Life With Clients

The heartworm talk

The flea talk

The vaccine talk

The allergy talk

The dental talk

The weight talk

If you’ve been in small animal private practice for more than a year, you’ve probably lost track of the number of times you’ve had each of these talks. Many of us give every one of these “presentations” at least daily… and it might just be making us crazy.

In all seriousness, I’ve had more than one veterinarian tell me he or she left practice because they couldn’t stand to talk about flea prevention one more time. When we were in veterinary or technician school, most of us imagined ourselves saving lives, playing with kittens, and performing complex surgeries. Few of us salivated over the prospect of reviewing the lifecycle of the heartworm six times daily for our entire career. (Shout out to my colleagues in the Southeast!) I think most of us struggle with this monotony at some point.

Still, these repeated conversations are becoming increasingly important. As pet owners get more and more information from non-traditional and potentially unreliable sources (i.e. the Internet), we need not only to know basic healthcare information backwards and forwards, but to present it in a meaningful, engaging, and memorable way.

At some point, most of us ask ourselves, “How am I going to keep this up?”

When I started wondering that myself, I reached out to colleagues for advice. Generally when I survey people with a question like that I get a wide variety of tips and tricks on how to solve my problem. Here, however, that wasn’t the case. Everyone I talked to who had successfully dealt with this problem told me some variation on the exact same thing. Here it is:

Look past the conversation. Focus on your own goal.

Without exception, the people who had mastered the art of the repeat conversation advised me simply to remember why I got into this profession, then hold onto that. End of story.

I know it may sound trite, but I got into veterinary medicine to help people. I genuinely like people (and pets, of course), and I love that I get to help families. That’s what makes me feel good about what I do. It’s the part of our profession that I find the most rewarding.

[tweetthis]Look past the conversation. Focus on your own goal.[/tweetthis]

So how does that knowledge help me not want to beat my head against the exam table while doing the flea talk for the 900th time?
It’s simple. Now, when I do the flea talk, I’m not talking about fleas. I’m talking about a family. Sure, fleas get discussed, but they’re not the whole point of the conversation. The real focus is the people in that exam room and how this talk will help them. That’s what I find rewarding. Reciting the life cycle of fleas or ticks or heartworms… not so much.

It’s amazing how the “why” behind our conversations can change the way we feel about them. When I launch into a talk with to pet owners about some vaccine or parasitic organism with the feeling that I’ve got to do it because I need to educate them or “it’s my job,” it just makes me feel tired. However, when I remind myself that I’m telling them all this because their dog is awesome and part of a family and I’m helping that family keep him safe, it’s easy — because I’m doing something important to me.

[tweetthis]It’s amazing how the why behind our conversations can change the way we feel about them.[/tweetthis]

Pet owners feel this too. They recognize our intent when we engage with them. If they sense that our intention is to deliver a rote lesson about heartworms, their eyes are almost certain to glaze over. They’ll lose interest and begin to ponder subjects they believe will be more important in their everyday lives, like “What should I cook for dinner?” or “Is Jon Snow alive?” and “Who would win: Ronda Rousey or a tiger?”

Enthusiasm is contagious. If we show it in a real, heartfelt way to pet owners, they’re much more likely to pay attention and ask questions. Then the conversation become more enjoyable for everyone, on both sides of the table.

So the next time you are dreading having the same conversation AGAIN, ask yourself why you do this job… and then go talk about that.

[tweetthis]Ask yourself why you do this job… and then go talk about that.[/tweetthis]

Hopefully, you have a veterinarian who you really like. Maybe even love. (But when I say love, I do not mean love, because that is another problem.) The veterinarian-client-patient relationship is built on mutual respect and trust. Sometimes the veterinarian-client-patient relationship becomes a friendship, which is confusing, and not necessary or even advisable. A successful veterinary-client-patient relationship requires boundaries. This may seem counterintuitive, but boundaries really help to maintain mutual respect.

