What is normal? This is a rhetorical question, often asked by people who apparently want to know the answer. Most normal people are intent on, even obsessed with, being normal. Being the compassionate consultant I am, I feel it is my task to eliminate confusion, but as my mission is to increase operational efficacy and economic success, I am by nature also a change agent. Only one-third of the Americans today have a behavior type that wants change, while the majority have behavior styles that want to maintain the comfortable status quo. So our corporate consulting quest is usually centered on enhancing a practice's operation by using a healthcare delivery team approach. This team approach may not be perceived as normal, or even possible, especially by those who have the inherent "fear of failure" syndrome for a business backbone. So, I figure the best news we can deliver, in many cases, is to spread some joy and knowledge, by helping veterinarians and their staff members think that being confused is normal.

Since we "push the edge of the envelope" with everything we publish, and plan for ten years in the future, we sell knowledge. Many read our material, with such a string of past-tense paradigms, they cannot understand the message, through their own bias and prejudice. In a profession obsessed with measuring themselves to the "national average", or "norm", our consulting doctrine and knowledge-based approach to change are seldom perceived to be in the mainstream pack of "normal" consulting. Most of the alternatives are procedure-based, turn-the-crank, one-deep, consultants, who deliver the same "middle of the road" cookbook report, time after time. When challenged, they fall back into the "It worked in my practice, so it will work in yours!" defense, ignoring the different demographics, the different staff, and the different practice paradigms or resources. In reality, we send about one e-mail or postcard a month to some other consultant, who is starting to use some of our published material, usually without referencing their source, and it says something to the effect, "Congratulations in upgrading your resource materials."

Most perceive that "normal" in veterinary medicine is a quest for being at or above the national average. And average is defined by me as the best of the worse, or the worse of the best. The last time I looked, this was also the definition of mediocrity, and since the "norm" is considered the average, we therefore create chaos with new thoughts, which is not normal, yet needed. So we will be happy to spread some happiness by helping veterinarians and their staff members think that being confused is normal.

*The only expert we know is Jack. He lives in the greater Houston area, and travels to Belize with me for leadership courses, which we conduct in the jungle. So if you are average, maybe you know Jack. If you are not, it could be said that you don't know Jack!

Before the 1950s, there were many barn cats and farm dogs. The families raised in that year just knew that pets were just pets. That was "normal" for our agricultural forefathers and foremothers, although the term "foremothers" was not a normal phrase at that time, as equality of the sexes did not have to be proven in that era.

By the time the 1970s rolled around, veterinary practices were seeing "dog people" and "cat ladies", and neither were considered "normal" in that era. These were clients overly affixed to their critters, making the four-footed critters members of the family. That could not be normal, could it?

When the 1990s rolled around, and the same "small animal practice" started to become the community's "companion animal practice", virtually everyone we saw gave the pet some form of family status. With that decision, the "pet is just a pet" household became abnormal.

By the new millennium, a third of the households had given their companion critters "people status". As a population, America had entered the era when "cat people" and "dog people" became normal classifications of endearment in small talk, replacing the long-abused, astrologically-based, pick-up line of "What's you sign?"

They say normal people can hear a pitch between low "D" on the piano and high, high "E". If you have grown older and can no longer hear normal pitch, or are younger, but have blasted your ear drums with heavy metal music since you were ten, you probably no longer hear "normal pitch". Therefore, you are considered abnormal, or "below normal;", or better yet, "mutated", since evolving out of the normal range, as you grow older, is said to be "normal". A good friend in Windsor, Colorado, an "infamous" female doctor of veterinary medicine, has said many times, "As we get older, our hearing seems to become less astute, with the exception of the voices in my head, which seem to actually be getting louder and clearer every year."

I have been told that "winners never quit" and "quitters never win", but then we are told to "quit while you are ahead". Does this mean that winners who quit, before they lose it all, are not normal? Or are they normal for the average, but abnormal for winners? There are those who say it is normal to quit trying after one has failed badly. (Can we fail "goodly"?) Therefore, if you are persistent and determined, as if "tenacity" was your middle name, you should probably consider yourself abnormal, or possibly obnoxious, to normal people. If you were an intrapreneur, as discussed earlier, tenacity would be normal for a creative innovator. But finding a practice leader, who wants a creative innovator, is an abnormal and difficult quest.

It seems that normal people complain incessantly about those tenacious people, calling them, Type-A personalities, workaholics, high "D", or "movers and shakers". I normally call them work enthusiasts, which probably makes me appear, once more, abnormal. It seems to me that normal people generally distrust, or even dislike, tenacious people, because that level of commitment to a dream is not usually normal. They try everything imaginable to help them become "normal", or else they make them go away.

A normal, compassionate, caring person would probably say, "Whoa, that is not nice!" Yet, a "normal" terrorist actually expects to do things that are "not nice", like fly airplanes into buildings, or bomb people they do not know. The government understands that this behavior is normal for terrorists. Therefore, they try to kill terrorists, which according to history, is normal for governments. The question then arises, "Does this mean that normal people would be considered abnormal terrorists, or that people become abnormal if they go to work for the government?" Let's slow down a moment at this point of our discussion. Trying to figure this out makes most people confused, which, thankfully, we established earlier that being confused can be considered normal. I guess this makes normal people like normal terrorists in some bizarre way.

