The anatomy of firing a client

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Oct 01, 2002

The Greens appear unannounced as the staff is finishing the daily close out.

Mr. Green wants "Muffy" seen "pronto" and thinks his dog may be dying.

Dr. Johnson has wrapped up a busy but rewarding day, but is willing to stay a little longer. The staff, however, cringes as Mr. Green enters. The last time he was in the hospital he created a terrible scene at the front desk and made Joan, the new office assistant, break down and cry.

As they enter the exam room Doris Green holds Muffy close to her throat and barely lets Dr. Johnson get a look. Dr. Johnson gently and repeatedly asks Doris to put the animal on the exam table. Doris reluctantly does so. Muffy stands on the table long enough to urinate. With her back legs and feet covered with urine, she climbs back between Mrs. Green's left shoulder and neck.

Jimmy Green pipes in that he is really concerned about Muffy. While he and his wife have been coming to Academy Animal Hospital for more than five years, he hasn't been in recently. Actually the only time he had come in the past was to complain about the bill. This time is different.

Recurrent nightmare

Dr. Johnson remembers working with Muffy several months ago trying to stop a nasty cough. Although Dr. Johnson had recommended various blood tests, radiographs and follow-ups, the Greens had only wanted medicines. They were reluctantly given medications and asked to call tomorrow with updates. The Greens never called and phone calls to the Greens were not returned.

"The medicines you gave Muffy didn't work," offered Doris. Upon further questioning it finally came out that she only got the medicine down her every three or four days because Muffy didn't like the smell of the pills. What pills Muffy did get down were eaten with cheese.

"About a month after we were here we called our cousin in Georgia," Doris bleated. "She had been reading on the Internet that there is a shot for this kind of cough and so we took her to Elsewhere Animal Clinic. That doctor is so nice over there. He gave that shot while she was under my jacket without even having to see Muffy."

"We think you should give her the same shot," said Mr. Green. "She already had an exam at the other clinic and we just need the shot. We just went by Elsewhere Animal Hospital but they were already closed."

Dr. Johnson now tries to gain some control.

"Mr. Green what makes you think she is dying?"

"Well, we just took her to McDonalds and she would only eat the cheese and just a little of the meat from her cheeseburger. She never fails to gobble it all up so she must be dying."

Decision time

Dr. Johnson now looks at his watch and realizes that his staff is waiting to see what he wants to do. After all, it is now 45 minutes after closing and Jane is already on overtime.

Dr. Johnson's options are:

* Call his wife and invite the staff and the Greens out to McDonalds to see if Muffy will eat a cheeseburger.

* Call the humane society and see if there are any cages left for veterinarians to occupy.

* Kindly ask the Greens to bring their pet in tomorrow so that you can find the source of her problems. A deposit will be required. Ask the owner to write an orderly and dated history of the problem.

* Ask all but one of your staff to leave and try to work up the case on an emergency basis.

The answer is the third option.

Your goal is to satisfy the needs of the client and obtain as much information about the pet's condition as you can.

It is obvious that that will not happen under the late evening circumstances. This also allows you to try to let the owner's head clear a bit. Other benefits include:

* Full staff availability

You will be able to better see Mr. Green's reaction upon leaving a sizable deposit. This will indicate the level of trust he places in the hospital and staff.

* A linear path to the diagnosis without interference from the owner.

* You will have a written and dated history of the problem.

* You will be able to further evaluate this client's willingness to follow through with instructions.

* You will better be able to use your professional time.

Some things to consider

Some things to point out concerning these types of client interactions:

* Clients can be insensitive to the needs of others when it comes to their pets. They can be going about their own lives in a structured way and then at the end of the day seek to unstructure the business and professional business hours of a veterinary office.

This, in reality, is a form of cheating other clients who, in good faith, make appointments and take time from work to see the veterinarian.

* Many of these clients tend to exaggerate their pets' maladies in order to convince the staff of the importance of their eleventh hour visit.

* Some of these clients can become abusive if they cannot control the situation from start to finish.

* Some of these clients tend to engage the staff in endless telephone conversations that get nowhere. This behavior is another form of cheating the clients who are patiently waiting their turn to see the doctor and are delayed by staff telephone interruptions.

* These clients tend to accept veterinary advice from any source that seems "reasonably" willing to offer helpful "hints."

A parting of the ways

There comes a time in the life of every veterinary office where the firing of a client is in order.

The previous scenario could lead to the dismissal of a client depending on certain factors.

It is imperative that if the firing of a client is proposed that the veterinary clinic be able to say that they have bent over backward to avoid it. Many client relationships can be improved dramatically by simply asking to talk to the clients in a frank and open manner about the issues that are causing problems. Sometimes a client will not even realize that they are creating problems.

The Green solution

Mr. Green exhibits all the beginning symptoms of a client who needs to be fired.

However, this does not mean that you should fire him-at least not yet. After you have determined Mr. Green' reaction to Muffy's work-up you should monitor their willingness to follow through on a therapy plan. This therapy plan may include dental work or even surgery. If it is determined that a referral is necessary, how willing are they to comply?

For Mr. Green the following criteria or in combination (other issues may also apply: see sidebar p. 24) would initiate the process of eventual firing.

* A blow up from Mr. Green concerning issues out of the control of the veterinary hospital, such as poor response to therapy after an appropriate diagnosis and therapy by the veterinarian.

* Abusive language in front of staff and the public.

* Dictating appointment times along with demanding behaviors out of proportion to real events.

* Threatening to bring suit over trivial matters (there are real events that lead to legitimate lawsuits against veterinarians; it would be uncommon for these lawsuits to originate from individuals who are just trying to throw their weight around.)

The talk

It is important for the veterinarian to communicate one-on-one before any move is made to ask a client to leave. Ideally this is done in an exam room or in the doctor's personal office at a less busy time of the day.

It helps for only one member of the family to talk to the veterinarian or manager in private. At this point it should be said that veterinarians hate to do this-it goes against human nature to confront an issue in private head on. In most cases both parties in question would rather "bad mouth" the other party to friends or anyone other than the person they have an issue with. However at these talks, perceptions of events surface in that meeting that neither party had been aware of beforehand.

The talk should address these issues:

* Try to get all issues that bother the client out and on the table. Do the same on behalf of the hospital.

* Ask the client to look at the issue from the viewpoint of the veterinary hospital.

* If the client has a legitimate concern do not trivialize it-instead address it in a meaningful way. When appropriate, indicate that the hospital could have performed better but do not back down on issues that you feel are important from the hospital's viewpoint.

* Ask the client to change the behaviors that cause problems for the hospital and staff.

* Finally, indicate that if a meaningful change cannot be made that the client should seek the services of another veterinarian.

If the client shows a willingness to improve and does, in fact, becomes a better client, so much the better. If the client continues to behave badly you will need to ask them to seek another veterinarian. This is in the best interest of both parties.

What are the chances?

Will Mr. Green improve after a talk? Chances are he will not. But some "Mr. Greens" will become wonderful clients. Happily the Mr. Green's of this world are not common. Either way you must use an approach that creates the least amount of conflict. You will also reduce the overall dollars you spend on Pepcid AC and Pepto-Bismol.

 

Dr. Lane is a 1975 veterinary graduate of the University of Illinois. After graduation he practiced as an associate in California before moving to Carbondale, Illinois and establishing Lakeside Veterinary Hospital in 1978. Dr. Lane completed a master's degree in agricultural economics in 1996. He is the author of numerous practice management and economics articles.