the efficiency of your hospital’s curbside appointment program but kept it to yourself. Or the time you didn’t understand the policy the practice manager was explaining during the all-staff meeting, but you didn’t ask questions because everyone else seemed to get it.

All those scenarios are an indication of low psychological safety in the team.

Dr. Amy Edmondson, a professor at Harvard Business School and a research champion of psychological safety, defines it as, “A belief within a team that one will not be punished or humiliated for speaking up with ideas, questions, concerns or mistakes.”

When psychological safety is present at high levels, teams learn more, innovate more and produce more. Teams with high psychological safety are more efficient and effective, have significantly lower turnover, are more resilient and tend to thrive.

The problem is that psychological safety is not the natural state of affairs for a work team. My research suggests that as many as 75% of veterinary teams have room for growth in their psychological safety. The good news is it can be cultivated and nurtured, and leaders have an incredible amount of influence over this.

When we were working on Graybeard and I shared my concern about the doctor’s approach in midsurgery, that was what psychologists call interpersonal risk. He could have responded defensively or dismissed my comment. He could have told me to “Stay in your lane.” Instead, in a genuine effort to be sure he was getting things right instead of feeding the need to be right, he paused and considered my comments. He responded by thanking me for speaking up.

That is how leaders cultivate psychological safety.

2. Purpose

People do not like being pushed around. When we feel pushed, our motivation tends to drive us to push back. That is why externalized forms of motivation don’t get the kind of results that leaders strive for. Sure, things like bonuses, raises, fringe benefits and promotions are important. The problem arises when these are the only sources of motivation. Being pushed toward something has diminishing returns.

Feeling pulled toward something, though, tends to be energizing, even life-giving.

Purpose — in particular the experiencing of mattering and meaningfulness — is a pulling force. It lights us up with warmth and energy, and it motivates us to do more as we strive toward the best version of ourselves.

One part of occupational burnout is the experience of depersonalization. It’s the sense of utter detachment from everything to do with work, the exhaustion that comes from a sense that nothing we do really matters. This is anti-mattering and anti-meaningfulness.

On the flip side, when we feel as if we matter and what we do matters, we tend to think that our efforts are positive, purposeful and impactful. It’s almost impossible for human beings to feel anything but alive and energized under those conditions.

The next day, when the doctor told me, “You helped do this, Josh,” what he was saying was that when it came to Graybeard, I mattered, my efforts mattered, and the results of those efforts were positive, purposeful and impactful. That is why, over 20 years later, the experience is vivid in my mind and heart.

Every day in a veterinary hospital, people who matter are doing things that matter. Purposeful leaders find ways to consistently show their teams the meaningfulness of what is already there. When they do, they improve workplace engagement and job satisfaction. In fact, the experience of purpose at work tends to be one of the top predictors of overall job satisfaction.

3. Path

My next statement might feel a bit controversial, though I’d argue it shouldn’t. Here it is:

In my 20-plus-year journey through veterinary medicine, psychology and leadership, I’ve come to believe that the vast majority of veterinary team members — I’m talking 99.999% — want to do the best they can in the work they do. They are naturally driven, compassionate, caring people who take pride in their jobs and the lives they impact.

So, why do so many leaders find their teams disengaged and demotivated? Because when the path to success is broken, it’s unfair to expect the success of the traveler.

Three ingredients are necessary to unleash the best parts of who we are on our journey to accomplishing the best we can. They are role clarity, autonomy, and resources.

That means:

  • We must have a clear understanding of what is expected of us.
  • We must have a meaningful sense of control over how we achieve those expectations so that we feel energized to get there.
  • We must have the resources we need to succeed, both tangible and intangible.

Positive leaders take action, routinely and with intention, to provide as clear a path as possible for their teams. They then entrust and empower their teams to get there and are prepared to support the efforts with whatever resources are needed.

Before Graybeard’s surgery, the doctor gave me time to read the textbook’s explanation of the hip procedure. Certainly, I would not perform any of it, but he wanted me to understand everything. He then asked me what I needed to best support him and feel a part of things. Those relatively innocuous gestures left me feeling as if I was a meaningful part of the team, a critical component in succeeding in our shared goal.

4. Progress

Humans are built for connection. Neuroscience research shows that when we feel disconnected or excluded from the people around us, our brain perceives that in the same way it experiences physical pain.

All business — including the business of veterinary medicine — is first and foremost a human endeavor. So, connection in the workplace is critically important.

Some research suggests that the connection we share with our leaders affects both our work and life satisfaction. In fact, as much as 40% of work satisfaction is predicted by the quality of the relationships in that job, especially with our manager. And 25% of life satisfaction is predicted by our sense of work satisfaction. Not to mention that some research suggests how teams perceive the quality of their organizations’ leadership strongly predicts long-term profitability.

What most contributes to a higher perceived quality of leadership is a team’s belief that its leaders care about them as people. Positive leaders authentically connect with and support the people on their teams. They are dedicated to team members’ personal and professional success and show it by providing genuine, routine feedback when folks do well and when they fall short.

After Graybeard went home, the veterinarian took me aside for a debrief. He genuinely thanked me for my support, my learning the details of the procedure, my suggestion to tape the copied textbook pages onto the OR walls, and the courage I showed to call him out on the mistaken step.

He also pointed out how my enthusiasm for helping got the best of me at times during the surgery and was a bit of a distraction. Then he hugged me and said, “I don’t think I would have had the confidence to do this so well without your help, Josh.”

When Graybeard’s owner came to pick him up, we set the cat on the ground to show his progress. He just about ran to her. The joy in her face was palpable and made my skin tingle.

At that moment, I knew we had done something meaningful. I was so jazzed to see what the rest of the day would bring.

Josh Vaisman is the co-founder of Flourish Veterinary Consulting, where he is a positive psychology practitioner and a positive leadership and culture consultant. He combines more than 20 years of veterinary experience and a master’s degree in applied positive psychology and coaching psychology to empower veterinary organizations in cultivating environments where employees thrive. He is a certified compassion fatigue professional.


Another thing I’ve learned about the veterinary profession is something I’ll carry with me for the rest of my life. It’s this: The vast majority of veterinary leaders are good people doing the best they can with what they have to care for the people on their teams.

However, it’s not enough to want to energize a team. You must show that you care. It takes action. Here’s a simple way to get started:

  • Write down the four P’s of positive leadership: psychological safety, purpose, path and progress.
  • Think about which one is your greatest strength as a leader. Which one do you most support in your team through consistent action?
  • Write down one way your actions most support your greatest strength. Then, how can you perform it just 10% more often?
  • Think about which of the four P’s is your best area for growth. Which one could you do more often to support your team through consistent action?
  • Write down one way you could use action to better support such growth. What can you do to boost your positive leadership in that pillar by just 10%?