One of the distressing realities of veterinary care is that there are often difficult interactions. While plenty of our day-to-day work is routine care, check-ups, and other simple engagements, there are always going to be problematic situations. Many people only bring their animals to the vet when something goes wrong, and vets are the go-to source of care when medical issues are reaching a life-threatening extreme.
People care for their animals, and seeing them in distress is stressful. It's even worse if you have to deliver bad news – cancer, inoperable conditions, life-threatening injuries – and the heightened emotions need an outlet.
You're in a position of authority, of perceived power, but there's so often little you can do. Or worse, there are things you can do but not things your clients can afford.
The realities of veterinary care are such that you are going to, far more often than you want to, end up in situations where emotions run hot, and you're the only place they can be focused.
Angry clients, distressed clients, clients in denial; whatever stage of reaction and grief they're in, you need to be able to deal with them. The question is, how?
Priority #1: Stay Calm
The single best thing you can do is focus on staying calm yourself. It can be very difficult to be confronted by an angry, stressed, irate, and confrontational client and feel the desire to defend yourself, to fight back, to push back against their attitude, to make your point clear in a harsh or brutal way.
Unfortunately, this helps no one.
Reacting inappropriately will further escalate a situation and will never solve one.
Escalating into heightened emotions can be oppressive and stressful for the rest of your staff, leading to a toxic work environment where your staff walk on eggshells to avoid being the target of that outburst.
Conflict and confrontation are not ignored by the animals under your care, many of whom are already stressed, sick, or otherwise in an uncomfortable position and who can react with their own increased stress, illness, and outbursts.
Reacting poorly can have knock-on effects when word spreads, your reputation tanks, and other clients cancel for fear of receiving the same treatment, which reduces your practice's income and makes it even more stressful to continue.
Maintaining an appropriate bedside manner is difficult. No one enjoys being the target of an outburst and just having to take it, no matter what role they hold. Yet, it's what you have to do to provide the best possible care and setting for further care.
Whenever possible, take difficult conversations or confrontations to an isolated office where it won't be disruptive to other clients, patients, staff, or be public. Along the way, apologize for any mistakes or inconveniences if they happen; studies show not only does an apology – warranted or not – reduce confrontation and conflict, but it also reduces the chance of eventual lawsuits if there was a genuine mistake involved.
Pay Attention to Body Language
Not just the body language of your clients, but your own.
When you speak, be assertive but calm, and don't raise your voice.
Make eye contact to show that you're listening and engaged, but don't stare.
Try to keep your facial expression neutral to compassionate; avoid scowling, rolling eyes, sneering, or anything else that could be interpreted poorly.
Keep your arms loose to your sides, but don't cross them in front of you, which can be interpreted as a resistive or confrontational posture.
Try not to stand too close to the client.
Body language can be an important part of avoiding escalating a situation. Clients will often be able to get over their initial emotional hump quickly with assistance, but weathering that initial outburst can be difficult.
Avoid Trash Talk
While it can be cathartic to talk trash about a difficult client when they leave, the benefits of letting off your own steam are outweighed by the drawbacks of putting that burden on your staff. No matter how much you know or trust your staff, it's not appropriate to use them as a venting board. If you absolutely must vent, do so in a setting where it can't get back to the client, is free of context or potentially identifiable information, and where the balance of power between you and who you're venting to is not professional.
"It's important to remember that you set the tone for the rest of your team, so avoid disparaging difficult clients or venting your frustrations in any public-facing setting. Set an example for how you would like your staff to respond when faced with a challenging client." - Talkatoo.
A bit of temporary catharsis for you isn't worth the negative repercussions across the board.
Part of being able to move on and let it go is recognizing that, even if the angry or difficult client is hurling personal attacks at you or questioning your skill as a vet, it's really not about you. In these kinds of situations, no one could ever be perfect enough; it's not a personal failing, and it's not your fault.
Look for Underlying Issues
Most difficult clients boil down to a few specific concerns or circumstances.
They're faced with the mortality of a beloved pet and are rapidly experiencing the first stages of grief.
They're faced with the difficult or impossible decision between attempting to keep their animal alive or maintaining finances… or otherwise faced with the expense being the primary roadblock to care.
They're worried that you aren't taking an issue as seriously as they think you should.
Once the initial outburst has passed, you can often dig down into their primary concerns and offer what you can for solutions.
Discussions of ways you can extend the quality of end-of-life for an animal and whether or not various treatments may be appropriate versus simple palliative care.
Discussions of payment plans or low-cost alternative options they may be able to pursue.
