In this episode, Dr. Cari Wise discusses the significant issue of external validation within the veterinary field and provides strategies for overcoming this challenge.
External validation is defined as the need for outside affirmation to confirm one’s worth or correctness in actions. The academic environment perpetuates the belief that grades are synonymous with self-worth. Many students enter veterinary programs already grappling with insecurities, and the pressure to excel can create a cycle of anxiety, where temporary relief is experienced upon receiving good grades.
Dr. Wise stresses that veterinary professionals do not have control over patient outcomes or client behaviors. The emotional states of clients influence their actions, and veterinary professionals cannot dictate how clients feel or respond.
The dependence on patient outcomes and client interactions as indicators of success can lead to burnout and dissatisfaction within the profession. Dr. Wise encourages veterinary professionals to understand that their self-worth is not dependent on external factors.
Dr. Wise advocates for a transformative shift in mindset, urging veterinary professionals to concentrate on their responsibilities and efforts rather than seeking external validation. She underscores the importance of recognizing that mistakes and adverse outcomes are inherent to the practice of veterinary medicine. Embracing this fundamental truth can reduce pressure and cultivate a healthier relationship with their work.
Dr. Wise concludes by reminding her audience that perfection is an unattainable goal in veterinary medicine (and life); and that accepting the human experience, including errors, is crucial for both personal and professional development.
Key takeaways include:
- The education system promotes reliance on external validation, causing anxiety and self-doubt in students.
- Veterinary professionals measure success through patient outcomes and client satisfaction.
- Many veterinarians internalize negative outcomes, feeling responsible for patients who do not improve or challenging client interactions.
- Dr. Wise emphasizes focusing on true responsibilities like exams, histories, recommendations, and treatment plans.
- Dr. Wise promotes a shift from perfectionism to accepting human imperfection in veterinary practice.
- Listeners are invited to identify their need for external validation and reclaim their power by acknowledging their intrinsic worth.
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EPISODE TRANSCRIPT
This transcript is auto-generated and may contain typos.
Hi there. I’m Dr. Cari Wise, veterinarian, certified life coach and certified quantum human design specialist. If you’re a veterinary professional looking to up level your life and your career, or maybe looking to go in an entirely new direction, then what I talk about here on the Joyful DVM podcast is absolutely for you. Let’s get started. Hello my friends. Welcome back to the Joyful DVM podcast. In today’s episode, we’re going to spend some time talking about the trap of external validation and how to break free.
Now, external validation is when you are seeking evidence that you are good enough or that you’ve done the right thing. And there’s all kinds of ways that it shows up in Vet Med. But before we get to that, let’s first explore why it is that it is so prominent in Vet Med in the first place. It really all starts back with our education. The education system is set up to give you feedback, to tell you how you’re doing.
And that doesn’t sound like such a bad thing, does it? Because we all want to know, like, are we learning the material that’s being provided? But if we take a look at the system itself, a system where we put in effort and then we have some sort of external validation in the form of a grade that we are doing well enough, then we start to become dependent on that thing.
And the further that we go up the education cycle, the more advanced our education becomes, the more we begin to rely on those external grades to keep going. Now, here’s why. Whenever we are in new situations, whenever we are learning things that are difficult or challenging, whenever we are in programs that have a lot of pressure that go with them, and, you know, a large victory at the end in the form of a big degree, it’s very normal to feel insecure.
It’s really normal to feel a little bit afraid, to be nervous, to compare yourself to the people around you and believe that you’re not as good as they are, or they’re not, you’re not as smart as they are. And then our academic systems tend to reinforce that by ranking us. And so you have a class rank and you have a gpa, and so you’re gathering up all of these data points that are supposed to be a reflection of how good you are at what you’re learning.
Now, interestingly enough, it’s not an unbiased system. It’s also not a direct reflection of your abilities, the subject matter, or in this career as a whole. But what it does is that it sets up A system to evaluate a student population. And though data in that regard might be useful for the academic institutions, oftentimes it’s not the greatest reflection of learning itself. Nevertheless, as we go through our academic programs, and especially when we get into our professional programs, we usually arrive with a bit of anxiety and fear and just doubt, like self doubt.
