How to deal with difficult clients (Proceedings)

Benefits of active listening:

Active listening means:

Active listening is a way of checking

Active listening responses have two components

     1) Naming the feeling that the other person is conveying.

     2) Stating the reason for the feeling.

Here are some examples of active-listening statements:

     • "Please don't be mad at me."

     • "Sounds like you're upset about what happened with that client this morning."

     • "I'm hearing that you think this is my fault."

     • "You're annoyed by my lateness, aren't you?"

     • "You sound really stumped about how to tell Sarah you can't work for her Saturday."

     • "It makes you angry when you find errors on Dr. Ann's medical records."

     • "Sounds like you're really worried about Wendy."

     • "I get the feeling you're awfully busy right now."

     • "I'm sorry."

Actively listening is not the same as ______________________________

Improve your process

     • Active listening: reflecting back (paraphrasing) to the other person both words and feelings expressed by that person.

     • Identifying your position: stating your thoughts and feelings about the situation.

     • Exploring alternative solution: brainstorming other possibilities; rating the pros and cons; ranking the possible solutions.

Techniques that can be used in dealing with difficult clients and in difficult situations

Active listening

Active listening proves to the client that you are paying attention and that you believe that the client and what he or she has to say is important. Active listening involves rephrasing the key points of what the client has said and reflecting them back to the client, often in the form of a question.

     • For example: "So, you're saying that you were told the total cost of service was going to be $240.00 and you are not willing to pay anymore than that, is that correct?'

Here's what to do

Venting

You are probably familiar with the concept of venting. By allowing the client to let off steam uninterrupted, the idea is that the client will eventually calm down on his or her own. While this may work, you should know that there are two types of people. Venters are people who will calm down if allowed to let off steam. Obsessors, however, will get angrier and angrier the more they talk about their situation or grievances.

     • If you allow a person to vent and find he/she is getting more and more agitated, more active measures are needed, such as empathy statements, attempts to refocus, neutral mode and so on.

Here's what to do

Apologize

A sincere apology can help calm a client, particularly when you or your practice has made an error. You can apologize on behalf of your practice. Keep in mind that tendering an apology does not necessarily mean that you are admitting culpability. As with admitting a mistake, your apology should be "short and sweet," followed by a focus on solving the problem or addressing the client's needs.

     • Insincere apologies are worse than saying nothing and can anger your client. Also, due to the general overuse of the words "I'm sorry," apologies are not as powerful as you might think. They should always be used along with other techniques.

Here's what to do

Sincerity of effort

When clients don't feel you are making an effort, they get angry. On the flip side, when clients feel you are making an effort above and beyond the call of duty, they are less likely to target you and become upset if they can't get what they want.

     • Sincerity of Effort is a statement that tells the client you will do your best to meet his or her needs. For example: "I can see you are in a hurry and I'm going to do my best to get an answer for you in a few minutes."

Here's what to do

Guarantee of results

A Guarantee of Results is a stronger statement than sincerity of effort: it promises that the client will have his or her problems resolved. Guarantee of Results should be made only when you can legitimately guarantee the results you are promising.

     • An example of this would be "Mrs. Smith I am sorry the medication was not ready for you when you came in as it should have been. I will get that for you right away and have you on your way in the next five minutes".

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Broken record

This technique is used primarily with clients who won't work with you to solve their problems. Its intent is to send the message: We're not going to continue the conversation until we deal with the specific issue that I want to deal with.

     • It involves repeating the same message, until the client starts to work with you. For example: "We will not be able to dispense heartworm medication until Casey has had a heartworm check."

     • If the client ignores this, you repeat the message, "We will not be able to dispense heartworm medication until Casey has had a heartworm check."

     • The same message can be repeated four or five times until the client finally chooses to accept it.

Here's what to do

Empathy statements

Empathy statements are used as primary responses to any situation where the client is upset or frustrated or even might become frustrated or angry in the future. They are intended to prove to the client that you understand his or her emotional state or why they are feeling that way. You need not agree with the reason why a client is angry, but you need to acknowledge that the client is angry.

Here are some examples:

     • "It seems like you are pretty upset that we are behind in our office hours today"

     • "I know it can be frustrating to have to complete these forms"

     • "I understand why you are upset that the doctor did not call you back when she said she would"

     • Here's the key to effective empathy statements. Be specific. Name the emotion (anger, frustration, upset) and identify the source of the emotion (the delay, the forms, the product failure). Avoid general statements like "I see where you are coming from."

