Loyalty is a firm and consistent allegiance and a lasting faithfulness. That is what we all want with our valued clients. Because end-of-life circumstances are supercharged with emotions, almost everything you do or say at this time either deepens client loyalty or causes the opposite reaction—which you certainly do not want. Some practices ignore the unique needs of clients whose pets are near the end of life. This experience is often dismissed as the end of this relationship. I hear from clients every week who were alarmed at the cold or unprofessional way their trusted veterinarian handled their last pet when it was dying or when it was time for euthanasia. A 2011 American Express survey found that three in five unhappy clients will relay their bad experience to others, and consulting firm Lee Resources International has found that more than 90 percent of unhappy customers will not come back. You may not see this reaction or know the client is gone, never to return. You also may not see the deep emotional wounds in these families. If you knew how you have a direct impact on the emotions of these clients, you likely would change your approach to all pets nearing the end of their lives. Negative client reactions may be subtle or outrageous, but all are awful and can cause lasting deleterious effects for your practice. My final installment in this series focuses on those actions and communications that can happen at this time and how a proper approach can generate or deepen loyalty with your clients. Personal Tragedy A week before I was scheduled to write this article, I had a personal tragedy with the unnecessary death of a wonderful dog, my sweet boy Tucker. It was every veterinary hospital’s nightmare, and it happened to me, the client, as I sought specialty surgical care. In this awful event, I had experiences with two clinics: the specialty hospital that did a surgery and dismissed him before he was recovered, and a local general practice that did everything it could to save his life. My experience with these two hospitals could not have been more different. After Tucker died, everyone at the general practice, from doctors to staff, communicated real caring and genuine grief. Even doctors who knew Tucker from previous contacts wrote wonderful notes expressing their surprise and grief. In stark contrast, neither doctors nor staff at the specialty hospital bothered to call or express sympathy. This painful experience illustrated how some clinics do these things so well and communicate real and honest caring, while others do it poorly and are short and business-like, or worse yet, silent. No communications at all can be extremely damaging at a time like this. Our profession must remember that the reactions clients have from how we handle these cases can be either extremely positive or so negative that they can last a lifetime. Extreme cases can lead to bitterness and horrible public and social media statements, or even state board actions. When it comes to the art of communications, crisis media situations and emotion-infused end-of-life situations are two of the most critical. These are also the most overlooked, both in preparation and in response. A Justifiable Investment in Time I am going to recommend that you do things that take time—yes, time you don’t have. Did you know it can cost up to 20 times as much to attract new clients as it costs to keep those you have? Take the time needed to keep your clients by finding ways to connect and comfort them in their grief. If it is true that 30 percent of all pet owners experience significant grief after the loss of a pet, what you and your team do in end-of-life situations can either comfort and engender loyalty or can increase the grief and cause bitter feelings. It has been reported that half of all clients will question their decision after euthanasia. I find this appalling. If provided with sincere counseling and honest communications, clients should not regret their decision. Spend time helping them understand when the time is right as you reach the end of what medicine can do or what the pet’s body can withstand. Real Caring In a busy practice, it is easy to create an appearance of caring. What is harder is displaying feelings of real caring. However, real caring is what we must have with clients whose pets are nearing the end of life. The challenge is to shift your focus from clinician to compassionate counselor and offer reassurance if euthanasia is the right decision. To do this, you must shift your advice and discussions to support the difficult decision of ending the suffering and why this is best for the pet. I would never want half of my clients to doubt their decision after euthanasia. Busy practices have so many distractions that demand our attention, and we get in a frantic, multitasking mode trying to handle it all. This frame of mind is not conducive to the kind of compassionate thought and time needed to exhibit real caring for clients who desperately need it. You must find a way to pull real, honest caring from your heart and deliver it in a genuine fashion. That is a tough assignment. If you can remember how you felt when you lost a loved one or a beloved pet friend, then use those feelings in deciding what to say or write to a client. This technique goes a long way in helping your communications be full of real caring, and not something superficial. When sending sympathy cards, or even a note by text or email, use the name of the pet and the family members. Write in a way that shows you were listening when they told you a great story about the pet in their lives. Write in a way that shows you really understand the ache in their hearts by recalling your past personal pain. I’m going to be brutally honest here. If my dog died, or was euthanized at your office, I wouldn’t want to receive a card with a note from your technician or a receptionist saying, “We’re sorry for your loss.” Impersonal writing is worse than no writing at all. Such a thing screams: “We put very little thought into caring about your loss.” It is meaningless, and therefore has no power to help them in their grief, much less engender loyalty. Why not have special cards made containing an extraordinary photo and thoughtful words that express the special nature of your true caring? You gave this kind of thought to your logo and hospital design, so why not do the same for this critical item? Then you, the doctor, should handwrite a short note. Whether expressed in person or in a sympathy card, make your clients feel as