Category Archives: Clients

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The secret reason your clients are afraid

There’s a problem in your office that gets in the way of doing what you went into veterinary medicine to do: Make animals well and win the hearts of their caretakers. Your clients are afraid, but not for the reason you think.

What scares clients that you know about

As a veterinarian or technician, you have plenty of conversations with clients that might scare them, at least at first.

They bring their pet in for a simple checkup, and you find a lump. They think their dog has a nosebleed, you suspect cancer. They’re glad their tubby cat has finally lost weight, and you have to tell them it’s diabetes and then explain insulin injections.

You probably have your own special techniques for calming clients when you know they are afraid. Maybe you’ve practiced a Dr. Herriot smile that makes you look wise. Or you have a simple analogy to explain how the brain works. “See, it’s like a lightbulb.” You’ve learned to look for clients’ shoulders to relax when they realize they can pill their cat.

But what about the ones who are going to pieces right in your office? Maybe before you even walk in the room.

What scares clients that you don’t know about

“How can that be?” you ask. You haven’t even looked at their pet, so what are they scared about?

Let’s leave aside the possibility that they came in because they had found something that worried them.  And then looked it up on the internet. And asked their Facebook friends what they thought. Assume they were fine till they hit your front door. What could have gone wrong?

Think about off-hand remarks. Overheard complaints. A funny look on the face of one of your co-workers. Or your lengthy silence while you stare into their dog’s eye.

Surgeon staring down

Let me give you an example. Yesterday I went to the dentist for a routine cleaning and partial x-rays. I’m fine with the dentist, but by the time they were done, I needed a neck brace for emotional whiplash.

As we were getting started, I mentioned in passing that my gums were a little sensitive and that a bruisey-looking thing that I’d had for years had gotten swollen last week and was now better. Suddenly they were recommending a full set of x-rays and a quick check by the oral surgeon downstairs. “It could be a dying nerve”, the hygienist speculated as she scurried out of the room. “Dying nerve?”

The oral surgeon, a big middle-aged guy with huge hands, swaggered in, drew on his gloves, and tried to yank my lower lip into the backyard. He jabbed every tender spot and announced it was probably a swollen salivary gland that would take care of itself. “It’s not a tumor except in the broadest sense of the word.” “Tumor?”

“If it gets bigger and really bothers you, we can remove it. Of course with the architecture of your mouth, that would be some surgery.”  “Holy cow. The expert thinks this would be ‘some surgery’?”  And as he rode out of sight, he tossed off “It’s nothing to lose sleep over.”

Put yourself in my shoes. I came in for a routine event, no drama. But when several professionals looked worried and casually threw around tumors and nerve death, my whole day veered off course like a doomed rocket. It managed to fly straight again for two reasons: 1) The team figured out pretty fast that nothing was wrong; 2) I politely spoke up about how heavy-handed and brusque the consult was. The hygienist acknowledged that it was true and that she’d heard it before.

If your clients speak up about their concerns and ask you questions, you’ll have a chance to clear things up too. But what if they don’t tell you?

What’s the big deal?

A panicking client can’t concentrate on you or make decisions. She’s tuned into the radio station in her head that’s saying, “Run for your life. Martians have landed in New Jersey.”

Clients who feel blindsided by bad news inexplicably refuse to let you do tests. They stall so they can wrap their minds around this potential disaster.  If they overhear your staff express curiosity about how this will turn out, your clients seethe because employees seem nonchalant about finding a problem in their pet. They may even feel you manipulated their fears to get them to spend money.

But if you don’t figure out that they are unnerved by something they’ve heard, you won’t know what’s going wrong.

How to fix your clients’ secret fears

Since reading minds is hard, you want to prevent secret fears and intervene if they happen. Here’s how.

  • Make your office a calming environment. Use distractions, like music, a TV, or an aquarium to give clients somewhere to focus besides their anxieties.
  • If you sense clients are confused, say something like “Let’s pause. Let’s take a break.” Then ask if they have any questions so far.
  •  Breathe easily as you examine the pet. It will calm everyone in the room.
  •  Talk as you work, so clients know what you are doing. Incidentally, when clients recognize the time and skill that went into the exam, they are more willing to pay your bill.
  • Don’t casually speculate about bad possibilities. Wait till you do at least a brief exam and have some evidence for your assessment.
  •  Watch what you say where civilians can hear you. Complaints about coworkers, blaming others when you can’t find something suggests this is a badly run place with interoffice drama—not a place you want to trust your pet to.
  •  At the end of every encounter, review what you did and what the options are. That way, if your clients tuned out for a while to take stock, you have another chance to get through them. If you suspect something you’ve said might disturb them, acknowledge it. “I know this isn’t what you expected when you came in today. It’s a lot to take in. How are you doing with all this?”

