James Barr Of Emergency Pet Hospital: 5 Things I Wish Someone Told Me Before I Became a Founder
It is OK to not know the diagnosis right away. It is important to be comfortable with not always knowing the answer. And you must also be OK with saying so when the time comes. For example, a pet may come in with symptoms that indicate a certain condition, but test results do not verify this diagnosis. It is OK to let the client know that the results are inconclusive, and you do not know the answer now but are prescribing additional tests to zero in on a diagnosis. Knowing the steps to get to the right answer is oftentimes just as important as the diagnosis itself — especially in emergency cases when time is of the essence.
As a part of our interview series called “5 Things I Wish Someone Told Me Before I Became A Founder”, I had the pleasure of interviewing James Barr.
James Barr, DVM, DACVECC, is chief medical officer (CMO) for BluePearl Specialty and Emergency Pet Hospital. Dr. Barr holds undergraduate and veterinary degrees from Louisiana State University. He was a staff criticalist at Florida Veterinary Specialists (BluePearl’s original hospital), then left to teach at Texas A&M University in 2009, returning to BluePearl in 2017 to serve as a group medical director and then CMO. As CMO, he oversees the medical operations of BluePearl’s 100+ practices, supporting more than 1,300 veterinarians. Dr. Barr also serves as a member of the Diversify Veterinary Medicine Coalition (DVMC), focusing in areas of scholarship and mentorship. As part of DVMC, Dr. Barr works alongside members of Mars Veterinary Health as well as other industry partners to help meet the needs of members of the BIPOC community and other underrepresented groups who are interested in the veterinary profession.
Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you got started?
I grew up in rural North Louisiana around a myriad of animals and was involved heavily in 4-H and FFA. My sisters and I learned how to care for and deal with the ailments of our livestock and pets. Our community veterinarian was one of the most revered people by our family and that influenced me to follow this path although I did not definitively decide to become a veterinarian until I got to college. I can remember from a very early age the respect and admiration I had for those that dedicated their lives to the welfare and care of animals. That persists still today as I still feel very fortunate to be a veterinarian.
I hold an undergraduate and veterinary degree from Louisiana State University. I was a staff criticalist at Florida Veterinary Specialists (BluePearl Pet Hospital’s original hospital), then left to teach at Texas A&M University in 2009, returning to BluePearl in 2017 to serve as a group medical director and then Chief Medical Officer (CMO). As CMO, I oversee the medical operations of more than 100 BluePearl specialty and emergency practices, supporting more than 1,300 veterinarians nationwide.
Can you share the interesting story that happened to you since you started your career?
Early in my career as a general practice veterinarian, I encountered an “aha” moment that shifted my approach to practicing medicine. A five-month-old boxer named Ollie was brought in by his owners for a standard surgical procedure, which I performed alongside a more seasoned clinician. After the procedure was completed and Ollie was sent home, he began experiencing complications. Even though complications after surgery are common in younger, more active pets, I was devastated the procedure did not turn out as I’d hoped.
I struggled to understand how I could succeed throughout my academic career in veterinary medicine and yet fail at this simple procedure. However, the response and advice I received from my mentor and Ollie’s owners helped me to accept this common reality and grow as a veterinarian. My mentor made sure that we were able to keep Ollie’s health at the forefront, by referring Ollie to a specialist for more advanced care than we could provide. Putting Ollie at the center of care, while offering me a safe space to learn, taught me that patient-centered care and empathy for hospital staff can help pivot even the most devastating of situations. Ultimately, Ollie received the specialized treatment he needed, and I became a better, more effective doctor.
Are you working on any new or exciting projects now?
BluePearl is a national specialty and emergency care provider, seeing more than one million pets each year. As Chief Medical Officer of BluePearl’s 100+ hospitals, I am overseeing the development of a new, exciting service that will soon be available in many of our practices nationwide: urgent care. Along with this new service, our medical team has developed an online urgent care curriculum that will provide an alternate career option for those veterinarians that want to care for ‘sick’ patients but are not yet ready to make a full transition to ER. Program candidates have the option to remain in urgent care or complete more didactic and hands-on training to transition to ER. Along with improving our hospitals’ efficiency, this effort aims to enhance both Associate and client satisfaction by lessening ER caseloads. We hope this will create a lasting impact on the communities we serve and quality of life for our hospital team members.
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?
Luckily, I have had two rewarding mentorship experiences.