If you are trying to decide what level of contact is appropriate between a client and veterinarian, try to imagine that they are your family doctor (because they are). Veterinarians tend to give more access than physicians, but sometimes this can result in a dysfunctional relationship and then things can get tricky.

If things are not going well, here is how you break up with your veterinarian: first, you find another veterinarian, then you ask to have your records transferred over. It’s that simple. No awkward discussion. No break-up text that says, “I’m just not that into you.” No drama. At least there shouldn’t be. Most veterinarians are fine with clients getting second opinions or finding another practice that suits them better. In fact, they will probably help you to set this up before you can even get the question out.

[tweetthis]A successful veterinary-client-patient relationship requires boundaries.[/tweetthis]

Like most relationships in life, if you don’t feel like things are going well, the feeling is probably mutual. The veterinary-client-patient relationship is not exclusive. It’s ok to see other people. Again, think of it as you would when you see a physician that you do not have confidence in. It is not realistic to think that every health professional you work with will be your cup of tea, and that’s ok. Just move on.

Here is how not to break up with your veterinarian. Yelling at them. Yelling at the person who answers the phone, the veterinary technician or the veterinarian is not ok. This may or not be the intent, but it is amazing how this type of verbal abuse makes its way through a veterinary hospital like a tsunami of shit, leaving no one in its wake unscathed. Moving your way up the food chain to yell at anyone who will listen to you is not ok, from the veterinarian to the practice owner, or hospital director, or Dean or President of the University. Why stop there, you might as well write a letter to President Obama that you are dissatisfied with the veterinary care that you received.

What is the goal of the yelling and the aggressive letters of complaint? Are you trying to get your veterinarian fired because you don’t like them? Are you trying to get them into trouble? Are you 12? We are a self-regulated profession. If you really feel that your veterinarian has done something worthy of a formal complaint, there are appropriate channels for this. Yelling at them is not one of them.

When did the yelling start to be ok? That is the question. It is a combination of misdirected anger/sadness because of a sick pet, and the feeling that the yelling is going to result in better service. Sometimes the latter is true and that is a tragedy. In every other health professional office waiting room, there is the ubiquitous sign that says, “Abuse will not be tolerated”. Is the lack of signage in a veterinary hospital tacit approval to unload on veterinary professionals?

I should say that this is a very small percentage of the clients that I see, but even if only 5% of the clients are difficult or abusive, it will take up 95% of your time and, perhaps more critical, 95% of your emotional energy. You will take it home with you and it will wear you down. You will lose sleep. You will talk about it with your spouse. You will write a blog about it. You will forget the 95% of your clients that are grateful for your services. You will forget the joy of veterinary medicine.

[tweetthis]How you break up with your vet: find another vet, then have your records transferred.[/tweetthis]

Once a client becomes abusive, the trust and respect part of the veterinary-client-patient relationship is broken. It becomes difficult to work together in this context and you shouldn’t. As a surgeon, it is disconcerting to say the least to perform a surgery on a pet if I feel that the client does not trust me. If a veterinarian is performing a medical procedure on your pet, you need to trust them. You have to believe that they are doing their best to work in your pet’s best interest. You have to believe that they are excellent at what they do.

This is critical because veterinary medicine and medicine in general are an imperfect art and science. Sometimes things go wrong. Medical errors and adverse events (which are not the same thing, even if the result can look the same) can and do occur. It is rare, but if I have to explain a complication to a client, I need to feel that we are on the same side.

The abusive veterinary-client-patient relationship often goes on much longer than it should. Veterinarians (the Tina in the relationship) are over-achievers and often blame themselves and are reluctant to leave. The abusive client (the Ike in the relationship) doesn’t seem to want to go, even though they are clearly unhappy. And so, if you are a client and you do not trust or respect your veterinarian, I’m begging you, please break up with them. If you want to, let them know why. Try to be respectful and control your emotions.

Please don’t abuse your veterinarian or the staff. We are a sensitive profession and even if you don’t find us particularly attractive, we have all dedicated our lives to helping animals and we are doing our best. If you are a veterinarian and you find yourself in an abusive veterinary-client-patient relationship, try not to take things so personally. Reach for your joy and take it, you deserve it. Have the courage to tell abusive clients, “It’s not me, it’s you.”