Here's what to do

Expediting

Expediting means "making things go faster." In other words, give the impression that you are doing things to speed up whatever process the client is trying to get done. You can convey this by talking more quickly and emphatically, while clearing away barriers that may be slowing down progress toward getting what the client wants. This can be conveyed by both body language and actions.

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Explanation of action

It's easy to assume that a client will understand why you're doing something or why you're saying what you're saying. That's a mistake. The client is not going to be familiar with your practice, policies and procedures, or at least not as familiar as you are. Explain what you're doing for the client and why you are doing it. Clients want to understand what is going on and may become frustrated or even frightened when they don't understand.

     • Here's a simple example: "I would like to obtain your e-mail address so that we can send Fluff's reminders to you via e-mail, we are trying to become more "green" and environmentally conscious."

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Agreement

When the client sees you are being "on the same side," he or she is much less likely to strike out at you in anger. One common technique often used in hostage negotiations is to create a sense of "we're in it together." Look for things the client says that you can agree with. Even expressing agreements on small points, like the weather or how cute their pet is, can create a better sense of rapport.

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Finishing

Finishing is the process of getting back to a client to tie up loose ends, confirm that a problem has been solved, or obtain feedback from the client. When contacting a client to follow up, it's standard to introduce yourself, explain why you are making the contact and ask permission to continue or ask if this is a good time. Following up is an extremely important method of showing the client that he or she is valued, you care about their pet and their opinions matter. Many times if a client is upset or unhappy, finishing or calling back the client after the pet has been seen or discharged from the hospital will help to change the clients mind and make them feel better about you practice.

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Don't go there

One of the simplest techniques, and one of the most important when dealing with an angry client, is to not go there. Do not respond to insults, comments, innuendo, or other angry or abusive comments made by a client. Typically you can respond indirectly (using empathy statements), but not respond directly. The key thing to understand is that if you focus on or even simply acknowledge a client's unpleasant comments, you are going to spend much more time arguing and talking about those comments than you would if you simply ignored them or responded to them with empathy statements.

     • An essential tactic, "Don't Go There" requires some self-discipline. Remind yourself that the unpleasant client shouldn't be allowed to upset you or ruin your day. Don't lower yourself to the level of an insulting client.

Here's what to do

Offer choices

One of the major reasons why clients get upset is that they often feel helpless and buffeted by policies, procedures, red tape, and other things they perceive are beyond their control. You can counter this feeling by offering choices to clients whenever possible. By offering them choices, you also show respect for their wishes and help them exert some positive control over the discussions, how and when they occur, and related issues. Even simple things, like offering for someone to wait in their car or the reception area, can help to create rapport and prevent conflict escalation.

     • Example: "I am sorry Mrs. Smith that the doctor is behind on her office hours today. Would you like to wait? It will probably be about another 15 minutes, or you can leave Casey with us to run your errands, and then come back when you are done."

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Terminology

It's easy to forget that our clients do not necessarily understand the jargon, acronyms and terms that we use every day and take for granted. Using plain language involves translating our language into language that the client can understand.

     • For example, we might tell a client that we wish to do a heartworm test to look for microfilaria in their pet's blood. Or worse yet, we might say that we wish to do an occult heartworm test and the client thinks we are doing some type of voodoo. Did you know what microfilaria was an occult heartworm test before you got into veterinary medicine? When we use fancy terms and talk over a clients head, we are going to confuse them and possibly anger them. Did you know that magazines and newspapers are written to accommodate 5th or 6th grade reading levels? Think about the fact that we could possibly be talking to 10 and 11 year olds! It is important for you to use terminology that clients understand. If they don't understand what you are saying, it could be detrimental to the client, their pet and your practice.

     • The idea is to focus on clarity and simplicity without being patronizing and to remember to communicate for the benefit of the client, not you.

Here's what to do

Preemptive strike

The term "preemptive strike" is borrowed from the military. In client service it means anticipating a problem a client might have and addressing or acknowledging it before the client brings it up. For example, if a client has been waiting a long time, you can apologize for the wait or use an empathy statement to show you understand that the client has been waiting a long time and that he or she is frustrated, rather than wait for the client to start complaining. By mentioning the problem first, you demonstrate you both understand and are concerned about the client's feelings. This technique can go a long way to prevent interactions from escalating.

