The 5 most difficult veterinary clients

Every practice has them: clients who inspire you to find a task that needs doing in the back or who trigger a frantic game of rock-paper-scissors to determine who has to deal with them. There's no other way to say it, some clients are just plain difficult. But a difficult client isn't necessarily a detrimental one. Sometimes, those cranky, stubborn, and annoying pet owners who seem like a curse are really gifts in disguise. And sometimes, skillful managing of these clients can transform pain to gain. Here's how to handle them.

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The Demander

A Demander wants nothing but the best for her pet (who no doubt has a delicate constitution and sees the veterinarian on a regular basis for various issues). The Demander asks the doctor a million questions and often uses more than her allotted appointment time. She's on a first-name basis with each team member. If she sees a technician at the grocery store, she corners him with questions. She's been known to call the practice several times a day to give regular reports about her pet's current state of health.

Although Demanders are, well, demanding, they're a boon to your practice. The Demander is among your top 20 percent of clients who produce 80 percent of your practice's business-part of the solid core that allows you to keep your doors open. Compliance is never a problem with The Demander. She recognizes and appreciates the value of the services you provide, and her desire to give her pet the best care is an attitude you should admire. As long as her needs are met, The Demander will be one of your biggest fans and will tell others how wonderful you are.

How do you handle a Demander?

• Don't let The Demander take control. Some creative management will allow you to meet her needs while managing your associations with her.

• Don't be rude if you encounter The Demander outside the practice. Assure her it's great to see her, tell her you want to hear all about her pet, and ask her to call you at the practice.

• Do schedule additional time with the doctor and charge appropriately. Tell The Demander, "We typically schedule 20-minute appointments but would like to offer an extended appointment to make sure that you have enough time with the doctor to get all your questions answered." If The Demander agrees to this, be sure to mention any additional fees that may apply.

• Do (patiently) answer each and every one of The Demander's questions. Her intentions are noble.

• Do encourage The Demander to write down questions at home and bring the list when she comes in for her pet's appointment. This may decrease the number of times she calls your practice with queries, and it reinforces to her your commitment to her pet.

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The Cheapskate

The Cheapskate wants his dog treated for free. He waits until the end of the visit, after the exam and the radiographs and the lab work, to mention that he doesn't have any money right now. No payment options work for him. He earnestly promises to make payment installments and even signs a financial agreement. But The Cheapskate fails to follow through and is eventually sent to collections. In response, he files bankruptcy. Some time later, The Cheapskate returns to the practice for further treatment, and when he's advised that services can't be rendered without payment, he accuses the staff of being willing to let his pet die.

As a client, The Cheapskate is a pain. His promise to pay isn't sincere, and he's unkind to those who refuse him free service. He'll suck your practice dry of energy and finances if you let him. To The Cheapskate, money isn't a problem because he has no intentions of paying in the first place. He'll require firm management to prevent him from taking advantage of your services.

How do you handle a Cheapskate?

• Don't back down by changing your prices. Doing so diminishes the value of the services you provide and could ultimately undermine the practice. Prices are set at levels that allow the practice to stay solvent. Reducing them hurts the bottom line.

• Don't take attacks personally. The ultimate responsibility for the health and well-being of The Cheapskate's pet lies with The Cheapskate

• Do repeat yourself. The Cheapskate may need further reinforcement. Ask at the outset of every visit, "What form of payment will you be using today?"

• Do get The Cheapskate's agreement first. When diagnostics or treatments are needed, make it clear beforehand that payment is due at the time services are rendered. Once the doctor has completed a recommended treatment plan, technicians should review a printed copy with The Cheapskate that includes fees and expectation of payment. Obtain his approval and agreement to pay then proceed with the plan of care.

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The Cynic

The Cynic just got a new puppy, and things aren't going well. He chews on everything, barks too much, jumps on people all the time-and don't even get The Cynic started on house training! The Cynic has taken his pup to every doctor at the practice, plus a trainer and an animal behavioral consultant. He's been given numerous solutions to his problems but is full of reasons why those suggestions won't work.

Although The Cynic is a pain, he can be a gift in disguise. By working straightforwardly with him, you can improve your client communication skills and educational abilities. Handling him may require patience and determination, but he has a problem you can solve. If you stick it out with him and resolve his issues, he'll sing your praises.

