The GeniusVets Show - Garth Jordan

Garth Jordan discusses new game-changing technology and practice strengthening programs from AAHA.

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Hello everybody. Thank you so much for taking some time out of your busy day to join us here today on the GeniusVets Show. I'm your host, David Hall, co-founder of GeniusVets, and today, I have the distinct pleasure of welcoming a guest who is certainly one of the titans of the veterinary industry, overseeing one of the most influential organizations in setting the standards of excellence that all veterinary hospitals are encouraged to strive toward. Of course, I'm talking about the CEO of the American Animal Hospital Association, Mr. Garth Jordan. Now, prior to joining AAHA, Mr. Jordan served as Senior Vice President and Chief Strategy Officer for Healthcare Financial Management Association, which has a membership of more than 56,000 healthcare finance professionals. He spearheaded an initiative to make HFMA the Netflix of associations by designing and executing a digital transformation of its business model and achieving outstanding results. Prior to that, he served in various executive roles, including chief operating officer, chief financial officer, chief strategy officer and more. He's created educational nonprofit organizations. He's improved student success by funding and scaling new models of teaching and learning, and consistently driven increases in both retention and new member acquisition. However, since late August of 2020, Mr. Jordan has led the American Animal Hospital Association through a series of successful initiatives to continue pushing forward with AAHA's important mission. Today, he's graciously taking a little time out of his busy schedule to join us here on the GeniusVets Show. With that, I'd like to welcome Mr. Garth Jordan.

Hay, David that was one heck of an intro. I'm not sure I'll be able to live up to all that, but I appreciate it.

 Well, I mean a heck of a career in all that you're doing. I mean, I think I speak for everybody in the veterinary profession in the industry when I tip my hat to all that you're doing, I mean, really fantastic. Hey, listen, Garth.

I saw in a previous interview you gave an incredible updated mission statement for AAHA in just eight words. I think it would be a great way to kick off our interview today. Would you just share that with us?

Sure. The eight words are pretty straightforward: Simplify the journey toward excellence for veterinary practices, and the key in those eight words is that you don't hear members only. We're a pretty open, inclusive organization. The other keywords are simplify the journey and excellence. Excellence doesn't necessarily mean being better than everyone, it can also mean frankly, like a rising tide that lifts all boats. As we all collectively meet certain standards and adopt certain guidelines of practice, it doesn't mean we're making things more expensive for our clients or anything like that. We're just trying to make the world a better place for pets and pet owners. Simplify the journey, it's not a destination. For example, AAHA’s known for accreditation. That's what we're known for as if it's a badge of honor, but it's really not about getting the badge, it's about the process of continuous improvement.

Most veterinarians, vet techs and vet teams that I know, they're always striving to improve. We want to try to simplify the journey for them to the best that we can. That's where the eight words came from in terms of high level, in terms of the process that we got there, how we got there, we used a process called Design Thinking, which is used in a lot of new designs for everything from websites and consumer experiences to product development. We involved well over 150 voices from members and non-members to help guide us in the development of those eight words that we live and breathe every day on behalf of our veterinary ecosystem.

That's brilliant. It's fantastic. You said a couple of things that really resonate with me. Number one, I mean, I have a family that has a long tradition in the fishing industry. My grandfather was chief engineer and fishing boats out of San Diego and whatnot, and he shared something with me. My family shared with me when I was very, very young that concept, a rising tide lifts all boats. Coming from that and it just resonated with me, and it's just living your life, lifting up everybody around you and that's going to lift up the profession. It's obviously what you're doing at AAHA, and that is the notion of really simplifying everything. I mean, in business, it's so easy. It's so easy, especially for a small business with these practice owners that are entrepreneurs and have the weight of everything on their shoulders and spend all day putting out the fires. It's so easy for a business to get incredibly complicated. Constantly simplifying everything down and making it easy, and that needs a lot of direction. I love the direction and how you're steering the ship there. Now, for today's show, I have a few very specific topics I'd like to talk about with you, very focused on current AAHA initiatives for '23.

I'd love to start off by you taking just a couple of minutes and giving us a big picture overview of the various programs and improvements you've been driving forward at AAHA over the past couple years.

Sure. Those eight words simplify the journey toward excellence for veterinary practices have manifested in a handful of projects for us. One, for example, is we're known for accreditation. Accreditation has typically been, if you will, a one-on-one sport. It's been a practice, raises their hands, says they want to become accredited, and we hand off a book of about 47 to 50 pages of standards. We ask them if they need any help, but we give them about, it's on average, it takes about six months for a practice to get accredited. We've been doing that for dozens of years. It's not necessarily the easiest. Doesn't mean it should be easy to get accredited, but it doesn't mean that the process has to be difficult. What we started to look at was the process of accreditation. Because what we learned when we started talking with members is that accreditation in and of itself, as I mentioned earlier, the end of accreditation being evaluated, earning your accreditation is important, but the process actually builds a better team, results in lower attrition or higher retention rates. It improves the finances of a practice.

