Setting boundaries helps block conflict and stress

By Cecelia Soares, DVM, MS, MA

Several years ago, some colleagues and I began a support group for veterinarians. We met for almost two years and discussed a broad range of topics. I soon noticed that the solutions to almost all of the problems raised included setting limits with other people. For example, we brainstormed the best way to handle an unreasonably demanding client, how to approach recurrent staff problems, and why staff members honor some policies and violate others.

It all comes down to limits, or how far we can be pushed and still feel comfortable. Like cell membranes, healthy human boundaries are flexible, semipermeable, and responsive to the environment.

Realizing you need a fence

In veterinary practice, each person on the team has different needs and desires, and each plays a different role with clients, colleagues, and staff members. Setting healthy boundaries helps team members in any role establish more open, comfortable relationships with others.

Clear boundaries give you a sense of privacy and security. When you know and communicate your boundaries, the people you work with know what you expect and what they can expect from you.

Not sure whether you’ve set clear boundaries? You may need stronger limits if you feel angry, frustrated, uncomfortable with a person or a situation, or stuck in a series of difficult situations. For example, the limit-challenged doctors in the following case studies noticed they were frequently running behind with appointments, struggling with staff management, and facing unbalanced hours and workloads. (For more on these doctors’ problems and solutions, see the case studies on pages 65, 68, and 70.)

Keeping to your set limits really does minimize conflict at work. However, the people who most need to stick to boundaries generally have the most difficulty doing so. If you’re in this group, make sure you consider these issues when you draw lines in the sand:

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Clarity.

You can’t protect your boundaries if you don’t know what they are. For example, your clinic opens at 8 a.m., but a client asks you to admit her pet at 6:30 a.m. for a procedure. What’s your rule, and how firmly will you adhere to it? Now suppose this client often expects special concessions. Would that change your limits?

Clarity often rests on surprisingly small details. If you expect your technician to keep the surgical suite clean, then you must define clean. In one clinic, clean might mean culturing the surgery table at regular intervals; in another, no visible dirt might be clean enough. And what does it mean to “treat others respectfully,” as so many practice manuals say? You must define off-limit words and behaviors.

Most conflicts with clients over fees arise from lack of clarity. Written estimates help, if you’re precise about what you’ll offer for the price—and warn clients as early as possible if the final bill will be higher. I’ve seen estimates that were just a guess at the total charges scrawled on a paper towel. That’s not clear enough!

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Consistency.

All the clarity in the world is of no use if you don’t enforce your limits consistently. As you know from those animal behavior classes, variable reinforcement is the most effective way to establish a behavior. Imagine a mother with a 3-year-old who’s begging for a cookie. One day it takes 20 minutes for Mom to give in, the next day it takes 10 minutes, and the day after that it takes 30 minutes. Before long the child will keep it up forever, because he never knows when whining will pay off. And clients and staff members will learn the same thing—if you let them.

Here’s another example: A client wishes to pay a bill over time. Do you have a clear policy, and do you adhere to your rules consistently?

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Consequences.

You likely know from experience that limits aren’t effective if you won’t follow through. In fact, it would be better to set a more modest limit—or not set one—than to make a rule you won’t enforce.

For example, if someone who tends to be late is annoyed with you because you won’t see her right away, tell her you take people right on time. Then you must always do that. Otherwise they always expect to be fit in when they arrive. Or if you don’t charge for a procedure one time, then you do, clients will pick up on that and won’t understand the inconsistency.

Theory into practice

Let’s say a practice doesn’t allow staff members who work with clients to wear jeans. One morning, an employee, whose position required her to work in the reception and pharmacy area every afternoon, arrived at the clinic in jeans. When asked, she said she was aware of the dress policy, but that all of her work pants were dirty, so she thought it would be OK to wear the jeans. The practice owner told her to go home, a 30-minute commute, launder appropriate pants, and return when she had finished. He didn’t pay her for the two hours of work she missed.

The result? From that time on, not only did she always wear appropriate clothing to work, so did the other staff members. A bonus: Staff members passed the story down through generations of employees and the owner never faced that issue again.

In another case, a regular client was consistently rude to staff members. One staff member, a 10-year veteran of the reception desk and a highly valued employee, finally threatened to quit if she ever had to see “that woman” again.

The veterinarian took action. He copied the client’s pets’ records and wrote a diplomatic letter expressing his concern that the practice didn’t seem to meet her needs, given that there was generally a dispute with staff members whenever she visited. He suggested she seek veterinary care elsewhere.

When the client received this packet, she called in tears. She asked, “What do I have to do to come back?” That gave the owner the opportunity to tell her how much he valued his staff members and that she was welcome at the practice as long as she treated them with respect. She never acted out again.

Ready to set effective limits? The first step: Really think through the situation, your current approach and feelings, and your goals. Then act on your new understanding. Set clear limits, hold to them consistently, and tell people when they step over the line. I think you’ll find this is one of the best ways to resolve conflict in any relationship.