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Pros and cons

Clients see you as more credible or believable when you present both sides of something, like the pros and cons of products. For example, when describing a flea control or heartworm preventative, it's much better to include both its strengths and weaknesses relative to other products, rather than present only its strengths or only its weaknesses. The same applies when explaining any options a client might have to choose from. Keep in mind that when you present a one-sided view, the client will wonder why you are presenting what may appear to be an unbalanced perspective and will question or suspect your motives.

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Provide alternatives

This is a simple technique to present possible alternative products, services, or action that might apply to the client's or pet's situation.

     • For example, "You can contact me by phone or e-mail, whatever is more convenient" provides two alternatives to the client. What's the difference between offering choice, as described earlier, and offering alternatives? When you offer choices, you usually ask the client which alternative he or she wants to pursue. Providing alternatives demonstrates your interest in ensuring that the client understands his or her options.

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Provide a client takeaway

Providing a client takeaway involves giving something physical to the client to take away. For example, you might provide a brochure, product information, a sample of a product, a medical care plan (estimate) or written discharge orders upon discharging their pet. When you provide a takeaway, you are not forcing the client to reply on his or her memory and the client can refer to it if needed. If you don't have printed material available, you can write down notes for the client to take away. This is often seen by clients as being helpful beyond their expectations, which is a good thing. Takeaways can also be brief summaries of a conversation.

Here's what to do

Manager

There are situations when you are unable to help a client further because you lack the authority or information to do so. There are other situations where a client, usually angry, will likely respond more politely if he or she can talk with someone perceived as having more status in the organization – a manager, supervisor or practice owner. We know that when a client talks with a manager or someone else with more status he or she tends to behave more civilly than with someone seen as having less status.

Whether you are unable to help due to lack of authority and information or whether you feel the client will respond more positively with a manager, the techniques used are the same. First, ask or confirm that the client wants to speak with the practice manager. Second, contact the manager and explain the situation to him or her. Normally you would provide the manager with the client's name, the problem or issue, and the client's general state of mind. This step ensures that the manager isn't blindsided, eliminates any need for the client to explain the entire situation, and allows the manager to take control of the interaction when he or she makes contact with the client.

Finally, the manager is "connected" with the client. This might involve the manager introducing him or herself as follows: "Hi, Mrs. Jones, I am Cindy the practice manager, I understand you have some concerns about your bill." Whether the manager initiates contact in person or on the phone, the procedure should be the same.

It's absolutely critical that you and your manager are on the same wavelength. Some managers don't ever want to have clients referred to them, (which is not acceptable) some are willing under certain circumstances, and others are much more open. You need to know what your manager expects – the time to find out is not when you have an angry client waiting. Ask your manager when it's OK to refer clients and how he or she wants the process handled. Then abide by those wishes.

Here's what to do

Refocus

Refocusing a conversation means bringing it back to the original issue or topic. Let's say an angry client has a complaint about a product or service. He starts off talking about the problem, but then starts making critical remarks about the practice or about you personally. Those comments and discussing them in depth are not going to help the client resolve his concern.

     • What you do is couple an empathy statement with a refocus statement as follows. "I can see you are angry about your bill being more than you expected it to be. I certainly would feel the same way. Let's look at why this has happened and what we might be able to do to work out some payment arrangement." What you want to do is shift the client's attention away from his anger and to something more constructive.

Here's what to do

Setting limits

You set limits in situations where a client is acting in non-constructive ways. The client might be raising his or her voice, swearing, or making repeated nuisance phone calls. In order to help the client (and keep your sanity), you need to encourage the client to stop the inappropriate or destructive behavior. There are several parts to setting limits.

The setting limits process begins with an "if...then" statement. In that statement you are going to identify as specifically as possible what behavior you want to stop. You are also going to identify the consequence that will occur if the client does not stop. It sounds like this: "If you do not stop swearing, I'm going to have to end this conversation." Here, the behavior is "swearing" and the consequence is "end this conversation."

But you aren't finished yet. The next step is to provide a choice statement. So, after the "if...then" step, you add, "It's up to you whether you'd like to continue." This step is included because we want the client to understand that he gets to decide whether to stop swearing (and continue the conversation) or continue swearing (and end the conversation). By framing it as a choice for the client, the consequence seems less like the employee is 'punishing' the client.

