I drop into my office chair, flip open the puppy's chart and start frantically writing. I'm 15 minutes late for my next appointment and clenching my teeth. Even my eyelids are tensing with stress. When did I start carrying emotional tension in my face? Is it even possible to do stretches for these muscles?
With no time for a facial yoga session, I glance toward the appointment schedule for the rest of the morning. It's packed, and it's not looking like this day is going to end anywhere near our 1 p.m. Saturday closing time.
Before I can rush out the door to meet my next client, the phone lights up. "Dr. Roark, Ms. Nuñez is on the phone, and she says she'll speak only to you."
I know what this means. I have crossed paths with Ms. Nuñez before. She's a loving cat owner but a demanding client and master negotiator. (Takes one to know one: I once talked a limo driver into loaning me his snakeskin boots when a nightclub bouncer took exception to my tennis shoes.) Our conversations feel like they should take place at Camp David.
As I press the flashing button to take the call, I run through the negotiation tactics I know she'll use against me. Any of these sound familiar?
Get to the decision maker
If a client wants baseless discounts, waived emergency fees or complete circumvention of scheduling protocols, the doctor is whom they ask for. No one else has the authority, or lack of common sense, to make these things happen. So Ms. Nuñez insists on speaking to me directly. She's off to a solid start.
Create a looming deadline
As soon as I pick up the phone, Ms. Nuñez jumps into the details of her visit to the emergency clinic the previous evening and the impending doom that looms over her cat, Petie.
Petie, it turns out, has had a urethral obstruction and, while he has been catheterized, Ms. Nuñez knows deep in her bones that the cat needs a perineal urethrostomy...right now. She is adamant that re-blockage is imminent and that leaving the patient at the emergency clinic until Monday is simply not an option. She feels surgery must be done immediately—but not at the emergency clinic (or at emergency prices).
Go heavy on flattery
Once she lays out the urgency of the situation, Ms. Nuñez targets my ego. She is certain, she says, that I can help her and do a better job than anyone else. I am, after all, the best veterinarian she's ever met. (Fortunately, the stress tension in my face prevents my head from expanding noticeably.)
Understand the other party's priorities
We, as veterinarians, deeply want to help animals. Ms. Nuñez knows that her cat's health and quality of life are more important to me than money. She is also willing to bet that they're more important to me than my Saturday afternoon. She uses this knowledge and ends her impressive pitch with, "Doctor, please don't let my kitty suffer! You'll save his life, won't you?"
My mind races as I try to form a response.
She's made her case so masterfully, I'm almost ready to book the after-hours appointment and risk mutiny by my technicians. But no. Today, I'll do what makes the most sense for everyone involved, including Petie. I've got some negotiating strategies of my own. Here they are:
Recognize the pitch
As soon as a client demands to speak to me and me alone, I go on high alert. This is someone who's looking to bypass the regular guidelines of the practice.
Control your heart
As her frantic story unfurls, I force my analytic brain to prevail over my warm and fuzzy side. I care about Ms. Nuñez's cat, but I can't let that emotion blind me to the consequences of my decision. I must also care about all the other pets who are scheduled to come in, my staff and their time, and my own family.
Understand the other side
Often, we think we know our clients' priorities, but we rarely know the entire story. I ask Ms. Nuñez why she doesn't want the surgery done at the E-clinic. She tells me first that it's because she feels so good about working with me (back to the flattery), and then that the estimate is very pricey. Finally, she tells me she just doesn't know these people, and she's scared. Now I really understand where she is coming from.
Ms. Nuñez has thrown a lot of information at me at once. None of it has been verified by the veterinarian she saw last night, and all of it is emotionally charged. My next goal is to get off the phone, so I can think clearly and quietly. "Did the emergency clinic fax me your record?" I ask. "I'll review it as soon as I can and call you back in a few hours." She nervously agrees to wait, and now I have time to unclench my face and contemplate my options.
Think through the whole scenario
After a few moments of reflection, I am certain that, though I want to help, I won't be seeing Ms. Nuñez and Petie this afternoon. To do so would make my technicians work well past their scheduled shifts, leave my patient unsupervised after the procedure, and force me to do a solo surgery I am not comfortable with—not to mention strand my wife at home with a young child and infant. Rationally, I just can't agree to it.
Address concerns, offer options
When I have reviewed the record, I call Ms. Nuñez back. I tell her I want to help, and that her cat's health is my top priority in making a plan. I answer all her medical questions and then explain that I am not comfortable with the surgery, nor do I have the necessary staff available.
I tell her that I have great confidence in the E-clinic, which helps address her fears about dealing with unfamiliar people. I also tell her that I will support her in either having the surgery there or continuing supportive care until Petie can be transferred to me (and a more experienced surgeon) on Monday.
I have given Ms. Nuñez all the information she needs to make an educated decision on her pet's care. I tell her she can think everything over, confer with the emergency doctor, and then let me know how she wants to proceed.
An hour later Ms. Nuñez decides Petie should have the surgery and come home as soon as possible. With my endorsement of the E-clinic, she feels comfortable going forward with the procedure there. She tells me that she will plan to see me when Petie needs his sutures removed.
I have no doubt she will talk me into doing it for free.
Dr. Andrew Roark, MS, is an associate veterinarian, author, and speaker. He practices in Ijamsville, Md.