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Difficult clients come in so many varieties, from clients anxious about a pet's impending surgery to those upset about their bill, that most practice managers agree it's nearly impossible to plan for every possible scenario. Because mishandling a disgruntled client can have serious repercussions for a practice, veterinary consultants stress the importance of responding quickly and appropriately to these challenges.
Rule number one: "Listen, listen, listen!" advised Carin Smith, DVM, owner of the Washington-based consulting firm Smith Veterinary Services. "No one will listen to you until you listen to them." It may be counterintuitive to respond calmly to a client's rant, but doing so can defuse a volatile situation, Dr. Smith said.
Mitigation is better than damage control, said Cecelia Soares, DVM, MS, a veterinarian and marriage and family therapist in Walnut Creek, Calif. "Just like vaccinations for distemper, there are verbal vaccinations for potential behavior problems," she said. "You can prevent a lot of common complaints by simply giving people information." That includes letting clients know when a doctor is running behind and keeping them informed of any changes in treatment or billing.
"Many clients come to a veterinary hospital with their own idea of what they'll be paying for a service or procedure," said Heather Vittori, hospital administrator at Arroyo Pet Care Center in Lake Forest, Calif. "That's why we make sure every client has a clear estimate. If you don't make it clear from the outset what you're actually charging for, there's a lot of room for confusion."
To that end, Peter Eeg, DVM, of Poolesville Veterinary Clinic in Pooleville, Md., is a firm believer in itemizing charges rather than lumping them together on a client's bill. "Many people don't have a clue about exactly how involved and advanced veterinary medicine is today," he said. "In those few cases where you have to deal with a disgruntled or irate client, it makes it much easier if you can point out specifically what was done."
Aware that his staff is often the first to encounter a difficult client's undesirable behavior, Dr. Eeg trains his staff to first listen carefully to the person's concerns, then convey them to the clinician on duty. At Carolina Veterinary Specialists Medical Center in Charlotte, N. C., hospital director Doug Swain is the point person for clients' complaints. "The support staff does what they can to placate disruptive clients, but if the situation really gets out of hand, we separate them from the public part of the building, put them in the conference room or library and talk to them there," Swain said.
In the case of telephone complaints, Swain records the client's concerns, writes down the client's comments on a complaint form then consults with the doctor or support person involved in the incident. "Even if our staff feels that things have been misconstrued in some way, it's important for us to understand how the client views the situation. Often, simply listening to the client's story and assuring them that we have a process for dealing with their feedback is enough. In some cases, we may even end up refunding money," he said.
Dr. Soares believes in-house training is best for most practices, although most national veterinary conferences and many state and regional conferences have a track or two that addresses dealing with unruly clients. Training staff in their own environment is generally less expensive than attending an off-site session, even if a human-relations education firm is brought in, since many more staff members can be trained at one time. Smith advocates role-playing, which gives employees experience with client interaction without the stress of an actual confrontation.
Discounts, Rebates and Refunds
While not all veterinarians and practice managers agree it's the right course to take, offering refunds and discounts can often placate clients who are upset about fees. Vittori authorizes the front office staff to allow small discounts or rebates in those cases where nothing else is working, and she reports a significant success rate with the program.
Smith supports this policy, maintaining that it makes a practice run more smoothly. "If a client has a gripe that could be solved with, say, cutting $5 off the bill, the employees should not have to wait until they can get together with the office manager for permission," she said.
But, added Smith, there should also be controls in place to make sure a discount policy is not misused. "The amount of money an employee is empowered to offer should be specified by the office manager," she said. "If an employee ends up giving lots of $5 concessions, then the office manager should re-evaluate the staff training on handling complaints."
The subject of "difficult" clients usually brings to mind angry verbal exchanges and hurt feelings, but Soares notes there is another type of client who can be just as disruptive: the one who won't leave or get off the phone. Sometimes these are lonely people who thrive on the attention they and their pets receive at a veterinary clinic or hospital; others may simply like to talk. Either way, they slow the progress of what is usually a very busy day for most staff members.
"Maybe it's a widow who calls every couple of days and needs to talk, and the receptionist chats with her for 20 minutes or half an hour because she feels sorry for her," Soares said. "You want people who are sensitive like that working for you; the trick is to support the client and still fulfill the needs of the practice. Those are good things to bring up in staff meetings. Maybe someone from the practice can call at a convenient time and give her a few minutes of support."
Honesty: Still the Best Policy
Unfortunately, sometimes the client is complaining for good reason. Despite best intentions, mistakes do happen. When they do, the best course is to simply own up to the error and offer to make amends. Vittori recalls an instance where a client had ordered the testicular implants known as Neuticles for her dog; when the package arrived, Vittori put it in the inventory coordinator's inbox, not realizing what it contained. The inventory person was out for a few days, so when the Neuticles couldn't be located and the surgery had to be cancelled, the client became upset.
When Vittori remembered the package, she called the client to apologize. "I just explained flat-out that I had messed up and put the package in his inbox, not realizing it was the Neuticles because it was in a different type of packaging," she said. Vittori offered a free night's post-surgical stay for the client's dog, which she happily accepted despite the fact she had often been a difficult client in the past.
"I think she appreciated the fact that I didn't give her a runaround story," Vittori said. "I could have said that the company messed up and took longer than we expected to get the package to us, but I think she appreciated the fact that human error happens and we did what we could to make it work for her."
The Firing Line
Sometimes, however, no effort seems to be enough to satisfy a client. Anyone who works with the public for very long learns there is a small minority of people who almost seem to enjoy being disruptive and aren't happy with any attempt to mollify them. After several negative experiences with the same antagonistic pet owner, many practices decide they simply can no longer afford to spend the time and energy it takes to deal with such negativity. In these cases, a "firing" is in order.
"One client had seven dogs, two of which had heartworms and were given medication," Soares recalled. "He insisted the practice give him medication for the other five without being seen by the veterinarian, which is against practice policy, not to mention state law. He wouldn't take no for an answer. The veterinarian finally had to tell him to leave the clinic."
"Certain behavior should be defined as unacceptable," Smith said. "Usually, a one-time episode is not sufficient to fire a client, but it could be if the incident is severe enough." Vittori uses a form letter to inform the pet owner that despite the hospital's best efforts, its services don't seem to be working for the client; the form letter includes a list of alternative veterinarians. Eeg sends a letter explaining the reason for the expulsion, followed by a phone call.
In some cases, the receipt of such a letter has an almost magical moderating effect on a client's attitude. "We've had a couple of clients beg us not to fire them—suddenly they're willing to do whatever it takes to make it work for both parties," Vittori said.
Soares stresses the most important element in dealing with difficult clients is staff support. "Human hospitals have social workers, but in veterinary medicine the job of dealing with difficult people often falls to people who aren't trained for it," she said. "Our vocation attracts people who are very dedicated, but if you don't back them up you won't keep them. I can't think of anything that will bring a practice crashing down around your head faster than not supporting your employees."
Mark Cantrell is a freelance writer based out of Wake Forest, N.C.
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