Good client relationships are essential for any veterinary practice, but what do you do when a client really tests your patience? By John Burfitt
Anyone working in a veterinary clinic knows of at least one difficult client who transforms even the most routine task into a drama, and can turn a consultation into a catastrophe.
Sometimes, these patients are just demanding, irritated or angry. There are also the highly-emotional ones, distressed about their beloved pet. Then there are others who want the best service, but will question every cent on the bill.
These sorts of dramas can have, however, adverse effects. It was an issue highlighted in the 2014 Royal College of Veterinary Surgeons Survey, with respondents revealing the main challenges facing the veterinary profession were high client expectations and demands (53.8 per cent) as well as stress levels among veterinary staff (53.4 per cent).
Attrition levels of people leaving the profession was one of the main areas of investigation of the recent Lincoln Institute’s Vet Shortage Think Tank report, which also concluded the main reasons for the exodus ranged from high stress and mental health issues through to excessive client expectations.
Aussie vet Dr Ruth Parkin, who now works in the US cities of Portland and Denver, was the head vet of busy practice for a few years, but eventually gave up the role in favour of locum work due to excessive client demands.
“The thing that burns out a lot of vets is the owners,” Dr Parkin says. “Many are reasonable and understand the costs, but there are enough who don’t and pass blame on as they can’t afford the test or the surgery and expect the vet to do it for free.
“I’ve had clients screaming in my face over a $20 test because they didn’t think they should have to pay. There’s also the stress of having reasonable owners who legitimately can not afford the service and that limits the quality of care you are able to give to your patient, which can make good doctors feel like they are failing their patients even though it is not through any fault of their own. Dealing with all of that, often on a daily basis, exhausts good people.”
Experiences like Dr Parkin’s are not isolated, claims veterinary training consultant Dr Diederik Gelderman. “I hear about cases like this all the time and I think a lot of this stress comes down to a matter of training,” he says. “It is an established fact that veterinary science is a high-stress profession, so assisting people on how to cope with clients who are challenging needs to be a priority.”
Associate Professor Martin Cake of Perth’s Murdoch University believes vets need to adopt a more balanced approach towards their work, one that places as much focus on how they deal with clients as it does on taking care of their own wellbeing. Professor Cake is the project leader behind the VetSet2Go program, which aims to build veterinary employability, with effective relationships one of the major framework dimensions.
“Rather than trying to change the client, you’re far better trying to focus on the way you deal with situations like this,” he says. “A more balanced approach is important and empathy is the key. I’m not trying to push a ‘Pollyanna’ attitude, but if you only focus on the negatives, that is all you will see. We need to balance out the view and just as equally recall the many happy clients who are great to work with. That’s when you need to take a good look at how you deal with your circumstances.
“A major dimension of the VetSet2Go employability framework is effective relationships, which includes client relationships. Capabilities underpinning that includes communication skills, empathy, trustworthiness and relationship-centred care approaches.”
Utilising resilience and empathy are the key factors when dealing with challenging clients claims Michelle Gibbings, the founder of consultancy Change Meridian and author of the book Step Up: How to Build Your Influence at Work.
“If you use empathy and mindfulness to understand what the client is going through, it allows you to detach from the experience and makes you realise the way they are reacting is usually not about you,” she explains. “Recognising that can be a really important way to cope and means you are not engaging emotionally. You remain as professional as possible but show understanding.
“Never forget that when people are emotional and feel vulnerable about a pet they love, they’re not at their best and compassion can make the world of difference to how it plays out.”
Which does not mean, however, that vets should tolerate extreme levels of behaviour. There are times, Gibbings insists, clear boundaries need to be set.
“All relationships are two-way streets, so you might need to consider the way you are communicating, and if it is abrasive and abrupt, then don’t be surprised if you are encountering the same back,” she says.
“By the same token, you should never allow yourself to be emotionally abused. So if someone is screaming, you might need to say, ‘I’m happy to help you, but not when you talk to me like that’. You need to be calm and not emotional as you do it, but if that client continues to carry on, then you are within your rights to ask them to leave. Taking care of you own wellbeing must remain paramount.”
Vets adopting a personal care wellbeing regime, be it regular exercise or techniques like yoga and meditation, is something that needs to extend way beyond the workplace, adds Dr Gelderman.
“It’s about how you take care of yourself, and if you’re going to be in this profession, then that needs to be a part of your approach,” he says. “You can’t control what another person feels or what is happening in their lives, but you can change how you perceive and manage it. With all we know now, that needs to be a part of the way vets approach their careers.