Right out of veterinary school, I went into general practice and was fortunate to have a fantastic mentor, Dr. L.D. Eckerman. He gave me the tools I needed to become a more competent veterinarian as well as how to communicate well with clients. I grew self-confidence under his leadership, and by the end of my time there, was able to have some of the most difficult client conversations — relaying a negative prognosis of a pet or discussing finances. During my residency, my assigned mentor taught me how to optimize the system of hospital care. This meant arranging my patients so that nurses and technicians could best do their jobs or improving processes during patient hand-offs, so the next attending clinician had a better understanding of the pet’s condition and needs.
Both mentors taught me how to give feedback to colleagues in a kind way, teaching me to shift my narrative to more positive sayings like ‘You overlooked this, which is key here’ or ‘You missed the mark on this, but this is how you can do it better next time’ or ‘I know what you are capable of, and I want you to continue to give your best effort.’ Although people often become defensive when receiving feedback, constructive feedback is actually a gift. This form of feedback can be incredibly rewarding if the mentee is receptive to it.
These mentors also brought me to accept the idea that I will make mistakes as a doctor. Giving a mentee the freedom to make mistakes, when the stakes are not high, allows them to become a better doctor as they are able to experience risk/benefits analysis first-hand. This skill is not only applicable to medicine, but in managing people, or making financial choices involved with running a practice. Getting to the other side of a case or a difficult situation, reflecting, and figuring out what you could have done better is key to growth.
Is there a particular book that made an impact on you? Can you share a story?
Crucial Conversations: Tools for Talking When Stakes are High has made a profound impact on the way I engage with others — at home and at work. The authors explain that when you are stuck in any situation, there is often a crucial conversation that needs to be had. And it is this critical conversation that ultimately keeps you from accomplishing your desired goals (or results). If you can master the skill of speaking up in these crucial moments, you can reach the results you seek. After studying successful communicators over a period of 25 years, the authors concluded that what differentiates these communicators from the rest is simply their ability to handle crucial conversations. The authors go on to assert that the certain skill set these communicators possess allows them to deal with any situation, no matter the power or position of the individuals involved.
In veterinary medicine, it is important for a doctor to understand how clients/patients arrive at a certain point of view — especially during a difficult conversation involving finances or a bad prognosis of a pet. Although these are hard conversations to have, it is critical the doctor explains the ‘why’ behind treatments and the value that costly medical interventions bring to the patient. There is gravity to these situations that must be addressed to get to the desired result — which typically is a treatment plan that serves both the client and patient’s best interests.
When engaging in these difficult yet crucial conversations, it is important for doctors to remember:
a. You did not make the pet/patient sick,
b. You are there to help,
c. You know what the costs are going to be and the steps you should take,
d. You can work with the client to devise a plan according to finances, but there may be financial limitations beyond your control.
How have you used your success to bring goodness to the world?
Aside from my direct work in patient care, I also have helped others care for pets. I have been both a mentee and mentor, paying forward the skills and lessons I was once taught as a young vet. One such lesson is to keep self-preservation top of mind. Many of us enter the vet field with the altruistic goal of helping as many sick and injured animals as possible. However, amid the dizzying web of daily clinical tasks, we often forget to set aside time for ourselves. This could even mean skipping meals or breaks for the sake of a patient. Sadly, this is a caretaker’s plague — a phenomena only recently talked about within the realm of veterinary medicine. As someone who worked on the practice floor for 15 years, I know this burden well. Today, I am an advocate for self-care, and work to bring to light the mental health stressors of the veterinary profession. As the saying goes, “You cannot pour from an empty cup.” When we take time to replenish ourselves, we in turn bring our best selves to work. And in this profession, that means we are able to pour more goodness into the world.
Can you please give us your favorite “Life Lesson Quote”? Can you share a story about how that was relevant to you in your own life?
As quoted by Brene Brown in the book Dare to Lead, “Who we are is how we lead.”
Good leadership requires you to remain who you are in the company of others, and a commitment to authenticity. It is vital to sustain an alignment between your values and your actions as it serves as a bond of integrity that enables your team members to trust you. You can increase the alignment between your values and behaviors by better understanding what drives you to do what you do, then making them apparent to your clients and teams. The goal is to produce a more consistent and authentic expression of who you are in the moments that matter. For example, transparently sharing your thoughts as you work through a difficult problem helps those you lead to understand the tradeoffs and shows that have thoughtfully considered the consequences of your decisions. This coupled with communication and follow through help to establish trust.
Can you share your top three “lifestyle tweaks” that will help people feel great?