We start looking at how we make the process of accreditation friendlier, easier, simpler in that journey. One of the things we've been doing is building accreditation as if you will, a team sport. We're going through and we're putting groups of practices together. We call them cohorts and they're going through accreditation together. We can talk about that in more detail later on. We're also building accreditation less as a checklist of standards to be evaluated against and more like a curriculum, a learning process that supports not just one person but the entire team when it comes to why are we bringing these standards in? How are we adopting them and adapting them for our practice, et cetera? Making it a team sport and a curriculum together makes that process and that journey simpler and frankly a lot more meaningful and much more team oriented. That's one example of something that we're doing.

I want to comment, two things, two big things there I want to comment on. Number one, I want to put a little focus on the fact that, just as you took over AAHA, first of all, that was obviously a rocket ship already in flight as you took over the reins there. You still started by focusing on the mission and then looking at how the business can manifest that mission. Something that we're always, I've always been talking with in the seven years, seven and a half years we've been serving the veterinary industry, something that my partner, Dr. Drake has always been preaching to her colleagues, veterinary practice owners, is that when it comes to running your business, if you really want to improve the results you've got, and it has to be first you focus on your mission, your values, and your culture.

From there, you can build into your leadership team, you can build into your policies and procedures, you can build into how you express yourself to the outside world and get everything just resonating in a way that it just all works better. Everything starts to click, everything, you just get better results. Most practice owners, like most small business owners, decide that they want to start something, they write a mission statement and then it goes in a book on a shelf and never sees the light of day again. But to have you taking over this organization and go, no, we need to pull that off the shelf, we need to examine this, we need to really make sure we get this right and maybe it needs some serious retooling, and then we commit to that all the way and we manifest that. That's really incredible. Living by example, those principles are really fantastic.

One of the things that you said resonated for me when we came up with those keywords, especially to simplify the journey, I mean, those three words are almost the essence of the eight words. When we looked at that and we said, well, our core business has been essentially accreditation standards and guidelines. In that, we have this intellectual property around the process of accreditation and the process of doing the evaluations and the intellectual property around the content of standards and also guidelines. We said to ourselves, well, if that's our core intellectual property, how is it manifesting in the world? Is it manifesting in a way that simplifies the journey? And he answer was no, and so then the next simple question is, how might we manifest this content in a way that simplifies the journey? You're making that connection very purposefully without saying, oh, we're going to go off and not focus on our core business. It's really saying, well, is our core business living up to this new mission, this new standard we set for ourselves on behalf of trying to do right by our members and our ecosystem at large?

Yeah, that's exactly it. It's brilliant. I know in one of our first conversations and still you were tackling it because it was pretty early and after you had taken over, I think the first time that we really talked was maybe November 2020, and you were certainly focused on that. One of the things you talked about having a realization early on is that so much of the accreditation process was this checklist that people were going through to earn an accreditation, but that you were already grappling with how do we make this more real in people's lives and change it and to change it to the educational curriculum focus? You had the realization that this actually is massive team building. The result of this process is a tighter team. The result of this process is people who have better control over their departments and more buy-in, and that's really this huge benefit that nobody's looking at and thinking about. It's so critical.

It's a project that requires a team, number one, to go through the process of accreditation. I'm going to say this, and I hope it's not offensive to consultants out there, but there are a lot of consultants out there that make a lot of money helping you build a better culture and a better team when frankly something like the process of accreditation can help you do that, where it's more almost like self-help, right? Without the expense of someone coming in, doing an analysis, doing a bunch of surveys and trying to tell you how to be better and then give you a book and then have you go implement that book later on down in life. Again, no offense to consultants, but I've been a consultant and I've received a lot of consulting help, and so I do adore them. But in this instance, I think, there's ways for veterinary teams to find a path towards improvement, not just of culture, but of business process, et cetera, that through something like accreditation may not be the only thing, but certainly we've learned that that process is incredibly helpful.

Yeah, and it's a framework, that's what you need. There's been more and more over the past, I don't know, six, seven years, studies have come out saying, hey, building a good culture is good business and you should do it. People go, okay, so let's focus on that. But now, they're in on the concept, but they don't have the framework. There's a lot of ways you could go about doing things, but having one that really works and one that's simple enough to start with is so key now that you're bringing that. We do have a lot to jump in, and I know that you have limited time today.

I know we did not at all tackle everything that AAHA has done over the past year. That was just the tip of the iceberg. Do you want to bullet point really quick and then we can jump in?

Yeah, sure. Sorry, I should have bullet-pointed to start with, but another thing that we're doing is we're turning our guidelines into competency based certificates. Taking a 25-page manuscript and actually turning it into a learning tool that also has a lot of tools and that can be brought into and applied in practice, it's really hard to read a 25-page manuscript and raise your hand and say, yes, I know anesthesia management. We're basically turning those guidelines that we're very well known for into certificate programs. By the way, yesterday, our very first certificate launched nutrition management on February 1st of 2023, and we'll be bringing out anesthesia and pain management soon thereafter and another seven to 10 after that this year.