And so what keeps us going? Well, there’s a couple of things that keep us going. Number one, what we believe our lives are going to be like once we finally earn that degree. So that’s the vision that we hold. And as we hold that vision and we feel all anxious and stressed out and all the things that come up emotionally as we go through these academic programs, there are these external variables or values that give us a little boost when we see them.
So when we pass a class, when we get a good grade on an assignment, when we ace a test, whenever those things happen, then we feel for a moment like we’re good enough. And what’s actually happening is that we’re believing that we’re good enough. And so we feel confident to keep going. That confidence that we feel in the moment when we have that sense of like, relief when we see, okay, we passed the class, we got the next grade, all those things as we get those little bursts of relief and confidence, then it helps to offset what’s underneath there with the anxiety and the fears and the doubts and the insecurities.
And so it becomes this kind of back and forth experience, this up and down roller coaster where the stress and the anxiety builds and builds and builds and builds and builds. And then there’s some point of evaluation and then you receive some kind of score that keeps you in the program. And so you’re like, okay, I’m good enough, I’m going to keep going. And you don’t have any reason to stop.
You become dependent on the external validation to override the fear and the insecurity that you have on the inside. And because we have been through professional programs, you’ve become very, very good at this because of the degree of pressure around the programs themselves. Those pressures, those doubts, those insecurities, and even the bullying environments that a lot of us learned in, all of that can be justified almost if we’re getting passing grades.
So that’s how that habit of external validation really gets deeply seeded to begin with. It starts at the youngest and lowest areas of education, even in grade school. And our own personal insecurities and self doubt get balanced by the grades that we earn. And for many of us, we have even had this reinforcement from our family that earning good grades is a reflection of you as your value and your acceptability.
So you might have been in a situation where you were even punished for not receiving a certain grade in your, like your education when you were younger. So there’s a whole pattern of things that get set up. So what we learn when we’re younger and how our family interacts with our grades, and whether or not there’s punishment or reward associated with earning a certain degree, when that kind of thing happens, it just complicates and magnifies everything else.
Because then you’re really starting to build into your own personal understanding of your self value that good grades mean you’re good and bad grades mean you’re bad. And for a lot of us who get stuck in that kind of paradigm, the good grades are only A’s and anything less than that is considered bad. So then you get into your professional programs, you have the normal pressures and stresses, you may not be able to earn those A’s.
So you might be compounding like that you’re feeling bad about yourself, but you’re still there enough, you’re still getting good enough grades to stay in the program. And you just keep pushing through, even though on the inside you’re full of self doubt and insecurity and worry and just belief that you’re not measuring up to what you need to be in order to be the professional in this career field.
So then what happens is you graduate. So once you graduate from your professional education, you have your degree at this point. So veterinarian, veterinary technician, whatever that degree is, you take your national exams, you pass those national exams, and now you’ve made it. So what does that even mean? So you finally made it through all of the academic pressure, all of the academic journey to earn the credential, the ultimate credential that you were seeking.
And because of the way that our society connects achievement or circumstance with emotional well being, all along the way of your education, you were likely believing that once you finish the education itself and earned that degree, that you would feel better. But that’s not what happens. So for a moment, you will celebrate, you will be excited, you will be proud of yourself for a heartbeat, for getting that degree, earning that degree.
And then you step into the real world. And here’s what happens. In the real world, there are no external validators. So in the real world, where your insecurities, your doubts, your negative perception of yourself and your abilities, your habit of comparing yourself to everybody else and judging yourself harshly, all of that shows up in the real world. And now you’re the doctor or you’re the technician that is expected to do this job.
You don’t have anything outside of you to tell you that you’re doing it well enough that you’re doing it right. And so because of that, what we do as veterinary professionals is we have inserted two things into our experience and decided that those are the external validators. Those two things are patients that get better and clients who are happy. So think about that for a second. When’s the last time that you were involved in a case where the patient didn’t get better?
Did you blame yourself? Many, many, many of us do. We look at the decisions that we made, we look at the way we interact with the client, the recommendations, we look at all of it and we decide that if we had done a better job, that that patient would have gotten better or it would have lived if it had passed away. If we look at a client who’s frustrated or angry, we take that on as evidence that we have done something wrong, that there’s something in the presentation of the information, there’s something in the pricing, there’s something that’s within our control that has created that negative client interaction.
