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Episode 79: Helping Clients Sustain Improved Outcomes—with Dr. Scott Thomas

Deb Zahn: Hi. I want to welcome you to this week's episode of the Craft of Consulting Podcast. So today is going to be a really hot topic. It's going to be a topic that is not only going to enable you to serve your clients better, but you'll be able to get more business if you walk into prospective clients with this ability in your pocket. That is, we're going to talk about how to help your clients sustain the improved outcomes and the results that you help them achieve. The reason that that is such a big deal is one of the complaints that people so often have about consultants is that we come in. We do a bunch of work. We bill them a bunch of money. We leave. And if we were able to help them achieve the result that they wanted, it starts to slip. And over time it disappears. That is really frustrating for clients. And it is avoidable.

So we're going to talk about what we can do. Not only to help them achieve, but also to sustain those results. It is a wonderful way to serve your clients. It is also a wonderful way to get more business by walking in with an understanding of this in a framework that most consultants don't have. So that's what we're going to talk about. It's going to be great. I am also bringing in one of my absolute favorite people in the entire world to talk with us about it. I'm going to leave you in suspense as to why he's one of my favorite people. But it's Dr. Scott Thomas, who is an expert in both sustainability and behavior change. So let's get started. I have the great pleasure of welcoming Dr. Scott Thomas to the show. Scott, thank you so much for joining me on the show.

Dr. Scott Thomas: No, thank you. Thanks for having me.

Deb Zahn: So let's start off. Tell my listeners what you do.

Dr. Scott Thomas: Well, currently I'm a division director at a mental health organization here in upstate New York. I cover the clinical and rehabilitation programs that have such things as mobile crisis units, peer programs, care coordination, day treatment, those type programs.

Deb Zahn: So really important work that truly, truly saves lives. Now, you've also been a consultant. Actually a few times before. So say something about your consulting career.

Dr. Scott Thomas: Well, I like doing both. I definitely like being in organizations because you get to see work go on long term. But then when you go out and consult, you get to learn what other folks are doing. So there have been periods where, for seven years, I go out and I consult foundations, universities, nonprofits and places like that. Then I go into organizations for a few years and might pop back out to consulting for two or three years. And then back into organizations.

Deb Zahn: That's right. So once you make the switch, it doesn't necessarily have to stay that way. Actually, I really like the mix. So you have one other distinction that we're going to tell people, which is you are also my beloved husband. And you're very grateful that you're going to do this because you're also my really smart beloved husband, and-

Dr. Scott Thomas: Wow.

Deb Zahn: We're going to have a great time talking about one of our favorite nerdy topics.

Dr. Scott Thomas: Thanks. I'm happy to be here and happy to be your husband.

Deb Zahn: Aww. So years ago, before we were...actually, before we were married, I think, or even a couple, we worked on behalf of three organizations, which we'll talk about in a little bit. We took a really deep dive into what it takes to sustain improved outcomes. So when organizations do the hard work, whether they do it themselves or they do it with consultants, of actually getting a change to happen. They get the results they want. They get the outcomes they want. How can those be sustained? Because it's not a naturally occurring phenomenon that they're automatically going to stick. So how does that happen? So we worked on that. We're going to talk a little bit about what that work is, but let's start off. If you could describe how you define sustainability in the context we're talking about it in?

Dr. Scott Thomas: Well, I take the definition from the best place I've ever seen it, which is National Health Service in the United Kingdom has a very simple one with three factors, which have to be there for something to be considered sustaining. The definition is, when new ways of working and improved outcomes become the norm. Real simple, but it hits on. You have new ways of working. You have to have improved outcomes. And now they're the norm. A real nice definition.

Deb Zahn: I love that. Let's talk a little bit about why it matters. I've certainly seen it, but I'd love to hear from you why it matters so much to pay attention to this type of sustainability.