Misconceptions over the severity of a given ailment and how curable it may be. Veterinary medical science has been improving by leaps and bounds in the last decades, and what used to be a death sentence may be a lot more treatable now, but the client doesn't know.
You can often get to the underlying issue of a difficult client by practicing active listening, as well as understanding the most likely concerns someone may have. You may be thrown a curveball from time to time, but there are usually a few categories of concerns that come up, and once you can recognize them, it becomes a lot easier to deal with them, often proactively.
Establish a Protocol for Handling Difficult Clients
It's one thing to deliver bad news and have to deal with a difficult client. It's another to have that bad news sink in and have a client show up to your practice and start yelling at, abusing, or otherwise attacking your front desk staff, your veterinary nurses, or others in your practice. Often, those individuals don't have the training or the expectation of dealing with irate clients either, making it a more difficult situation across the board.
Here's a way to help minimize this issue from Zoetis:
"Avoid putting your team in this difficult and unfair position by implementing a practice-wide protocol for handling angry clients. Tools to empower your team may include:
Knowing what to say — Use key phrases that acknowledge and redirect the client's energy toward actionable steps (e.g., "I can see that you're upset. Let me take down your concerns so I can bring them to the manager's/veterinarian's attention").
Knowing whom to see — Design a flowchart or decision tree for how to respond and where to direct the complaint (i.e., chain of command). Post these cheat sheets in communal areas and at the front desk.
Knowing what to do — Rehearse appropriate responses through role play to ensure comfort and understanding.
Devising an initial response can help your team feel safe and in control during an unexpected emotional encounter. Team members will feel supported, while difficult clients will feel that their complaints are being addressed."
The protocol you create, the empowerment you give to your staff, and the training you give them will vary depending on what you intend to do to handle these kinds of difficult situations. In general, you want to work on de-escalation training, ways that they can remove themselves from a situation if it escalates, and options for coming to you as necessary.
Do What You Can to Give the Client Options
The options you're able to present may depend on the kind of issue at hand.
For example, a patient suffering from an incurable illness and reaching the end of their life will be a distressing event for the client, but there are only so many options you can offer them. Palliative care, at-home euthanasia, or attempts at treatment to prolong life where appropriate can all be discussed.
This is very different from, say, a billing issue leaving a client in dire financial straits. Whether it's a billing mistake, an issue with insurance, a glitch in a system, or something else entirely, working with them to provide options or even waive fees can be better for long-term client and practice health than sticking to your system.
Review the Client's Concerns and Adjust Your Practice
Sometimes, a client is difficult because they're confronting a stressful reality, and they aren't capable of handling it immediately. Other times, the issue is firmly on your end, and while it's stressful to the client, it's something you can fix to prevent it from happening to anyone else.
Any time you have a difficult client, evaluate the situation after the fact and look for ways to improve. This might mean adjusting or even revamping an entire computer system. It might mean adding or changing the services you use. It might mean finally swapping out medications with side effects you can no longer justify. It might mean adjusting your policies. It might even mean firing a front-desk worker who continually gets into conflicts you need to de-escalate.
Last Resort: Firing a Difficult Client
Unfortunately, sometimes a difficult client is just going to be too much of a problem to justify keeping on.
You can't care for a patient if the client refuses to accept your diagnosis or treatment options, and while it's painful to know that an animal you could help is going without that help, if there's nothing you can do, there's no sense in wasting time, effort, and cognitive energy on trying.
"If the client is threatening, abusive, or has otherwise behaved in an unacceptable way, it is perfectly acceptable to fire the client with minimal warning. Send the client a written letter (via certified mail) informing them that they are no longer welcome in your practice, along with a copy of all of their pets' medical records. If the client's behavior is threatening to you or your staff, contact the local authorities." - Dispomed.
As a midway point, sending a warning about a disruptive and abusive client's behavior later can set a precedent and ensure that you have grounds to fire them later if they escalate while tempering their behavior in the future once they've calmed down.
Don't Forget Your Own Mental Health
Unfortunately, as the vet in charge of a practice, chances are you're going to bear the brunt of any difficult clients, and that can be difficult to handle. Fortunately, you don't need to go it alone. There's help available so you can lighten the burden on your own shoulders, whether it's therapists and specialists who can help you through times of crisis, relief veterinarians to take over while you take a mental health break, or even our own services to offer second opinions.
At Hope Vet, we know you're often forced to go it alone when you shouldn't have to. That's why we've put together our business: to offer consulting and second opinions for tricky cases in oncology, dermatology, neurology, internal medicine, and more. Whether you have a challenging case, a difficult client, or just need help yourself, we're here to help. Reach out today, and we can talk about what we can do for you.