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Constructive Criticism, Poor Communication and More

Opening Shots columnist Dr. Ernie Ward answers your questions.

Constructive Criticism, Poor Communication and More

Q: I have an employee who can’t take constructive criticism. When my practice manager talks to her privately, the meetings take forever and she is full of blame for others. How can I help her understand that we’re only trying to help?

A: First, make sure your communication isn’t part of the problem. Delivering constructive criticism is as much art as science, and many times we inadvertently miss the “constructive” and crash into “criticism.”

Next, you’ve got to set boundaries for the meetings. An employee can easily steer meetings into all sorts of tangents if you don’t retain control. Move from blame-focused conversations to solutions-oriented chats. For example, whenever someone else’s actions are mentioned, immediately pivot back to the person in front of you: “So, how could you have helped Beckie in that situation?” Rein in blame by anchoring to outcomes the employee can control.

Finally, remain emotionally neutral, refrain from personal attacks (“But you were also part of that issue.”), and center your thoughts on how to help.

Too often we enter these discussions subconsciously biased with a foregone conclusion. To help maintain your composure and stay objective, listen attentively, remain engaged and present, and accept that you can’t fix everyone. The unfortunate reality is that unless a person truly wants help, you can’t provide it. If you’ve given your best effort a couple of times and the employee isn’t improving, the time might be right to let the employee discover the perfect workplace somewhere else.

Q: We’ve been overwhelmed during COVID. My associate veterinarians have gotten into the habit of skipping direct communication involving some of the surgery patients and laboratory results. Because of curbside pickup, they might never talk to the client during an appointment. They say they don’t have time and have to prioritize sick patients, but I’m worried that clients are unhappy. Should I confront my veterinarians or let the issue go due to the pandemic?

A: What you describe calls for confrontation. A veterinarian has only a few valid excuses for not taking the time to personally communicate with clients, and almost all involve having hands inside a body cavity.

Times are tough, but tough times call for even more communication, interaction and reassurance. Many pet owners are anxious, overwhelmed and even frightened, just like many of us.

My advice is to gather your associates for a private powwow, pronto. Get their opinions (and excuses) about how to make clients more comfortable during curbside visits. Suggest a minimum of one personal interaction per visit either face to face or mask to mask. Leverage videoconferencing if they can’t do it in person. For lab result callbacks, you might consider a triage system in which registered veterinary technicians make “normal result” calls and veterinarians ring up clients to explain more complex or concerning interpretations. I advocate that veterinarians make nearly all diagnostic callbacks, but I understand that trying times require flexibility.

When the pandemic ends, I don’t want to see the veterinary profession cast to the curb by pet owners due to a lack of personal attention. Actions have consequences, and clients have long memories. Let’s do our professional best to keep making positive impressions no matter how disrupted or deluged we feel.

Q: An employee of mine does satisfactory work but constantly butts heads with co-workers. I’ve discussed and documented the issue multiple times. She needs to be let go, but there is never a good time to fire someone. What should I do?

A: Firing an employee is never enjoyable, nor is there a right or wrong time to do it. I’ve had to let staff go during holidays, after hurricanes and while performing surgery! None of those times brought me joy, and all were difficult professionally and personally. Yet, termination was the right thing to do.

No matter how well people do their jobs, unless they can work harmoniously within a team, they probably need to go. In veterinary terms, imagine a dog with a large lipoma on the inner thigh. The benign tumor is rubbing the abdomen, causing pain when the patient walks. The lipoma isn’t likely to kill the dog, but the discomfort affects the dog’s quality of life. I bet most veterinarians would recommend that the tumor be removed immediately.

Why do so many practices crawl about, trying to lessen the pain of an adversarial employee? Do they believe the situation will improve on its own? Do they think it will disappear or that suddenly the pain will abate? These issues usually require termination of the employee, especially if you’ve exhausted all diplomatic channels.

Once the lipoma is removed, you’ll probably see a playful and grateful dog jumping for joy. I suggest applying that metaphor to your team. To cut is to cure!

Q: We lost a longtime client due to an extralong wait. A technician explained that we were running behind because of curbside service. The client went to another clinic and posted a nasty review of our practice. I found out that no one on duty had wanted to see the client and that everyone was slow-rolling the person because of past problems and complaints. Who do I blame, the client or the staff?

A: There are times when veterinary clients must wait and times when we make them wait. I’ve encountered the “delay them to teach a lesson” tactic more than once and even overheard one of my associate veterinarians suggest it. She didn’t last long.

Your situation sounds more like staff procrastination than a problematic pet owner. First, interview all involved to determine what transpired. Next, conduct staff training in which you discuss:

  • What constitutes a legitimate appointment delay and how to communicate it to clients.
  • Alternatives such as drop-offs and reschedulings.
  • Why punishing clients by making them wait is always inappropriate.

I’d advise responding to the online review and apologizing. You don’t have to get into the details, but ask the client to call you to discuss the experience. Briefly explain how you strive to avoid excessive waits, that the client should have received clear communications and been offered options, and that you’d welcome back the client. Know that you’re posting the response for the world to see, so keep it succinct, polite and repentant.

Q: I heard a podcast in which a veterinary practice manager insisted we charge an exam fee during rabies vaccinations. I have many clients who can’t afford the extra charge and would skip rabies immunizations because of it. Forcing a pet owner to pay for an exam as part of a legally required vaccine feels unethical. Who’s right?

A: Prevention is a key public health responsibility for veterinarians. The majority of U.S. states require rabies vaccinations for dogs and cats, and veterinarians are issued that authority. Further, the Veterinarian’s Oath compels us to use our knowledge and skills for “the promotion of public health.”

So, I inject my needle squarely into the “vaccinate as many as possible” ethical space. The public health stakes are too high to allow exam fees to interfere with human and animal life. Besides, every rabies-only visit is an opportunity to educate and impress. You never know what a kind word or an invitation to return for a full exam will yield.

Opening Shots columnist Dr. Ernie Ward (drernieward.com) is an award-winning veterinarian, impact entrepreneur, book author and media personality. When he’s not with family or pet patients, Dr. Ward can be found contemplating solutions for the future as he participates in endurance athletics and meditation.

If you have a question about practice life, personal well-being, leadership or veterinary careers, email [email protected].