Dr. Scott Thomas: I always think of three different sort of levels or reasons for why sustainability is important. One of them is the staff and organizations and staff morale, which is...You see this happen sometimes, where people come in. They do a bunch of work. There's a whole initiative that everyone's focused on. There's a little extra time, a little extra effort. And then a couple years later, it's all gone away. And then you come back, and you say, "Now we have a new initiative. We're going to try this for a while." And the staff's thinking, "Oh really? Because we've been through that." And then you try it again, and staff start to get burned out. They don't believe in your initiatives because they don't see anything sustaining.

So staff and their buy-in and their morale around initiatives is critical for sustainability. Same thing, you could almost repeat it for the population that's being served by the organization, which is if they keep seeing the organization do all sorts of new initiatives and this and that, and then just fade away, they start to lose faith. And then the third one is the straightforward money thing, which is, you spend a bunch of money, time and effort trying to make something happen. And you get it up. It's running. And then you move on. If that's not sustained, what are you going to do? You're going to circle back, spend more time and money. So I think about sustainability in terms of staff, population served, and the money, time and effort spent.

Deb Zahn: That's great. Consulting has everything to do with that because if you're a consultant and you come and you swoop in and you save the day and you help them achieve the results and everybody is happy, and then you disappear and it starts to slip or it disappears, that's about you and your reputation to make change actually happen. And the next time you come in, whether it's to that organization or another, you carry that with you. That ultimately, it wasn't a success. It might've been a success in terms of what was actually in the contract, but if it caused all of the low morale and all of the things that you've talked about, then your ability to tout your successes diminishes, and probably your client base diminishes because they all remember the frustration of it not sticking out.

I, in fact, remember when I was...oh, back in the day when I was in a consultant. And there was a consultant that worked for the organization and was working with our clients. And our clients complained that they had spent all this time. They had spent all this money and the results didn't stick. The consultant, much to my horror, said, "That's not our problem. That's your problem." This is actually one of the origins for the work that we did together to try and get at, OK, what does create this type of sustainability?

So do you want to describe a little bit about the research study that we worked on together to try and answer that sticky, sticky question?

Dr. Scott Thomas: Sure. It was a great study. It was out of the Primary Care Development Corporation (PCDC) in New York City. They asked the question of sustainability in a very simple, yet meaningful way. So here's what happened, which is that there was a healthcare collaborative with multiple healthcare organizations that were making quality improvements around diabetes, asthma, cancer screening, and such. What happened was the collaboration ended. But a few years later, the PCDC went back and looked, and they found that a number of the health care organizations had sustained their improvements. So very simple, the question asked, which was, how come? How come some of them just sustained it? It's two, three years out, and they still have the improvements in place?

So what we did was...I was the lead consultant on it going in, and I helped design and run a qualitative study that did hours and hours of interviews with staff at all levels of the organizations. We basically just talked to them. So how come you think this is still working? How come you think the initiative is still going, or the improvements you've made are still going? We transcribed all the interviews and threw them into a software program to do a thematic analysis and just help us get clear on, what were the factors that were showing up over and over again in the places that had sustained the improvements?

Deb Zahn: We also noted that there was kind of a rock star organization within the group that seemed to have all the factors working really well together. We're going to get into the factors in a bit. So I do want to give a shout out to Paloma Hernandez, who is the leader of Urban Health Plan, which is a large healthcare provider in New York City. What was amazing and what was smart about the way that this study was set up is that it was really people at all levels. Often, what happens is when people want to know information about organizations, they just go to the leaders who only have a certain view of what is actually true and not true. And what happened and what didn't happen. So what did you see when you went in there that told you that they had sort of the right ingredients together?

Dr. Scott Thomas: To tell you the truth, I think it goes to the old culture, culture, culture, which is, we are interviewing...Again, we did interview Paloma. That's, I guess, how I always think of her, which is Paloma. And so we interviewed her, and we saw, obviously, her interest. Her buy-in and her effort. But we also were interviewing receptionists who understood what was going on. We interviewed people on IT that understood what was going on and why the initiative was important and what it meant for both them and the patients they served. We interviewed nurses. We interviewed program directors.