You must handle the entire process of setting limits and enforcing them calmly, so it does not seem like the process is personal. If the client abides by the limit, then the conversation can continue. If the client continues to swear or argue, then the conversation must be terminated. Here's what you would say on the phone. "I'm going to end this conversation now. You are welcome to call back at some other time."

You include the last sentence to tell the client that you will be glad to help at some other time – provided that he stops swearing. Once you've indicated you are ending the conversation, you will do so unless the client offers a clear apology or commitment to abide by the limit you set.

     • Before using limits to end interactions, you should be clear about your organization's policies and wishes regarding what constitutes reasonable grounds for ending an interaction or refusing further service. Also remember that setting and enforcing limits should be a last resort - use it only after other techniques have failed to encourage the client to act more constructively.

Here's what to do

Firing

There are just some situations that are unacceptable and go beyond reasonable limits. A client verbally abusing a team member, a client throwing something at another client or a hospital employee, or a client being physically abusive with their pet is completely unacceptable behavior. In these situations there is no choice other than to fire a client. When firing a client, you are basically asking them not to return to your practice. This can be done by mail or in person. When firing a client, state the reason why you are firing them and inform them you no longer wish them to return to the practice. This should be done in a neutral tone and not out of anger.

     • Example "Mr. Jones we do not allow our clients to verbally abuse our team members. Your behavior is unacceptable and I am going to have to ask you to choose another veterinary practice for your pet's future needs. Please let me know who you wish us to forward your pet's medical records to and I will be happy to do that for you".

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Neutral mode

Neutral mode is an indirect way to acknowledge something a client has said without agreeing with it or disagreeing with it. That's why it's called neutral mode. Because it's an unusual, novel, or unexpected response, the technique tends to interrupt the flow of anger or emotion and causes the client to stop and think. This provides the employee with an opening to use other techniques.

     • This technique has a specific form. If you change it much, it doesn't work as well. It goes like this: "Some people do think that [rephrase what the client said in a straightforward, dispassionate way.]"

     • Let's say a client is going on and on about how expensive your practice is. The employee, wanting to interrupt the flow or rant says, "You know, some people do feel that our fees are expensive, but we feel that our fees are very reasonable for the quality of care and service that provide."

     • When the technique works, the client will respond with a short sentence or two, then stop. Then you can use other techniques to intervene and get control of the conversation.

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Summarization

A simple technique used either in the middle or at the end of a conversation, summarization involves doing a quick recap of the critical parts of the discussion. Summarize any important details and particularly any specific commitments you and/or your client have made during the conversation.

Summarizing shows that you are paying attention, but there's a more important reason to use it. It's not uncommon during conversations for both parties to believe that they understand what is being said in exactly the same way. But they may not. If misunderstandings are not caught, serious problems can arise. Summarizing allows you to confirm with the client that both you and he or she understands what has been said in the same way.

     • Example "So, Mrs. Smith as we just discussed I will talk to the doctor and see if we can refill Casey's medication. I will get back to you by 4 pm and let you know what she says."

        (continued...)

     • Summarizing verbally can be accompanied by providing the client with a takeaway – a written summary of the conversation.

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Telephone silence

It's sometimes hard to get someone on the phone to be quiet and listen to you so you can offer help. Some people talk incessantly when they are upset, angry, frustrated, or frightened. One of the best ways to get a client to stop talking over the phone is to say absolutely nothing. No Words. No "uh-huh." Nothing. What will happen is that the client will stop and ask, "Hello, hello, are you there?" and then wait for a response from you. That gives you an opening to use other techniques and get some control over the conversation.

If you have a mute button, that works even better, because it blocks out all sounds, including background noise. Do not put a client on hold in this situation. Putting a client on hold means you cannot hear them or know when they have stopped talking so you can jump into the gap to take some control of the conversation. The mute button allows you to hear the client, but the client cannot hear you or any background noise.

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Emphatic tone of voice

You can use an emphatic tone of voice to convey that you are strongly committed to helping the client. For example, let's say a client has been telling you that she's late for an appointment and she has to get to school to pick up her child, or run some errands, and needs to get out of your practice quickly.

     • You can respond in a laidback way, but it's better to respond more emphatically – "I understand Mrs. Smith, I will get this done for you as soon as possible and get you on your way!" Note the emphasis on "will." Emphatic voice tones work best when they match the tone and energy that the client is using.

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