Podcast #55

Bulldog bow
Unlike this adorable Bully, bully clients are some of the most upsetting clients we need to deal with in veterinary profession.
Bullies exist in all forms, and they go through their lives threatening, blaming and guilting others to get their way. They don’t care who they hurt on the way, and we need to be strong and stand up to these individuals. We need to break the cycle and display that their behaviour will not get them where they want in your clinic.

We need to stand up to these individuals not only for our own mental health, but for the profession as a whole. The more clinics that display to clients this behaviour won’t be tolerated, the less people will attempt it!

For more blogs on dealing with particular types of difficult clients, see blogs on Upset Clients, Dangerous Clients, Manipulative Clients, “I Know Better” Clients and General Tips on Difficult Clients along with Self Preservation When Dealing with Difficult Clients.
Overall:
girl covering face with multiple fingers pointing
Clients that blame everyone else, and try to turn different parts of the veterinary profession against one another, do immense amounts of damage to not only the individual vets, but the profession as a whole. We need to band together for collective growth.
This type of bully client tries to get their way by blaming anyone and everyone they can. They try to belittle and attack anyone in the process hoping to scare someone into doing treatments for free. They often try to blame the ‘other vet’, whether it is another vet in the practice, or the emergency or GP clinic. They downright lie, and they throw anyone they can under the bus if they feel it will get them ahead.

They will also blame the person right in front of them, picking on any tiny small thing they can to try to get a discount or as justification to not pay a bill. For these clients, it’s usually all about the money.

DON’T PLAY THE BLAME GAME:

The first thing to note is that these clients are unfortunately common, and working in emergency we see them all the time, blaming their GP for not ‘catching something sooner’ or ‘not doing a good job.’ And let me tell you, 95% of the time it turns out their vet did exactly right, offered everything, and the owner declined. Yes, 5% of the time maybe the GP did miss something, or mess something up, but we ALL mess stuff up once and a while whether we are GPs, emergency doctors or specialists. (See FREE webinar on Medical Mistakes!) And also, hindsight is 20/20, and hindsight bias is a very strong and real thing, so we should never judge! (See webinar on Medical Biases.)

Make sure you are not feeding into these bullies by playing the blame game. Make sure you are not throwing your fellow colleagues under the bus, and that we are supporting one another. If you do have a real concern about how a case was managed, privately inform that colleague later on, when you have the full story and when you can both learn and grow together as collective veterinary team!

“All we know is that right now Fluffy has ___ condition. Animals don’t speak to us, and hide their diseases, so I cannot comment on what happened at your GP.”

“Conditions can change quickly, and sometimes we treat conservatively first because it will fix 95% of cases. I cannot see anything that your vet did ‘wrong’ and Fluffy’s case has just escalated. Let’s focus on what we can do now.”

These lines are great for diffusing and redirecting, and showing support, for your colleagues.

When the blame is directed towards you or your direct staff, you will need to be a little more direct in your response.

“I understand that you feel that Fluffy’s care wasn’t appropriately managed/(insert their complaint here), however medicine is not an exact science, and Fluffy’s case was managed in the best way possible with the information at hand. We did everything we could given the resources we had.”

Often you will run into the situation in emergency situations where clients bring in a critical patient, and say “do everything”… you give them a verbal estimate, a poor prognosis, you even recommend euthanasia. They refuse to consider euthanasia and tell you to do everything. They are ‘too distraught’ in the moment to leave money, and their pet’s condition means you just have to act. So, you act. You do $500-$1000 worth of treatment including your consult, fluids, imaging, pain relief, initial bloods, tapping, etc. Their patient, with their critical injuries/illness, as you directly and clearly warned the owners… dies. This wasn't your fault, this was the case. The owner then comes at you with “you killed my dog and now you expect me to pay??” These clients try to blame you for not knowing enough, not doing enough, not being enough… as if we don't already suffer from Imposter Syndrome! These comments hurt us to our core because we did do enough, we did know enough, we were enough, but it wasn’t enough for that pet. We are hurting, and they throw blame on top of it!

“Fluffy was incredibly sick when you brought him in, and we communicated that to you, along with how much attempted stabilization would cost and a poor prognosis. We did absolutely everything for Fluffy, as you requested, and the injury/illness unfortunately won. I did not kill your dog, the injuries/illness were too severe and too profound for us to save Fluffy.”

