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Unpleasant interactions with clients have, unfortunately, become more common at many veterinary practices. The ongoing pandemic and, more recently, supply chain issues and staffing shortages have created a more stressful environment. Many practice managers have found the need to create and implement protocols for managing these situations so pet care remains the focus and staff feels supported in doing their job.

In 2019, a repeated situation with one client at their suburban Omaha, Nebraska clinic was the final straw prompting VHMA Members Nicole Mathis, CVPM, and Janine Jernigan, CVPM, to tackle this situation head-on.

“Ninety-nine percent of clients are respectful and kind, said Mathis, RalstonVet’s Culture and Development Manager. “We see 100 to 150 people a day, but it seemed like we were spending a lot of energy on the 1% of unruly clients.”

 The comprehensive safety program they developed is one other clinics can learn from. Under the Ralston program, staff members learn to recognize the difference between angry clients and abusive ones. They receive training in techniques to diffuse angry clients and the assurance that they can always call for a DC Manager – a Diffusing Client Manager - when an abusive situation requires it. Ralston also educates their clients, using emails and posters to emphasize that kindness and respect are required.

“I recommend clearly communicating expectations about behavior to all parties involved,” said Jernigan, Ralston’s CEO. “It’s important to have clients on notice that they cannot treat our team badly, “she said. “We want to provide health care for pets, but we have given our team the authority to decide if an owner is somebody who we don’t want to work with.”

Empowering Staff

Mathis provides training to new staff members early in their onboarding process. 

Staff learns that angry clients stay focused on the situation while abusive clients launch personal attacks.  For example, a client who says, “I can never get in for a BLEEPing appointment,” is angry, but a client who says, “Why can’t you get me in for a BLEEPing appointment? You don’t care about my dog. You want my dog to die!” is abusive.  Abuse can also take the form of threats of physical harm; bigoted, homophobic, or sexist remarks.

Staff members who are dealing with an angry client are taught how to make the client feel heard and are able to offer potential solutions to solve the client’s problem prior to consulting management.

If a client is abusive, if the situation has escalated beyond effective communication, or the staff member wants assistance for any reason, they may call for a DC Manager. “What this really did was show our team members that they had somebody they can go to for help, that management has their back,” said Mathis. 

The DC Manager Role

Ralston is a large practice with 62 staff members and 11 doctors. There are eight DC Managers, all of whom are members of the leadership team.

In summary, they:

• Explain that they will be better able to understand and help if the client speaks calmly.
• Listen without interrupting while the client states the problem.
• Maintain a polite, professional demeanor however the customer behaves.
• Are honest about what they can do to solve the problem and refer to relevant practice policies or contracts with the client.
• Warn clients that if they continue to be abusive, they will no longer be welcome at the practice.
• If necessary, end the call or summon security or police.

Results

Jernigan and Mathis have also seen an increase in problematic encounters with clients over the past two years.  Most are not abusive, and often a reminder to be kind results in an apology.

Even most abusive situations are eventually resolved, she said.  One client kept telling young staff members jokes with sexual innuendos. A manager was unable to get him to stop. After he left, “I called him immediately and told him not to do it again, to talk to staff only about his dog, or we would no longer be the veterinary practice for him,” Mathis said. There were no issues on his next visit.

Ralston has fired just a handful of clients since the DC Managers and new protocols were adopted in 2019.  “We were glad to see them go, as they were very toxic,” Jernigan said.

At a time when staff retention is extremely important, the policy shows employees they are valued. “Our new hires are shocked and amazed that we care about our employees enough to provide them with this support,” Mathis said.

Posted on behalf of the Ethics Committee.