[tweetthis]Have the courage to tell abusive clients, “It’s not me, it’s you.”[/tweetthis]

The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.

Facebook and other social media sites can be great customer service tools to delight your veterinary clients in between visits. However, veterinary hospitals can also manage to really tick customers off with some seemingly harmless posts.

Here are a few moves I’d avoid to keep pet owners coming back to your social media accounts (and your practice!)

1) Shame!

If you’re a Game of Thrones fan, you’ll recall feeling a new level of awkward as Cersei walked through King’s Landing – *ehem* – totally exposed.

That level of uncomfortable shame is N-O-T what you want to make your veterinary clients feel with your social media posts.

It can be super tempting to bash a pet owner that you perceive to be irresponsible on your page, but it’s not a smart move.

• Your other veterinary clients might be scared off, thinking they’ll be shamed if they ever come to you with an issue.
• That client you shamed is never coming back, and they’re going to tell their friends – some of whom might be super responsible pet owners – all about why.

So the next time you have a heartworm positive dog, think before you post his pic to Facebook with the caption, “MY IDIOT OWNERS FORGOT MY HEARTWORM PREVENTATIVE!”

Teachable moments can be great to share on social media, but only when the client involved in is on board. You have to navigate these types of posts very cautiously. My tips? Just remember to be empathetic and positive… instead of making your client walk through the Facebook version of King’s Landing without their clothes on!

Related: The 5 Social Media Tools EVERY Veterinary Hospital Needs

2) Surprise!

Just like clients don’t like to be surprised to find out their pet’s bill is twice what they expected, they don’t want to come across a picture of their pet on social media that they didn’t authorize. We have enough surprises in vet med without adding in the ones that could be avoided!

Getting consent to share a patient’s photo and story is super easy. I recommend adding a little blurb about sharing a patient’s photo/story onto your check-in sheets. This just makes it “part of the norm” for clients, and it also ensures it actually gets done. Alternatively, you can just ask verbally! My experience is that ZERO clients have ever said no when asked verbally, and maybe only 10% decline sharing when asked on a form.

Veterinary clients generally like making their pets “Facebook famous.” Just have a little consideration, ask permission, and keep your patient posts upbeat.

[tweetthis]Veterinary clients generally like making their pets “Facebook famous.” [/tweetthis]

3) Chirp!

Social media is increasingly becoming a favored method of communication. The last thing a pet owner should hear when they reach out to you online is crickets.

If a pet owner asks a question online, be timely in your response. Smartphone apps like Facebook’s Pages app makes this easy to stay on top of. (You can get 5 other social media tools I love here!)

And if you’re reading this and thinking I’m a total crazy person for keeping up on social media, just know it is pretty minimal for me, even with 5-6,000 active clients. If you STILL think I’m a lunatic, we just might have different customer service points of views.

[tweetthis]The last thing a pet owner should hear when they reach out to you online is crickets.[/tweetthis]

Then there are the pet owners that like to share on social. When a veterinary client posts a photo of Pomeranian in a costume to your Facebook timeline, be excited. Even if it’s the 100^th hot dog, Batman or lion costume you’ve seen Lola in, her owner is excited to show you.

Don’t stomp on that connection. Though it might not seem critical, I think it means a lot for these clients to share their pets with you outside of the exam room. Act excited, or at least like the post. It only takes a second, but it can mean a bunch to the bond you share!

4) Yawn!

Social media is a great way to educate pet parents between visits. However, social media is also a place pet owners are going to have fun. It’s our job as businesses to provide entertainment and relevant information. Don’t bore your average pet owner with the latest JAVMA article on pathology.

Instead, share practical, simple pet health tips they can relate to. I especially suggest blogging on your practice’s website. That way, the content gets you web traffic. Additionally, it establishes you as the resource for pet info online, not that Dr. Google guy. (Which should be avoided until we can at least establish which veterinary school that guy went to…)

Related: 4 Reasons Your Veterinary Hospital Needs a Blog

5) Busted!

