Treatment option for a tense situation: Communicate, educate and de-escalate

Client conflict is, sadly, inevitable at a veteirnary practice. It’s an emotional business—for clients and often the veterinary team as well. For example, a complicated exchange with a client in the New York practice of Shirley Koshi, DVM, turned into a very public cat ownership dispute. Many say the conflict led to Koshi’s suicide in February. While not all client conflicts reach that level of turmoil, Jeff Werber, DVM, owner of Century Veterinary Group in Los Angeles, says veterinarians should be ready to de-excalate situations when they happen to avoid a greater friction. Here, Werber gives his take on how to manage tense situations presented in these common hypothetical scenarios.

Gaining basic care compliance with a community cat client

A first-time client who cares for several cats in her neighborhood brings in a cat with fairly minor injuries, apparently from a fight with another cat. She’s willing to pay for treatment of the injuries but doesn’t seem inclined to do routine tests and vaccinations or even schedule a follow-up appointment. How do you transform this possibly one-time—even skeptical—client into a regular client and, in addition, convince her to provide her community cats better care?

What would Werber do? I would praise this client for her commitment to the stray cats in her neighborhood and thank her for her willingness to help financially with this injury. I would tell her that since she’s being a Good Samaritan, our follow-up exam would be at no charge. Since she clearly wants to help these strays, I would attempt to educate her about the big picture and help her understand that it would be beneficial to make sure they’re tested for FELV and FIV—communicable, deadly diseases—vaccinated, and spayed or neutered. We would provide her with our rescue organization rates as well as post notices on our bulletin board and e-mail our client base to try to help with donations and even find these cats permanent homes.

Managing an ownership dispute

A dog found dirty, dehydrated and hungry was brought in last week by one of your veterinary technicians who lives near the clinic. The dog had no identification and no microchip. The technician paid for an exam, heartworm testing and medication and hoped to adopt the dog. She posted a picture of herself with the dog on the clinic’s Facebook page. Later that day, a nearby resident showed up claiming ownership of the dog. The woman had no previous veterinary records or documentation of ownership. How do you manage this situation?

What would Werber do? It would not be a good idea to challenge this woman or call her a liar. I would subtly imply that without some sort of proof of ownership, we couldn’t by law give the dog up. If in fact she was the dog’s responsible owner, she clearly should have something to verify her claim of ownership. I would also stress my extreme concern that any responsible pet owner would have had this dog vaccinated, microchipped or wearing an identification tag, and I would express my doubts about whether she was ideally suited to really care for the dog. If she could verify that the dog was hers, I would have a heart-to-heart conversation about the elements of basic care, then I’d put the ball in her court and ask if she truly thought she could care for this dog appropriately. If she said she could, I would insist that she cover all the expenses incurred to have gotten this dog into shape and up to date.

Defending your clinic against a vocal and volitile client

After you’ve performed surgery on a patient—having provided the client with a written invoice prior to the procedure—the owner arrives to pick up the patient with no money and no intention of paying. You inform him that the patient cannot be released until the bill is paid. The client leaves and that afternoon a local news truck pulls into your parking lot. Before you know it, questions are being hurled at your receptionist, then you, about the whereabouts of a puppy hostage. A technician sees that the client has taken to the Internet as well, saying you’ve excessively charged him for services and is holding his pet hostage. Online commenters call for a boycott of the clinic.

What would Werber do? First, having a news truck pull up in front of your office can be great PR. I would invite the news crew and cameras in and give them a tour of my magnificent, AAHA-accredited, state-of-the-art hospital. I would then talk about the necessary, difficult surgery we had to perform, how this client signed a complete estimate before leaving his dog with us, and how we informed him of our hospital’s policy requiring a deposit on all surgeries with the balance due in full on pickup. I would then stress that since everything happened so suddenly and the client was unable to leave a deposit, we in good faith performed the surgery anyway—which, by the way, was very successful. I would make sure to say something like, “I’m sure you can imagine how surprised we were that this gentleman came to pick up his dog with no intention of paying for our very successful surgery, knowing full well that we did him a huge favor in the first place.”

This client will come off seeming like a total jerk and deadbeat (which he is), and you get to showcase your hospital on television and the Internet.