And so if we have those situations, then our sense of competence in this job really starts to get decreased. On the other side of that, we are using every case that gets better and every positive client interaction as evidence that we’re good enough, that we’re supposed to be here, that we should be in this role. And anytime we have anything to the contrary, then the self doubt just jumps right in there.
But here’s the deal. If you can’t control it, you can’t be responsible for it. And I can guarantee you that when it comes to patient outcomes and client behavior, you don’t control either one of those things. Now, it might be a little bit easier for you to understand that you don’t control human behavior, right? So the way a client interacts in a veterinary setting or anywhere in the world is not something that you can control.
Like, you can’t do it right enough to guarantee that that client is always nice to you. It’s just not possible. And that’s because if we think about human behavior and what drives it, it’s emotion that drives behavior 100% of the time. So that personal, that client’s personal emotional state is what’s driving that person’s actions and behaviors in the moment during that visit. So it’s their emotion that’s driving their action.
You don’t control their emotion. You can’t control their emotion because emotion is only created by what we believe. So our thoughts, opinions, beliefs and conclusions, those beliefs overall, those thoughts overall are creating the emotion that we experience. The emotion that we experience then drives the behavior. You can’t control what they think, you can’t control what they believe, you can’t control their opinions, you can’t control the conclusions they draw.
So therefore, you cannot create the emotion within them and you cannot control their behavior. If you can’t control it, you’re not responsible for it. So a client that is behaving in a very friendly and supportive manner is not evidence of your success. And a client that is being unreasonable and rude and disrespectful is not evidence of your failure. Now, what about the patient outcomes? Many of you are probably thinking, no, if a patient doesn’t get better, that’s my fault.
I did something wrong. There’s something that I missed. And what I want you to understand is that the frequency in which a case not improving being a direct correlation to a decision that a veterinary professional made is very rare. So, yes, there are situations where we have medical accidents, right? We have liability insurance for that. So I’m not talking about those situations. I’m talking about everything else where you did your job and the patient didn’t respond the way that you anticipated that it would.
That is not your fault. You cannot control it. It is not your job to fix animals. That’s not what you do. The reason I am so passionate about making sure that you understand this is because of this habit of external validation, the one that has gotten you through probably many, many of the different phases of your life so far. Always looking for something outside of you to tell you that you’re doing a good enough job and that you’re on the right track.
And when we use our patient outcomes as one of those external validators, we lose every single time. Because no matter how hard you try, my friends, no matter how well you work up a case, no matter how perfectly you come up with a diagnosis and the absolute gold standard treatment plan that the owner 100% is on board with, you have no guarantee that that patient will respond because you will never control its physiology.
That is the most important thing for you to remember. You don’t control patient physiology. If you can’t control it, you can’t be responsible for it. And so you sure as heck do not want to use that as evidence of your worthiness or value or success in this job. You can let Yourself off the hook a little bit. Your job as a veterinary professional is to do a physical exam to get a history.
Now remember, the quality of the history that you gain from the client is not dependent on you. You ask the question. So be thorough in your questions. But they will not always tell you all the information. That’s okay. You don’t need it to do your job. Because your job is always going to be based on the information and the resources that you have available at the time. And if the client elects to omit some of the information and it might have been useful to know as you’re going forward with the case, that’s not a failure on your part.
You didn’t have the data. You cannot consider something that you don’t know. So keep that in mind. But you do an exam, you get a history, you make a recommendation for the client on how to proceed with diagnostics and treatment of their pet. Now, whether or not what they decide, like that’s their choice, you don’t get to decide that. So a client that says no to everything doesn’t evidence that you failed.
A client that says yes to everything isn’t evidence that you’re really good at your job. It’s neutral. It means nothing. Your job in this part of the veterinary care cycle ended with the diagnostics in the treatment plan that you created and recommended for the client. That’s what you need to do. Put your effort into that and then you let the client decide. Now, once the client decides what they’re going to do, then you move forward and implement those wishes to the best of your ability.
And then everybody has to wait because it’s not the client and it’s not the veterinary care team that’s going to be able to save or fix or heal that animal because you don’t control the physiology. If you take that situation and you use a no from a client or a patient that doesn’t respond as evidence that you’re doing a bad job, then you will burn out in this profession very quickly.
