Among other things we’ve learned from studying animal behavior, we know all creatures have their limits. Whether we’re talking about territorial disputes among felines or resource guarding among dogs, we understand these triggers often culminate in a crescendo of emotional arousal when they’re effectively messed with. Identifying these incitements is often half the battle when assessing problematic animal behavior. So, too, can spotting our own personal provocations help us manage the emotional storms that inevitably ensue when clients say things that offend our moral sensibilities and crush our egos. Because they will... And they’re by far our biggest stressors. To be sure, there are other sources of anxiety: intercollegial acrimony, staff-related friction, financial fears, professional anxiety and grief, to name a few. But somehow these pale when compared to the chronic onslaught of client-based angst. Knowing our triggers All practicing veterinarians are likely to identify with the examples discussed here. But note: My intent is not to wallow. Rather, it’s to help us all identify our stressors, which, as for our patients, is how we survive the war. It’s only when we’re armed with an understanding of our collective weak spots and triggers that we can soldier the worst our clients can muster. So here we go: “I don’t have the money. Euthanize her.” Some clients give in too soon over financial considerations. But financial “euthanasia” takes many forms. Typically, it’s the slow burn of a half-assed approach to chronic disease management that gets them in the end. This is arguably way worse than the client who wants you to end the life of a patient experiencing manageable nausea, pain, or respiratory distress, but not half as bad as the client who refuses to live with a three-legged pet. Either way, talking your way through these situations takes its emotional toll. “I want her to die naturally at home.” Whether it’s the cat with untreated diabetes or the dog in congestive heart failure, we’ve all been there. So it is that when the cardiologist’s nursing staff calls you to please, please, plead with the owner of a gasping patient that just left the clinic against medical advice, you know you’re in for one slog of a phone call. “I have the money, I just refuse to go there—financially.” Just because we can do something doesn’t mean we should. I get that. In fact, I find myself using this line a lot. But how many times have you heard, “I just don’t want her to suffer, Doc,” while knowing in your heart that what they really mean is… “I’d rather go shopping at Saks for a cute Dior clutch than commit any more funds to this breathing money pit that’s been sponging off me for the last 10 years just because my kids wanted a dog before they up and left to a fancy Northeastern college that costs 15 times more each semester than your estimate.” Steals a little bit of your soul every time, doesn’t it? These next ones might, too. “You’re fired!” It’s one thing to fire a client; it’s quite another to get fired by one. Whenever clients ask for their records, I cringe. Interestingly, though, the mortification has little to do with my financial fears (which dog me mercilessly). Rather, it’s more about my fear of rejection and feelings of inadequacy, which is probably universal. I mean, who likes getting dumped? “You suck.” Nothing hurts worse than having a client imply you’re bad at your job. Nothing. Except maybe when they tell you that outright. Whether it’s an unvarnished accusation of incompetence or an insinuated charge, nothing slices to the bone of our self-worth like being told you’re not a good veterinarian. As hard as we’ve worked to get here, it stings to have your impostor syndrome fears validated so nakedly. “You’re a heartless money-grubber.” This is probably the most common epithet aggrieved online reviewers aim at veterinarians who request payment (either in advance of services or when services are rendered), fail to offer discounts, or refuse to comp their bills. No other profession is infected so tenaciously by the notion that payment is optional. Bursting your clients’ bubble is never an enjoyable undertaking, is it? Sure, the widespread public perception of veterinary medicine as a labor of love is great for our reputation, but it’s decidedly bad for business. Now that you know you’re not alone, at issue is how to handle the worst our clients have to offer. Here’s what I do (when I can remember to): 1) Put yourself in their shoes. Imagine you never went to veterinary school and lived under a rock. How would you feel? 2) Come up with a reasonable justification for their behavior. For example: “Well, maybe she’s having a bad day because her mother just died.” 3) Remember that not all people are well-adjusted or sane. This may be a truly sick person you’re dealing with. 4) Focus on being of service to your aggrieved client. How can you help them? Somehow, I find this kind of works. It turns things around so you’re not stuck on the defensive. 5) Sneak off into the bathroom or your office (if you’re lucky). Close the door. Strike a yoga pose. Meditate yourself to clarity. All that stuff isn’t so important, now, is it? 6) Be grateful for what you have. You’re smart. You’re educated. You live in a free country in one of the most comfortable places on planet Earth. You work with animals, most of them nonhuman. What’s not to love? Patty Khuly, VMD, MBA, owns a small-animal practice in Miami and is a passionate blogger at drpattykhuly.com. Columnists’ opinions do not necessarily reflect those of Veterinary Practice News.