The saturation at every level of the organization, I would say, to me, is what really stood out. I can picture sitting. Again, I think it was some of the IT folks. Why were these people so bought into the whole idea of diabetes care? How come we're trying to get improvements on A1C cons, but they're in IT? And they understood that. So that, to me, the saturation through the organization of why an initiative is important and what is going to be the payoff, not only for the organization itself, but for the patients we serve. That's what was really pronounced there at that organization.

Deb Zahn: I remember reading in the interviews, and if you had cut out some of the quotes and mixed them up, you wouldn't be able to tell who said them. Whether it was a receptionist or the CEO or someone in IT. We were so struck by how they paid attention to both: cultures and systems…that they had systems that were behind supporting what they were trying to do, so that you didn't have to remember everything. They automated as much as possible. But it was a real standout. So it was from that study, and then looking at other studies that had been done...Which there weren't that many of, if I recall. Now it's been over a decade.

But we tried to pull out. What are those factors that we think contribute to sustaining improved outcomes? And then hot on the heels of doing that, we were asked by three funders to put together a tool kit on sustaining improved outcomes because the idea is if we know what contributes to it, surely, we can use that information to try and get more folks to be able to sustain their outcomes. So we're not going to do all the factors, but do you want to highlight some of the factors? Because you've now done so many trainings and so much technical assistance related to this. Do you want to talk about some of the ones that are really standouts that have been shown time and time again to contribute to sustainability?

Dr. Scott Thomas: Well, what's funny about the factors is, I think both you and I, at the beginning, thought, "Well, we should just kind of not order them. We should kind of mix them up, have them kind of...When we talk about them, we just kind of go through them." We gave up on that because one of the factors that we call perceived value just popped up to the forefront over and over again. Whenever we talked to a group. Whenever we did trainings. Whoever we talked to. Whoever we got feedback. This was a very iterative process, which is, we'd go out and do some trainings, and we'd say, "How does this sound to you? What examples do you have?"

Again, what I say is perceived value. Which is unless it is perceived by leadership within an organization. Unless it is perceived to be a value to the staff, the effort to do it. Unless it's perceived by the population being served. And unless it's being perceived by the funders about how valuable it is. Then nothing else matters. You can't build a system to force people to do things. You think you can do mandated fields in the EHR and stuff like that. Believe me, if docs are involved, they can get around it. So truly believe in infrastructure and systems, systems, systems, but there has to be a true belief. It's not just buy-in but a true belief that the effort we're doing right now is going to make a change.

Again, going back to docs in terms of them getting around mandatory fields. Once docs feel that this is truly going to help the patients I serve, and they perceive that value, then they'll do the work. They'll do extra work to make it happen. So perceived value continually shows up as one of the most important.

Deb Zahn: Perceived value is a funny one because the word perceived really matters here. Because it's not necessarily actual value. So you've given a great example of programs out in the community during a tough economic time. It wasn't like people said, "OK, well, what is...Based on actual research, what is the highest value, so we know which programs to keep?" They were the ones that had more perceived value because they did deliberate things to increase the perception that what they were doing was valuable. They didn't let anybody else determine whether or not they were valuable. They put specific things in place to make sure that the folks that mattered never had to wonder if they were valuable.

Dr. Scott Thomas: Yes. They were definitely in charge of the narrative about the program or the initiative, and making sure it was clear to people. Again, you're absolutely right, perception is the key thing. That that perception was there. That you could have great results. Great metrics. This and that and the other. But unless the perception is there, then it really...Even though maybe having a good thing, it could fade away.

Deb Zahn: That's great. It's funny. I just want to say as an aside, so you and I met at Kaiser Permanente in Oakland, California. They would put us both on at the end, during training because we tended to get some of the higher scores with our trainings. Not that we were competitive at all. That never happened. But your thing was always culture, culture, culture, and mine was systems, systems, systems. Which is why we had to get married because those two together are unstoppable. So perceived value is really a culturally driven one, but you can also put systems behind it.

Dr. Scott Thomas: That's one of the other factors that showed up, which's called organizational infrastructure. So yeah, culture is very important but also people could get fatigued if there's not the supporting infrastructure, that you don't have a system in place that makes it very simple to do things. So people may be gung ho, again, that's the perception this is worth doing. But if month-after-month and year-after-year, getting it done is exhausting, that doesn't support it.

