Tame the abusive veterinary client

They swipe and slash, claw and needle. They poke and prick and push and prod. Sometimes their roars make you angry. Often their bites hurt. We've all dealt with abusive clients, usually on a personal level. Like most creatures, even mild-mannered clients can attack when they feel cornered or confused. The following examples are real cases from my experience as a receptionist, a veterinary assistant, and finally a licensed technician. For each scenario I've encountered, you'll find an example of how my team responded to soothe the savage beast. Not all the stories have happy endings, but we did our best to handle the situation professionally and attempt to retain clients who proved they weren't repeat offenders.

Walk the tightrope

The scenario: The client who blames the team for his or her own mistakes

Mr. Knows Best blasts into the hospital snapping because he's already run through his two-week prescription of antibiotics for his beloved cat, Wigglesworth. When we try to soothe the client, we realize the 1 ml of medication that was to be given twice daily is actually being drawn up as 1.5 ml. It helps to defuse the situation by saying, "It's an easy mistake" and offering to, just this time, provide a free refill.

To avoid these situations, it's key to clearly show the correct dose with a syringe or tablet before the client leaves the exam room. It may be helpful to mark the syringe with a sharpie at the appropriate measurement or to pre-cut tablets. Not only will this prevent client errors, it will show you don't mind going an extra step for client satisfaction and ease. And don't forget, it's important for the doctor or technician to explain the possible side effects of an overdose.

Unfortunately, it's not uncommon for clients to misunderstand or fail to follow your care instructions. Consider the case of Sammy the beagle. He comes in covered in ticks and experiencing lameness. Dr. Kind prescribes an antibiotic. A few weeks later, an enraged client storms into the waiting area, claiming Dr. Kind made Sammy even sicker, since he vomits daily on the medication and isn't showing signs of improvement. The client admits she administered the medication without food, despite the "give with food" label on the vial.

It may be difficult to defuse a situation like this, but it's important to avoid blaming clients if they've made an error that could potentially hurt their furred family member. In this situation the team apologized, even though they had offered proper instructions from the start. They explained Sammy was most likely not even keeping the medication down, so the client should try the medication again while giving it on a full stomach. Once the client understood what was happening with her pet, she was much calmer and willing to try again.

A quick note: To protect the practice from any unwarranted lawsuits, the hospital team should always make note in the client's record of verbal, as well as written, instructions and keep a copy of the prescription in the file. In this case, the direction to give with food should be included as part of the prescription.

Let's look at one more example of an angry client who didn't follow instructions. Mrs. Debbie Doesn't-Listen brings Max in with damaged pads from walking on hot pavement. After we clean up the pads, we bandage them and tell Mrs. Doesn't-Listen to place plastic bags over the bandages to keep them dry when it rains. Max visits the next day with soaked bandages that are barely staying on. Mrs. Doesn't-Listen is very upset. She yells at the team members who placed the bandages, saying, "You have no idea what you're doing."

In this case, it helped to have the doctor talk to the client and explain she'd personally watched the placement of the bandages, and it was performed thoroughly. She explained that the bandages did look wet and asked if the client placed bags on Max's feet when it rained. The client admitted she didn't, and the doctor calmly explained this is probably why the bandages weren't staying on. We offered to re-bandage and reminded her to cover the bandages with plastic bags. The client, in this case, willingly paid for the re-bandaging once she realized her mistake.

Out-guess the fortune teller

The scenario: The overprotective client who interferes with procedures

Most of us are familiar with always overly concerned clients. They even bring their own thermometer to take Sally's temperature to avoid possible contamination. This can work in our favor—clients who care this much about their pets will definitely visit your hospital at the first sign of a health issue. In the following case though, it was a problem.

Sally the Chihuahua visits to have her anal glands expressed. As we're expressing the anal glands, Sally yelps. When this happens, the client, Ms. Concerned, gets upset and tries to pull the technician's arm away. Not only is this interfering with the procedure, but it could potentially hurt the patient.

In this case, we told Ms. Concerned we didn't want to upset her during procedures. We explained that Sally may get more worked up as well if Ms. Concerned became distraught. Once she understood this was in the best interest of both her and her pet, Ms. Concerned seemed pleased that we cared. We avoided future potentially dangerous mishaps by expressing Sally's anal glands in the treatment area, out of site of her anxious pet parent.