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If you’re having client communication problems, Dr. Susan would be happy to meet with you and your staff.

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Be a better doctor with stuff you already own

If you’re a veterinarian, you’re in a bind.

How can you take great care of patients, educate staff, keep clients happy, grow your business, and still make money in this competitive market? Clients demand top quality pet care, but they want to save money. They also want their pet’s healthcare team to keep in close touch and to include them in planning. For their part animal health professionals want to provide care in a way that helps pets, satisfies clients, and pays the bills for the practice.

It’s tempting to think that buying the latest gadget will make your practice stand out and attract business. If you have a real need and know it will get used a lot, a specialized tool can give you bragging rights on your Facebook page. If not, that shiny new toy just takes up space.

Smart devices

But there’s a cheaper, easier option right in your pocket. Use the smart phones and tablets you already own to make money, save money, and provide better client service and pet healthcare. The beauty of this? You already know how to make them work. There’s no manual, no time lost to training.

Phones and tablets let you monitor your patients, fine tune care, and tap the commitment and skill of colleagues and clients to keep pets healthier at less cost. Good use of technology saves you time and lets you delegate conversations and client education to others.

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Check out these 17 ways to use your smart devices:

1. Track the progress of pet care at home, such as weight management, by having clients text you updates.

2. Use an app or your own checklist to help clients evaluate pain in their pet.

3. Use your smart phone to monitor vitals and illness. Devices like the PetPace smart collar http://petpace.com/ allow you to track and analyze data and to receive alerts minute by minute.

4. Encourage your clients to keep up with treatment by texting non-judgmental messages every few days. Make sure you provide a way for them to write you back. Conversation is key to cooperation.

5. Improve in-house education by using free web conferencing tools, like Google+ Hangout or Big Blue Button.

6. Use a medical calculation app to figure dosages.

7. Use your tablet to take notes for your electronic medical record or to check information on VIN (Veterinary Information Network) right in the exam room.

8. Use your tablet or digital camera to take pictures of pets, so their families can keep up to date. This is especially helpful when patients are hospitalized. A picture of their loved one resting comfortably or wagging its tail reassures families that your staff is kind as well as competent. You can also add those photographs to the pet’s medical record.

9. Make your tablet a tool to educate clients. For example, show clients how to give sub- cutaneous fluids to their cat by showing them a video on YouTube. That way you can watch it together and answer any questions they may have. You can also introduce them to websites you think have the most accurate information. You may even have a PowerPoint presentation of your own to share with them.

10. Use a storage site like Drop Box to share photographs, radiographs, and any other files among your computers.

11. Use your tablet’s “virtual desktop” to share radiographs (x-rays) with your clients, so they understand what’s wrong and what you plan to do about it. Especially for visual learners, a picture is worth 1000 words.

12. Use sound effects apps to test a pet’s reactions and to help desensitize them from the things they are afraid of. You can also use one sound to muffle other sounds from the waiting room that can disturb a nervous pet. For example, you can make your practice more cat-friendly by putting them in a room with sounds that block the noise of barking dogs.

13. Use the timers on your equipment to track how you spend your time. You may be surprised. Think about one part of your day, like meetings or data entry. How long does that activity actually take?

14. Have clients video record behavior that occurs at home but not in the office. How many times have you had a client say, “My dog had an episode at the dog park that looked like a seizure, but who knows?” Or, “I swear, she was limping this morning.” Now you can see what they see. Make sure they know that sending you a photo doesn’t take the place of an exam.

15. A variation on #14 is to have clients record behavior problems and their surroundings. For example, if a client complains her cat urinates outside the box, have her take pictures where every box is located. She might even video what the cat does in the box, such as perching on the sides. You may be able to tell at a glance that the box is too enclosed or that the cat is avoiding that kind of litter. Solving problem behaviors keeps pets from being surrendered to shelters.

16. Ask clients to video themselves doing health-related tasks, such as drawing up insulin and injecting their pet. You might also ask them to send you before-and-after pictures of injury healing, photos that can go right into your electronic medical record.