That's a great initiative that will help simplify the use and application of those guidelines. Then another big one is benchmarking. We believe deeply that data that resides within the practice management system of all of our members and non-members is incredibly valuable when we treat it collectively and holistically as a tool that can help us improve practice together. It's going to have to be a team sport to do that, but we've built this benchmarking product that will allow us to work with our veterinary ecosystem to elevate practice through the use of data and benchmark comparisons.

Well, hey, as we're looking at what AAHAs focused on now, you've got all these exciting new programs you're introducing. I really think that's the biggest game changer to me, what I've heard so far. There's a lot that you're doing and not to diminish anything else, but this benchmark and benchmark plus that you're rolling out is just fantastic.

Why don't you tell us a little bit more about the AAHA benchmark and why you've made that the focus and what you think it's going to do for veterinary practices.

Sure. Okay. Let's start off with what benchmarking is not. Benchmarking is not just competitive analysis or number crunching, it's not data tourism, just looking at a couple of charts and then walking away. It's not just copying your peers or catching up to your peers, it's not spying, it's not data espionage, it's also not necessarily quick and easy. What it really is I would say a simple way of saying what benchmarking is: it's data-informed insights that lead to improvement, which is another way of saying that it's a practice of being humble enough to admit that we can learn from each other. What we're trying to do is to create along the lines of our mission a simpler and more collaborative journey that allows folks to take that journey toward excellence.

When I say all of that, those are maybe some esoteric ways of describing benchmarking, but what we're really doing with benchmarking, I'll just talk about what it is in detail, where it came from first. We surveyed members and non-members, we surveyed them on a regular basis monthly, and we got statistically significant data back every single month. Essentially one of the questions we ask is, what do you think AAHA should be doing for you? On every single survey, what we get back is we need benchmarking products and tools. We need AAHA to help us with data. When we do that, we've been doing that for almost two years quietly, and over the course of probably 18 to 20 of those surveys, benchmarking was in the top two requests every single time. The demand is there, the request is there. That's the point. It didn't come from AAHA saying, we want to do this by ourselves, it came from our members and non-members and our general ecosystem saying, someone's got to build a better benchmarking product. Can you do this for us?

That's where it came from. We started to tackle that. The quick story is we started to think about that and tackle that and look at historically data products that we made, like our vital stat series that really weren't contemporary benchmarking products. We said, well, if we redirect that energy into something else, what are the things that we have to solve in order to bring a benchmarking product to the table? One thing that we had to solve for that's pretty straightforward is data visualization. When you get the data, how are you going to visualize it in a benchmark form that your practice can compare itself against 10 or 20 or 30 other practices, whether it's by geography, specialty, practice size, whatever. Data visualizations are one challenge. The second challenge is how do we make it easy for practice to give their data, extract the data from a practice management system and put it into a data lake that now is shared, right? Well, data extractions are getting easier every day with APIs and various different ways to extract data from systems.

Everything's getting easier. The app that I wanted to build in the late 2000s was hundreds of thousands of dollars and now you can snap it together with content with various JavaScript libraries, but that's not still quite because these APIs are complicated and the data in the PIM system is all different and there are so many. We looked at trying to build something like this and we're like, white flag, man, we got to look who's going to do this, and thank God you're doing it.

I won't name names, but there are practice management systems that are really easy to work with. Let's put it that way. There are some that are, I can't say they're obstructionists, but they're not necessarily making life easier for practices to share their data.

I can't believe that the PIM systems don't have credible reporting built in like any business intelligence software suite does for any other industry. All the data's in there. Show us the charts and graphs that we obviously need to run a business and it's just they don't do it, which has always been crazy.

Well, that gets to the third problem, which is the big problem. The big problem is not visualization and data extraction, it's data standardization. If you're on the same practice management system as I am, and we're two different practice owners, your data structure and nomenclature and everything is different from mine. Most if not all, but practice management systems don't have any data standards built in, meaning they're not forcing, and I hate to use that term, but they're not forcing the practices that they provide their system to adhere to a data structure. Even if they had a reporting system, they wouldn't be able to do benchmarking because they did not force the 300, 500, 5,000 practices that they provide their system to adhere to specific data standards. The simple example, really, really simple example is in your system, you might label a dog German Shepherd as G Shep, I might do Germ Shep, someone else might do GS, someone else might do the full name German Shepherd. If we wanted to do a study on across 500 practices on hip dysplasia in German Shepherds, how are we going to find all the German Shepherds in those systems? Unless we take all of the different ways we might name German Shepherd, put them into a box, and then collectively label them one common name like German Shepherd, right?

