As veterinary professionals, we all endeavor to deliver
value and the best medicine to our clients and patients. Likewise, we have all
experienced cases where the client’s expectation for accommodations, medical
services and associated outcomes is unrealistic based on legal, moral, and
ethical implications. So how is it that we best attempt to deliver on their
expectations while remaining accountable to the legalities and regulations that
guide our actions in veterinary medicine? The answer, of course, varies by
practice, situation, and client, but ultimately, a strong component to success
relies in engaging clients confidently with clear, concise, and detailed
information to support our actions and in-actions within the practice.
I recently dealt with a client that was upset due to our
hospitals refusal to dispense medications for her ailing dog. She had just
completed an extensive workup on one of her other dogs and the very next day a
littermate showed similar symptoms. The client expected that we would recognize
the connection between the two pets’ conditions and dispense medications
accordingly. The pet was current on a physical exam within the past three
months, so of course the owner saw no reason for us to require an exam for this
situation. Due to our hospital policy and the legal necessity to have a current
VCPR/diagnosis to dispense medications, I politely and firmly refused her
request. After further discussion with the client to support our refusal, I
outlined the potential negative impacts of medicating her pet in this manner
and the related ramifications on behalf of the practice and the doctor by doing
so. The client accepted our refusal after some “bickering,” and armed with her
newfound insight, conceded that it was in her pets’ best interest to pursue the
exam and diagnosis. In this case, it proved beneficial that we were able to
educate this client as to the reasons behind our policies and how they
translates to best medicine for her pet.
A few months back, a patient of ours had not received the
scheduled diagnostic testing required to refill their maintenance medications
as part of an ongoing treatment plan. The client had missed the first needed
testing waypoint and we approved a short-term refill within reason to
accommodate these circumstances. When the client missed their next scheduled
appointment for required testing, we firmly refused to refill the medication.
After dealing with some contention relating to their assumption that we were
price gauging them, I had one of our senior technicians explain to the client
our reasons for refusing. The client agreed that the testing was in their pet’s
best interest and appreciated the efforts we took to educate and inform them
accordingly.
Either of these situations could have easily gotten out of
control. Practices are able to avoid many instances of contention simply by
preparing teams to engage in these client discussions with confidence. In turn,
clients are more likely to support the hospital’s positions when they can
better understand how the legal, moral, and ethical accountabilities within
veterinary medicine can serve to their best interests. While it is never easy
to refuse a client request, it is relatively easy to engage them with proper
information to support your actions.