Show your strength

The scenario: The overbooked client who feels inconvenienced

Mr. Harry Hurry calls to request a refill for his pet's heartworm prevention. The receptionist explains we haven't performed a heartworm test for Spike in a year and a half, and it appears as if he also hasn't received heartworm prevention from the hospital for the past six months. So Spike will need to visit the practice for a preventive care exam and testing before the doctor can refill his prescription. The client strikes with stinging retorts, calling the hospital money-grubbing and stating he simply doesn't have time for the appointment.

In cases like this, sometimes it helps to ask the technician to step in and explain the reasoning behind this policy. When clients realize having their pet visit for the recommended services is for the well-being of their pets, they may be more receptive to scheduling regular appointments.

Jumping through hoops

The scenario: The client who thinks the veterinary clinic is a charity

A couple brings in their 15-year-old cat, Fluffy. Fluffy is experiencing respiratory difficulties as she arrives in the exam room—just as the assistant is checking the patient in. The assistant rushes out of the exam room with an estimate and asks for permission to start basic life-saving techniques. The couple becomes very upset, yelling at team members and even calling them names. They imply that as a veterinary hospital we should be saving lives for free. We explain that the practice is a business, and rendering these services costs us as well.

Ultimately, since the clients resorted to insulting team members and name calling, we fired them. Unfortunately, this is the reality of any business. We can't expect to calm every offensive customer.

If the client hadn't attacked, we would have explained that these services cost the practice in staff time, expertise, and supplies. Then we'd offer payment options, such as third-party payment plans or promissory notes. We might also refer the client to a local charity that may help cover veterinary services for low-income households. In many cases the client's ability to pay is the issue—most clients don't actually think the hospital is obligated to function on a charity basis. Payment options may help clients feel more at ease and empowered to care for their pets.

Soothe the savage beast

The scenario: The client who questions the medical team's integrity

Mrs. Susie Skeptical enters the clinic with a very sickly, vomiting bulldog, Joey. We perform blood work, then radiographs, and we quickly discover the problem. A foreign body shows up vividly on the radiographs. The client also casually mentions the sock that went missing in the living room pile of laundry, which she also saw Joey playing with and chewing on earlier. The client reluctantly agrees to pursue surgical treatment but tells the doctor that she'd better find something if she's paying this large amount.

Although we did in fact find something in the form of a gastric juice-soaked sock, it's not acceptable for clients to threaten or insult the doctor's judgment. When the client insulted the medical team, we explained nothing in medicine is clear cut or guaranteed. Even with human medicine, when you go to your doctor, would you dare suggest that the doctor better find something with the blood work he or she recommends? Putting this into perspective with the client can sometimes help them realize we're working in the best interest of their pet. After this explanation, the client dropped the argument and signed off on the release forms without further complaints.

And sometimes the price can upset clients so much they try to argue that the services aren't worth of the fees you charge. In one case, an 8-month-old poodle presented with a tibial fracture, which we later splinted. A discussion began in the lobby area as the client was checking out, and quickly a client who was upset about the price turned into the client attacking the attending doctor and stating that the doctor didn't know what she was doing.

Nothing stirs emotions quite like the combination of financial strain when a family member falls ill. In this case, we tried to calm the client, saying we understood her frustration. Because she was a long-time, trusted client, we offered a payment plan. And as we discussed earlier, third-party payment plans can also help alleviate some of the financial strain-induced abuse team members face.

It's a practice, not a circus

Unfortunately, we can't expect to please every abusive client. We can, however, do our best to professionally handle the problem. It's important to invite the client into a private place, such as an exam room. This way they feel you're offering your undivided attention, and other clients won't observe the scene if the client is upset. It's helpful to remain calm and caring, but it's also important to be firm and stand up for your team members and hospital. With vigilance, we can foster positive relationships with our clients to provide the best health care possible.

Oriana D. Scislowicz, BS, LVT, is a technician in Richmond, Va. Share your thoughts at dvm360.com/community.