Threats, Insults, and Pandemic Pains: Coping with Challenging Clients

Advice from practice leaders about how to effectively communicate with clients, from extending compassion when appropriate to setting boundaries and knowing when to terminate a relationship.

by Jen Reeder

SINCE MARCH OF 2020, John MacFadyen has heard countless clients begin a complaint with, “I get that it’s a pandemic, but . . . ”

The business manager at AAHA-accredited Veterinary Specialty and Emergency Center of Thousand Oaks in Thousand Oaks, California, MacFadyen said the practice was incredibly busy before the coronavirus outbreak forced the practice to adopt curbside protocols.

Leadership hired more staff and essentially converted two exam rooms into call centers. But with so many people sheltering in place with pets and a dearth of 24/7 ER practices in the county, wait times still skyrocketed to six to seven hours on bad days.

“A couple of months ago, I had a customer service representative say, ‘I get yelled at as much now in a day as I used to in a month,’” MacFadyen said.

To help buoy the team, MacFadyen gives $25 gift cards to anyone he sees coping with a difficult day, frequently orders pizza, and hosted a March Madness Bake-Off with a staff oncologist to bring in tasty treats and spread smiles with their over-the-top competitive antics.

Yet inevitably, compassion fatigue has “blown up.”

“Our people are swimming as hard as they can just to keep their heads above water, and it’s incredibly difficult because now you feel like you’ve got a 20-pound weight dragging you down that didn’t exist before,” he said. “So they’re having to swim that much harder just to keep the high level of medicine where it needs to be. But people don’t see that, of course.”

Challenging clients are nothing new to the veterinary profession, but the pandemic has led to them increasing in both number and intensity. The crisis has highlighted the importance of effective communication with clients and within a practice, from extending compassion when appropriate to setting boundaries and knowing when to terminate a relationship.

“We have to realize what our ultimate goal [is], and that’s generally to help the pet, help the client, and also take care of ourselves along the way.”
—Jason Sweitzer, DVM

Pam Drake, DVM, a veterinarian at AAHA-accredited New Frontier Animal Medical Center in Sierra Vista, Arizona, said the pandemic presented a steep learning curve.

“I have developed better boundaries in the last year than in the entire 30-plus years I’ve been in practice,” she said. “While we remain compassionate toward people, we hold the line.”

Dealing with the Distraught

While some clients seem to want or need to be angry in general, others are genuinely upset about a diagnosis or end-of-life discussions. Drake finds it helpful to share as much information as possible about potential outcomes so clients aren’t completely surprised by bad news.

When they lash out, she will be quiet and “let them process,” understanding it probably has nothing to do with her. If they don’t regain control of themselves, she will ask if there’s a family member they can call or excuse herself to give them time alone.

She recommends that when a client is obviously distraught, veterinarians document the conversations and have a technician witness the interactions.

“When people are in that level of distress, they will oftentimes misremember conversations,” she noted. “It just goes back to why we have the AAHA standards that we do—that documentation is your friend and having somebody else present is a nice safeguard, too.”

Jason Sweitzer, DVM, a veterinarian at AAHA-accredited Moorpark Veterinary Hospital in Moorpark, California, finds when clients are struggling with emotions, it is helpful to slow down, be present, and think about what they’re going through.

“As a profession, we tend to be very good problem-solvers, so once we look at it as a problem and we see they’re not acting in the way that they should, what’s the problem? Then we go ahead and solve it with empathy for them. When we look at it as, ‘They’re attacking me,’ our natural defensive tendencies go up and we immediately counterattack,” he said. “We have to realize what our ultimate goal [is], and that’s generally to help the pet, help the client, and also take care of ourselves along the way.”

He’s quick to mention that there are some clients you just can’t please, in which case leadership must be willing to protect themselves and the staff by firing the client or telling them, “This is a line you cannot cross. We can reconnect at a later point, but we need to end this conversation.”

For self-care, Sweitzer relies on crafting “dad jokes”—“My jokes are as lame as a cruciate tear”—to help himself and the team laugh. Colleagues might recharge by listening to music for a few minutes or taking a walk around the practice. He recommends everyone keep a list on their phone or next to a computer of activities that help them cope, including bathroom breaks and drinking water.

Placating Penny Pinchers

Of course, a common client complaint is that animal hospitals charge too much. Suzanne Tousley, DVM, of AAHA-accredited Urban Vet Care in Denver, Colorado, recently dealt with a man with preconceived notions of veterinarians being “money grubbing” who yelled and swore at her for discussing proposed diagnostics for his dog.

“He said, ‘It’s even more than human medicine,’” she recalled. “I said, ‘No, it isn’t. If you did not have health insurance, would veterinary medicine be more expensive than human medicine?’”

When he continued “dropping F-bombs,” though rattled, she calmly explained she was making appropriate recommendations to rule out things in a step-by-step way and that there are costs associated with it—and also that she did not deserve his disrespect.

“I told him, ‘How you’re talking to me right now is not OK.’ He totally changed his tune,” she said. “I have two preteen girls who I’m teaching how to be respectful to others. I thought, ‘Who raised you?’”

Curbside check in at The Village Vets

A vet tech returns a dog during a curbside visit

Some clients have a difficult time being separated from their pets despite dedicated care inside

During the pandemic, Tousley has also dealt with people hysterically crying about having to leave their cat in a carrier in the entryway instead of coming inside for an exam because they think their pet will be too scared without them. The animal is usually fine with it.

