Reader feedback: Disagreeing with Dr. Stone, and ‘the whitest profession’

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Disagreeing with Dr. Stone

Regarding the dilemma “No more badmouthing clients” in the February 2020 issue of dvm360, I would—and do—operate differently from Dr. Stone. I am a practice owner in upstate New York and I have worked for owners like Dr. Stone. These owners want their technical staff and associate veterinarians to tolerate bad behavior from clients until the client is irate and belligerent. In my opinion, that is waiting way too long before protecting your staff.

I agree with Dr. Stone’s associate: It is not too much to ask to be treated with respect. At my hospital, if a client shows disrespect, gives attitude, is impolite or challenges my or my staff’s competence in a rude way, I fire the client with a polite, professionally worded letter informing them of the termination of service. The mental health of my staff and me outweighs the costs of letting clients go from the practice. In my area there is an abundance of pets and clients. As veterinary professionals, we are providing help and care. There is no reason to have to deal with unpleasant, mean-spirited people who return our kindness with a miserable attitude and ingratitude. If more veterinary professionals protected their staff more aggressively, respect for the veterinary profession would only increase.

I agree with Dr. Rosenberg. We are professionals when we step into the exam room and we need to be professional to convey our message to the client so that the necessary patient care is implemented. I also agree that there is no reason to escalate a confrontation with a client as this will not help with patient care.

But I agree and disagree with Dr. Rosenberg’s statement that “the key to successfully helping our pet patients depends on our successful interactions with their owners.” I have interacted with clients for 15+ years as a professional doing exactly as Dr. Stone and Dr. Rosenberg would have it. It does not make clients nicer or cause them to respect me or my staff. It just sends a clear message that bad behavior will be tolerated and they have the green light to behave poorly any time they feel like it.

I am all for professional behavior, but once a client shows that they are going to be rude, nasty, disrespectful and impolite on a consistent basis it is time to let the client go.

—Dr. James David Nickel, Whitesboro, NY

The title of this article really caught my attention. I have been the practice manager of a five-doctor practice for 37 years and we face this challenge every day.

We are in an affluent area just west of Boston, and the clients we serve have very high expectations of us and our hospital. We know that, and we try every day to meet these expectations. For a practice to be successful, we need to win over our difficult clients. We do try to kill them with kindness. If someone is unhappy, we try to find out why and let them know that we understand. It is a first reaction to lash out at bad behavior, but you should never stoop to their level. Remaining calm and cool in these situations is the answer.

That said, I do think there is something very important missing from this answer by Dr. Stone: We only occasionally have clients angry or lashing out at the doctors or technicians. I know from much experience that it’s the front desk staff that is hit the hardest in this area. The doctors do not understand how the front desk team members are treated. I find it very easy for a doctor to say “develop a thicker skin” when they rarely are the ones subjected to this behavior.

Difficult clients are an everyday occurrence at our practice, and I do try to have a manager or supervisor take over if a team member is being verbally abused. We practice tolerance and respect, but I truly believe sometimes the doctors have unreal expectations of how much abuse should be tolerated.

—Moira A. Guigno, practice manager, Wellesley-Natick Veterinary Hospital, Natick, MA

More on the ‘whitest profession’

I would like to offer a comment about a recent letter in dvm360 (‘Whitest profession in America’ inappropriate’). The facts are relatively straightforward: Over 90% of veterinarians are white in a country where about 81% of the workforce is white. Imagining this is an accident rather than the result of systemic racism is naive or disingenuous. Acknowledging an injustice is critical to rectifying it, and we cannot shy away from clearly and directly describing an unjust reality if we seriously hope to change it.

It is not unusual for white people to feel personally attacked or accused of racism when white privilege and discrimination against people of color are discussed, but it is an unfortunate and unnecessary reaction. I have been lucky in having friends patient enough to explain the difference between acknowledging the systemic factors that favor white people in American society and accusing individual white people of being undeserving or racist. White privilege doesn’t mean white people have not had to struggle or face adversity as individuals. It simply means that our skin color has been an advantage rather than an added obstacle in our life’s journey.

As a relatively old, white, male veterinarian, I can acknowledge the injustice that has favored those like me without feeling that the effort and struggles I endured to get where I am are being invalidated. I may be good at my job and even deserving of it as an individual, but so are many who have not had the same opportunities I’ve had. It does not diminish me to acknowledge this, but it does engender a responsibility to contribute to a more just future.

Rather than getting upset about the word “white” or open discussion of white privilege, I think it more useful to try and be part of the solution. The article Dr. Clemente responded to (‘Institutional change in the whitest profession in America: Veterinary medicine’) offers specific, appropriate steps to improving diversity and inclusion in veterinary medicine, including “leveraging power and privilege to advocate on behalf of others.” I find nothing at all objectionable in that.

—Brennen McKenzie, MA, MSc, VMD, Los Altos, CA, skeptvet.com