Now, when you're typing an address into a system, it automatically says, oh, we're going to standardize this address so that it makes shipping better and faster and easier. Think about where shipping was 30 years ago. We had no standardization and it made shipping very difficult. But now shipping is fully automated as you type in your addresses, think of it that way. In trying to figure out that challenge, AAHA doesn't have the technical chops to do that, but we had AAHA data standards in terms right that we have been building for the last 15 years. We found a partner, Petabyte, who essentially had for the last two to three years been building a machine learning, if you will, type of system and algorithms that was taking billions of pieces of data from different practice management systems and different practices.

For every single piece of data in your system, they're saying they have a data standard to run that against. Now, they know the 50 different ways someone calls a dog German Shepherd, and they will basically translate any one of those 50 ways into the standard German Shepherd. But they do it not just for species, they do it for lab results, they do it for pharmacological stuff, they do it for procedures, for vaccinations, for everything. This partner, Petabyte Technologies, has been awesome because they essentially have solved this idea of translation of non-standardized data into standardized data. What that allows us to do then is when you extract data from any individual and multiple individual practices, you're not reaching into their system and changing their data or their data structure, it's just getting translated when it gets pulled out into standardized data. Now, I take from 1,000, 5,000, 10,000 practices, I put all that data into a data lake, and now I can let you benchmark your data against all of those practices that are contributing their data to the data lake.

When you say a data lake, I mean, that's fully anonymized data. There's no risk to somebody knowing what's going on at any individual practice. It's just across the industry we know the average invoice value is this and has been going up, or is this and has been going down and we know that this many, of any metric you can think of.

Bingo. Right. It can be for whatever's in the practice management system, it can be so clinical, it can be whatever. As we build this data lake, as we get people contributing data to this system, I like to think of it as democratizing access to data. All too often, data in my system is not necessarily valued the way I might value it externally as it might be intrinsically to me. If I give my data to an organization, they might sell it back to me in a format that makes it a little easier for me to understand, but where is the value in my contribution to them because I'm actually contributing to their data pool. I know that sounds a little wonky, but that's like just paying to have someone give me back my data in a way that gives me some nice graphs and charts.

What we want to be able to do is have people contribute their data. This is longer term, but maybe in the next year, people contribute their data to this data lake, this data pool and say, hey, your contribution is valuable, therefore you should get benchmarking in return at no cost to you. Right now, we're charging a little bit and that's part of that's like the Tesla launch. Remember when Musk launched Tesla and the only car you could get was like $150,000, right?

I mean, that's not how much benchmark can cost right now, it's 65 bucks a month for a member. It's not that much, but ultimately they have to go make a little bit of money to be able to start to drive down the price of future Teslas. We want to make our future Tesla free. Because of the value of the database of that de-identified anonymized data, we can now start to make money off of that collectively for research and things that are going to improve our overall ecosystem while you also have individual access to benchmarking for your own practice. You can improve at your own practice level too.

Right. I think that's really important to sit on for a couple of minutes. For the benefit of veterinary medicine and for the veterinary profession at large to allow organizations that are coming up with new treatment modalities or new pharmaceuticals or whatever, this lake of benchmarking data will allow them to just understand the veterinary landscape and come up with things that are going to be better, that are going to further empower veterinary practices to practice medicine at a higher level, is that it?

That is a beautiful way of saying it. Yes. That you just took the complexity out of everything I said and you simplified it very nicely. Yes. The key in all of that, just like in human health data, when someone like Merck goes out and they do a massive data research study, they have ICD-10 and CPT codes and all kinds of standardized human health data so that they can do high level research on their pharmacology, their pharmaceuticals that they have out in the market. They have a whole bunch of standardized data to do that research.

They don't necessarily have the same platforms and same standards to do that with in veterinary medicine, but we can offer that to them so that they can create better products, services, whatever wrapped around that research. But it's done again with anonymized de-identified data. What I want to make sure people understand is when they contribute data to something like this, that data is not being handed over to a researcher like Merck so they can say, oh, David's practice in Denver, Colorado prescribes X amount of vaccine and now I'm going to go send a salesperson to his door to get him to sell more. That is not what this is used for. Because it's anonymous.

When we think about that, that is the high level long-term goal to provide that type of product. But then in the short term, we're already providing the benchmarking product. We have a good variety of practices that are already using the benchmarking product. Yes, in the early stages they're paying for it, but as part of that product, they're also getting, what we used to publish as AAHA in vital stats was pricing comparative data in quartiles. For example, the price of your vaccinations against the prices of other practices. We actually are able to provide pricing data not down to the state level, but at a regional level so you can get an idea if your practice is charging a fair price, too low, too high, just right, kind of the Goldilocks of pricing for the products and services that you provide. That's a great step forward to replace the old vital stats books that we used to publish. That's now also part of this benchmark system. Again, long-term in the next year or so, we hope that it's free for everybody.