- Prioritize physical health — Consider physical health a key stone foundation. Without your physical health in good standing, you will not be able to sustain everything else in your personal and professional life. Prioritizing your physical health boosts confidence, brings mental clarity, promotes optimism, and provides energy. Set aside time each day for physical activity and watch how this improves multiple aspects of your life.
- Prioritize sleep — At the end of each day, there is always the desire to fit in one last thing. But a good night’s rest will give you the energy, clarity, and reserve you need to keep up with the demands of daily life. Figure out how much sleep you need to feel well-rested (seven to nine hours for adults is the U.S. recommendation), and consciously ‘turn off’ about 30 minutes before bedtime. This could mean shutting down electronic devices, dimming lights, turning on relaxing music, or reading a book chapter.
- Continue to learn. Until you try and learn new things, especially something that may not be related to veterinary medicine. As said by Neale Donal Walsch, “Life begins at the end of your comfort zone.” Learning new things helps us to expand our minds and challenge previous beliefs or perceptions. And there is also the rush that comes along with learning or trying something new. When you feel tired of your daily routine, or overwhelmed by everyday chores, do or learn something new. This newness will bring you a feeling of accomplishment and delight and may even open doors to new possibilities.
What are your “5 Things I Wish Someone Told Me Before I Became a Doctor” and why. (Please share a story or example for each.)
- It is OK to not know the diagnosis right away. It is important to be comfortable with not always knowing the answer. And you must also be OK with saying so when the time comes. For example, a pet may come in with symptoms that indicate a certain condition, but test results do not verify this diagnosis. It is OK to let the client know that the results are inconclusive, and you do not know the answer now but are prescribing additional tests to zero in on a diagnosis. Knowing the steps to get to the right answer is oftentimes just as important as the diagnosis itself — especially in emergency cases when time is of the essence.
- Approach conversations without judgement. As a clinician, it is important to stay objective, listen to understand, not to respond, and to stick to the facts. Emotions and stakes are high in the veterinary setting — whether dealing with team members or clients — so it is critical to approach conversations without preconceived notions. For example, if a clinician assumes a client’s financial well-being is lower than what it actually is, they may approach a conversation with limiting treatment options. This approach is harmful to the patient and is handicapping the doctor’s ability to do their best work.
- Outcomes vary by perception, so be specific. What a clinician may deem an optimal outcome is not always what a client may deem an optimal outcome. For example, a client may see an optimal outcome as being their pet resumes their normal life; they are able to go on multiple walks per day and play fetch. However, the clinician may see the optimal outcome as being the pet has improved quality of life (from the pet’s current condition); they are able to walk without a limp. It is important to clarify outcome expectations while in the exam room discussing treatment options.
- Recognize the importance of your nursing and paraprofessional staff in your success. Clinicians must make their nursing and paraprofessional staff experiences as good as possible. Excellence and efficiency in veterinary medicine is dependent on teamwork, and teams work best when all members feel safe, supported, and heard. Civility between team members, specifically, can create a sense of safety and is a key ingredient of successful teams. Alternatively, incivility robs teams of their full potential and can lead to poorer patient outcomes.
- Take care of yourself. The truth is we can care too much — too much about work and too little about ourselves. Day in and day out, we pour ourselves into our work, yet forget that we must refuel our own engines before we can service anyone else. Compassion fatigue and burnout are common byproducts of an always on, always ready clinical culture, so be wary of this reality. Make sure you are taking time to care for yourself — even if this means scheduling five-minute breaks throughout the workday or doing breath work in between patients. Small daily steps can amount to big change.
If you could start a movement that would bring the most amount of wellness to the most amount of people, what would that be?
If I could start a movement that would bring the most amount of wellness to the most amount of people, Everybody Needs a Dog.
Most of us dog lovers know that life is better with a dog, but sadly, not all people are able to enjoy this luxury. Dogs love you unconditionally, provide devoted companionship, and constant entertainment. Beyond this, spending time with a canine companion does wonders for well-being. Research consistently shows that owning a dog is good for a person both physically and emotionally as they make us happier, healthier, and can even help us cope with a crisis. From children to elderly people, the Everybody Needs a Dog Movement would allow each and every one of us to experience one of the deepest connections known to man and that is the human-animal bond.
Is there a person in the world, or in the US whom you would love to have a private breakfast or lunch with, and why?
I would love to have a private meal with Eilon Musk. I would like to know how he innovates so quickly, and applies simplicity, even in the most complex circumstances.
This was very inspiring. Thank you so much for joining us!