One of the factors that people would say over and over again, which is, "Oh, they put a new system in place, which makes it easier to do." I'm actually going through that right now at the organization I work in, which is, we had to put in a new documentation system for something that people were going to be like, "Oh no." And they saw it, and they said, "Oh, this is going to be easier." And they're willing to do the effort. So organizational infrastructure. The supporting system is critical for sustainability if you reduce the time and the effort it takes people to do what you're asking them to do.

Deb Zahn: That's great. Definitely, if you're a consultant going in there, you better know that because...We used to say this at Kaiser. Training is not implementation. So if you want people to do things, if they perceive that it's valuable and all you do is train them but you don't make it easier for them to actually do what you want them to do, you now have reduced the probability that it will sustain.

Dr. Scott Thomas: Correct. Yup.

Deb Zahn: So what are some of the other factors that jump out?

Dr. Scott Thomas: Again, these ended up sort of naturally ordering themselves. What was right at the top was another one that we called monitoring and feedback. The monitoring means the initiative is being put in place and the improvements are happening, you're watching how the improvements are going and you're giving ongoing feedback on it. I say ongoing because what can oftentimes happen is you might have an improvement initiative going on, and you almost wait until the end. And then you tell people, "Here's how it was." Well, they need to know along the way, and that sort of almost constant feedback. Here's how this worked. Here's an improvement we've seen here. The patients are really responding to this.

That actually starts to strengthen that perceived value. Just a survey, one shot report at the end, doesn't do it as much as ongoing feedback of, you're putting a lot of effort in, but we're already getting these good results. We call that monitoring and feedback because unless you're doing the monitoring, it's hard to give accurate feedback. But again, the feedback. The emphasis was on regular, throughout the process.

Deb Zahn: Some of the better places that I've seen it, and I've certainly encouraged my clients to do this, is to have easy-to-understand graphics and visuals and put them everywhere throughout the organization, so that everybody sees. Not just what a great job that everybody's doing together but also, what's left to do. So it motivates them and inspires them to take it to the next level. But if the only people who see the data that's being monitored are the leadership and then it somehow trickles down through the managers and maybe it gets down to the folks who need it. It's not as effective as feedback being widespread enough that it can have an impact as quickly as possible. So if it's as real time as possible, that's better.

Dr. Scott Thomas: I'm happy you brought that up because data and numbers don't mean that much to a lot of staff versus color pie charts, which is kind of just look at this real quick. See that there's a change, an improvement happening. Looks like we're having a good impact and move along. Most people, except for maybe higher admin, don't need to see the nitty gritty numbers.

Deb Zahn: Yeah. They need to see what matters to them. So you think of them as your audience…

Dr. Scott Thomas: Yes, your audience.

Deb Zahn: And then what matters to your audience. I love it. Any other factors you want to highlight?

Dr. Scott Thomas: Well, another critical one is staff. It's not just staff buy-in. Again, it's got to be more sort of granular than that. The three areas that were broken down over and over were that the staff need to have the skills, the confidence and the interest. You could say perceived value. But skills, confidence, and interest. Unless they have all three, it's very hard for, again, the improvement that you've done to sustain itself. They have to know how...If you're asking them to do something, they have to have the skills to do it, and then they have to have the confidence. Good old self-efficacy. One of the most important things for behavior change and for behavior to stick, which is they have to have the confidence to apply whatever skills you're teaching them.

And then they have to have the interest, and that's where the sort of perceived value loops back in, which is they have to...We saw this over and over again. You think some staff are just doing it. They're doing that. Most staff we talk to, they really want to see that. Is this going to make a difference with the patients we serve? That's why they went to that field versus other fields. So with staff, try to go a little deeper than the good old, do we have staff buy-in, and ask yourself, have we given the staff the skills, the confidence and the interest to make it happen?

