Daisy’s time had come to an end. Her little body that once followed her owners from room to room and wiggled with joy every time they came home had been ravaged by cancer. She was a shell of her former self; her owners knew it was time. As her loved ones wiped away tears, I administered the final injection. Her owners stroked her one last time and kissed her. I extended an arm and offered a simple, “I’m sorry.” We hugged. They thanked me. We took her body to the back for pawprints and cremation. The owners went home to a house that would feel very empty for quite some time. I took a deep breath and reflected on my long relationship with Daisy and her family. Twelve years earlier, I delivered her by caesarian when her mother experienced dystocia. I extracted her tiny, brand-new body from her mother’s uterus and handed her off to my techs for warming and resuscitation. I watched her grow up and get old. I watched her owners get older, too. I learned about their adult children and grandchildren, their retirement, a recent stroke, and their difficulties in caring for an aging pet. I didn’t know them outside of our work relationship. Thirty minutes a couple of times a year is not much time, but somehow they felt close. At their age, it was unlikely they would get another pet. It was somewhat of milestone for me as well—I was saddened that I may not see them again. Grieving for loss of empathy I thought of this experience after reading a recent discussion at an online veterinary forum. A group member had been reprimanded by her boss for diverting a client to the local emergency clinic. The client called an hour before close. She didn’t think it was her job to talk to the client on the phone, and she didn’t think it made sense to see the dog briefly when it might need more workup and treatment than they could provide. She thought she had made the best call from a medical standpoint based on limited information. More than 100 comments were posted, and two camps emerged. One group supported her decision; the other said they would triage, begin treatment, and send to the e-clinic if necessary. What struck me was the lack of empathy in the majority of the comments. After 21 years of practice, I can attest that we are not effective caregivers when we don’t maintain some measure of empathy for our clients. Without empathy, we resort to vilifying our clients, blaming them for our low morale, exhaustion, and job dissatisfaction. We risk creating an “us versus them” mentality that seeps into our body language and our conversation tone. We tend to display righteous indignation at the notion that we should endure a measure of inconvenience for the sake of a client. The real nature of our work relationship becomes obscured, and we focus our attention and energy on the expectations of the person who signs our paycheck, rather than on the clients who generate our paycheck. Sacrificing relationships for “balance” This is not just a generational issue. Pets have become a much more important part of owners’ lives. Our profession has actively promoted the human-animal bond to drive business to our clinics. Owners are more informed and opinionated than ever. Our expectations of ourselves have increased. Private practice grows ever more complicated. However, in our efforts to manage our workload challenges, I fear we are sacrificing one of the key elements that can sustain us—the relationships with our clients. When we try to do our jobs at arms’ length, it becomes a dissatisfying experience for both parties. Pets have become a much more important part of owners' lives, owners are more informed and opinionated than ever, and private practice grows ever more complicated. In the midst of these challenges, it's important to practice empathy and preserve client relationships. Much of our dissatisfaction is born from the mistaken notion that it’s possible to hold a position of great responsibility and demand and somehow remain constantly “balanced.” An entire generation has bought into the idea that they will be unhappy and unfulfilled if they don’t achieve perfect and consistent work-life balance when, truthfully, this feel-good philosophy doesn’t square with the reality of many professions. Kara Powell, Ph.D., with Fuller Youth Institute is fond of saying, “Balance is something we swing through on the way from one extreme to the other.” Expecting that we should remain balanced when it’s impossible to achieve leaves us feeling defeated. We would be much better mentally and emotionally equipped to deal with the unexpected demands on our time if we come to expect that our days will be unpredictable and that continual balance is unrealistic. In the history of humankind, nothing great was ever created from a position of balance. We accomplish great things when we are willing to devote ourselves to a cause. If we are not willing to temporarily sacrifice our position of balance for