How do you handle a Cynic?

• Don't let him believe there's no solution. You're the expert, and you know he's been given solutions that work.

• Don't continue offering alternatives. This communicates a lack of confidence in the solution he's already been given and indirectly reinforces his "victim" status.

• Do focus on task specifics. Speak directly to The Cynic, saying, "We know these solutions do work, without exception." Get specific about each situation. Go down a list and address each point, if necessary.

• Do give your suggestions in writing. Check in with him a few days later to see how things are going and what challenges he's experiencing. Stay solution-oriented and positive. The Cynic will feel your encouragement and have more energy to stick to the suggested program.

• Do talk frankly about compliance. Make sure he's aware that the responsibility for follow-through is on his shoulders. Let him know that if he does follow through, these methods will work.

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The Bully

The Bully is just plain mean. No one at the clinic has ever seen him smile. He's rude to the staff and other clients. He's quick to find fault with everything from the time he has to wait for the doctor to the cost of his cat's prescription food. He loudly-and sometimes vulgarly-proclaims his opinion on everything and has zero tolerance for other points of view. There's no denying it: The bully is definitely a pain. Your practice-and everyone in it-is better off without him.

How do you handle a Bully?

• Don't be intimidated. Intimidation is the tool The Bully uses to get his way. Don't play into his hands, and don't cave in to his unfair demands.

• Don't engage in arguments. You won't change a Bully's mind on most issues, so don't bother trying

• Don't take his negative communication personally. The Bully treats everyone in a demeaning manner, not just you. Don't buy into his insults.

• Do be professional. Keep all traces of animosity and antagonism from your voice. Drop your tone of voice. Speak slowly with quiet dignity.

• Do make The Bully's visit task-focused. Don't give him a chance to push you around-take care of his needs as quickly and efficiently as possible.

• Do clarify your expectations. Treat The Bully respectfully and demand the same courtesy. Say, "I'm trying to help you with your problem, but when you speak to me so unkindly, I have a hard time staying focused on what's best for Brutus."

• Do establish a cut-off point. If The Bully won't comply, tell him your practice will no longer be able to provide services for him and his pets.

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The Know-It-All

The Know-It-All has already diagnosed his pet. He researched the symptoms on the Internet and talked to his neighbor, whose brother-in-law's co-worker's pet had the exact same symptoms. He insists that his cat just needs a simple prescription. The Know-It-All is impatient and annoyed at having to make an appointment, but he makes good use of his time at the clinic-he willingly provides diagnoses for other clients' pets that he encounters in the waiting room. He declines all lab work, because he knows his pet is in good health.

Believe it or not, with proper management, The Know-It-All can be a gift to your practice. He wants the best for his pet and has a circle of friends to discuss veterinary care your practice offers. With clear guidelines on your expected client-practice relationship and with The Know-It-All's influential voice in your community, he can be a strong supporter and a source of positive referrals.

How do you handle a Know-It-All?

• Don't let him dictate your practice's standards of medicine. If you give a Know-It-All a prescription and forego an appointment, you're communicating that your medical standards are negotiable. You're also encouraging similar behavior in the future.

• Don't engage in arguments about his opinions or diagnoses. It's rude (and usually pointless).

• Don't neglect making important medical recommendations, even though he may not accept the advice.

• Do educate him. The Know-It-All enjoys being in the know, obviously, and giving him correct information might empower him to make better choices for his pet.

• Do be agreeable (if you can). If the Know-It-All insists his pet has ear mites, say something like, "He very well may have ear mites. And if he does, you did the right thing by bringing him in for treatment."

• Do chart all doctor recommendations. If The Know-It-All declines these recommendations, chart that too.

• Do make an exam room available for The Know-It-All as soon as he arrives, in order to minimize his contact with other clients and their pets. The Know-It-All may not know as much as he thinks about veterinary care and could offer incorrect information to other clients.

Debbie Allaben Gair, CVPM, is a Firstline Editorial Advisory Board member and a management recruiter and coach with Bridging the Gap in Sparta, Mich. Christine Hall Johnson is practice manager of PetsFirst! Wellness Center in Brigham City, Utah. Post your comments and questions on the community message board at dvm360.com/comment.