Many people in veterinary practice, who are not me, ask "Are we normal?" to which most normal business people would respond, "What are you, nuts?" This question seems like the teenage question in the above example, and probably is the foundation for a better question, to which I would respond, "Probably, but then who really cares? Who wants to be normal anyway in a profession where "normal" means low net and long hours?". However, since we know there are lots of you out there worrying about being normal, but are apprehensive about being average, we offer the following premise as a public service. I think the best way to tell if you are "normal" is to examine your sense of humor:

 An animal owner comes to your practice, engages you in thirty minutes of Q&A, receives a diagnosis and medication for the animal. At your front desk she informs staff that she has no money and expects you to provide the care for free, because of your love of the animals. Are you laughing, smiling, or grinning?

 Would you laugh if Ralph Nader reportedly feel asleep at the wheel of his new full-sized SUV, with Firestone tires losing their tread, and smashed into a two-hundred-year-old, old-growth, Douglas Fir tree, injuring all seven Oregon residents, who were living inside the tree or are otherwise attached to it?

 You hired a new employee. She agreed on the shift schedules, core values, and operational demands during her orientation and training phases. After joining the team, she provided you a list of times she could not work, due to family, school, phases of the moon, or other whimsical desires. In fact, she wanted you to change the normal practice schedule to match her abnormal requirements, so her forty hours would then become normal, although it required over-staffing and under-staffing to occur, based on client access demands. The normal thing for a veterinary practice usually to do is make the schedule changes to meet the "needs of the one", sacrificing the "needs of the many", which is abnormal in any other business entity, except maybe for Star Trek. So, is that enough to giggle about yet?

 You would be considered deviant by normal people if you laughed with/at terrorists or deviant people, unless you were trying to impress them, because you want to hang out with them. In that case, you might have a chance of being normal, at either the government or terrorist level of perceptions.

 Then there was the time the practice bought a business "software management program" for $35,000. Remember, the basic College 101 course defines "business management" as being based on the premise of Income minus Expenses equals Profit (I - E = P). All the software does is collect income like a cash register, and does basic word processing, with a mail merge for the client address book. No one on the team can find the expense categories in the $35,000 program, and the vendor talks about alpha-testing some "alternatives", and has for the past six-plus years, which is normal "stall speak" for a software vendor that is not planning to give that service. So, you must buy a $229 QuickBooks© program for expense tracking, and then you discover it does great invoicing also. Then you find the Access Bible©, when you are looking in the local bookstores for a spreadsheet program to merge the veterinary and QuickBooks© software system. You discover that the Access Bible© has "Mountaineer Veterinary Clinic" on the CD-ROM as the practice exercise. Further, the book actually walks you through the full customization process. Average people would take about a week to customize the CD-ROM into a normal integrated business program for veterinary medicine. You find that for $59.95, you could have modified the existing Access Bible© program to give you a totally integrated practice software, and Access Bible© came with an instruction book, giving you all the knowledge and proprietary rights to the codes and software. Then you see the Deluxe $69.95 hard-covered version of the Access Bible©, with two CD-ROMS, that takes you the extra mile in understanding the full power of the integrated software system. Laughing yet?

 If you won the multi-million Power Ball lottery, and were asked if you would stay in veterinary practice, would you respond, "I love this profession, and I plan to stay in it and stay active in my practice, until all the millions are gone"?

Battling Partners, Staff, or Friends During Change

Families are forever. Your practice is a short-term project! - Dr. Tom Cat

The first two chapters provided you with insights into where we perceive that the veterinary profession has come from, and the "over-abundance" of options for where it can go. The basic fact is, if the leadership does not change, we are not going anywhere, except maybe follow in the footsteps of those independent pharmacists and optometrists, who buried their heads in the sand two decades ago, and said, "No one could ever replace our professional services, so why worry?" Their associations supported them in this group think, and in blaming clients and others outside their profession. They are all gone now.

Concurrently, the dentists saw the same trends, and said, "Let's get it together people. Painless restorative dentistry is not a market niche that will hold us!" They discovered wellness care, prophylactic dental hygiene, first annually, then every six months. Now they have gone to every four months for people whose gums get red. They discovered life-like replacement dental arcades, pediatric dentistry, adolescent dentistry, orthodontics, and more recently, whiteness.

Supported by medical assistants, one dentist works seven to nine chairs, one general practice physician works four to five rooms, one chiropractor works four tables, and a podiatrist works six rooms. And a veterinarian works one column in a linear fashion, and then wonders in public, "Why do the other professions earn more than we do?"

The veterinary associations come to the rescue, and say, "You do not charge enough. Raise your fees!" In the recent AAHA compliance study, most every item was found to be the lack of exposure by the provider, not client compliance, as the name hints. It should have been called, The Standards of Care -- Not! study, since the problems are inside our own practices. Raising fees is like expense control. It works as a short-term fix, but it does not have holding power. When expenses are controlled too tightly, the staff becomes minimized, and cannot be veterinary extenders. When the fees are jumped greater than ten percent above the community high, loss of the C-D clients is imminent, and many of the B clients will follow also. There are too many other choices on the street, and too much public media exchange of community prices, for any client to blindly return to a gouging practice. In fact, one of our common consults comes about eighteen to twenty-four months after a "fee increasing" consultant encounter, and after the clients stopped returning to the "rape and pillage" feeling they had been subjected to by the new leap in fees.