In a perfect world, we’d all have those nice cages and runs with the clear fronts. I dream about these ideal scenarios. However, the reality for many practices – including my own – is that cages look like…. Cages. Pets in lock up don’t look like pets having a positive experience.

If you want to take a photo of an admitted patient, don’t do it behind bars. Get the pet out of the cage and into the arms of a staff member, or simply – wait for it – open the front of the cage!

[tweetthis]If you want to take a photo of an admitted patient, don’t do it behind bars.[/tweetthis]

If I’m taking a photo alone, I usually manage to get my iPhone lens close enough to the cage to peek through the bars. This way the pet doesn’t look like a character on Orange Is The New Black, but I don’t risk them leaping out.  (I can’t fix the pets, so I try not to break them). You get a cute pic, but no one thinks his or her Golden Retriever finally got locked up for the time he jumped on the counter and ate the whole coffee cake.

Avoiding these social media missteps will undeniably strengthen the bond you have with your clients. Want to take that connection to the next level? Make social media posts that pet owners will LOVE using my 5 favorite social media tools for veterinary hospitals, available here.

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Danielle is a veterinary practice manager and the founder of SnoutSchool.com, a website dedicated to teaching veterinary hospitals to use social media effectively. You can get her 5 favorite social media tools here, or follow her on social media to see excessive photos of her Brussels Griffon. She’s @DanielleSnout on Twitter & Instagram!

Some days in the clinic, I’m just tired. It’s usually on those days when I’ve had about a dozen nearly identical conversations about the importance of clean teeth, heartworm prevention, or weight control. Sometimes it’s not though. Sometimes it’s just hard to get going and be enthusiastic after a vacation, or weekend, or lunch, or hearing my technicians make a truly awful pun while expressing anal glands.

Sometimes we just hit a point where we can’t get thrilled about marching into that next appointment, don’t we? The hard part of this scenario is that usually, no one cares how you feel about the next appointment, because it’s loaded up in an exam room and everyone is waiting for you to get in there.

At times like these, I can’t help but wonder, “What if I just took it easy in this appointment? Would anyone know or care if I phoned it in?” I mean, not the big stuff — just little things. What’s the harm in not telling one pet owner things she doesn’t want to hear anyway, like “your cat is overweight,” or “your dog needs a heartworm test,” or “we need to see your other pet for an exam before prescribing ear medicine for it.” It’s not like taking it easy this one time would make me a crappy vet.

The truth is: it could.

There’s a thought exercise I’ve recently become quite fond of called Sorites Paradox, or The Paradox of the Heap. In this exercise, we imagine a heap of rice on a table. I take one grain of rice and lay it by itself. Does that one grain of rice make a heap? I think we can agree it doesn’t. However, if I take additional grains of rice, one by one, and add them to this new pile, asking you each time, “Is this a heap of rice?”, at some point, I will add a single grain of rice and you will have to say, “Now it’s a heap.”

So one grain of rice does make a heap.

I’ve seen this paradox illustrated with money (“Can one penny make you rich?”) and exercise (“Can one workout make you fit?”). In all cases, the point is the same. Big things are made up of little things, and at some point the accumulation is undeniable. If I skip a conversation I don’t want to have with pet owners one time, could that possibly make me a crummy veterinarian or technician? Sorites paradox says yes.

A single grain of rice doesn’t make a pile, and a single penny doesn’t make us rich, and a single workout doesn’t make us fit, and a single half-hearted appointment doesn’t make us bad at our jobs… until it does.

The challenge is not to be AMAZING in the exam room whenever we are in just the right mood. Rather, the challenge is not to half-ass the appointments that happen when we are not in the perfect mood. It’s to have the conversation that needs to be had, to give people information they don’t necessarily want to hear, and to do and say what’s best for the pet every time.

