Our guest in this episode is Sophia Nicola. Sophia is the Practice Manager at River Valley Animal Hospital.

In this episode, we cover:

• Sophia’s journey into veterinary medicine

• What Sophia’s job role as practice manager involves

• How Sophia engages her team

• And much more!

We apologize to everyone watching for the quality of the recording. We ran into some technical issues that could not be fixed, but we still hope you enjoy the episode!

Thank you so much for listening to this episode! We hope you enjoy it!

Elliott Greenwood:

Welcome back to another episode of Vet Clinic Convos. Today we have our wonderful guest, Sophia Nicola. Did I say that correctly?

Sophia Nicola:

Yes.

Elliott:

Okay, great. Well, Sophia, how are you today?

Sophia:

I'm good, how about you?

Elliott:

I am doing very, very well. Before we kind of deep dive into everything, do you mind giving a little bit of background on yourself and your kind of journey into veterinary medicine?

Sophia:

Yeah, so I live in Roland, Oklahoma now, but I'm originally from Colorado. I moved here in about 2015.

I really honestly did not have any veterinary background prior to moving here. I kind of was your typical, I have no idea what I want to do. Went to a couple classes just to be an assistant and then I did an internship at the... facility that I'm currently employed at now, where I will be honest that we utilize our assistance a lot more than some facilities. So what you learn in your classes you're like just restraining whereas this facility you're placing catheters, pulling blood, you're doing a lot more than they teach you in the classes. So I saw that and I was like oh wow you're a lot more hands-on than I would have ever thought. So that really grasped my knowledge of Not only are you able to be hands-on with the patients and the clients, but you're able to actually see the day-to-day of what they're doing.

And yes, like on an outside perspective, like you're hearing these dogs crying and all this other stuff, but you're not seeing that we're actually helping them. They're just scared. So that really opened up my eyes. And then I've been in the field for about eight years. So I worked my way from very low assistant to the lead assistant, to the lead tech. and then now I'm the manager.

So I've kind of stayed at the same facility and that's the only background I have.

Elliott:

Well, there's nothing wrong with that.

One thing I will say that it's funny that you bring this up, but I think you're going to see a lot more practices in the future utilizing their assistance or their techs more just because whether it's the overall industry-wide staffing shortage or whether it's just the veterinarian shortage itself. I think also I think it not only brings more purpose to the people who are in that position.

Because I think people generally want more responsibility, but they're not always given it. So whenever they get it, I think they actually, more likely than not, beat expectations, then I guess fall short of it. So we were talking about this on an episode I recorded like two weeks ago.

So it's glad to hear that this is the trend going forward. And I see that's probably what got you. to stay is because they trusted you with so much and you got to be more hands on. And you were like, I kind of like this.

Sophia:

I mean, because you see all these people that are doing things and you're like, you know, I hope I get to that point. What did they have to do or how, like, where did they start? Like, did they start like me where I had absolutely no knowledge and then work their way up? Or did they go to school?

Or, you know, kind of just understanding, like, you honestly just have to put your mind to it and show, like, hey, unless I fail, like, please just... assume that I'm going to do amazing and if I need you know adjustments or anything like that I am more willing to accept criticism but you kind of have to have faith and hope for everyone and just give them the best chance that they can in order to prove you right basically.

Elliott:

Yeah, well, I mean, plus, even if you do fail, I mean, you're probably going to learn from it. So I'm very much a proponent of learning from my failures.

So I don't even think that necessarily is a bad thing.

Sophia:

No, not at all.

Elliott:

But kind of touching on what you mentioned, do you want to go into the clinic you specifically work at and talk about kind of something that's unique about just in general, or if there's a specific way that you'll run? your practice that you would say is a little bit different than the average practice. I'd love to hear your thoughts on that.

Sophia:

Yeah, at least I know the average practices around this area. They do as far as I know, because I haven't been to another facility. So if I'm wrong, correct me anybody. But they don't utilize as much as we do. So, I mean, the technicians are going in the rooms and. getting vitals, getting a history.

If the owner's approving diagnostics, they're immediately running those. They're printing out the blood work results and giving it to the doctor. So the doctor is basically going in there, looking at the blood work, diagnosing the pet, prescribing the meds, but we're doing every little thing to that patient. So when they're prescribing injections, we're giving those. Anytime you're doing surgery, they're placing the catheters, they're intubating the patient and monitoring anesthesia. I mean, they're... From the front to the back, they're doing every little thing for that patient.