Directly responding to these comments not only displays confidence which will take the wind out of the Blamer’s sails, but it will show them that you will not be one to be bullied. You display that you were clear with the owner from the get-go, and their tactic won’t work on you. You also say something to defend yourself, and your team. For mental health this is HUGE, as a lot of us will remember these comments, and will “Loop” on what we should have said. Standing up for yourself is incredibly empowering!

It is important to note that sometimes we do make true mistakes, and managing and dealing with the situations where we really did mess us, is important. We need to own these situations and manage them appropriately. See the blog on Managing Complaints.
Threatening Client:
snake hissing
Clients that show their teeth, hiss, and put on a display do this because they spend their lives getting their way by these methods. These clients need to be told that their threats will NOT be tolerated!
Some clients display their bully side by being threatening. They threaten to sue, they threaten to tell our managers, they threaten social media. They try to bully staff by threatening the safety of our jobs, our financial security, and in the situation of social media- sometimes our personal safety and the safety of our families.

These clients are annoying, often shrill, and irrational. They hang up whenever you try explain your side of the story or cut you off, they repeat their irrational thought over and over, and they have no interest in truth or fairness. They are also often entitled individuals, and they are the ones that demand to be seen right away for their dog’s nail trim when they walked in off the street with no appointment, and don’t care that a dog was just rushed by on a stretcher with a crying family following. Their needs are more important than anyone else's.

This is another subset of client that needs to be FIRED!

THREATENING TO TELL YOUR MANAGER:
horse laughing
When you have a manager that supports you, and backs you up, when difficult clients threatening to go to your manager you are laughing!
“I’m sorry that you feel I haven’t helped you appropriately. Here is my manager’s name and phone number, they are available on Monday at 8am.”

Personally, I love it when people threaten to go to my boss or manager. Why? Because I know that I give 100% to every client, every patient, and I am thorough and polite. I know that 99% of my clients love me, and that my attitude and approach are professional and empathetic. So, I know that if someone complains about me, I know in my heart I did nothing wrong.
IMPORTANT NOTE:
We can always learn from a complaint, so just because you didn’t do something ‘wrong’, doesn’t mean you can’t do it better. So, take into account these complaints and see what you can learn, but don’t let it make you feel less of yourself!
Also, I work in a clinic where my managers are supportive of me, will back me up, and will defend me! Don’t get me wrong, they do their due diligence, they will ask me about a case, what happened, follow it up. They do their job to see if there are places the clinic and staff can improve. They also need to determine if our clinic and team really did mess up, in which case they need to be honest and make amends with the client (see Managing Complaints). But, when clients complain just to complain, when they threaten our staff, when they are bullies to us, my managers will inform them that their behaviour is unacceptable, that our staff acted appropriately, and if they unhappy with our service they can go elsewhere.

Working in a clinic where you know the manager will back you up, makes a HUGE difference on mental health! And, sometimes the manager does just give in and say “OK Mrs. Smith, I will let that vet know.” Sometimes it isn't worth it to them to fight every single client, and that’s OK… but what is not OK is when the staff don't feel supported.
IMPORTANT NOTE:
GIVING DISCOUNTS TO THREATENING CLIENTS:

Managers, when you concede to threatening and bullying clients, and give discounts, you are basically telling your staff “F*#k you, this client’s business is more important to me then your mental health or feeling of self-value.”

You tell the client they were ‘right’ and perpetuate the behaviour. You tell the staff you are OK with them being treated like crap. And then you wonder why they leave….

This is a HUGE factor in employee retention in the veterinary world. Make sure your staff can trust you, can depend on you, and you will receive a loyalty and work-ethic back 100-fold!

As a boss/manager, you might be thinking, “But I just want to help the animal!” And you can do that if you want, just do it the right way!

Example: Your staff see a dog that needs a foreign body surgery and you aren’t in the clinic. The staff give owner an estimate and they go off on the staff. Yelling, screaming, threatening, guilting, blaming. Comments like “you just want to kill puppies” and “all you care about is money” get thrown around. Your staff doesn't have the authority to give a discount. Your staff then calls you to talk to the owner. You tell the owner you’ll do it for a fraction of the cost, and the client is sweet as pie to do you. You then tell the staff they have to stay late to do the surgery, discharge the dog to the now snarky and snide Mrs. Smith who has an air of “I won” and “I told you so” and makes comments as such to the staff.

