In most organizations, when employees won't use what the organization sells, leaders reach for the easiest explanations available — it's a location problem, a scheduling problem, simply a matter of convenience. That explanation is almost always wrong, and I found that out within my first few months of taking over operations at Iowa State University's veterinary teaching hospital — one of the leading facilities of its kind in the country — when I started in this role back in late 2024.
What bothered me more than any number on a report was something quieter: a fair number of our own employees — faculty and staff — were taking their pets somewhere else, and not occasionally. We had a student discount in place, but nothing for employees. On paper, that looked like a pricing gap. In practice, it was a message — and not the one we thought we'd been sending.
Leaders spend a lot of time crafting the messages they mean to send — mission statements, strategic plans, town halls — but those aren't the signals people actually trust. The signals people trust are the ones buried in everyday decisions: what gets funded, what gets delayed, which barriers have been sitting there so long nobody remembers deciding to leave them. Your policies tell people what you say you value. Your inconsistencies tell them what you actually believe, whether you meant to communicate that or not.
So when your own employees choose a competitor over what you built, it isn't really a logistics problem. It's closer to a referendum — on quality, on culture, on trust, and on whether leadership is paying attention to any of it. Cost is part of that equation, sure, but it's rarely the whole story. Still, I wasn't willing to let it stay the excuse that let everyone off the hook.
On paper, the fix seemed simple: extend the student discount to employees too. For more than 36,000 people across Iowa State, a flat 15 percent discount sounds like something a private practice would decide over coffee and roll out the next week. At a university this size, it took eight months — legal review, audit requirements, eligibility verification, budget approval, policy language, the whole apparatus a large institution brings to bear on what should be a fairly small decision.
What that process made clear was that the real barriers were never financial — they were cultural. The discount itself cost very little. The harder thing was admitting, as an institution, that it should have existed for years, and that nobody with the authority to fix it had ever treated it as a priority. That kind of admission doesn't show up on a budget line, but it shows up in how long it takes an organization to act on something everyone already knew.
The point of the discount was never simply to drive more appointments through the door, though that mattered too. The real goal was to change who saw themselves as part of this hospital. When a faculty member from another college brings their dog or cat to us, they don't just become a client — they become an advocate, the kind who talks about the experience in places we'll never see and conversations we'll never hear. That kind of credibility can't be bought with a marketing budget. It has to be earned, one good experience at a time, and you can't earn it from people who are quietly opting out before you ever get the chance.
Even after the discount went into effect, not everyone came back, and that's where the more useful work actually started. Once cost stops being the obstacle, whatever's left becomes both harder and more valuable to look at. Maybe it's scheduling, or a perception about teaching hospitals that's been floating around for years, or a bad experience from a decade ago that nobody ever circled back to address. None of that gets fixed by a memo, and some of it means making changes that cost a lot more than 15 percent ever did.
Most organizations never get this far, because cost gives everyone a tidy place to stop the conversation. It lets leaders feel like they did something, and it lets employees keep their real reasons to themselves. Take that excuse away, and the conversation gets a lot more honest, whether anyone particularly wants it to or not.
None of this is unique to veterinary medicine. It's the engineer who won't touch the product his own company ships, the physician who quietly sends a family member to a competing hospital, the consultant who's never once used the framework he's selling to everyone else. Leadership usually has an answer ready for these — they're not the target user, they have unique insight, their situation is different — and sometimes that's even true. More often, it's a way of avoiding a harder question: why don't the people closest to what we're building actually believe in it?
A few months after the discount took effect, we saw a modest uptick in employee-driven appointments in primary care, which was good news. But the change that actually mattered wasn't in the numbers — it was in the language. Faculty and staff started talking about "our hospital" instead of "the hospital," which sounds like a small thing until you notice how often pronouns are where culture actually lives. That shift didn't come from the 15 percent. It came from what the discount represented — that leadership had noticed, and that whether our own people wanted to be part of this place actually mattered to someone.
There's a question underneath all of this that cuts through most of the noise: if your employees had complete freedom of choice, how many of them would pick your product or service — not because it's convenient or discounted, but because they genuinely think it's the best option out there? If that number is low, the problem usually isn't your competition. It's your own credibility, inside your own walls, and if you don't know the answer, that's worth paying attention to on its own.
Rolling out the policy was the easy part. What comes after is harder, and it means actually going looking for the reasons people still go elsewhere, even when you'd rather not hear them. It means sitting with feedback that challenges assumptions you've held for years and making changes that have less to do with price than with how the place actually feels from the inside. Most organizations stop at the announcement — they roll out the policy, send the email, and move on to the next initiative. But the policy was never really the point. It was just the door that opened onto the better question: are we building something our own people actually want to be part of?
For leaders trying to build something that lasts, this is closer to where reputation actually gets made — not in the polished strategy decks or the well-rehearsed presentations, but in whether you're willing to notice the thing everyone else has learned to look past, and then do something about it. Sometimes that means fixing something that should've been fixed years ago. Sometimes it means asking a question that makes a room go quiet for a beat longer than anyone expected. None of that shows up on a dashboard, but it's how culture actually gets made, and culture is the thing that eventually shapes everything else.
The next time something lands on your desk, it's worth pausing before you reach for the version of the problem that's easiest to solve. Ask yourself whether you're looking at the real issue, or just the one that lets everyone move on without examining what's underneath it. Cost is usually the easy issue. Trust, quality, and culture are not, and your team almost certainly already knows the difference — the only real question is whether you're willing to find out what they know.
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