Whereas I think some facilities, which is not wrong, but the doctors prefer to be more hands-on, which is perfectly fine. But sometimes it can get you tied up with, let's say you are a facility that accepts a bunch of walk-ins and appointments. And if your doctors are more hands-on, then that's time away from seeing these other patients. So. I really like the fact that everyone gets the chance to really connect with the clients and the patients and do it in that aspect. I think that's the one thing I absolutely love about this place.

Elliott:

Yeah, I mean, that sounds great. And I bet it is the case. But part of the benefit of utilizing your staff is it really just allows you to see more pets.

I mean, if you are eliminating the bottleneck of a hands-on doctor, which, again, there's nothing necessarily wrong with that.

But if you allow the other members of the staff to do more, you're basically allowing more pets to get through the doors. And that's, I feel like, one of the biggest inhibitors now is practices are so booked up that it's hard to fit any more pets in. So that sounds like a great way that y'all are utilizing everybody.

So I know we kind of already started going down this path, but I know one of the things that you specifically asked that you wanted to mention is just kind of breaking down the day-to-day of these, I guess, the non-doctor staffs of practices, like the techs and the assistants. Is there anything that you kind of want to break down, whether it's from your experience with managers or just

Sophia:

Right. Exactly. I think just in general, so I always laugh because when I compare it to like when you're at a restaurant and you ask the waitress for like a refo or like a cup of ranch or something that like is so little to you but adds on so much to their plate and then they forget and you know not that it makes your day horrible but you're like dang it you know I really wish I'd have gotten that so it's kind of the same way of like You've got one person that may be running an emergency that walked in and a wellness appointment and all these other things.

And then you've got the owner asking for one more thing, which is fine, but that wasn't acknowledged at the very beginning of the appointment. So it's one more thing that slows you down. And it's just multiple things that they have to, like their brain is just moving so quickly between several different patients and making sure. all the hospitalized patients are taken care of and you've got a critical that comes in and you've got to drop what you're doing to address that, but you can't forget about your patients earlier.

So it truly is just kind of, we have chairs, but we very rarely use them. So it's just constant footwork and constant running back and forth of who needs what, what's more critical, what needs to be assessed first, those kinds of things where it's just. It is nonstop moving.

And so like, when you feel like you've been in the room for a little bit, it's not that we forgot about you in any way, sense or form. It's just something at that time was a little bit more critical. And we do our best to go back in the room and say like, hey, I'm so sorry, I haven't forgotten about you.

We're just addressing something a little bit more time-sensitive right now. 9.5 times out of 10, people are very understanding because they're not here for an emergency. So they're like, oh no, deal with what you have to do.

So it's just that, that it, you know, wait times can be a little extended, but it's, it's just because there are more patients that are true life or death situation that we have to assess at that time.

Elliott:

Yeah, now that makes sense. I know from my perspective, my brain is in a million different directions.

And one of the best ways that I've found, even though it's a very simple solution, is having consistent quality of work comes down to just being organized. Is there something that you do as a manager at your practice to make sure that your team is organized when those things happen, those extra things, like you compare it to just asking for like a refill or something like that.

Sophia:

So there's not anything drastic that I do. It's more just kind of delegating and seeing where everyone's at. Because if you think of like a panic situation, if everyone was to panic, no one's gonna know what to do next.

So when it's super busy and everyone's kind of frantically going about and around not knowing what to do next, I'm that person that's like, what are you working on? Okay, you're waiting for blood work to finish. Is there any way that you can help so-and-so do this so they can keep it moving along?

So it's really just kind of assessing where everyone's at and seeing what they need help with, what they need done. And obviously there's times when I need to step in because everyone else is busy, which is perfectly okay. But it's truly just constantly watching the schedule, see what's here, communicating with owners and communication along the whole client. the whole staff members to make sure everyone's on the same page. And if you're passing appointments to each other, you need to make sure they're aware of everything that's going on with that one. So it's not just kind of you're going in there dumbfounded. So it's really just kind of communication and delegation.

Elliott:

And is there anything else that you might do to just help improve that? Like either like a morning huddle or something like that, or like rounds.

Sophia:

Yeah, so you can. There are honestly a couple things that we've tried that we're just so busy that it kind of... You can follow it to a certain extent and then after that you may have to just break.