the causes we hold dear, then we must adjust our expectations for our lives and our impact accordingly. Owning it and leaning in We voluntarily committed to being caregivers for creatures who are dearly loved by their owners. We perform a vital role in preserving their bond. Recently, a middle-aged woman in my exam room was beside herself because her 7-year-old boxer was suffering from colitis and hadn’t eaten in two days. We planned to hospitalize him. Through tears, she implored me to do all we could for him because “he is the only creature in the world who loves me.” Healthy or not, the attachment is real. We deal with it daily. We are better prepared mentally if we own up to the fact that being a caregiver is inherently taxing. I doubt I would have been blessed by my long relationship with Daisy and her owners had I not been willing to juggle my schedule to accommodate her needs 12 years ago when her mother was experiencing dystocia. There will be times when you are harried and exhausted, but your relationships with clients will thrive and take on a deeper, more fulfilling layer of meaning that itself is sustaining. When our clients appreciate that we are all on the same team, striving for the same goals, they trust us more, argue less, and comply better. When we lean into the relationships with our clients, we open doors. As a young vet and a new father I struggled. But I made changes that shored my support network and created some flexible boundaries so I could regroup. I scheduled more intelligently and gave up some areas of practice. I model for my children a life committed to a cause where I often put others’ needs above my own desire for comfort and structure. Practical advice Frank Bealer, author of The Myth of Balance, suggests a four-step approach to managing your career when achieving sustained balance is impossible. I’ve expanded his list to a 10-step approach specific to veterinary medicine. 1. Embrace the challenge You took on a tough assignment that also can be beautiful and rewarding. Recognize that your current situation is temporary, be it good or bad. Arrive every morning ready to tackle whatever challenge the universe has in store. 2. Manage well your life away from work Prioritize overall well being. Rest, exercise, make healthy food choices, and consume alcohol in moderation. Build quiet time into your daily routine. Avoid over-committing yourself, but get involved with a nonveterinary group activity—a book club, an adult volleyball league, a worship group, etc. Vet school tends to shape us into borderline sociopaths. We spend four years with the same group of perfectionists, talking mostly about school. We must remember how to manage normal relationships and conversations outside of our profession. 3. Prepare with knowledge Dr. Google is here to stay, and that’s not a bad thing. Informed and educated clients can be the best clients. Stay up to date on the latest advancements in medicine and surgery. Offer to prove every diagnosis and explain yourself in a nonconfrontational, objective manner. 4. Develop a 2-minute offense At the end of the day when we need to rapidly triage and begin treatment on a patient before everyone else goes home, a rehearsed protocol can be critical. Also, give the client advance warning that you will stabilize and transfer the patient to the local e-clinic for ongoing care if necessary. 5. Build in time for the unexpected Twenty percent of your daily workload is the result of same-day appointments, walk-ins, or emergencies. Accommodate those demands to keep them from wrecking your schedule. 6. Instill a formal policy Clear team expectations for handling late appointment requests, emergencies, and walk-ins eliminate confusion and keep the messaging consistent. Resist the urge to “awfulize” cases based on the owner’s perspective over the phone. Many times what sounds really bad ends up relatively simple and straightforward. 7. Practice empathy When I talk with our staff about customer service, I suggest that everyone pretend as if the person across the desk or exam table is their best friend’s mother or father and treat them accordingly. 8. Celebrate the joy Don’t let one negative experience overshadow 1,000 victories. Be intentional about identifying the good things that happen in your day, and congratulate yourself. 9. Recognize the warning signs of catastrophe Learn to recognize when you have been on the busy side of the spectrum for too long. Create a plan for how to temporarily cope and swing the pendulum the opposite way. 10. Appreciate the investment Deeper, more meaningful relationships with your clients are not only investments in your sanity, they’re also investments in your future and in your bottom line. Dr. Randall is a University of Georgia College of Veterinary Medicine alumnus and owner of Foothills Veterinary Hospital in Greenville, S.C., a five-doctor, two-location private practice.