Deb Zahn: That's great. What all of this begs, and I didn't say it earlier, but I want to say it now, and we talk about this all the time, is, these things are why sustainability doesn't happen at the end. These things are why sustainability should be part of how you design, implement, monitor, et cetera, et cetera. Whatever it is you're trying to make happen. So whatever the initiative is, or the project or the change is, you start thinking about sustainability at the beginning. Because you will make different design decisions. You will make different implementation decisions when you do that. If you just wait until the end...It's that horrible thing of what the project's done in two months, maybe a luxurious three months, and then they start talking about sustainability. And that's when it defaults to money because all of these other things have not been baked in.

Dr. Scott Thomas:You've probably hit on one of the major...I don't know what I would call it, flaws, in most sustainability work. Which is at the end of the project, you think, "OK, now how are we going to sustain this?" You're bringing up the major thing, which is, sustainability has to start at the beginning with the design. The example I always give is, so what if the initiative you have relies on transporting people to a central location? Maybe to get screenings of some sort? And then when the project is over, nothing...

So what happens to transportation? Is that built-in? Did you plan for transportation? Is there ongoing money for transportation? Or should you have done satellite sites, so you didn't have to rely on transportation? That's a sustainability question you can ask at the very beginning while you're designing it. I can't tell you how many times I've sort of been brought in at the very end, and they said, "Now, we're about to end. Train everyone on sustainability." And I'm like, "Well, the first thing I'd like to say is, they brought me in a little late."

Deb Zahn: Which always endears you.

Dr. Scott Thomas: Actually, to the trainees, they like it because they're thinking the same thing. But it is what I call sustainability conversations should be there at the beginning. And also just that concept of, are we talking about sustainability through implementation? Are we talking about sustainability when we do evaluation? Again, you don't tack it on the end. You start to use the word sustainability beginning, middle, and end.

Deb Zahn: I have found, as a consultant, has been just like you, one of the people who introduces the concept early and often gets blank stares. It's happened more than once. It's a new concept to a lot of folks so it's not like you say it once and they get it and they switch up. I certainly know some of the organizations...We've worked with organizations together who, truthfully, took them years to hear the words we were saying. That it's not something you do at the end. You do it at the beginning, and here's why.

It's so antithetical to how people were trained to design and implement programs, that it is a significant shift. But that's the beauty of consultants being in the mix who understand that, is we are change agents. And we are perfectly situated to be the folks saying to the leader, saying to the funder, saying to the staff, "Let's now..." And I'm going to steal from you, "Let's put on our sustainability hats and have a conversation about this." And to be able to facilitate that because it's not ingrained in people yet to do this. We hope someday it will be.

Dr. Scott Thomas: This is a wonderful thing consultants could bring in. You're right. It doesn't take much. I think consultants, obviously, when they're going into even pitch their work of what they'd like to be doing or how they're going to do things, for consultants to speak about sustainability with this type of framework and sake, funding is a real thing. What I often just say is, just separate out those conversations. Funding is real. And future funding. Not for improved outcomes. Once you improve outcomes, if you're doing it right, you shouldn't need future funding for that.

Now, future funding might be required for all sorts of other things, so I always talk about having a sustainability conversation around improved outcomes in like room A. And that if you want to talk about funding, go to room B and have that one. Because if you are talking about them both at the same time, it's, like you said, people aren't used to thinking about sustainability mostly in the improved outcomes, and those slip right into the funding conversation.

Deb Zahn: That's right. And getting the outcomes to stick. I really, really like the way that you talk about it in terms of, if it really is new ways of working and they've become the norm, then...Can I say it, or you want to say it?

Dr. Scott Thomas: You can.

Deb Zahn: I'm very impressed, though. Is that if they're really embedded. If they really have become the norm, you would have to have an initiative to get rid of them. That's how embedded they should actually be. And that takes deliberate action. That takes deliberate planning. And then yes, you can have the funding or financing conversation separately. But this also gets us into funders because we've both also worked with funders who have brought us in to have conversations about sustainability, again, often too late. But we usually try and get them having us brought in at the beginning and help folks at the beginning. But what do you think...for consultants that are working with funders. What is it you think we can do to help them do differently? Obviously, bringing us in early is one. But what else should we help them do or think about?