Yeah, I mean, also just because of the lack of a practice that doesn't have any sort of data visualization, because the PIMS systems are not great at delivering reports. They got the data, but they're not great at delivering the reporting. My understanding is this goes pretty far into helping them look at the types of things and not just only compare them across, understand what's happening in their business and compare them across. Maybe their number of times people are coming and seeing them per year being revisited again is below average, right? Or their invoice value is down, or they're not selling as much of a certain type of product

They can see those business issues and be like, hey guys, we should be focusing a little bit more on this, on preventatives because everybody else in this area seems to be selling a lot more preventatives than we are. How come we're not doing that? Maybe their doctor's like, well, I mean, it's not the fun medicine that we love. You give them a chew, we like doing our medicine stuff. We focus more on that, which by the way is a big thing. That has been a conversation I've had a few times recently.

One of the things that we've done with the benchmark product, and it's hard to describe it visually, but I'll give it a shot. Oftentimes, we get awash in data as individuals or as businesses. Even when we subscribe to a service that gives us our data back visually, you can be awash in visuals. You can get a bunch of charts and say, yeah, but so what? What do I do with this? What we've tried to do with the benchmark product is essentially roll it up into something visually rich that allows you to drive down into the detail and the insight as fast as possible. We modeled it after a FICO score. Most of us know what our FICO score is, or it's easy to know, hey, I've got a 763, I'm in pretty good shape, I'm not going to worry about it.

But if your FICO score drops below a certain level, if you're monitoring it all, you see it turns yellow and then turns red, and you might click into your FICO score and find out, okay, well, I haven't paid my credit card on time. If I do that, it'll improve my FICO score, or I don't have enough loans. I should get a loan and it'll improve my FICOs, whatever. There's things that you can do very quickly to improve that score. We model it after that. We call it a SPOT score. When you contribute your data to the benchmarking system, the first thing you get is a SPOT score. If it's in the green range, out of a 100 and you're at an 88. If you're in the green range, you may say, great, I'm not even going to look at the rest of the benchmark product.

But if it's not in the green range, you look at four sections of the SPOT score, sales revenue, producer performance, opportunities for growth and trends in medicine. That's what SPOT stands for. Each one of those four categories has four reports attached to it, and you might be green in three of those categories and red in another. So then you're going to drill down into the red category, maybe it's trends in medicine. Then when you drill down with that, you're going to look at it and say, oh, well, out of the four reports, my report on well check appointments is the reddest of red, and I'm going to look at that. Oh, I'm not low on well check appointments relative to the benchmark. What are the things I can do to improve or increase my well check appointment rate? It's that type of thing that makes the data, again, it becomes less about the data and more about quickly getting you to an insight because we don't want you to spend time being awash in data and reports and trying to figure it out. That's the goal.

I love it. I mean, this is going to help everybody who utilizes it to run a healthier business when it comes down to it. So needed. So needed for so long and you're really delivering on that. That's fantastic. One thing that we should probably touch on is data concerns that people do have, just I mean, they're out there and you and I have talked about this a little bit and I've loved what you've said on it. I just want to make sure that more people have the chance to hear that wisdom.

What do you say to somebody who has concerns about their data and sharing their data and wants to hold their data, even though they probably don't even really have access to it themselves. What do you say about those concerns?

I don't want this to sound flip at all, right? But depending on who you are working with, it's very likely your data's already out into the ecosystem in some way, shape, or form. Again, I'm not going to name names, but in our ecosystem, there's a lot of companies that own a lot of companies. When you start to look at ownership and et cetera, if you're worried about where your data is going or where it's ultimately owned, it's very possible and very likely that it's already got a track of ownership or potential exposure that could already concern you. I'm not trying to make anybody more paranoid, actually, I'm just trying to reduce the paranoia around that. It's data, I hate to say it, but data is typically exposed much more than we already know and are aware of. If you want to use the data to your advantage, you actually have to expose it.

Having the data just confined in your own personal box is not going to help your practice. The question becomes how do you want to expose it and with whom and for what purpose? Again, I would be an advocate for exposing it in a benchmark product that you're philosophically aligned with, and that if you read the data and the privacy around it, you feel good about it. Frankly, between you, me and the listeners here, data and privacy laws are getting more and more stringent. I would be less and less concerned going forward about figuring out how to share data with the right partner that's philosophically aligned. From our perspective, that whole thing about democratizing access to data and the results and the benchmarking that we can do with that data once it's standardized, to me, that's a pretty straightforward philosophy.

It's a little on the socialist side, I guess, if you want to call me a data socialist, you could probably do that. But frankly, in the nonprofit view of the world, I look at this as this is not AAHAs data. It is absolutely not. This is our members and concentric circles, non-members who want to participate, wanting to do something, contribute to something bigger than they are individually to make our ecosystem better holistically. That to me is the goal. It's really straightforward. We can do that in a way where we protect each other, protect our own data, but still make this kind of collective holistic data view of the world, a place that just, all I can say is it makes us better, right? Because we're sharing our data.

