Build relationships with veterinary clients with healthy power and helpful behaviors

Monday: A moderate-sized practice in a Baltimore suburb.

Dr. Tonya Anderson looked at the cage. A dog, Juno, was jumping up and down looking for attention. Juno was the next procedure, and Dr. Anderson wanted to get organized. Gail Venuti looked in the doctor's direction. Donna Nelson, the other technician on duty, was finishing up paperwork.

David M. Lane

"Gail, get Juno out. I want you and Donna to anesthetize this patient, and then I want you to prepare the site for surgery."

Dr. Anderson barked the orders like a Marine sergeant. She then sat down and watched.

Dr. Anderson had been out of veterinary school for 18 months and was confident in her approach to small-animal practice. This was her second practice and her first time in charge of the practice while Dr. Sample was gone.

Donna nervously inserted the catheter while Dr. Anderson watched with a knitted brow. Donna and Gail successfully intubated the dog and proceeded to the anesthetic machine and started preparing the surgery site.

Dr. Anderson approached the prep table. The IV catheter had been inserted and secured but had become angled to the side during the rotation of Juno's body.

Dr. Anderson pointed to the inserted catheter.

"This, of course, is unacceptable," she said to Donna.

Donna, who was happy to have inserted the catheter in the first place, was crestfallen.

Dr. Anderson grabbed the arm and proceeded to try to rewrap the IV set.

"Insertion of this type of catheter should be taped in the other direction," she said. "The university protocol for this can be found on their website—if you would bother to check."

Just then, the drip from the IV bag quit dripping altogether. The IV had come out during Dr. Anderson's dialogue and re-wrap.

"See I told you. This was inserted incorrectly in the first place. Please replace this while I call one of my clients."

When she returned, Dr. Anderson looked at the shaved surgical site, and then looked sternly at Gail. "This is all wrong and will most certainly lead to contamination and possible infection. You need to shave her 3.5 centimeters anterior and two more centimeters laterally on the sides. This is done improperly. This is another example of inadequacies in your care that Dr. Sample pointed out," she said brusquely.

Dr. Karen Sample was the practice owner and was coming back from vacation in two days. Dr. Sample had owned the practice for 15 years and was admired by clients and staff alike.

After the surgery, Donna and Gail talked briefly in the laundry room.

"She's good at what she does, but she is so difficult. I'll do what she says but nothing more," whispered Donna.

"We have to deal with this," Gail whispered back. "Dr. Sample left her in charge. It's obvious she took the opportunity to lord it over the whole staff and even the clients at times. She constantly is harping on how they did this or that at her last practice and how they do it at the university. It's all about how everything at our practice is wrong, and she needs to change everything.

"She doesn't show any interest in any of us as individuals," Gail went on. "I told her last week that I had a new puppy at home, and she just turned and walked away. I'm with you. We'll do what's necessary to do the job and protect the pets but I, for one, won't lift a finger for her otherwise."

"Should we talk to Dr. Sample?" Donna inquired.

"I think so. Even though Dr. Sample is critical at times, she always encourages us when we do a good job."

Tuesday morning

Phoebe Davis and her dog waited in the exam room. Phoebe herself had recently been discharged from the hospital for hernia surgery. Despite her personal discomfort, she was determined to bring her dog Franklin to the vet.

Dr. Anderson entered the exam room. The dog's eyes widened. Franklin retreated under a chair.

Dr. Anderson stood erect and remarked: "Your dog needs to be over here, Mrs. Davis. I obviously cannot examine him under the chair."

"Franklin is a 'her,'" Mrs. Davis timidly corrected.

"Franklin is a male name," Dr. Anderson intoned. There was a pregnant pause. Mrs. Davis said nothing.

"Regardless, please bring her closer to the exam table and lift her onto the table so I can examine her," she said. "You do that while I get one of the techs to help me look at her paw."

Dr. Anderson returned with Gail. Franklin was still under the chair.

"Gail, place the patient on the table," Dr. Anderson commanded in apparent exasperation.

"I'm sorry, Dr. Anderson. I just had surgery last week," Mrs. Davis said. "The doctor says I can't lift anything, but I can help when we get her on the table."

Franklin was difficult to extract but friendly enough when finally on the table.

Looking at the right front leg, Dr. Anderson could see that she had been licking a thickened wound over her right carpus.

"Is she licking this at home?"

"She won't leave it alone."

"That's not what I asked."

"She licks it all the time."

Dr. Anderson turned her back on Phoebe and wrote for a few minutes on the chart without talking.

"She'll need a biopsy and culture. In the meantime I want you to do absolutely nothing," she said clinically to the wall.

"What do you think it is?" Phoebe asked.

"I won't speculate on the unknown.Gail, put the patient down on the floor," Dr. Anderson ordered.

Dr. Anderson finally turned to Mrs. Davis and said, "If you want to do something, we can fit her with an E-collar."

Phoebe looked on sheepishly, then asked: "Can you do her toenails while she's here? And what is an E-collar?"

"Mrs. Davis, you should have told me all this when we had her on the table."

She turned to Gail. "Get Judy from the kennel and come back and do the nails. Make an appointment for the biopsy and culture tomorrow or maybe Thursday."

Dr. Anderson left the room. As she did, Franklin uttered a barely perceptible growl.

Eight days later

Dr. Sample was back. Outside the exam room, she looked at Dr. Anderson's chart history for Franklin. Then she walked smoothly into the exam room.