Dr. Scott Thomas: Well, really, it's to say that you think about sustainability and you have a framework for approaching sustainability. I would say out of everyone I've worked with, it's the funders who have been most interested in sustaining improved outcomes. They are the ones I've seen over and over again, when I'm working with foundation, they get tired of...They put things out there. They put money out there. And then they go back a couple years later, and it's almost disappeared. Especially at a community organization or someplace like that. And funders want to see this.

So I actually don't think there's much that has to be taught to funders. I think the awareness is there. Oftentimes, in-house, they don't have the resources or the background on, how do you do sustainability? How do we work with our grantees around sustaining it? So I would say most funders are after the support and the how. But again, I'll repeat my experience over many years now. The funders are asking for this. Are aching for this.

Deb Zahn: The piece that I'd...I would agree with that. The piece I would add is...This can often happen simply because of who's on their board, but there can be more mercurial funders, or magpie funders that constantly want new projects. Constantly want new things. The problem is if you're on the receiving end of that, that means it does create this do something, ignore it, do something, ignore it, do something, ignore it kind of cycle. Because that's what funding cycles look like. And that's why a lot of organizations end up sort of chasing the money. And it doesn't necessarily, in a lasting way, change the things that they're trying to change for whomever they're serving.

So this is where I would say, I think it is because sustainability can take time. And you have to have some patience for it. That single year, short term projects can work against sustainability. And they might consider longer term projects. I would definitely, personally, prefer to see more funders willing to do general operating support, which is basically, here's money to help keep everything running within the organization while you're working on the changes that you want to work on that are going to be over a longer horizon, or are going to be connected to other things. I think if they did that, I think it would help.

The other thing is just define it clearly. So we've both done grants. We know the sustainability question that appears on all grants for nonprofit organizations, and everyone writes, essentially, the same paragraph. We've written that paragraph, and it's nonsense. If they defined it relative to sustaining outcomes and not just defined it relative to where you're going to get your money when the grant goes away, that will really start to help with the culture change with the people that they fund.

Dr. Scott Thomas: Again, I don't think there should be laws like this, but I can't stand one-year funding. I have no idea what one-year funding is about. It can be about, maybe you want to make sure people are doing what they said they do. But maybe you do a two-year funding with the idea that we're really going to evaluate how you're doing after a year. To build things that are sustainable, it takes more than a year. That's the one thing. The other thing I'd say is on the website that we're going to talk about, and in the toolkit, we basically have a lot of cheat sheets. How to answer the sustainability question. It has to be probably one of the most popular documents we have on the website, which people can download for free. And we'll talk about that. But everything on the website's free and stuff, and it's...basically, it says, talk about sustainability this way. I guarantee, you will get almost all the points that you're being asked for on the grant if you write sustainability in this type of improved outcomes becomes the norm language.

Deb Zahn: Because they're not used to seeing it. And I am proof that it works because I do it. So let's talk about the toolkit because the tool kit is sustaining improved outcomes. It was funded by three funders, The New York State Health Foundation, The Health Foundation of Western & Central New York, and The Asian & Pacific Islander Healthcare Forum. So it is free because it is intended to be in public use. It has two parts. So the first part is for people who are doing the actual improvement work themselves. And then the other part is for funders.

So Scott said we have the, here's how you can answer the sustainability question if you're trying to get a grant. I have guidance in there for funders about how they should define sustainability and how they should support their grantees in it. But talk about what they can get if they go to the website. The website is, and I'll have a link in the show notes, it's sustaining outcomes. But what do they get when they go there?

Dr. Scott Thomas: Yes. I send people to the website. The toolkit is on the website. The toolkit is great for a deeper dive, really to kind of absorb the framework. But just the website, it has two tabs. It has multiple tabs, but two of them which are great. One's called tools for organizations. One's called tools for funders. The tools for organizations will give you tons of...or not tons of, lots of forums. It gives you the sustainability factors. A list of them with definition and examples. It gives you a plan for sustainability.