Recently, when I’ve been standing outside that exam room and looking at a chart that says something like “Pet has fleas again. Owner says this time really will give medication,” I’ve been thinking about Sorites Paradox. I’m not a crappy vet, and those individual appointments are where I have to prove it. When it comes to bad appointments, I don’t want a heap, and neither do you.

By Peter Weinstein DVM, MBA

 

Post offices, banks, doctor’s offices, motor vehicle departments, restaurants, veterinary clinics… They all have a similar reputation—they never seem to run on time.

 

Does your practice belong on the above list? If so, do any of these situations sound familiar?

 

• The first client arrived late and things just snowballed from there
• The client was such a Chatty Cathy that we couldn’t get her into or out of the room
• The cat was sooooo fractious that it took a while for us to get our hands on it
• That last patient was much sicker than we thought.

 

And where are you in this mix?  Is lateness ever the doctor’s fault. Do any of these phrases ever describe you?

 

• On the phone instead of in the exam room
• On the internet instead of in the exam room
• Distracted, disorganized, and unfocused while in the exam room
• Never in a rush, because you know people will wait for you.

 

If you want to claim that you are a client-centered practice, you need to change your approach to client waiting.  It is disrespectful and just bad client service to keep people waiting.  On the other hand, if you want to continue in the old model of a doctor-centered practice … take your time!

 

[tweetthis]If you are a client-centered practice, change your approach to client waiting. [/tweetthis]

 

Instead, what if you guaranteed your clients that if they arrive on time, they will be seen within ten minutes of their appointed time OR the appointment is FREE!!

 

 

Now, your first reaction is likely, “I can’t do that, I’ll be giving away FREE EXAMS all day!”   But keep in mind, you are probably already doing that due to appointments that last longer than they should.  If you DID make this promise to your clients, though, wouldn’t it differentiate you from other practices in your area? Think about it this way: “If I’m on time every time, then maybe I’ll be done on time at the end of the day, too!”  Wouldn’t that be nice?

 

So, let’s see how we could accomplish this.

 

First, make being “On Time, Every Time” a goal for the entire practice team.

 

Second, take a month to identify WHY your practice runs behind.  For each appointment over the next month, note when the client is late arriving, the time the client gets into the exam room, the time that the veterinary nurse or doctor enters the room, the time the doctor leaves the room, and, if the doctor is late leaving the room, note the reason why.

 

After you have completed a month or more assessment of your exam room operations, determine the most frequent causes for why you fall behind.  What percentage were client caused? Staff caused? Doctor caused?

 

For those things that you can control—staff and doctor—what changes are needed to get the team to stay on time?  For the things you can’t control—clients or pets—what can you do?

 

Armed with your research and your ideas, make the necessary changes in your practice workflow to keep the doctor and staff on time.  For example, it might be as simple as cutting out phone calls and Facebook time between appointments, or developing a system to let the doctor know that time is up.  With your changes implemented, repeat the tracking for another month.  Were you on time more often this month?  Did you go from 60% late appointments to 30% late?  Of the 30%, were they doctor/staff or client/patient caused?

 

Once you have implemented enough changes so that 85% to 90% of your appointments are on time, issue the challenge to your staff to be an “On Time, Every Time Practice” and make this promise to your clients. Reward your staff for staying on time, and promote the heck out of your promise to the world at large.  Tell clients they can leave War and Peace or Harry Potter at home when they come to see you, because you will be seeing them on time, every time or their visit is FREE.

 

If this seems simple, that’s because it is! The more significant aspect of this change is to challenge the veterinary profession to repair one aspect of its image that can be controlled – late appointments.

 

Being on time shows respect for the client, sends a message to the staff, and is good for business.

 

Stop making excuses.  Start making changes.

 

 

[tweetthis]Being on time shows respect for the client. We need to change our approach.[/tweetthis]

 

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Dr Peter Weinstein sees himself as a cheerleader and advocate for the veterinary profession. From his current job as Executive Director of the SCVMA to his speaking and writing, he likes to help veterinarians and their teams enjoy what they do everyday. Feel free to reach out to him at peterw2@aol.com