How does your staff feel? They have just been abused and attacked for having a difficult conversation about something they NEVER want to talk about, euthanizing a fixable situation due to finances, because they are trying to support and up-hold your billing rules. You then placate the owner, give the discount, and tell staff that Mrs. Smith is fine and not mean at all. You then leave the staff to be further abused on discharge or further communications.

Your thought process, “I don't want to kill this dog, I don't want my staff to have to kill this dog, I want the dog to be fine.” These are admirable and great ideas and concepts, but the way you went about it missed a huge piece of the puzzle, and that is the mental health of your staff.

Here’s how you can give the discount, and also support and defend your staff. When your staff calls you with this situation, you either come into the clinic or talk to the client yourself. You tell the client that in no uncertain terms will their behaviour be tolerated. You tell the client that your costs are set appropriately to cover the costs of the treatment required. You tell the client that your staff work very hard, love their patients, and that their comments are abusive and completely unacceptable. You can then say that as the owner of the clinic, you are willing to do the surgery at a discount/set up a payment plan, solely for Fluffy’s sake. This is to protect the mental health of your staff who love animals and would never want to euthanize a dog that could be fixed, so you are willing, and have the authority to take that financial hit as a business. However, this comes with strings. The client will need to leave the building immediately leaving Fluffy with us. Any further communication will occur via the boss and Mrs. Smith directly. She is not to come into the clinic, or call the clinic. Once Fluffy’s current issue is fixed, she has the option of either coming into the clinic and apologizing to the staff, and has one more chance to be polite and respectful to the staff and can stay on as a client, or she can find another clinic. Any further abuse will not be tolerated and will result in our inability to provide ongoing care for Fluffy. If the owner is unhappy with these terms, she can take Fluffy elsewhere.

This communication should be clear to your staff, along with an apology from the owner that they had to deal with this client. It needs to be clearly stated that the owner was told that the behaviour is unacceptable, and that the only reason we are doing the surgery for less is for Fluffy.

This approach will show your staff you understand what they went through, that you support them, that you value them, and that you also care about the animals. It also displays to clients that your costs aren’t inflated, and that discounts cannot be obtained through threats and yelling.

It also removes the interaction your staff has to have with these clients, which is often incredibly stressful and emotional.
THREATENING SOCIAL MEDIA:
lemur bya keyboard
“Keyboard Warriors” are rampant, and dealing with social media attacks is a huge stress point for veterinarians in today’s world.
In today’s world this is a common, and very scary threat for professionals. Especially in the medical field, as confidentiality means that we cannot even defend ourselves. Some vets have been bullied so aggressively on social media that they have had their houses/cars destroyed, been stalked, their families including young children have been bullied and threatened, their clinics have been vandalized, you name it. We can fear for our safety. And, when you read terrible comments about you over and over again, it is a huge toll on mental health, and has pushed some veterinary professionals into suicide.

We cannot be nameless, as prescriptions, discharge instructions and medical records have our names!

We are vulnerable to social media attacks, with very little to defend ourselves aside from our own thick skin, and the odd supportive person out there. Keyboard warriors however are awful, and have way too much time on their hands.

So, when people threaten with social media, it’s an attack that does install a sense of fear. It’s a tactic that people use, as they know the power that social media can have.

So, when people threaten social media, I don’t take that lying down, especially when they threaten it of my colleagues! However, it is important to remain CALM when delivering these lines, and not yell or escalate the situation. Power comes with remaining in control, and that includes displaying control of your emotions (on the outside anyways).

“I am sorry you feel we haven’t appropriately addressed your concerns, however threatening to go to social media is abusive and bullying, and we do not tolerate that at this clinic. We have provided Fluffy the best care possible, and for you to imply that we have not done everything, not provided appropriate care, and not cared for Fluffy as if he was our own is not only downright insulting to our team that has worked hard, but it is unacceptable.”

I aggressively respond to these comments, and will even go on to say

“Suicide and depression are rampant in the veterinary industry, and it is bullying and comments such as yours that contribute to this statistic. We will not be bullied or abused.”

“If you feel we have not provided Fluffy the best care here is the information for my manager”

Remember: Deliver this CALMLY!

Now, this might not be the best for client retention, but honestly these clients are toxic anyways. For my own mental health, and to support my colleagues, I need to be aggressive and stand up to these bullies. And, to follow up with an avenue where they can then complain is important, to re-direct their anger away from social media.