Yeah. I love that. Number one, you're right, I can absolutely say as a owner of a tech company and being in tech for a long time, every month, there's more and more standards and regulations and things that are coming down that are making data safer because increasingly our world depends on data for absolutely everything. Laws and standards and stuff are just getting tighter and tighter and tighter, and in ways and sometimes as a marketer I'm like, oh, come on. That was such a good way for us to be able to get a message in front of people. Now, we can't because data standards are tightened, which is good for consumer protection and everything overall. That's very, very true. But still also in this stage where we are, I do think it's still very important to align with organizations that truly are looking out for your best interests, and for veterinary practices, I don't think there's another organization that does that more and is more committed to that than AAHA.

If there's going to be a product of this kind, and there's a couple other products that are out there, I won't name specific names, but they're not from an organization like this. They're not having been created by an organization whose primary mission is to look out for the good and the health of its members. They're businesses that are in business for being in business and they do what they do and they get bought and they share what they share and all of those sorts of things. But with AAHA being the one who brought this out, to bring this out and bring this to market, that's really what made me feel like, hey, this is the thing to wave the flag and to bring to everybody.

Let's go ahead and change topics a little bit. Let's go ahead and take a turn in the conversation, talk about the topic of culture problems in a practice, how AAHA has developed a systematic approach to building that culture? You've already started to touch on it, but I wanted to get into that benchmark.

What are the different types of cultures that you've identified and you see in a practice?

Well, how can I say this? I don't have a silver bullet for culture development, culture identification, culture management in any business, let alone in veterinary practice. I'd be the first to raise my hand and say, I'm not a DVM, I've never worked in a practice, I've been a client of a variety of practices. I can certainly tell you which ones when I walk into feel like they've got a great team-based culture and those that feel like they're struggling. You can feel it as a customer. But I'm not going to sit here and say that I've gone in and re-engineered a culture within a veterinary practice. I want your listeners to be clear on that, that any thoughts or advice I might give are a little bit more general. But what I can say is one thing we did for ourselves at AAHA was we went in and we identified to the best of our ability what kind of culture we have.

We looked at it on a kind of a grid of four primary types of cultures. One's called a market driven culture, which is very much numbers driven, like sell, sell, sell kind of thing. Another is a hierarchy, which is what it is. It's very top down, it's very give and take orders driven. Another is a clan culture, which is also a kind of a team-based culture. These are the kinds of typical cultures that you hear out in the world. Then the last one is called an adhocracy, which is very, very highly, highly democratic. If any of your listeners want to go check one out, probably the best one to look at would be Zappos, I think adopted adhocracy quite a while back. But those are the four cultures. We looked at the characteristics that comprise each one of those cultures.

There are eight to 10 unique characteristics that comprise each one of those cultures. Without labeling those characteristics, if you take those four cultures, market, hierarchy, adhocracy and clan or team culture, and you say there's eight to 10, so there's maybe 40 characteristics completely in those four cultures. You mix those characteristics up, we put those 40 characteristics on a wall and we asked our staff two questions. We said, pick the characteristics, and this was about two and a half years ago, David, by the way. We said, pick the characteristics that currently define the culture that we have. We weren't labeling them yet, but we said, just pick the characteristics that describe who we are today and now pick the characteristics that you want us to be in a couple of years. All right, so we did that and we had eight characteristics in the who we are bucket and the eight characteristics in the who we want to be bucket.

What we found was that the eight characteristics in the who we are bucket were almost a 100% in the hierarchy bucket. We were a very top down culture. The eight characteristics that were in the who we want to be bucket seven of those characteristics were in the team-based culture and one was in the adhocracy kind of more democratic culture, right? Fascinating. So then we said, okay, well, we're over here in the lower quadrant and we want to be up here in this different quadrant. How do we move from A to B? Then knowing where we're at and where we want to be from a culture perspective, then we just started taking baby steps to go from A to B. It doesn't happen overnight. Culture is not something we did. I can say it has worked, and if any of your listeners want to know more about it or talk more about it or get a presentation about it, I would be more than happy to do something more detailed than what I've just described here.

Because that process of identifying where we were, where we wanted to be and the steps that we wanted to take to get there took about three or four months. But then it's another couple years of work and ongoing work, of course, because you have to be actively, actively working on your culture. Otherwise, as I've heard, and I like to reiterate this mantra, the culture you create is the culture you tolerate. If you're not doing anything and you're just letting it be, it's going to make itself up whether you'll like it or not. You might as well be active and identify what you want to be and take the steps to get there.

I love it. That's a brilliant process. When you say if you want to do more and get more in depth with that, yes, please. I think we need to schedule another webinar where we just talk about that

Yeah, it was a lot of fun. I will say it's probably the most important project we've taken on at AAHA because it's enabled all of our team to do the work that we're doing now for our customers. If we hadn't done that, we would not have made nearly the progress we've made on building cohort accreditation, building certificates out of our guidelines, building the benchmark product, none of this and five other projects, we wouldn't have made any progress or not nearly as much with the hierarchy culture that we had when I started two and a half years ago.