And it is a trap, this external validation, because when it works in your favor, there’s a bit of a dopamine rush that goes through with all that. Like, look what I did. And we should be absolutely proud in the contributions that we make in caring for our veterinary clients and our veterinary patients. 100%, we should be proud of that. But your self worth and value in this profession is never dependent on it.
The way that you break free from this is simply by staying in your lane when it comes to the veterinary Care cycle, my veterinary friends, your role is to take a history, to do a good physical exam, to make a medical recommendation, so diagnostics and treatment to educate that owner. Then they decide, then your job is to implement whatever they decide. So to move forward with diagnostics and treatment, and then everybody has to wait to see how the patient responds.
And then the cycle starts all over again. Your only responsibilities are to do the exam, to ask the questions, to make the recommendations, and to implement the plan. That is it. Everything that has to do with the client and how they behave, and everything that has to do with whether or not the patient responds to that treatment at that time, you will never control. If you can’t control it, then it cannot be used as a validator of your success.
Notice how, if you will allow this to be true, how so much pressure can be released from you immediately. We have a long held habit, many of us, of relying on external validation to believe anything good about ourselves. And what I want you to know is that whatever happens during the day in your job, even when it’s a medical accident, a medical mistake, that does not ever diminish your value as a human, you are infinitely valuable and worthy simply because you exist.
And in this career that we have, which is the practice of veterinary medicine, built into the name itself is the opportunity for things to go sideways. That doesn’t mean that you’ve done anything wrong. You’ve simply been practicing veterinary medicine. And so for all of you out there who are beating yourselves up every time a client is just a jerk, or every time a case just doesn’t go the way that you thought that it would, I want you to take a step back and remember that this is simply medical practice, that no two cases are alike, that textbooks are simply written as a compilation of what’s worked for everybody or other people, not everybody.
What has worked for other people who have come before, but are never a guarantee that it’s going to resolve any case in front of us in this moment, because we will always be interacting with the physiology of our patients and the decisions of our clients. And because we can’t control those things, we can’t be responsible for what happens. Now, this doesn’t mean you don’t care. This doesn’t mean you don’t try.
Because your only job is to do the best that you can, which is to put forth your best effort with the information and resources you have available at the time. And there will be people who listen to this episode and believe that they are responsible for patient outcomes. And I urge you to just consider that maybe you aren’t. Just consider that. What if you’re not. What if how well you do your job isn’t dependent on your success rate with the patients?
Every time a case goes away that we don’t want it to go, there’s always an opportunity to learn something. So I’m not saying we’re just going to throw up our hands and go like, oh, well, no, that is part of the practice of veterinary medicine is to look at that and be like, huh, Be curious, be compassionate and learn from whatever went down with that patient. Because you’ll find that there are so many little nuances within this job.
Like there is no black and white, there is no absolute. So when you use that curious, that curiosity to look at the cases that don’t turn out the way that you want them to, you can start to see where your influence on that case ends. If you don’t take the time to be curious about it. And instead you just land in a whole bucket of self doubt and shame and guilt over those things.
Not only are those things more than likely very, very unfounded, but that stacking pressure that you’re creating on yourself will drive you out of this job. Perfection was never the goal here. Perfection is not attainable because it can’t be defined. And in medicine, where I know that you learn just like I did, that you can never guarantee to any client that a patient will get better. You have to ask yourself then why are you holding that expectation for yourself?
So, my friends, as you go forward in your career, I hope you will start to watch for the areas in your career and in your entire life where you’re looking, looking for things outside of you to give you evidence that you are good enough. Good enough in your jobs, good enough in your lives, good enough as humans, good enough in relationships, I want you to start to pay attention and notice where you are doing that, because those are the places where you are giving your power away.
And it’s all really based in just a shaky belief that you are already valuable and worthy. If you can really start to accept that as a fundamental truth that you are valuable and worthy simply because you exist, then that opens up the door to allow you to be human. Humans make mistakes. Humans are not supposed to be perfect. And humans who practice veterinary medicine are never supposed to get it right 100% of the time.
All right, my friends, that’s going to wrap it up for this week. I’ll see you soon. Bye for now.