Nobody needs "rage meetings"

Photo courtesy of Melissa Tompkins, BS, CVPM

At a recent Fetch dvm360 session in San Diego, Bash Halow, LVT, CVPM, presented the following fictional case to attendees: Mr. and Mrs. Ramirez and their 8-year-old daughter come into a veterinary practice with a Rottweiler mix showing parvo-like symptoms. Mom and Dad speak Spanish, and the girl needs to translate between her parents, Dr. Logan and the veterinary team.

"At the end of the conversation, the Ramirezes decline all services," reads the handout that small groups looked over and discussed in Halow's session. "When the little girl tries to explain that her mother and father are going to take the puppy home, she nearly chokes on the words."

After they leave, veterinary associate Dr. Logan leaves the appointment to cry in her office. She then does late-night and early-morning research to find a local nonprofit to help pay the bills for the dog.

When she's ready to call the clients with then good news, she's shocked to discover the parents didn't fill out the forms (they were in English), and no one dug deeper to get contact information since they weren't going to go further with treatment.

Dr. Logan goes off on the client service representatives and technicians the next day. And at the next team meeting, she finds team members pointing fingers back and forth.

"What's Dr. Logan's speech bubble?" asked Halow of his session attendees. Why did she call the meeting, what did she hope to accomplish, and did she get anything done? Here are comments and advice from Halow and his students.

What happened?

"The doctor just wanted a 'rage meeting,'" said one attendee in the session. Nobody was accomplishing anything, "they just wanted someone to flog," continued Halow.

Why make it an all-hands meeting? Sure, if you've got a new protocol to share with the team, great, but including those involved and uninvolved in the particular situation breeds shame.

How do we fix it?

Is there a protocol that needs to change? Is this more than "one person making one mistake?" asked an attendee.

If so, said another attendee, you need crosschecks: "What the receptionist misses, the technician picks up. What the technician misses, the doctor picks up."

Another attendee said veterinary practices could use an approach from the aviation world, "self-divulgence," where people feel free to admit their mistakes and help find solutions. It starts with the top-the veterinarian admitting his or her own mistakes publicly-so team members down the line can admit mistakes early and help fix them.

Maybe the best solution would be to empower team members over time to learn problem-solving skills. "When you have staff who can see problems and help solve them, fewer balls get dropped in the veterinary hospital," an attendee said.

How do meetings not suck?

The failure of the meeting, of course, might be because meetings at the fictional veterinary practice are places where team members hear about their mistakes and new protocols are built out of failures, not successes. You can change that, said one practice manager who creates new policies and protocols out of successes at the practice.

An important lesson, Halow said, is to remember this truth: "We're involved in medical work, and mistakes happen."

"Know thyself," urged Halow of his attendees. Remember the problem might be you.

"Take a hard look at how you're contributing to the problem," he said. Ask trusted friends for an unvarnished view of why your leadership might be lacking. Try a journaling meeting to find solutions-gather the team, write for 20 minutes in the morning, and talk about ways to improve flow and process.

Finger-pointing can be satisfying when everyone's looking for a scapegoat for their anger, embarrassment and frustration. But good practices and protocols aren't built on blame.