So we've tried one technician staying with that doctor specifically, but then you have the ones where if the appointment comes for a different doctor they don't feel like they can get it because if the other appointment gets here for their doctor. So we've tried a couple things where it's like, hey, we've got a fully booked appointment or... fully booked schedule, what are some things we can do?

We have assigned certain responsibilities to certain people. So like one is gonna be handling appointments that don't require a doctor. One is gonna be handling anything that's potentially contagious. One's gonna be handling surgery and the other one's kind of just a floater to see rooms, cleanups, stuff like that.

So that has helped tremendously. I do think that's a good. I wouldn't say quality, but a good aspect to have in that sense of just assigning the duties and say, hey, it may not always be like this today, but this is your main priority.

Elliott:

Yeah, now that makes sense. And it sounds like you've brought a very experimental approach to what works and what doesn't.

So pivoting things a little bit, I'm curious if you can break down one or two of the major problems that you kind of experience at your practice, and what is the just best way that you have gone about tackling those problems.

And I know you've touched on some of those already, but I don't know if there's you just happen to have a different answer or different topic you want to talk about.

Sophia:

I think the biggest thing is because we have a fully booked schedule and we see walk-ins, it can get crazy sometimes to where you're seeing like seven or eight walk-ins on top of your fully booked schedule.

So communication tends to lack when that happens and you can tell that people get very frustrated because they're not communicating with each other and they're not saying, I'm going to do this and then they're wondering where that person is. So that's where the delegation comes in of just, I mean, saying like, hey, who has this or who's getting this one? That and then honestly just telling everyone like to take a breath. Because yes, you want to be fast and efficient and quick and you want to get them in and out but the faster you are, the more mistakes you're going to make. So we kind of just say, okay, what are you doing right now? And they're like, oh, I'm just waiting on this.

So take a breath. This is what needs to be grabbed. Do you need any help with this? Do you have too many things on your plate that you would prefer from when else grab this? And unfortunately, when they have this kind of like tunnel vision of getting all the appointments, they're not going to say that to each other.

So that's where your lead person comes in or even your manager or even your doctor and just saying like, you know, what can I help you with? What do you feel overwhelmed with or stressed with? And I would say that just communication can go both ways in the sense of like, It's really, really good, but then when it doesn't happen, it can get really bad.

Elliott:

Yeah, now that definitely makes sense. And it seems that communication is, while I obviously agree that it's extremely important, it sounds like it's the number one driver at the practice that you're at.

Sophia:

I would agree.

Elliott:

So switching to a little bit more on your background again. So if you had to start everything over with what you know now, is there anything that you would do differently?

Sophia:

Honestly, no.

I mean, I was the type of person that was asking every question because, one, I wanted to know more about why we're doing what we're doing because you have to understand that we do this every day.

So a question that we think is just so silly like, oh, what do I do to help keep ticks off my dog? That's silly to us, but from someone who has no idea what to do for their pet that is, quote unquote, their child. then it's not a silly question to them. It's something that is very drastic and very big to them.

So I asked every single question I needed or wanted to learn. You honestly have to understand that when people or clients are being snarky or may not have a very happy-go-lucky attitude, nine times out of 10, they're just nervous and scared. So you have to approach it of like, do you have any questions?

What can I help you with? What's going on? They don't mean it in any way, sense or form of they think they know better than you, they don't know. And they want you to give them all the answers.

So you have to know the majority of the answers and the doctor will finish the rest, but you have to help educate them to know why we're doing what we're doing to their pet and why we're recommending these things to them.

So I've always say, ask as many questions as you need and you ask them as many times as you need to in order to fully understand it.

Elliott:

Yeah, no, I completely agree with that. Mainly, it goes back to my struggled focus. So sometimes I need to just hear things multiple times. So I'm not afraid to ask questions more than once.

But I think it's interesting that you touched on something that I only have recently realized how big of a deal it is, and that's pet owner anxiety. thought that people would be more anxious for like their own, I guess, medical appointments.

But I'm now realizing when thinking about it in a different light. But it's not like if your friend or sibling has a medical issue, you can't like ask them what's wrong and then base it on your own. personal, like unless you have a veterinary medical background, you have almost absolutely no idea what's going on.