I love that. I love it. Is that by chance something that maybe AAHA's going to be working on as another curriculum to come out with?

I hadn't really thought about it to be honest with you because it's just something that we did internally. It was a lot of fun that frankly seemed to work well. I hadn't really thought about turning it into a process or a template or a gift, if you will, to other organizations that say, hey, here's something we did, if you want to try it, it's not that hard to do. It really wasn't.

We have a workshop, so it is very, very similar to a process Dr. Drake created and used in her own practice, the Drake Center for Veterinary Care, to build an amazing culture where they do that as a whiteboard exercise and they just talk about, hey, what are the terms, the characteristics that describe the values and the culture that we want to adhere to and aspire towards? They write them all out. Then they spend a lot of time as a team discussing what does that mean? What does it look like? Then they whittle it down to five to seven terms that they want to focus on. Then once they have those defined, then they take that into, now how do we act this out in our policies and procedures and on a daily basis in the practice?

Yeah. Well, an example there for us was going from a hierarchy to a team culture. Those eight characteristics change dramatically from one to the other. One of the ones of course is if you will, the role of the manager or the boss or whatever words you want to use to describe those leadership roles. Leaders in hierarchy cultures, they're the ones that make decisions, et cetera. In team cultures, decision making is shared, it's much more shared. That's a different characteristic, and you have to build purposeful mechanisms for that shared decision making to come to fruition. But more directly around that role of a leader or a boss or a manager is there's a difference between the role in hierarchy to a team-based, and in the team-based culture, that leadership role, that title is a coach and a mentor. They are not a boss.

To alter someone's reality, who's in that leadership role, when they're in a hierarchy and say, oh, nope, today you're a boss, tomorrow you're a mentor. That's a big shift. That doesn't happen overnight. But finding people, oftentimes people are like, yeah, I want to go there. I just need help getting from A to B. It's not that leaders necessarily are, there are some that don't want to let go, right? You'll find that. But most are absolutely willing and say, yeah, it makes sense for me to be less about territory and less about decision making and more about how I can help people grow, become bigger, better, faster, whatever contributors to our business. How do I do that? How can I support that?

I love that. Those are the right questions. I mean, as the business leader yourself asking where is it that I want to even try and guide this path to go? But I think you're also talking a lot about the two major differences in communication style. One being that kind of dictatorship like bosses dictate, hey, this is what needs to be done, this is what I need you to do, this is what you should go do now, and like ba, ba, ba, here's a bullet point list versus the coaches and mentors. It's more the Socratic method that's more, let me ask you a question so that you can arrive at the conclusion you need to arrive and asking the series of questions that create the Hansel Gretel path that they can go along and they can pick up the treats along the way, but that gets that buy-in and that gets them taking ownership and that gets them coming up with the solutions and doing it. I think those are two really specific differentiators in those styles.

It is. At first, it takes a lot longer to live that path and to walk that path. But over time, you realize, wait a second, now things are getting done better and faster than when I was like the person, I was the hub in the hub and spoke method, right? Everything had to come to me to radiate out to another part of the wheel. When you do that, it feels right, and it feels like that's the quickest way initially. But as you remove yourself from the hub and you create it more like a web, it happens. It starts to happen a lot faster. Frankly, the work is a lot better that way.

Yeah. I absolutely agree. Yeah, I heard something you said to me previously when we discussed having this conversation today, you had said, this is the year of the team in veterinary medicine. I can hear that echoing through what you've been saying today about how you've been leading AAHA, some of the things.

Can you talk about some of the topics that you think are important for training the entire veterinary team? You mentioned things like pain management, financing, and veterinary care.

Sure. This gets back to one of our projects that came out of our simplify the journey mantra and mission. Really, it's less of a mission statement, more of a purpose statement. If you're a fan of Simon Sinek, he calls it I think a just cause or a purpose statement. We've gotten rid of this whole idea of mission and vision and we whittled it down into those eight words. But again, we're well known for of course accreditation standards, but also for guidelines which are really about, again, they're guidance. They're not telling people what to do. They're basically guiding people and they're here are ways to think about vaccination, nutrition management, pain management and anesthesia. There's some that are very hard coded and some that are less hard coded. When we think about the guidelines that we've created in the past, they have been these long manuscripts, 20, 25, 30 pages, manuscripts, peer reviewed manuscripts that basically say, here's how you might adopt and adapt anesthesia management practices in your practice.

Well, that's not necessarily the friendliest way in this day and age especially to provide content that would be then adopted and adapted into a practice, into day-to-day practice. Turning that rich intellectual property into something that anyone on the veterinary team can take in and say, okay, I can be a team member that is improving their knowledge and skill set around nutrition management, pain management, diabetes, et cetera. We've built these certificate programs so that they are for the team, going back to that rising tide that lifts all boats, right?

