It's always nice to get letters from clients. Usually they come in a Hallmark envelope addressed with your name in warm red
letters. You'll pull out a card that says, "Thank you," and read a nice note from a client who appreciates the effort you
put into caring for her pet.
But sometimes you don't pull out a small, cheery card. Sometimes you pull out two standard-sized sheets of paper covered in
Times New Roman font. Then you notice that there's a lump in your throat—because this one's not a thank you note.
I opened such an envelope a few weeks ago and was surprised at what I was reading. A client was chronicling the work we performed
on her pet several months earlier. Every decision and every ounce of care we offered was questioned and repudiated. There
was a lot of pent-up anger in this letter, and it was upsetting to read. I immediately went to the computer to look up the
case. I reviewed the medical record and decided I'd still give our hospital an A for how we managed the situation.
The patient had been taken to an emergency clinic over the weekend. I assessed the case and referral diagnostics and suggested
more tests to look further into the working diagnosis. The client accepted. But within four hours, I switched gears and completely
changed my assessment. I made the correct diagnosis, performed the initial therapy, and made the appropriate referral. I even
remember the client telling me thank you. Unfortunately, after an assessment by the specialist, along with other factors (including
cost), the client elected euthanasia.
My first reaction was that I should call the client to discuss the letter, refuting each point with an explanation of our
practice's sound medical judgment. But what good would that do? As long as the client wasn't filing a lawsuit against me or
slandering my name, would I be helping her by making that phone call? Eventually, I realized that this letter wasn't the first
step to a lawsuit—it was the client's way of dealing with the stages of grief.
I asked my practice manager if I should contact the client, but he had already talked to her. Apparently she didn't want to
discuss the case any further; she'd just wanted to put her thoughts on paper. It was upsetting to read the letter, especially
after I realized I wouldn't change how we handled it. I was frustrated thinking of all I did for this pet only to emerge with
nothing but this crummy letter. What did clients want from me?
Then it occurred to me that some clients just aren't going to see things my way—even if I've given it my all. When I'm drawing
on my medical background to evaluate the situation and the other person is drawing on her emotion, it's going to be difficult
to come to the same conclusion. Good client communication is key, but it's a work in progress, and no one's perfect at it.
So I began to appreciate the letter. I saw it as a rare opportunity to hear what a client is truly thinking. For every one
of these letters a client actually mails, there may be 10 more sitting on other clients' desks collecting dust. Most upset
clients just bite their tongue or find a new veterinarian without our knowledge.
It's easy to collect the thank-you cards, but sometimes you need to be reminded that there's room for improvement. A few days
after I received the letter, I saw that very client with the new dog she'd adopted. She didn't bring up the letter and neither
did I. It was a professional visit, and at the end, we shook hands and smiled.
Dr. Andrew Rollo is a Veterinary Economics Editorial Advisory Board member and an associate at Madison Veterinary Hospital in Madison Heights, Mich. This column originally
appeared as a blog post on
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