"You took us to the cleaners!"
Monday morning came and went without much fanfare, but then, around noon, John showed up at the front desk. He was fuming.
Tamara did her best to calm him down, but he demanded to see Dr. Hayes.
When Dr. Hayes approached the desk, he shouted, "You! You took us to the cleaners! I can't believe we ever trusted you with
As it turned out, Brutus' ear had begun to swell up again on Saturday, after Julie and John took the E-collar off at home.
They arrived at the conclusion that the surgery had been done incorrectly and took Brutus to Academy Animal Hospital, where
the veterinarian on staff said nothing could be done other than lancing the ear. Julie and John elected to do the procedure.
Brutus was doing OK until Sunday night. When Julie called the Academy veterinarian, he told her to take Brutus back to Dr.
Hayes to have the surgery done over again.
John was still seething. "You guarantee your work, don't you? We went into debt over this simple ear problem. We want our
money back and we want you to fix Brutus for free. Oh, and you better believe I'm going to post online about what a terrible
job you did!"
Dr. Hayes knew what she was up against. She went through the usual disclaimer discussion, the degree of difficulty and every
other defensive move she could muster. But the longer she spoke, the more she realized this was a no-win situation and began
to soften. Dr. Hayes, like so many veterinarians in similar situations, prepared to make a financial sacrifice for the sake
Combating reactive medicine
There are three separate issues that cause almost all veterinarians to work in a reactive mode:
> Private practice does not lend itself to easy patient planning. Animals get sick regardless of time and circumstances. Walk-ins
and acute crisis management are part of daily practice.
> Veterinarians are busy even when there are no patients. There is a lot of uncontrolled and unproductive time spent each day.
> Veterinary medicine is a helping profession. By nature, we veterinarians want to react and make things work out for both
the client and the patient.
Dr. Hayes was working in reactive mode. Let's review what she and the rest of the staff at Mountain View could have done differently
to be proactive rather than reactive.
Arm the troops. Anything out of the ordinary needs to be reported to the doctors before an appointment begins. A "heads-up" is always appreciated.
Dr. Hayes should make this a part of her employee training.
Expect the unexpected. Veterinarians will always work with unpredictable problems and patients. It's crucial to educate clients about your plan of
action and incorporate multiple outcome scenarios—this should take place before you move forward. And writing these plans
down is important. Dr. Hayes started out well with John and Julie but did not follow through.
Don't be an auctioneer. Because Dr. Hayes needed to move on to waiting clients, she did not take the time to offer even a general estimate to the
client. This was a critical mistake. If you are willing to come down in price after offering a reasonable estimate to the
client, you are conducting an auction. This is unfair to everyone—including the patient. You must make time for an estimate.
Clients should be told that estimates are just that—charges vary depending on changing circumstances. Estimate preparation
should be the responsibility of an employee in the practice so the doctor can focus on seeing patients.
Watch for red flags. A client will drop a wonderful veterinarian in a heartbeat. When a client disparages another veterinarian in your presence,
it's always a red flag. Trust is on the line. Once John turned on Dr. Hayes, she made the mistake of defending her actions,
which is always unpleasant music in the ear of the client. Take the client's perspective and find ways to solve the problem
for them, even if it's just asking them what they want.
Be wary of the beck-and-call. A veterinarian coming to the phone any time a client calls in will lead to reactive chaos. Clients calling in to "talk to
the veterinarian" should be told the veterinarian or technician will call them with a report within a given time range. After
reviewing the chart and the estimate, the veterinarian or a trusted technician will need to go over the patient care with
the client on the telephone and likely outcomes under specified home care. If you have given a proper estimate, you do not
need to go over charges.
Focus on the follow-up. Someone in every veterinary practice needs to be assigned to follow-up cases and call clients proactively. Julie and John
would probably have come in to Mountain View Animal Hospital with Brutus on Saturday—if they were called and prompted to.
This seems difficult, but checking on patients is much easier than the reactive scene that unfolded Monday morning.
Strategize social media. Remember—most satisfied customers don't take the time to post positive comments. Cross a client (even innocently) and they
will tell as many people as possible that they have been wounded. Add social media to the mix and you can have an explosion
of negative comments seemingly worldwide. This is all the more reason to be proactive.
Improve your outcome. Reactive medicine leads to poor patient care and client headaches. Being proactive means anticipating problems and planning
for better outcomes. So don't tell clients to call if problems develop. Clients who say they have no questions after an appointment
mean they have no questions for the front desk. If the veterinarian were to suddenly appear, you can bet the questions will
spill out. In this case, Dr. Hayes should have called John and Julie after the procedure or seen them in the exam room for
a scheduled checkout appointment.
Much of our job as veterinarians is simply to convey an understanding of the different scenarios that a client may face. Everyone
wants a better outcome for both the patient and the client. And above all else, we should practice what we preach—especially
when we preach preventive medicine. After all, that's what being proactive with client relationships is all about.
Dr. David Lane owns and manages two practices in southern Illinois. He has a master's degree in agricultural economics and
is a consultant, speaker and author of numerous practice- management articles. He can be reached at