Show bad clients the door

The other day i was talking to one of my clients. She was very upset. One of her receptionists had come to her, also very upset. This receptionist was dealing with a client who was also very upset—it was one of those days. The long-term client, who owned a number of pets, came in without an appointment. She was complaining that her dog just wasn't acting right, and she wanted the doctor to see her dog immediately.

The receptionist offered the client the option of dropping the dog off so the doctor could examine the pet as soon as possible—but the client would have none of that. The client wanted to see the doctor immediately: "Oh, she always sees me. Just tell her I'm here."

The receptionist went to the doctor, and the doctor said, "Oh, Mrs. Trouble. She's always doing this. Tell her I'm in surgery and ask her to leave the dog." The receptionist told this to Mrs. Trouble, who wasn't happy and declared that she'd wait until the doctor was out of surgery.

Once again, the receptionist went back and spoke to the doctor about Mrs. Trouble. The doctor said she'd have to wait.

Every five minutes Mrs. Trouble gave the receptionist a hard time and asked if the doctor was out of surgery yet. Finally the client became very agitated and said if the doctor wouldn't see her she'd find another one who would.

At this point the doctor walked into the reception area and, in front of the receptionist, apologized to the client. She said, "I didn't know it was you Mrs. Trouble. If I had, I would've been up here sooner. The receptionist didn't tell me you were here." With that, they proceeded into the exam room. When the client came out, she gave the receptionist an I-told-you-so look and said, "Next time, tell the doctor I'm here." The receptionist was livid!

Later that day, she approached the veterinarian, asking why she'd lied and hadn't stood up to the client and backed her up. The doctor explained this was a "good" client who'd been with the practice for years and spent substantial money there. She didn't wish to lose the client. "Don't worry about what I said. I was only trying to make the client happy. You're a great receptionist."

After the discussion the receptionist turned in her notice. The doctor, who was now on the phone with me, didn't understand why the receptionist quit.

We talked about several issues: backing up your receptionists and being honest—to name two. But the other big discussion centered on clients, specifically when does one cross the line, and when is it appropriate to "fire" a client?

Who to fire

Now, you know as well as I do that the words "fire" and "client" are seldom used in the same sentence. Normally you try to acquire more clients and bond them to your practice. But there are times when a client is just more trouble than he or she is worth and needs to be fired. Here are a few examples of these situations and advice on how to actually let that client go.

Termination of the doctor/client relationship

• Chronic complainers. There's an old management rule that says 20 percent of your clients will cause 80 percent of your problems. If you weed these clients out of your practice, life might be much improved. By the way, this rule also states that 20 percent of your clients are responsible for 80 percent of your income. While there's some debate about this percentage, I think I can guarantee the top-spending 20 percent doesn't include the same clients causing you all the problems.

When a client's always complaining, and it seems like you can never satisfy him or her, it could be time for that client to go to another practice. The same holds true for that overly demanding client you can never please. They want to be seen today! They want to hear back from the doctor right away! They will only talk to one doctor or technician. They want you to refill a prescription for a patient you haven't seen in two years!

Why do you put up with these folks? What effect do they have on your healthcare team? Maybe it's best to do them (and you) a favor—let them go!

• Dishonest clients. If a client tells the receptionist one thing and the doctor another, do you want that client around? If a client lied to you or a team member just to get his or her way, in my book that's grounds for dismissal. I wouldn't tolerate a dishonest employee; why should I accept a dishonest client? (Especially if the client's behavior might affect the pet's care and treatment.)

• Clients who don't respect your time. You know the client. She calls you and says, "Oh doctor, I just need a minute," and an hour later she still hasn't asked you a question. Or the client who calls you at home during dinner to ask about something she saw on television? These clients think they're the center of the world and everything revolves around them.