if they are the only pet owner going through this crisis, and give them the gift of your full attention and your deepest sympathy. That engenders loyalty. If you don’t, if you are being superficial in your level of caring or if you leave the impression that you have done something perfunctory—or worse yet, had your staff do it for you—your clients can feel that their precious pet was unappreciated by you. They will likely tell friends of your attitude, not to mention be the source of potential backlash in the social media sphere. Other Considerations If an end-of-life case requires your hospital to think through a measured response for legal reasons, never let clients sit in silence while you are deciding. That is a horrible thing to do to a precious client at a time when they are mourning. Let them know first how much you care and how seriously you are taking the situation, and then tell them you will be back with them on some sort of finding or response. To allow grieving clients to wait in silence is uncaring, cruel and highly unprofessional. As important as end-of-life communications are to client loyalty, you should honestly evaluate your staff. If anyone in the chain of communications has a problem with arrogance, or fosters a defensive or dismissive attitude, then someone else should do the communicating. Arrogance or rushed, artificial compassion is worse than no compassion at all. Regret is a powerful and long-lasting emotion. Proceed with these cases carefully so you avoid anything that causes the client to feel guilt or remorse. In my practice, I hear some strong client reactions to past euthanasias that went bad or were done in a cold, uncaring environment. If a client is left heartbroken because of this experience, it will stay with them forever, while a peaceful and respectful experience will produce gratitude and loyalty for decades. Handling these cases in a way that creates loyalty is not difficult; all it takes is time, a genuine level of caring and letting a little of your heart shine through so clients can see that you share their sorrow. Good Approaches Here are other ways to help clients with end-of-life events: Doctors, as much as we depend on our technical staff, do not depend on them for intimate end-of-life communications. It must be you. Be sure to have a special room for end-of-life conversations and euthanasias. Never perform euthanasia on a stainless-steel table. This is something clients often tell me they have regretted. Go to extra lengths to make the room special, warm, quiet and sound insulated. When empty, this is the perfect place for you to have important phone conversations so your words can be private. Make sure receptionists get end-of-life cases into the room immediately. Allow clients to stay with their pets as long as they like after the euthanasia has taken place. Be sure euthanasia clients have a way to leave the office privately. Try to make end-of-life consultations around noon or after-hour times so you don’t feel rushed. If you can, schedule an in-home euthanasia. It is a powerful way to show that you know this is a highly private and personal process. If this isn't possible, find a trustworthy and experienced DVM to make the calls for you. The service can be a valuable extension of your care. For in-hospital euthanasia, do not take the pet out of the room for catheter placement. This robs your clients of precious final seconds they have with their pet. Become comfortable doing it in front of the client. Always sedate the pet, if medical conditions allow, as this makes the entire process easier for you and more peaceful for the family. Never rush the family. They must have all the time they need to say goodbye. Train staff members about compassionate communications, and make sure all contact with a client who has an end-of-life case is made only by those who have a real heart for such important interactions. Whether in person or by phone, clients with a pet near the end of its life need to process verbally about the thing that is taking their pet from them. Remain patient with them, listen to them and talk more about the pet’s well-lived life than medical facts. Give clients the gift of time, even if you have heard it all before. They must talk it out, and they will be forever grateful for that gift. Try not to see the end-of-life situation as giving up on care or as a low-tech procedure. If that comes through in your communications, it can be devastating to the relationship. It’s the end of this relationship, but in the majority of cases the client will have more pets. Remember that there is no wrong way for clients to grieve or mourn the loss of their pet. Remember that this is the end of a deep emotional bond. Allow clients to play music, sing, watch videos or have any number of ceremonies to honor their beloved family member. These simple things will generate loyalty that lasts a lifetime. Express Genuine Caring Here is an example of superficial, rubber-stamp caring. Do not use such language in messages. Dear Ms. Murphy, We are sorry for your loss. Signed, The Staff Here is an example of a message with genuine caring that would engender client loyalty: Dear Ms. Murphy, I just heard of Rocky’s passing. I am so very sorry to hear this. I know what a great dog he was and how important he was to you. I’m sure this is exceptionally difficult for you and your family. My thoughts are with you and Robert. Please let me know if I can help in any way. Here is my cell number: xxx-xxxx. Please call if you have any concerns or questions. I will call tomorrow, but I just wanted to let you know tonight that I got your message and how sad I was to hear this. Please take care of yourself, and I’ll call you tomorrow. Parting Thoughts The American Animal Hospital Association publishes outstanding guidelines that would be fantastic starting points for you and your team to help clients through the end-of-life experience. The 2016 AAHA/IAAHPC End-of-Life Care Guidelines are available at http://bit.ly/2k1glag. I am proud of our profession’s leaders and a few organizations that have pioneered this topic. It is my sincere hope that end-of-life topics earn your focus and attention so your clients receive the caring they deserve. Jim Humphries founded the American Society of Veterinary Journalists and the Veterinary News Network. He owns Home With Dignity, an end-of-life practice in Colorado Springs, Colo. Originally published in the March 2017 issue of Veterinary Practice News. Did you enjoy this article? Then subscribe today!