So being that extra level of being in the dark, I'm, I guess I've never thought about it. I mean, I've had a pet my entire life, but yeah, like that's, that's a big deal that I feel like isn't talked about enough is that, especially for a lot of people in the veterinary industry, they're so used to their bubble of the industry that they forget sometimes that, hey, most people have no idea what's going on. So there's a reason they're either hesitant or what have you.

So I love to hear that you're approaching it from that perspective.

Sophia:

Right. Yeah. I mean even speaking from my own personal, so when I moved here, I got a, I adopted a pet from the shelter. This was before I worked anywhere. And they were like, here are all of his vaccines. He needs to do this. He needs to do that. And I was like, holy crap, I thought it was just going to be as easy as adopting this pet and I wouldn't have to do a single thing for the next 10 years. No, that's not the case.

So when people are not educated, I don't, and I personally don't think that anyone should be angry at them because can you like, this is what I always ask like my employees, like can you remember a time when you weren't in the veterinary field and you didn't know these things and you learned it on the job?

They don't have learning on the job experience. They have us to educate them.

So we need to do our best to understand that they're not speaking from a like, oh, these animals don't need these types of things, but more of they had no idea about it prior to us telling them.

Elliott:

Yeah, now that's a great point. And it reminds me of something that I try and live by, which is the kind of get out of the ivory tower and get on the front lines, because that's the best way you're ever going to learn anything.

Not everybody knows the whole industry and has industry experience, so the best way that you can really understand somebody is to be in as close of a perspective as they are in.

Well, with that being said, I also wanted to touch on, I mean, you just brought up client education.

I don't know what else you planned on discussing in the section or in the topic of emergency medicine. But I am curious to hear what your thoughts are on how much of emergencies can actually be either mitigated or minimized period by just proper client education for pet owners.

Sophia:

I mean, a lot of our emergencies that we see are things that they, there's really no true prevention that they could have done.

Like it would have been like a dog jumped in their yard and attacked their dog. They had a yard. Their dog was in their backyard and a snake bit him. I mean, there are little things like, you know, you can... look through your yard every day, but realistically, how many people are gonna do that every single day?

Unfortunately, things just happen. I mean, you have the cases that dogs got hit by a car, but was it in a fenced yard and it just jumped over the fence?

So the ones that are kind of preventable are like being on heartworm prevention and flea and tick prevention year-round because when they have heartworms, they can throw an embolism. which could be fatal.

So that is something that being on prevention could prevent. But a lot of the true emergencies are just...

Elliott:

Okay. Yeah, I mean, I get that. I know some people think they can feed their dogs anything. And that's part of what I meant. I didn't know if being like, yeah, don't give them this, don't do this, like, okay. Or if it was just like actual I mean, injuries,

Sophia:

I see what you're saying.

Oh, there are some where people, you know, you ask them, have you fed him any table scraps and they're like, oh, I just feed him, you know, something every now and then. They should not have any human food whatsoever.

The only things that are okay are like boiled chicken and white rice. And that is with no seasoning, no additives. I mean, that is just plain. That is really the only thing they can have that's not going to And even then, if they're allergic to chicken, yes, that's going to create a whole other issue, but their body can't process it like we can.

So then they get pancreatitis where their pancreas flares up and they get all these other issues that could have been prevented by you not doing that.

Elliott:

Yeah, that makes sense. Um, I know you have to run soon, so I guess one of the, I'd like to give the floor to you before we close this out. Is there anything you want to touch on? Anything you want to say?

Sophia:

Not entirely. I mean, I know, and this is, I guess, to the veterinary in general and people, but it definitely gets hard. I mean, burnout is a thing. You just have to realize, like, no one else is going to do what you're doing.

No one else is going to have the same passion as you. So, even if you think you're doing something so small, I mean, you're changing someone's... life because like I said people who do not have kids think of their dogs as in cats as kids so that is something so drastic and so big to them um but even if they're not saying thank you I mean it's just something so small that people don't realize and I think it just needs to go around that we're all trying to do the same job we're all trying to help people and help their animals and can't be mean you can't be rude about it because at the end of the day everyone needs help and everyone's trying to do the same job.

Elliott:

I completely agree. It's a very good point that just because somebody doesn't say thank you doesn't mean they're not appreciative of the work. But Sophia, I appreciate you coming on. I appreciate your insight.

For more info on the episode, see the sources below.

• https://www.linkedin.com/in/sophia-nicola-161317271/

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