Are women tough enough?

I recently had the opportunity to chat with a pet owner at a small-business networking event. While we were talking, it occurred to me that she was the perfect veterinary-client demographic: late 20s, college-educated, articulate, employed at an emerging high-tech business, and a dog owner. When this woman learned what I do for a living, she couldn't resist telling me about the last veterinarian she and her dog had visited. She really liked this woman and thought she was a nice doctor, but she'd decided not to go back. When I asked why, she responded, "I felt like I could talk her out of anything."

Coincidentally, I had worked with the veterinarian in question. I knew her to be bright, thoughtful, and thorough. But I also knew she sometimes appeared to lack confidence. At one point I'd even talked to her about how her tentativeness could affect her client recommendations. She consistently had the lowest client compliance for dental prophylaxes among her three-doctor group. What was even more interesting, though, was that the overall compliance rates for the practice's two female doctors, including this particular veterinarian, were always much lower than that of the male doctor.

The cost of communication

I started to wonder whether the compliance gap had something to do with gender. It's common knowledge that women and men communicate differently, but how might gender-related communication nuances affect the bottom line? Male practice owners who work full time earn an average of 30 percent more than full-time female practice owners with similar experience, and male associates earn 20 percent more than female associates with similar schedules and experience, according to the 2005 AVMA-Pfizer Business Practices Study. Could communication style play a part in the revenue discrepancy? The answer, I believe, is a decided "yes."

A few dollars makes a big difference

The graph on the next page illustrates an example from the book Women Don't Ask: The High Cost of Avoiding Negotiation—and Positive Strategies for Change by Linda Babcock and Sara Laschever (Bantam, 2007) of how an initial salary negotiation can create what sociologists call an "accumulation of disadvantage." When a man and woman negotiate different base salaries, by retirement the woman's salary will be about half as much as the man's. The numbers get even more dismal when you figure in savings. If, every year, the man deposits the difference between their salaries in an account that earns 3 percent interest, he will accumulate about $2.1 million by the time he's 65.

For veterinarians, making client recommendations is comparable to negotiating a salary. Your profits are determined by how firmly you assert the value of your services and how attentive you are to compliance rates. Setting your fees too low, discounting too much, recommending too little, and failing to educate clients all create an accumulation of disadvantage, just as in the salary negotiation example.

Now, I know many of you are thinking it, so let me acknowledge that this isn't an exclusively female problem. Plenty of men struggle with confident communication and can benefit from coaching in this area. But because of the way women are socialized, some gravitate toward a certain set of behaviors—speaking softly, being compliant, valuing harmony—that can hold them back in their financial and career success. So this advice is targeted toward women. (That said, there are many men who would enjoy greater success if they learned more stereotypically female behaviors such as building consensus and listening—but that's a different article.)

Average annual salaries

OK, back to the veterinarian with low compliance. She averaged 8 percent compliance on prophylaxis recommendations, whereas the male doctor averaged 35 percent. (This associate had two years' experience and the male owner more than 20, which undoubtedly made a difference. But I'm convinced through working with the associate that her communication style was a bigger factor.) At these rates, if each veterinarian recommended 500 dental procedures a year at an average fee of $450, the woman would generate $60,750 less in annual revenue than the man. If she were paid 20 percent of her production, she would lose the equivalent of $12,150 in annual income.

The cultural divide

When I was working with this doctor, she was aware of her low compliance rate but thought that communicating with clients more forcefully would be off-putting. She isn't alone, or so says Nancy Ainsworth-Vaughn, a noted linguist who has extensively researched communications between people and their physicians. "Women physicians walk this fine line between exercising authority and appearing too authoritarian," she says. "Culturally, women learn that they're more likely to get results (i.e., likability) when they express ideas as suggestions rather than orders. While this may make them likable, it also makes women seem less competent and self assured."

Lack of confidence and "soft" communication skills also affect a veterinary practice's bottom line when it comes to interacting with suppliers and team members. Historically, women have been poor negotiators, and in business, almost everything is a negotiation. As a practice owner, you negotiate where you'll set your fees, how much you'll pay for outside services, who gets hired and fired, and much more.

So why do women, including veterinarians, get the short end of the negotiation stick? Because many think of negotiation as confrontation—that is, as a man's game. Negotiating has gotten a negative reputation for being a testosterone-driven, heavy-handed, every-man-for-himself tactic that always results in a winner and a loser. This win-lose approach is how boys growing up learned to play and interact. Most girls, on the other hand, were socialized to believe that it's best for everyone to get along and that their role is to make everyone happy. As a result, many women don't engage in negotiation at all.

But negotiation doesn't have to be confrontational—or "manly." Rather than trying to talk like men, women need to capitalize on their assets. If you're a woman who struggles with negotiation, think of it as an opportunity to take care of yourself and others. Approach it as a win-win situation. Often a negotiation can be as simple as asking for what you want or need. So determine what you need from a situation—and ask for it—and find out what the other party needs, too.

If the doctor with low compliance rates were to think of dental care as a win-win situation, she would recommend it to clients with more confidence. The best part is that effectively recommending elective procedures such as prophylaxes really does create a win-win situation—it's not like you're making this stuff up. You'll be offering your patients the best care and generating more revenue. The client will enjoy a healthy pet whose long life is free from painful dental problems—plus he or she will save hundreds, maybe thousands, of dollars by avoiding the future cost of complicated dental extractions, for example. (For more gender-bending tips, see Related Links below.)

So, are women tough enough to be profitable veterinarians? The answer is that they don't have to be tough, but they do need to be strong, confident communicators. Women must make a conscientious effort to speak with more authority. That's not to say you should ditch your feminine tendencies and start dominating every conversation. Rather, refine your style and speak with maturity—then reap the revenue rewards.

Jan Miller

Jan Miller puts her communication strategies to good use as president of the consulting firm Veterinary Best Practices in Hillsboro, Ore. Send questions or comments to ve@advanstar.com