The definition sheet is probably one of the best sustainability cheat sheets you can have. Even with just what we were talking about. If you want to have a coherent conversation with your staff or the people you're working with. If you're a consultant, with who you're working with, just this one sheet, which says sustainability factors and lists them. Defines them and gives examples. If everyone's holding that right in front of them and referencing that, I can't tell you how rich a conversation you can have around sustainability. Just with that one thing. But there's a planning for sustainability worksheet. There's a sustainability worksheet where you kind of look at how strong you think you are on one sustainability factor versus the other. Lots of stuff you can just...Once you download those forms and you're just looking at them. Again, you just begin to internalize the whole framework around sustainability.

Deb Zahn: Here's the other pitch that I would give to consultants because I have personally done this myself. I have gotten engagements because of the way that I talk about sustainability because so many aren't that it makes me stand out. I've been told by folks who inevitably hired me, is that a lot of folks come in and say, "Oh, we're going to do this. We're going to do this.

We're going to do this. And we're going to help you make that change." I know, for certain, that most organizations or companies that I've ever worked with have experienced changes that didn't stick and the frustrations associated with those. So when I start to talk about it from that perspective, their eyes light up. And I can tell that they're hearing something that they have always wanted to hear but they could never articulate it necessarily themselves.

So it is a competitive advantage when you're trying to get business. And it's really interesting work to do. There are not a lot of folks out there doing it so it's...When you work with folks actually on the ground, making it happen, it changes the dynamic and it changes it in a really, really nice way. When you look on our website and you're going to see the tool kit, I do need to tell you that there's hidden romance. So his eyes are rolling right now, which is OK.

So we worked with the designer on the toolkit itself. And Scott and I met in Oakland, California, and so part of our whole logo is an oak tree. And it's us giving homage to the place where we met. Ain't that sweet?

Dr. Scott Thomas: Yes, it is.

Deb Zahn: We both decided that…

Dr. Scott Thomas: Oaktown!

Deb Zahn: Don't act all tough now, buddy. In the show notes will be everything you need to be able to get to this. I am going to end by asking you the big question I ask everyone, which is, however it is you define it, how do you bring balance to your life?

Dr. Scott Thomas: Balance. So work-life balance?

Deb Zahn: Yeah.

Dr. Scott Thomas: That type of…

Deb Zahn: Whatever version. For us it would be cat-life balance.

Dr. Scott Thomas: Yeah, cat-life. How do I balance with all the cats we rescue?

It comes naturally to me. So I hate to say it. So I don't make an effort because I love my work very much. But I love other parts. I love studying and I love reading. I have a meditation practice that is easy to do. We are fortunate to have woods right near our house and I can just hang out in the woods. So I guess for me, the balance is there cause there are things I love to do that I just make sure I get to keep doing. So yeah, that's how I'd say it.

Deb Zahn: It does look like you don't make a lot of effort, but definitely there's things that we both do, like clean cat dishes...But yeah, there is a nice flow. I've noticed that. I've been trying to get more into that zone myself. That's a great answer. Well, Scott, thank you so much for joining me on the show today. I've been trying to get you to do this for a while, and I'm so glad you finally did.

Dr. Scott Thomas: Well, thanks. It was lots of fun. This is a great topic. I will kind of circle back with that one last thing. This is a hot topic for consultants.

Deb Zahn: Oh yeah.

Dr. Scott Thomas: I can pretty much guarantee, as a consultant, to be coherent and with a workable framework—whatever framework, this framework or another one—just something that you come in with. I guarantee, you will be coming in with something that other folks don't have.

Deb Zahn: Exactly. Exactly. And I've experienced that. So thank you again.

Dr. Scott Thomas: All right. Thank you.

Deb Zahn: Thanks so much for listening to this episode of the Craft of Consulting podcast. I want to ask you to do actually three things. If you enjoyed this episode or if you've enjoyed any of my other ones, hit subscribe. I got a lot of other great guests that are coming up and a lot of other great content and I don't want you to miss anything. But the other two things that I'm going to ask you to do is, one is, if you have any comments, so if you have any suggestions or any kind of feedback that will help make this podcast more helpful to more listeners, please include those.

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So as always, you can go and get more wonderful information and tools at Thanks so much. I will talk to you on the next episode. Bye-bye.

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