Most clients, when you directly respond to their comments which they hope you will just back down from, and call their behaviour threatening and abusive, will come around. They will say, “I didn’t mean that”. These clients are used to people backing down when they provide threats. Letting clients know that their comments have serious side effects also tends to ‘snap them out of it.’

Giving clients a different avenue to complain is incredibly important as well, so even having a brochure that your team can hand out that outlines how to put in a complaint, will help divert complaints away from social media.

THREATENING TO SUE:

In this world we are all afraid of being sued. Especially in the veterinary profession where finances play such a big role, so often owners are suing us medically over a financial issue. This puts us doubly liable. Also, often the rules and regulations behind ‘informed consent’ are even more strict on veterinarians than they are on human medical professionals. We are expected legally to cover so much information, it’s impossible. How can you possible cover 7 years of university in a 15min consult. Just the practice of prescribing an NSAID for a couple days for a limping dog has become a ‘schpeal’ that I have to say.

Even if medically you do everything right, a line in your medical record that is unclear or misspelled (yes, I have seen that), or not documenting every line of conversation that you had when you spoke with the owner for HOURS, literally HOURS, can leave you liable and open to litigation.

This is a fear that is more and more prominent with younger vets, and is leading to clients being more angry about us ‘over-servicing’ because we are left in a situation where we have to offer/recommend diagnostics to ‘cover our ass’ instead of feeling a true need for the patients.

Our KICK ASS recommendations for these clients is two-fold:

1. Prevention:


We all know preventative medicine is best. Protect yourself from litigation by having great records, by recording what you offered and what was declined, by having discharge instructions handed out to every client, and by having conversations. Yes, it takes more time, yes it’s annoying, but it’s less time consuming and annoying than being sued. Also, once you create systems and templates it's not that time consuming.

2. Direct Response:
If clients threaten to sue you, they can either be referring to financial suing, or medical suing.

Medical is when they ‘take you to the board’. This doesn’t give clients a financial return, so if they are threatening this avenue they really do feel you messed up, and their pet has been wronged. These clients are best dealt with by sitting down and talking to them. Figure out how they feel wronged, and address their concerns. See Managing Complaints blog.

If clients are threatening to financially sue you, or take you to ‘small claims court’, this is about the money. They don’t care about the medical aspect, they just feel that you over-charged, or they were ripped off. Managers often deal with these clients.

You can try to discuss with the owner first, and show them a detailed outline of their animals case, the communication about finances recorded in the record, and a detailed invoice. You can explain why medical care costs money. But for some, this won’t do anything, because they don't care, they just don't want to pay.

In some places there is no financial risk to the client to go to small claims court, and the judge often just says “split the bill.” This news spreads, and leads to other people going to small claims court because they might just get half their bill back at no risk!

Often, clinics will give into these clients because it’s less work, easier, and ultimately can be less expensive than going to court.

These clients need to be fired in the future.

“If you won’t pay for our services, which we need to continue to function as a viable business, then we can no longer have a working relationship with you. Please let us know which clinic you would like your records forwarded to.”
Guilting Clients:
black lab looking guilty
As if our job isn’t hard enough, we get clients that say terrible things to us! These are the comments that push us to our breaking point, and they are NOT OK. #notonemorevet
One of the most emotionally stressful clients that we have a vets, especially as people pleasers, are the clients that use guilt to try to bully us into free veterinary care.

They play on our emotions, try to make us feel bad about ourselves, guilt us regarding their personal situations, or more commonly guilt us by implying that we don’t care about their pets.

“You don't care about animals”, “You only care about the money”, “You would rather watch my dog die than help”, “You are heartless”, etc.

These are the comments that get under our skin, that linger, that make us doubt our self-worth. Our job is already hard enough, we already hate talking about money, we already have to make hard decisions, have hard conversations, and perform euthanasias when we don’t want to. To then have untrue, hurtful, and abusive comments thrown in your face, when you are already hurting, is just unbearable some days.

“To imply that we do not care about Fluffy is not only untrue, but it is incredible mean and abusive.”

“We are only in this profession because we love animals.”

“Your comments are hurtful, untrue, and will not be tolerated.”

See Responses to Abuse blog for more.
Written by Dr. Ann Herbst BSc, DVM

Published April 8th, 2021

Advocate for yourself, you are the only one that will!

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