17. Use your brain and your tablet’s for what they do best. Let your smart device’s capacity remember those obscure, once-in-a-lifetime medical possibilities. Tap your people skills and professional experience to make the most of client time. Learn what they know, what their concerns are, and how they feel about what your recommendations.

How it works

Here’s a real-life example of how using everyday devices can save you time and make your clients happier. I used to work at a big veterinary teaching hospital in New York City. New Yorkers are smart and tough. They don’t just take your word for things. They want proof, and they demand service. A liberal visiting policy isn’t always enough. Some want to sit by the cage or call their doctor every two hours for an update.

When you think about it, it makes sense. When our human family is laid up, we get to spend hours at their bedside, holding their hand and asking questions of the staff. We can see for ourselves whether their room is clean and if the nurses are compassionate. With pets it’s different. Most veterinary clinics don’t have room for extra people to pull up a chair by a cage and hang out. Veterinary nurses can’t stop to explain what they are doing or answer phone calls.

Then the doctors got new mobile phones. With cameras. Not only could they email clients, they could send pictures of pets doing better. Clients were delighted, and doctors enjoyed spreading good news. And with emails doctors could document their client contact without having to write a separate report.

And that’s how smart devices allow veterinary teams to provide better pet care and client service in less time with less hassle.

Caution

For all the good that smart devices do, it’s important to set limits to their use. Give yourself tech time out. Don’t check your phone at dinner. Tell clients what hours it’s OK to message you and stick to it. And have an office phone or other system so calls go to the veterinarian on duty and don’t give away your personal number.

If you have trouble staying away from your smart devices, use apps that block emails during certain hours. Can’t let go of work? Practice meditation to learn how to stay in the present moment.

What are your favorite ways of using tablets and smart phones around the office? Let us know! Maybe you’ll see your tip in a future post.

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5 things to do for your pet before you get sick

My friend Lucy just had a medical emergency that took her away from home and her beloved toy poodle, Chrissy, for six weeks. Another dog lover took Chrissy for a few days but couldn’t keep her. Was Chrissy going to be homeless? People have dumped pets in the street for less.
Clearly this kind of emergency is something all pet lovers need to plan for.

You can’t wait till disaster strikes to think about who will walk the dog and feed the cat if you are temporarily out of commission. Whether you have a boarding kennel lined up or need to phone a friend, you need to plan ahead.

Here’s what to do.

Make a list.                                                                                                                                                  DSC_0457 First, think about what you do daily and make a list. “Walk the dog at 7:30 am, 2:30 pm, and again at 9:00 pm; dry food in the morning, wet at night.” Take a few pictures so someone else knows, for example, which scoop you measure food with. If your daily routine involves medication, take lots of photos and mark any measuring devices, such as a syringe, with permanent marker to show exactly how much to use. Here’s the list Chrissy’s temporary caretaker made. You notice she adds the all-important information that Chrissy “will want to sleep with you.”

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Next think about what supplies you need to do those things—bird seed, pee pee pads, cat carrier—and add that to your list. Don’t forget your pet’s favorite toy. Make sure you always have a few days’ worth of the essentials in the house at all times. Here’s what Chrissy came with– plus winter coats.

Decide who can handle different tasks.

After that, consider who could manage the different things your pet needs. The neighbor who loves cats may not be willing to give your diabetic kitty her insulin injections. Or walk your 50-pound dog. You may have to divide your pets and tasks to get it all done.

Once you have a list of prospective caregivers, talk to them and get their OK. Double check that their whole family is on board with having your 65-lb dog, who needs three walks a day, for a two-week sleepover. Give them a copy of your instructions and print a copy to hang on your refrigerator in case the first list gets lost.

Remove obstacles. 
The next step is to think about any obstacles that might get in the way. Will building management allow your volunteer caretaker to have a pet, even for a short time? Are your pet’s license and vaccines up to date in case he needs to go to a boarding facility? If your pet gets sick, which veterinarian should she go to, yours or your caregiver’s?

Make a long-term plan.
Finally, do some long-term planning. Do you have a Plan B in case your first-choice caregiver is out of town or out of patience? What’s to be done if your medical problem causes a long-term or permanent separation? Can you afford to give your friend some help with expenses in exchange for adopting your furry friend into a safe, loving home?

How it all turned out.                                                                                                                                In the end, Chrissy was not homeless. Lucy had discussed this kind of emergency with her regular pet sitter, who kept Chrissy till someone else could take over. The sitter wrote extensive notes, packed everything a little dog could need, and generously shared her expertise as a pet professional. Chrissy settled into a new family in a new neighborhood until her person was strong enough to come home.