“I make a phone call and try to diffuse it by saying, ‘Oh my gosh, this is such a nice cat. He was so calm and relaxed and great for his exam,’” she said. “I will ask, ‘Do you have any concerns about this kitty?’ and then tell them, ‘Thank you so much for bringing him in.’ It’s kind of like (dealing with) a separation-anxiety dog. I always tell people you can’t make a big deal about the goodbye or hello. You just try to be positive and not point out that they shouldn’t be upset.”

Pandemic Pains

Nikki Burk, DVM, smiles with a pug named Gidget

Nikki Burk, DVM, co-owner of AAHA-accredited South Hyland Pet Hospital in Minneapolis, Minnesota, instituted video chats for curbside appointments in fall of 2020. The goal was to assuage people’s fears of being separated from their pets and to help doctors see clients’ expressions during discussions. Surprisingly, most people choose to stick with phone calls.

Last summer when Burk had a day off, a client was so insistent on coming inside with her cat that a veterinarian allowed her to come inside, provided she wear a mask and maintain social distancing. Instead, she removed her mask in the exam room and kept trying to touch her pet while team members handled the animal. When the team protested, the client grew belligerent.

“The whole team was immediately upset,” she said. “That was not an acceptable risk to us.”

A veterinarian at a nearby practice told Burk about a man who burst into the facility without a mask, ranting that the employees were “communists” for requiring face masks. Because of such reactions, Burk trained her staff to explain that protocols are in place to keep the veterinary team healthy so they can keep the hospital open to treat pets. It’s a sentiment repeated on the practice’s website and phone messages played while callers are on hold.

Will Draper, DVM, poses with a new patient for a photo to send to the owner

“People on the front lines—the receptionists, the technicians—can bear the brunt of that. So, I want them to feel empowered and educated as far as what to do, and I want them to feel like whatever they decide to do in that moment, we’re going to support them,” she said. “They also know as soon as they’re uncomfortable, they can pass it off and go up the line to management or doctors or owners. I think it’s very important for team wellbeing.”

Will Draper, DVM, co-owner of AAHA-accredited practice The Village Vets, which has five locations in Atlanta, Georgia, and a sixth in Pennsylvania, said a plus to the pandemic is the dramatic increase in pet adoptions. He loves working with new patients and clients and allows a full hour for first exams instead of the standard 30-minute appointments for regulars.

Thwarting Threats

Draper always tries to behave like his grandmother is watching. He encourages his staff to be kind and remember Michelle Obama’s advice: “When they go low, we go high.”

Still, he’s fired more clients during the pandemic than he has in a long time, including people who have called female employees a name for a female dog. One angry client scheduled his dog for a 1 p.m. appointment before he had a 1:30 p.m. video meeting, and was furious about the exam not starting until 1:08 p.m. When Draper called to try to diffuse the situation, the client continued ranting and threatened, “You better check yourself before you wreck yourself.”

“I said, ‘Now you’re going white privilege on me, and you’re basically telling the boy to stay in his place,’” Draper—who is Black—recalled saying. Then he told the client he would be sending him his pet’s medical records, said, “have a nice day,” and hung up.

Will Draper, DVM, performs a socially distanced exam

Whitney Durivage, MBA, CVPM, hospital administrator at Burlington Emergency & Veterinary Specialists in Williston, Vermont, said the practice has dealt with clients calling to complain about costs—almost a buyer’s remorse once their pet is home and healthy—and recently, accusations of “negligence” from a woman upset that her constipated cat would need a second enema. (She later apologized and sent a thank-you note for her cat’s care.)

“It is hard,” she said. “But you’re trying to help the client help the pet, right? That’s our end goal: how to relate to the client enough so that we can ultimately do what we’re here to do, which is make their pets feel better.” 

The team at Burlington Emergency & Veterinary Specialists tries to show clients how much patients matter to them

How to Apply Your Animal-Handling Skills to Challenging Clients

While it can seem like a degree in psychology would be useful for veterinary professionals, Cyndie Courtney, DVM, founder of The Jerk Researcher, a consulting agency that tries to understand difficult people (including ourselves), said veterinarians already have skills with pets they can apply to communicating with challenging clients.

Veterinarians don’t take the “jerk shortcut” and label/blame pets who are frightened or showing behavior issues. For instance, a cat peeing outside the litterbox isn’t exacting revenge because of a personality flaw. “We’re not extending this benefit of the doubt to the people who we’re dealing with in the same way that we extend the benefit of the doubt to the animals,” Courtney said.

Veterinarians focus on an animal’s current state rather than what happened in the past. If an aggressive or anxious patient comes in, it’s not helpful to think about what the pet owner did wrong that led to the issue. Instead, talk about what to do moving forward to help solve the problem.

Veterinarians set boundaries with animals to stay safe. An aggressive patient will need sedation, or, if teams notice negative body language, they move more slowly and use caution. An anxious, angry cat might need to come back a different day to finish treatments. “The ways that we use body language and our voice are also things we need to monitor with our clients,” she said. “When we approach a scared animal, we’re not going to face them straight on with our body. We’re not going to stare at them in the eye. We’re not going to use a loud, booming voice. These are things we should do in our communications as well if we’re trying to de-escalate a situation.”

Jen Reeder
Journalist Jen Reeder was horrified to learn about the abuse veterinary teams have been weathering, including the amazing team at her dogs’ primary practice, Urban Vet Care. She is grateful to everyone in the profession for their commitment to helping pets despite such challenges.

 

Photo credits: doble-d/iStock via Getty Images Plus, SouthWorks/iStock via Getty Images Plus, Photo by Morgan Sherwood, Photos courtesy of The Village Vets, Photos courtesy of Brian Goldstein, photo courtesy of South Hyland Pet Hospital, Photo courtesy of Brian Goldstein, Photos courtesy of The Village Vets

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