When you think about, certainly anesthesia management's probably the most complex of our guidelines, but when you think about vaccination, nutrition, pain, et cetera, to have a team who all have a common knowledge and understanding and potential to display skills that now all step that up, to have that team able to share that language, speak that language and share in the same skillset is incredibly important and provides you hopefully a team that's got more efficiency, more efficacy in what they do for their customers, their patients, their pet parents.

You talked about changes in the accreditation process. What's that going to feel like for practices now that go through the accreditation process this year? What should they expect?

The ones that go through it in the team-based in that cohort? Yeah, so we've now run seven or eight cohorts, so about 70 to 80 practices through cohort accreditation. Essentially the first one was a pilot and we've been redoing it and improving it ever since the first pilot. But now when up to 10 practices go through cohort accreditation together, the experience is different from doing it by yourself, which can be lonely and very challenging. But when you're doing it in a cohort, A, it's facilitated over about a 14 to 16 week timeframe. You've got a little bit more of a clear schedule about what it's like to start the accreditation process from start to finish. You've got a clear schedule, it's facilitated by AAHA by more of like a facilitator/teacher, right?

You're doing it in a micro community of 10 practices so you're learning from each other. Indeed, we even start to see practices sharing documentation that allows them to fulfill some of the standards that they need to fulfill in order to get accredited. You start to see sharing going on and building a community, a micro community, which then is our connections and networking that you wouldn't have had if you hadn't gone through the process together. Then also that process, again, that takes place over about 16 weeks is more of a curriculum. It's not just a checklist, oh, did I do X? Yes, check it off. It's more of a curriculum I'm learning as I go, and that's in the short term.

That's this year, we're still doing that. We've still got another, we'll probably do another 10 cohorts this year. We've got a cohort open right now where we're recruiting 10 practices and we're making their cohort experience free. If anyone's listening to this and they want to email me at garth.jordan@aaha.org, and they want to go through cohort accreditation at no cost for your first year, you can email me for that, because we're experimenting with what it means to run cohorts for folks that are psychologically invested and they don't necessarily have to be financially invested to go through cohort.

That's right now, eventually when we get our curriculum really up and running, it'll be on the same learning management system as all of our certificates. When you go through the renewal process, you can use the online learning management system to also support yourself going through the renewal process. An individual will be able to get certified in the AAHA standards and accreditation. Now, you have a portable certification for yourself. You go to another practice that's not certified, you'll be their expert and you can support them as you'd see fit.

You talk about checking all the boxes, making things easier and more streamlined, more available and engaging through these platforms. I mean, that's what you've done throughout your career. It's what you're doing at AAHA. It's really just incredible work. I love it. It's fantastic. Let people know, again, one more time how they can reach out, where they can go to apply?

It’s easy, just email me garth.jordan@aaha.org, and you can also go to our website and look at AAHA Amplify, that's the name of our cohort program. We'll also start to see our new LMS and our certificates online and all that good stuff. Feel free to go and explore there, but if any of your listeners just want to chat one-on-one or learn more, they can always call me. I'll talk their ear off or hook them up with someone else who will do the same.

Awesome. One last big thing I think everybody should know, no more Connexity.

No. We have launched a new revised annual conference. It is called AAHA Con in the spirit of Comic-Con. It is about the fun and the spirit of veterinary medicine and building a community of people who want to learn, lifelong learners. We intend to make it a really, really good time.

You couldn't pick a better destination, my personal hometown, born and raised, San Diego.

San Diego, well, right. That's the birthplace of Comic-Con. We figured what better place and time to launch AAHA Con.

So much great stuff is coming this year from AAHA. Love all you're doing, huge fan. We may just pretty soon here, maybe by not too long, we might have a nice little announcement of some other ways that we can help push AAHAs different initiatives forward this year. I really look forward to doing that. All the respect in the world. Garth, thank you so much for taking some time and for joining us today and for all you're doing.

Thanks so much. Appreciate it.

All right, well, hey everybody. I hope that you enjoyed the conversation here with Mr. Garth Jordan. Please check out all that AAHA is doing plugins for the good of the veterinary professions, for the good of your practice, and just for the good of doing good overall. Thanks so much for spending some time with us. Plug in every week. We've got Webinar Wednesdays here on the GeniusVets Show. Check us out on whatever podcast platform you'd like to stream on. We're all over the place. If you have an independent veterinary practice, do you know you have a full page profile right now live on geniusvets.com? It's true, you do. You should check it out.

Go to GeniusVets. You can look up your practice by state, by city, find it, a beautiful full page profile, or you could probably just look up the name of your practice and your city and state in Google and see it there as well because it tends to be right at the top of the page. It's free. Claim it for free. It is your path to get so many free resources, to get workshops, to get downloads and guides and things that can really help deliver value to your practice, and help you run a better practice this year. Signing off. Thanks so much. This is David Hall, co-founder of GeniusVets, and I'll see you next time.