In fact, knowing her dog was waiting inspired Lucy to work extra hard in physical therapy, so she could take Chrissy for her usual walks in the park.

We’d love to hear about your experience caring for a friend’s pet. What do you wish you’d known? What tips can you share with your fellow animal lovers?

Self-Care for People Who Do It All

Chronic stress and a perfectionist streak can destroy you. Over the long haul you can quit caring–Burn Out–or care so unrelentingly you bleed out emotionally–Compassion Fatigue (CF). With CF you can’t stop yourself from getting involved the problems of others, so to recharge, you overindulge in things that aren’t necessarily good for you, from sugar to shopping. When that doesn’t do the job, you try to keep your energy from leaking away by isolating yourself, not only from friends but from your own body. (For more information on CF, see my blog post, (You feel sooo exhausted. Do you have Compassion Fatigue?

Not only does Compassion Fatigue take a toll on your personal life, it can eviscerate your practice. People with CF feel no one can do as good a job as they do. They work long hours, snipe at others for not working enough, and prevent coworkers from developing new skills and ideas by insisting that their way is the best, and therefore only, way.The things you do to care for patients and their families that should build your practice wind up hurting it.

The good news is, even smart, Type A chocoholics can prevent or treat Compassion Fatigue with these six techniques.

Blog_2_pic1. Move around a little, preferably outdoors.

Research confirms that even mild exercise is good for your mood as well as well as your health. Regular exercise lessens the worry and the blues that come with setting impossible standards for yourself.Here’s what WebMD says: http://www.webmd.com/depression/guide/exercise-depressionBeing outside in nature for twenty minutes a day makes you feel more alive and energetic. What’s more, outdoors you get a dose of Vitamin D, which fights depression and enhances thinking. Check out this  study on nature and mood. http://www.sciencedaily.com/releases/2010/06/100603172219.htm Instead of another double espresso, take a walk around the block. Declare a five-minute dance party.

2. Make sure you sleep seven to eight hours a night.

Americans are sleep deprived. We need it to give our bodies break and to clear the cobwebs from our brains. If you handle your work stress by cruising the internet till the wee hours of the morning, you risk poor thinking, slow reaction time, and trouble learning.

 

3. Eat healthy food and take time to enjoy it.

You know those doughnuts aren’t good for you, but when you focus everywhere but on yourself, you may take the shortcut to energy and grab a hunk of fried dough smothered in chocolate to give you a boost. The sad part is, you probably won’t even enjoy it. The next time you get hungry, pick something with protein and fiber to sustain you. Then, and this is the hard part, sit down to eat. Before you take your first bite, stop and inhale deeply. How does your food smell? What color is it? Taking a few extra seconds to tune into your senses will not only make the meal more delicious, it will help you reconnect to the body you’ve been ignoring.

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4. Talk to your neighbors.

 

I know, I know, you’re an introvert who needs alone time to re-energize. The problem is, Compassion Fatigue exaggerates your need to escape. You forget how to interact, and the next thing you know, you can’t make conversation even with the ones you love. If that sounds familiar, start small. Greet the receptionist when you come in. Ask the kid bagging your groceries how his day is going. You’ll be surprised at how less alone in the world you feel.

5. Tap a source of strength and inspiration.

We all need a life outside work, and most people benefit from connecting to something that braces us in the bad times and expands our minds when we’re ready. For some this will be a spiritual practice. Others read poetry or keep journals. Simple meditation can put life in perspective and remind you that what is happening in this moment, no matter how important it seems, will pass

 

6. Work with a counselor.

If you’ve tried the first five techniques and find you still overcommit to work and undercommit to yourself, it’s time to get outside help. Since your situation isn’t new to the profession, many local VMAs and other animal health organizations have support systems in place for veterinarians, technicians, and others who face challenges in their work and personal lives. Veterinary Information Network(VIN.com) has online boards that focus on practice issues and a confidential one, Vets4Vets, for those that want a private channel to find help locally.When you choose a mental health professional, find one who deals with your kind of concerns, one that you connect to personally. If getting through CF were easy, you’d have done it. It’s time to have someone on your side. Ask a friend to recommend someone, check with your physician, call your clergyperson, or see what the community mental health center suggests. You wouldn’t ask your patient to suffer; why should you? Since no one can have all the good ideas, let’s share ours. What do you do restore yourself? What are you doing to avoid Compassion Fatigue?