More Than Protocols and Improvisation in Veterinary Rehabilitation

You may have heard the term, ‘Are you a cook or a chef?’ Are you following recipes – or a set of protocols – or you are creating menus and recipes – in our case, are we devising our own protocols and treatment plans?

What we’re really trying to say when we ask this question is: Are you taking things to the next level in your treatments? Are you really considering the protocols you follow and changing them as the situation demands, or are you just following a set of instructions? And I think to a degree, what we are really asking is whether you are just using a cookie-cutter approach, applying the same protocol over and over again without consideration for the needs of the individual.

Well. Let me rock the boat a bit.

What does it mean to be a chef? Generally speaking, a chef has studied for a degree or completed an apprenticeship. They have climbed the kitchen ranks, and man, oh, man, can they cook. But they are far more than just cooks.

THE CHEF: Creating Rehabilitation Treatment Programs

For us as Vetrehabbers, what would it mean to be considered a ‘chef’?

• Rehabilitation: At any given time, a chef is the best cook in the room. When another therapist needs help with a technique, has a question about a case or condition or a patient not responding to treatment, you, the ‘chef’ are able to help them. You can answer questions and guide the less experienced to gain better outcomes. You don’t necessarily have all the answers, but you do have the training and experience to reason clinically and find solutions to problems.
• Vision: Chefs devise and plan menus. If you are a chef, you have vision, you’re a dreamer, and you want more. You want to reach more patients, more clients, and make a bigger difference. You know that with your own hands you can only impact the lives of a finite number of patients and clients, but with a team, you can change the world.
• Knowing the numbers: A chef does more than cook – she knows the running of the kitchen inside out. A chef in vet rehab knows the numbers. She knows what the treatment plan and protocol is going to cost her and the business, and what it will cost the client. She considers more than the treatment sessions. Will the client need to invest in a harness, a wheelchair or supplements, and for how long?  Will further surgery be needed down the line? As chef in your practice, you consider the entire picture, get into the shoes of your client, and help them prepare for the journey ahead. you help them gain a sense of perspective and ease them into the responsibilities entailed.
• Systems and processes: Like a well-run kitchen, our practices need to run smoothly, involving the whole team in providing a great customer experience and the best possible treatment outcome for patients. The chef ensures that each member of the team knows where they fit in and what their role is. The chef devises systems, including systems for clear and regular communication, so that nothing falls through the cracks.
• Lead a team: A chef leads a team. You need to manage your team in a way that makes them feel a part of something bigger, something worth striving for. You need a motivated team, and for that you’ll need to value each member, letting them know you value them. As chefs in our practices, we are completely dependent on our team for great customer experiences and successful patient outcomes – which means, ultimately, for the success of our entire businesses.
• Discipline: It’s easy to treat our patients. We’ve been trained for it, we’re good at it and we love it. But it takes discipline to recognise that we have our shortcomings and need to address and strengthen these areas. That means carving out time for courses or reading up on personal growth, business management, finances or marketing and then implementing what we have learnt.
• Hard work: A chef is the first person in the kitchen and the last one out. It takes work to be successful, and a team leader is not afraid to put in the time, energy and effort to make it happen.

So being a ‘chef’ is about much more than our rehab knowledge and skills! What does it mean to be a cook?

THE COOK: The Essential Link in the Team  

A cook is essential in any kitchen. They know their field – when to apply which techniques and what the likely outcomes will be. They follow protocols and recipes and they do it well. They know how to take their place as part of a team for the overall success of the whole enterprise.

For us as Vetrehabbers, what does it mean to be a cook?

• Rehabilitation: Know your recipe and follow it. Is the ability to follow a planned protocol a bad thing? No. We need protocols for our patients, and we need to follow them. Protocols allow us to work within the healing timelines of tissues, measure outcomes, and pinpoint the techniques that work and those that don’t for any given patient. This in turn helps us make clear and distinct changes to a protocol where necessary to enable the attainment of a specific goal.
• Taste as you go: A good cook is always sampling as they go. For us, this means reassessment. As we progress through any treatment plan and protocol, we should be ‘tasting’ – finding out how our patients are progressing, measuring responses to a technique or modality, and considering the final effect of progressions on the end goal.
• See the red flags: Ever watched cream separate because you added it to the pot too early? Seen lumps forming in a white sauce? Just like cooks, we need to be able to spot when things are going south and respond appropriately. This could mean referring back to your ‘chef’ for an immediate change in protocol, or to the Vet for further diagnostics on a possible secondary condition or complication. It may mean simply stopping the current treatment modality because the patient is not responding the way we intended.
• Communicate: You form an essential part of the chain of communication between the Vet, your ‘chef’, and the client. You are the one spending hours getting to know the client and the patient, and your relationship and relaying of information is essential to that client’s compliance and understanding of your patient’s condition.
• Be a team player: You’re never a lone ranger; you’re part of a team working toward a common goal for the good of a patient. It’s easy to start out as a team player and then gradually let the ball drop. Never lose sight of your responsibilities as a member of a team – whether you work alone in a small practice, in a large hospital, or in a rehabilitation facility.

COOKS and CHEFS

So here’s my view: Being a chef is no better than being a cook. Some of us are cooks, and we can be good cooks or great cooks. In fact, I believe most of us are cooks. It is only a small group of Vetrehabbers who have a larger vision and want to reach more patients than their hands can touch in a day; who want to lead a team and chase a dream, who are dedicated to excellence and professional growth to such a degree that they pursue it with everything in them.

So I challenge you; decide which you are, and don’t settle for being average in either role.

You can be an excellent cook; meaning you’re not just a recipes person – you can think on your feet and do what is right for the patient in front of you, because you are dedicated to your patients. You are dedicated to their health and well-being, and you will spend the time, energy and effort to give them the best possible outcomes.

Or be a chef. Nurture that bigger goal, expand your skill set, and develop the qualities you’ll need to lead a team.  Being the most knowledgeable and effective rehabilitation therapist around is not enough for a chef; you’ll need business skills, communication skills, leadership skills and emotional intelligence. You’ll need to be a team player. You’re a dreamer with discipline.

So which are you?

I hope I have made it clear that neither is better than the other. We’re different, and we thrive in different settings and with different challenges. We need cooks and chefs in this profession to get the best possible outcome for all patients.

Whether we’re a cook or a chef, we need to be dedicated to professional growth and excellence, because together we carry the profession of Veterinary Rehabilitation. It is our dedication that establishes our field in the minds of the public and ultimately elevates society’s expectations of the proper care of animals.