She smiled at Mrs. Davis and then gently placed her hand several inches in front of Franklin, who was peeping out from under the chair. The dog was tentative, but in a few seconds moved to sniff Dr. Sample's hand. Finding nothing threatening, Franklin's tail started a slow wag. Dr. Sample then moved to gently pat Franklin's head.

"Let me take a look at that foot, Franklin," Dr. Sample said. The dog circled and sought a corner of the room. Dr. Sample pulled up a stray chair and sat down. Franklin circled one more time and then placed her head on Dr. Sample's open hand. Suddenly, Franklin started licking her right carpus frantically.

"I heard from the staff that you had surgery a few weeks ago, Mrs. Davis. I hope you're getting better."

Mrs. Davis' eyes brightened.

"I am doing well. But I can't lift anything yet."

"You just sit there, and we'll check out Franklin here on the floor for a while."

Franklin offered the right paw. Dr. Sample looked carefully then turned to Mrs. Davis.

"Does this look worse to you?"

"It's about twice as big as last week when your other doctor looked at it," Mrs. Davis replied. "I decided to wait until you got back before I did anything. I hope that's all right?"

Dr. Sample looked squarely in Mrs. Davis' eyes.

"I'm so sorry that you and Franklin have had to deal with this. I can't be certain what this is, but it's most likely something we call a lick granuloma," she said. "Veterinarians are not in agreement as to what causes it, but fast action is necessary." She paused to let this sink in for a minute.

Dr. Sample then gently told her the various options she faced with her pet. Mrs. Davis gladly opted to leave Franklin for biopsy, blood tests and subsequent sedation and intra-lesional injection of lidocaine and steroids.

Dr. Sample told her there was a long road ahead. As always, Mrs. Davis felt safe with Dr. Sample.

Behavior in the workplace: The D.I.S.C. profile

So what can we learn from the two doctors in this story? Dr. Anderson is insecure. She exhibits two prominent behavior traits that are harming her relationships. Her overall behaviors are dominance (D) and conscientiousness (C) traits. People seeking to control their environment often display dominant behaviors.

Conscientious behaviors are perfectionist by nature. Those exhibiting "C" behaviors want it right the first time. They can be intolerant of others' ideas. Dr. Anderson blames others if things go badly but will silently become more insecure and isolated.

Dr. Sample is a people person. She exhibits influence (I) behaviors. These individuals are often in sales and excel at speaking to others.

Dr. Sample also exhibits steadiness (S). These individuals are nurturing, relaxed, deliberate and consistent. Dr. Sample is very successful but only an average practitioner in Dr. Anderson's eyes.

People can consciously change their DISC behaviors when situations change. Dr. Sample will need to be more assertive (D) when dealing with Dr. Anderson. Dr. Anderson, if she wants to stay in practice, will need to realize her behaviors are inappropriate and warm up to people—even if that goes against her current behaviors.

It's important to note that DISC profiles are not personality indicators but reveal underlying behavioral tendencies that are choices.

Discussion: Influence and power in the workplace

There are three types of power. All types are used to influence others. Power and behaviors work together to create positive or negative outcomes in the workplace. (See "Behavior in the Workplace: The DISC Profile.")

1. Role power. Role power is given to you by others and relates to your position in the workplace. In our example, Dr. Anderson is in control while Dr. Sample is gone and is enjoying her new power a little too much.

Role power exercised by itself does not always produce desired results. In the short term, it yields compliance. Staff or clients may go along with requests, but their hearts may not be in it. The more you try to influence others with role power, the less effective you are. This is especially true if dominant behaviors are used.

Role power is the weakest option with regard to influencing others. Role power works at first, but fails over time. Something more is needed.

The ultimate role power is the hiring and removal of employees and final decisions as to what to do with capital (money).

2. Expertise power. This is how others perceive your knowledge and intelligence. When Dr. Sample is gone, Dr. Anderson is the resident expert. She holds a degree from a veterinary school and is in a position of power to make choices for patients and for the hospital. Dr. Anderson holds expertise power over the staff because her education supercedes theirs.

Expertise power is a weak form of power but will often trump role power. Expertise power trumps role power when a client seeks a second opinion or when staff favor one vet over another when seeking advice for their own pets.

3. Relationship power. This is part of relationships with others that inspire them to want to do things for you.

Relationship power exerts the greatest influence over clients, staff and peers. This power grows over time.

Does this mean making friends with everyone you work with? No. Does it mean you need to be on everyone's Facebook page? I discourage this.

Relationship power is about being perceptive and helpful at all times to those you work with. It means getting to know others on a deeper level so you know where they're coming from. It means being more understanding. It means standing up for others when the need arises and avoiding gossip. It means being willing to do extra things for others when not required.

To generate relationship power, practice owners need to meet with staff one-on-one and give them appropriate feedback when problems arise. They need to be understanding of clients and their issues without being nosy. They need to develop good listening skills.

Relationship power is the strongest form of power and can transform your practice. When you make requests, people will want to the do the best job possible—both clients and staff.

All of us have behavioral tendencies that weaken or strengthen our positions and relationships at home and in our workplace. It's important to recognize the behavioral tendencies that interfere with our relationships and modify them as the need arises. It can be done with conscious effort.

Always remember: You attract more bees with honey than with vinegar.

Dr. Lane is a graduate of the University of Illinois. He owns and manages two practices in southern Illinois. Dr. Lane completed a master's degree in agricultural economics in 1996. He is a speaker and author of numerous practice management articles. He also offers a broad range of consulting services. Dr. Lane can be reached at davidlane1948@yahoo.com.