Take another look at clients who blatantly abuse your time and your team's time. The first step: Talk to them and try to set some ground rules. Some might be very nice people who're lonely or bored, and they need to know the effect they're having on you and your practice. If setting boundaries doesn't work, let them go. They might be causing more harm than good for your practice.

• Financial deadbeats. You have a client who's owed you $500 for several years. Every time he comes in he explains that he doesn't have any money. He pays $10 or $20 on the account and has $100 of services rendered. Your office manager has issued several promissory notes that he's failed to honor. He's broken promise after promise, but you still offer professional services and products. Who's the fool?

It's one thing to extend credit to someone in his time of need and work out payment arrangements. It's another to let people take advantage of you.

Some veterinarians ask me, "What will other clients say if I turn this client over to collections and 'fire' him?" I think they'll say, "Good for you." Everyone in the community probably knows this client is a deadbeat. And I think it causes more harm if you allow such a client to continue to take advantage of you than it does to liberate him.

You'll only lose the bad ones

I'm not saying that you should fire 20 percent of your client base. I am saying that I frequently see veterinarians who often put up with far too much. I've fired a number of clients in my life and something interesting almost always happens: They apologize and ask to be forgiven and allowed to come back to the practice.

The gift of peace of mind

I'll never forget this incident: I was administrator of the New Haven Central Hospital for Veterinary Medicine, and a client was verbally abusive to a receptionist working the evening shift. The client used foul language, yelled, and called the receptionist horrible names to the point where she was in tears.

When I found out about the confrontation the next day, I contacted the client and told her that her behavior was unacceptable. I explained we don't allow our team members to be treated like that and we'd be asking her to find another practice for her pet's care.

Later that day the receptionist received flowers with a handwritten apology. The next day the client called the receptionist and again apologized and then asked to speak to me. She wanted to know whether she'd be allowed to return to the practice. I told her I'd have to speak to the receptionist.

I discussed this client with the receptionist and told her it was her decision whether to allow the client back. The receptionist decided to do so. From that day on, she was one of our best clients.

How to fire a client

I see two types of situations that lead to firing a client. One is an egregious act, such as verbally abusing, swearing at, or physically or verbally threatening an employee. In this case, I believe you must fire the client immediately.

The second situation represents a more gradual problem—the client who's constantly late, always demanding, or fails to pay for services. In this case, bring the client up at your next team meeting. Discuss the client and let the team decide whether to fire him or her. This brings the entire healthcare team into the decision-making process and empowers them. Employees can also present a client they'd like to be considered for termination.

Once you decide to fire a client, the next step is to do it. I suggest sending a registered letter with a return-receipt informing them they're no longer welcome as clients in your practice.

Your letter shouldn't be mean. Instead, remain professional and courteous. Without placing blame or fault, explain that you feel the client would be better served by another veterinary hospital. Simply state that it appears that your veterinary practice is no longer meeting his or her needs and that it seems the client's no longer happy using your services.

Suggest that the client find another practice and let him or her know you'd be happy to forward the pet's medical records to the new practice. (See for a sample discharge letter.)

Make a note in the record and, if there's an outstanding invoice, bill the client. If he or she fails to pay, turn the bill over to collections. Your time and effort can be better spent on clients that appreciate you and your practice.

The bottom line: We simply can't please everyone all the time. There are some clients who, no matter what you do, will never be happy with you or your practice. The key is to identify those clients early and, if necessary, fire them. Believe it or not, it might be the best thing you can do for them and your practice.

The bottom line

There are two categories of clients that generally warrant firing. Those who do something egregious, such as yell at or threaten your team members. And those that slowly peck away at your standards by arriving late or refusing to pay for the services rendered. Let them go firmly, but politely—and you'll have a happier practice team that can provide even better services to other clients.

Mark Opperman

Veterinary Economics Hospital Management Editor Mark Opperman is a certified veterinary practice manager and owner of VMC Inc., a veterinary consulting firm based in Evergreen, Colo. Please send your comments or questions to: ve@advanstar.com