Why clients leave (and what to do about it)

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It hurts when a client chooses to leave your veterinary practice. Customer attrition not only can make you feel like failure, it threatens the viability and growth of your business.

When we study why clients leave veterinary practices, we tend to focus on the clients themselves, but doing so treats only the symptoms, not the disease. Customer churn is usually the end result of a long chain of events, the root cause of which is almost always leadership and culture. Let’s approach this topic from a different angle—one rooted in biology and psychology.

The role of hormones and neurotransmitters

Much of human behavior can be understood from the perspective of chasing or avoiding hormones and neurotransmitters:

• Cortisol: When we experience stress, it’s actually increased cortisol levels that make us feel so uncomfortable and wary of our environment. This amped-up hormone is an effective motivator that persuades us to get away from a negative stimulus.
• Oxytocin feels wonderful. It’s commonly referred to as the “love hormone” because it’s released in large quantities when we bond with our loved ones. Ever notice how you can sit in silence with a good friend, and it still feels good? Your friend isn’t what feels good—it’s oxytocin.
• Serotonin has complex biological functions. It’s also largely responsible for feelings of wellbeing, self-esteem and happiness. Serotonin can make us feel ready to take on the world, triumph over challenges and appreciate who we are as individuals. On the other hand, low serotonin levels make us feel incapable, small and worthless.
• Dopamine helps us zero in on what we want. Remember that pint of ice cream in the freezer? There’s some dopamine. You’re even more excited once you open the freezer door, and when you put that first spoonful into your mouth, there’s an incredible rush of excitement and satiation. That’s dopamine saturation.

At the core of every behavior, every action, every goal, we are looking to amplify some of these chemicals and minimize others.

What hormones and neurotransmitters are dominant in your workplace? If you motivate employees through serotonin and dopamine, you have probably found them to be capable motivators. People like chasing rewards, and they will always work to avoid cortisol. But this comes at a cost—even if it’s largely hidden. Cortisol and dopamine are meant for short bursts and are unsustainable. Oxytocin and serotonin are the hormones that we should be artfully employing to create happier, more productive and more fulfilling environments.

Why good leadership matters

The primary source of discontent among staff and clients alike in veterinary practices is failed leadership. The hospital’s leaders aren't incapable or bad people, but they absolutely need to change their approach. A leader has two primary responsibilities: to ensure the physical and emotional safety of their tribe, and to provide clear guidance on where the tribe needs to go.

Consider the following scenario: A technician administers the wrong medication to a dog. The dog has a bad reaction and almost dies. The technician is in distraught. Her supervisor can structure the ensuing conversation using one of two contrasting styles of leadership: correcting mistakes versus providing safety.

Correcting mistakes

“Listen, Becky, we just can’t have this. That was a serious mistake. And it’s become a pattern. I need you to figure this out, or we just can’t have you here. Do you understand?”

I guarantee you that Becky will be motivated to correct her mistakes after this conversation, but I doubt she’ll be successful. She will have a high baseline of cortisol when working. Nobody does their best work that way. She’ll be thinking about her fears and insecurities instead of the task at hand.

Providing safety

“Hey Becky, please sit down. You know, when I was your age, I misplaced an IV line in a dog that was recovering from surgery. The dog almost died. I was devastated. I felt like a failure, like I just wasn’t cut out for this. I almost quit that evening. But I wasn’t a failure, and you aren’t either. Now, how can I help you?”

This conversation provides Becky with what she truly needs to course correct: emotional safety. Most of us are afraid that we aren’t good enough—that there is something lacking within us, and maybe that something is intrinsically wrong. But it isn’t true. What real leadership does is help us to believe in ourselves. This is the most powerful gift you can give someone—and we all deserve it.

Culture eats strategy

Downstream of leadership is culture. When you work to prioritize the emotional safety of your team, their self-confidence and their feelings of connectedness to the larger mission, you create the necessary conditions for exceptional culture, one in which people lift each other up, are attentive to each other’s emotional needs and self-actualize.

When a team is constantly worried about messing up, they inevitably underperform and self-isolate. Cortisol haunts their every action. But a team whose psychological needs are met can develop their talents and serve the deeper needs of your customers.

The last link

Once the practice leadership is effective and the culture is empowering, you can forcefully address the last link in the chain: how you are making your customers feel. This is the sole determinant of why clients stay or leave, and their needs are actually the same as those of your staff: They want to avoid cortisol. They love genuine bonds and feelings of self-worth, and you and your team should strategize about how to create these neurochemical experiences at every possible stage of the veterinary visit.

How are you reducing cortisol during their time in the waiting room and exam room? How are you encouraging feelings of self-worth and status when they walk through your door? How about when you speak with them? How do your interactions encourage the release of oxytocin?

Once you are here, I would encourage you to become fanatical about reverse-engineering a customer visit from the perspective of how you’re making someone feel. It’s hard work, but you now have the right questions to ask.

Luckily for them, they have you.

Robert Sanchez is the founder and CEO of Digital Empathy, an award-winning web design and marketing firm for veterinary practices. He frequently lectures at national conferences, leads a team of wonderful employees, sits on the board of VetPartners and shares his home with two very spoiled dogs—Cole and Lula.