I was driving home from a clinic earlier this week and heard on the radio that unemployment had reached an all-time low of about 3.7% nationally. The AVMA has confirmed that it’s even lower in veterinary medicine at around 1.6%. This means that most people who want to be employed, are. To most of us who own or manage practices, this means that it’s increasingly more difficult to find good team members. Couple that with our industry’s turnover rate of nearly 30% across all positions, and we’ve got a problem our industry’s mantra of “hiring fast and firing slow” only exasperates.
The value of getting team buy-in
I’ve blogged in the past about the value of team buy-in. I’ve witnessed first-hand, in both my own hospitals and those of clients, the positive impact a “bought-in” team has on medicine, culture, client experience and profitability.
When themes like “empowerment” and “engagement” became the stuff of industry publications and conferences, I applied them in my practices and sure enough, I noticed a positive difference. In hospitals where team members never had a voice, where they didn’t feel empowered and engaged, taking that first step was a monumental leap toward gaining team buy-in. Once we had that buy-in, it was up to us as owners and managers to funnel it into productivity, better patient care and reduced turnover.
Getting team buy-in isn’t always so simple
But what happens when it’s not that easy? What happens when we try to empower and engage our team, but it doesn’t take? Just the other day, I spoke with two veterinarians who own a hospital together and they’d been trying to get the team onboard for seven years. They’ve thrown incentive plans at the problem. They’ve offered better benefits. They’ve flung money at the problem, but it hasn’t stuck. What now?
[bctt tweet=”Massive survey shows basic needs must be met before employees will buy in”]
One of my team members recently recommended a new book, First, Break All the Rules. What follows is not necessarily a plug for the book as much as it is the summary of my “lightbulb moment” put into practice. Gallup, the authoring party, surveyed 1,000,000 employees from a wide range of industries and interviewed 80,000 managers for this book. From this research, they built a yardstick featuring twelve specific statements , to gauge the “strength” of a workplace and the impact on productivity, loyalty and profitability. Of the twelve statements—which can be found by Googling the book—I want to focus on the six that have the most impact on business outcomes, including turnover.
Survey participants were asked to assess to what extent they agreed or disagreed with the following statements:
- I know what is expected of me at work.
- I have the materials and equipment I need to do my job right.
- At work, I have the opportunity to do what I do best every day.
- In the last seven days, I have received recognition and praise for doing good work.
- My supervisor, or someone at work, seems to care about me as a person.
- There is someone at work who encourages my development.
As I read through these statements, I suddenly realized that they’re much like Maslow’s Hierarchy of needs, in a business setting. We— or at least I—get excited about the power of a Ted Talk like Simon Sinek’s “Start with Why,” which has been popular (and rightfully so) in trade publications and on the speaking circuit. We get caught up in these inspiring talks and leadership books and run into our hospitals eager to work with the team to develop the lofty mission and vision we’re all “supposed” to have. Unfortunately, for many hospitals the endeavor to create their mission is like walking into a new patient appointment, handing this first-time pet owner a six-month supply of Trifexis and expecting them to just buy in with hardly a word spoken. We’re asking for ultimate trust, without ensuring the most basic workplace or exam room needs are being met.
The book argues, and then demonstrates with lots of data, that a business’s productivity, profitability and loyalty are linked to how employees score themselves on these six statements. Across all types of industries and all sizes of businesses globally, organizations where employees selected a score of 1 or 2, versus a score of 5 for “strongly agree”, consistently underperformed higher scoring organizations.
Putting the theory to the test
I decided this was interesting enough to try so I rolled the dice first at one of my brand-new hospitals, and then expanded it to several consulting clients’ hospitals. The results were eye-opening and here is my lightbulb moment. [bctt tweet=”Whether you’re a new practice owner hoping to charge in and rally the troops behind a common mission or you’ve been in ownership for decades and just can’t break the turnover cycle, our first mission is to make sure basic needs are being met.”] It’s hard for staff to buy in and get excited about a new service or product or challenge if they don’t even understand what’s expected of them on a daily basis. It’s unrealistic to expect a veterinary nurse to jump on board with promoting geriatric bloodwork if she doesn’t even have the tools needed to do her job day in and day out. We’re setting the team up for failure if we expect them to rally behind us during a slow month if they don’t feel genuinely appreciated when they come to work.
The concept is simple and if you look at most of the hospitals that are excelling, (clients are coming through the door, the staff are smiling and welcoming, and there’s profit left over at the end of the day) you’ll often notice that the owners and managers have uncovered this secret. What’s more, and this really got me thinking, this massive survey came up with what it emphatically states is an indisputable point. The data, all that data, “… tells us that people leave managers, not companies.” The book argues that productive, profitable organizations with low turnover succeed regardless of whether they do or don’t have the latest incentive plan, (not that incentives are bad) or whether they do or don’t offer certain benefits, but because they have leaders who have created environments where team members overwhelmingly respond to these six basic statements with 4s and 5s.
We need to buy into our teams before they will buy in to us
What’s the take away? Our teams won’t buy in until we’ve bought into them. In the case of the hospital I just mentioned, we came in with “guns a-blazing” excited to build the new culture the team had been asking for and create that guiding mission statement. Then, after it didn’t stick, we slowed down and administered a self-evaluation tool to confidentially assess their take on these six statements. What we found, and I’ve since found many times over, was that the team wasn’t ready to buy in because we hadn’t addressed their most basic needs. They needed clear expectations. They craved the tools and resources to help them perform their job at a level they could be proud of. They wanted to know they were appreciated. As owners or managers, we have to fulfill these basic needs first. There is an abundance of thorough, well-written blogs on the VetSuccess site detailing the cost of turnover, highlighting the benefits of a productive team and spelling out why profitably matters. The research and data exist, now it’s up to us to be the owners and managers our teams need us to be, in order to take our hospitals to new heights.
Stith Keiser is the Chief Executive Officer for Blue Heron Consulting. He and his team of veterinarians, hospital owners and managers coach new and seasoned practice owners alike to improve their lives and the lives of their team members while simultaneously enhancing client experience, building sustainable practice profitability and elevating the quality of care for pets. You can reach Stith at [email protected].
 Accessed 12.17.18: https://ycharts.com/indicators/unemployment_rate
 The Market For Veterinarians. Hansen, Charlotte. 10/23/18
 Tackling Turnover. DVM360. Accessed 12.17.18: http://veterinarynews.dvm360.com/tackling-turnover
 First, Break All the Rules. Gallup, Foreword by Jim Harter, Ph.D. 2016. Gallup, Inc.