Building client trust component of pet's care
Mrs. Johnson awaits your entrance draping her head over her usually trembling rat terrier named Wiggles.
Wiggles is behind on all her vaccinations and heartworm tests and is not spayed. She also hasn't had a thorough examination in at least three years.
Although Mrs. Johnson has been in the clinic with Wiggles for numerous toenail trims in the past three years, she has always stated that her pet was in fine shape and really didn't think an examination was necessary. When asked about getting her spayed Mrs. Johnson patiently explained to the assistant that she hadn't had a "period" in several years and now was beyond the need for such an 'operation'.
The staff really like Wiggles but has always dreaded her visits because she is very stressed by any treatment experience at all. It is also obvious that Mrs. Johnson is reluctant to let the staff remove Wiggles from her grasp. Her pet's trembling and reaction to handling has only made Mrs. Johnson more protective of any care beyond a nail trim.
This trip was different. While in a protective hug from her owner, Wiggles turned blue and fainted during a nail trim. Mrs. Johnson is now only too eager for the doctor to examine her pet. When you arrive, Wiggles is recovering due to the oxygen your fast-thinking technician has given.
Your exam (the medical crisis has made your exam much easier) reveals an advanced cardiopulmonary condition, serious dental disease, mammary tumors and fleas. After Wiggles has recovered somewhat, you gently tell Mrs. Johnson that a work-up is needed including, blood tests, X-rays, ultrasound, ECG and heartworm testing.
Mrs. Johnson becomes frozen in time. Seconds seem to drip along like humidity in August. She finally informs you that her budget cannot endure such an onslaught of tests and trips to the veterinarian. You sense that something else makes her hesitate. She may not be able to trust you.
A reactive client
Mrs. Johnson is what I call a reactive client. While she is resistant to a proactive approach to her dog's health care, which would save her a boatload of time and money, she also secretly does not trust veterinarians or anyone else who would come between her and her pet.
Therefore another problem also exists in that Mrs. Johnson has a co-dependency with Wiggles that does not allow her to release her pet to others-especially into an environment that would stress her pet. Although she has to be careful with her finances, her real problem involves a trust issue and an emotional dependency to her pet.
Your response is:
a. Give her a quote for all the work and await her response.
b. Offer to do everything for free because of her poverty and that she is a very nice person.
c. Spend some time talking to her about her dog and her relationship with Wiggles and then patiently give her all her options.
d. Refer this patient to a lowcost colleague.
e. Chastise her for her obvious abuse and oversight.
f. The rubber meets the road
Choice (a) is tempting in that time is always in short supply at a veterinary hospital and it is the practical and expedient approach. Unfortunately, this client is likely to be confused and inattentive during a crisis with her pet.
The best answer to this question is (c). Your responsibility now is to engender trust.
This client needs assurances that her pet will be all right and that you will do everything to protect her pet. This is a tall order and no guarantee can be made with regard to treatment outcomes, yet the owner must learn to trust you. Trust takes time, and in the past she has not given you time to develop a trusting relationship.
Wiggles is sick, and there is not a lot of time available. Can you develop an effective bridge of trust for this client? What follows are some points of reference.
Client trust is a function of:
Past experiences at previous veterinary offices. This can be a real hurdle for the current veterinarian to overcome.
It is always wise to investigate past "bad" experiences and perceptions the client holds. Until you resolve past concerns your client will withhold trust. Many clients misunderstand explanations made by previous veterinarians, which compounds any issues that conflict with their previous understandings.
Prejudices of family and friends. These can work for you or against you. Clients hold in high regard the information and dis-information they receive from others. This is primarily because they can relate directly at their level of experience. Your job is to investigate these issues and put certain concerns to rest in non-judgmental ways.
The amount of time you spend explaining all the issues and answers concerning a client's pet. (See sidebar, page 19.)
Staff sensitivity. Staff (past and present) plays an important role in how your client will perceive any future care they may receive. Most clients come to veterinarians because of convenience and proximity to their home. Surveys reveal that 65 percent of clients will lose confidence and switch to other veterinarians because of a perceived attitude of indifference from the staff. This is a training issue.
An unresolved medical/surgical condition. Pets under your care often do not respond to therapy in spite of quality animal care. If you are not communicating the nature of your therapy and its occasional potential for failure in spite of excellent therapy plans, you will eventually lose the trust of your client. A veterinarian must communicate ideas and rationale. In addition, many veterinarians feel that if they refer a case to a specialist the client may lose confidence in their abilities. A wise veterinarian knows when to refer a case to a specialist-to do so actually solidifies trust.
Follow-up. Clients need to know you are thinking about their pets. When they leave their pet in the hands of strangers it can be stressful for them. To gain their trust they need to know that you truly are a friend as well as a profession. Taking time to update a client with a pet in the hospital or who has been discharged connects you to them in an environment they know-their own home. Trust will build quickly when follow-up is a standard protocol.
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.
Sidebar: Developing trust through client education
Trust can occur in a number of ways but one of the best ways is to really become a teacher.
Clients understand little about what is going on in a veterinary hospital beyond the fact that their treasured pet is in need of some form of veterinary attention.
Listening to their concerns and explaining your treatment approach (especially visually) is very much appreciated.
The time spent doing this creates a trust relationship what will smooth the way for future treatments. Here are some key concepts:
1. Clients usually learn more efficiently when you draw pictures and present pictures from books and promotional material from your vendors.
2. Sitting down together in chairs side by side and then presenting material or concepts is often more comfortable for the client.
3. Using staff to hold the pet or taking the pet for a short walk through the hospital will help the client focus on your presentation.
4. Talks of this nature should be conversational and never confrontational.
5. Always take a position of understanding the clients' concerns before going forward with anything.
6. A final plan of action is never final until the client receives something in writing concerning your approach-even if only on a scratch pad for further review at home.