Can You Relate?

My most recent article, “Patch the Cracks in Your Patient Base” (bit.ly/patch-TVB), examined why pet owners delay or neglect seeking veterinary care. While the tactics I recommended can help recapture absent patients, that’s only half the story. The remainder is this: How can practices give the story a happy ending?

Here’s what pet owners told me recently about their challenges with veterinary care:

• “I wish I could find a good veterinarian.” When I asked what that looked like, they said, “A veterinarian who is happy to see me.”
• “I want a care team that knows me and my cats. I’m willing to pay for concierge care, but I don’t know how to find it.”

Those statements highlight the difficulties pet owners face every day. Effective reminder systems and efficient hospital operations aren’t enough; clients want a practice team that treats them and their pets as individuals and works to create a partnership.

Here’s how you can build lasting relationships with clients.

Start With Relational Interactions

I perform competitive market analysis calls as part of my consulting service. Ninety percent of the calls go like this: I ask a veterinary practice about its services, but the receptionist answers in terms of price. No attempt is made to establish common ground. Typically, the same goes for scheduling an appointment. The calls are transactional interactions devoid of a personal connection and characterized by a team member going through the motions to complete the encounter. Pet owners feel underwhelmed, unimpressed and disregarded when the reply to their question doesn’t acknowledge them as individuals.

In comparison, relational interactions are built when the team member establishes a relationship with clients. The practice identifies the pet owners’ needs by eliciting their perspectives. The clients feel that the team member, and by extension, the practice, truly care about them and their pets. They feel validated in their decision to visit the hospital, and they experience a sense of connection, the first step in bonding clients to a hospital. Sadly, relational interaction occurs in only about 10% of my competitive analysis calls. What a missed opportunity.

Practices can create relational interactions by habitually:

• Asking for the client and pet names early in the conversation and using both frequently. Doing it personalizes the interaction.
• Using good communication skills. Practices should elicit client perspectives and invite the owners to tell their stories since they are the experts in their pets’ lives.

The Money Talk

What clients value is often confused with what they can or will pay for veterinary services. When a pet owner declines a treatment option, team members often believe the price is the reason. A study found that only 2 in 10 clients refused care because of the cost. Instead, they said no because they didn’t understand how a recommendation would benefit the pet or were uncertain why a team member suggested it.

Distinct differences exist between the price of care, the cost of care and the value of care. How we discuss recommendations with veterinary clients is critical. For example:

• The price of care is the exchange of money for a service. It’s transactional and fails to individualize the client’s and pet’s needs.
• The cost of care considers how a declined recommendation or treatment affects an animal’s health and well-being. It’s best conveyed to clients by describing how the treatment options would benefit the pet and owner.
• The value of care relates to the tangible and intangible benefits that clients and pets receive during interactions with veterinary teams. The value is built on trust and is earned by doing things right, doing the right things and doing both without being asked. The value of care is foundational to creating partnerships with clients.

How to Build a Partnership

A partnership occurs when two or more parties work together to accomplish goals while building trust and a mutually beneficial relationship. In veterinary medicine, it’s enhanced when the team:

1. LEVERAGES NONVERBAL BEHAVIOR

Nonverbal behavior comprises 80% to 93% of all communication and includes:

• Body language (facial expressions, gestures, body position, tension and touch).
• Spatial relationships, such as the distance between the veterinarian and client, and physical obstacles, such as a reception desk, exam table, computer and pet.
• Paralanguage (voice, tone, rate, rhythm, emphasis and volume).
• Autonomic responses (flushing, sweating, changes in pupil size and breathing patterns).

 In most cases, verbal and nonverbal communication work together to strengthen a message. When inconsistency exists between the two, a mixed message is sent. Nonverbal messages more accurately reflect true feelings. Because we are hardwired to believe what we see over what we hear, nonverbal communication can appear inauthentic, damaging credibility and the relationship.

The key to leveraging nonverbal behavior starts with self-awareness. Ask co-workers about the times they saw you fully engaged in a conversation.

• Did you look comfortable, and why?
• What nonverbal actions did they note when you were in an uncomfortable conversation?
• Which policies and procedures are you uncomfortable discussing with clients?

Remember, your nonverbal signals can telegraph unease to clients. Talk with your practice leaders about how to deliver messages more authentically. Practice the statements during role-playing exercises.

2. DEVELOPS RAPPORT

Rapport is a harmonious connection in which the client and veterinary team understand each other’s perspectives and relate to each other’s thoughts and feelings. The four components are:

• Acceptance: It occurs when team members are nonjudgmental and acknowledge the legitimacy of clients’ views and feelings. A skill that cultivates acceptance is perspective, which requires team members to understand their own and realize that clients have perspectives, too. During a successful interaction, both parties attempt to understand the other’s viewpoint and find common ground.
• Empathy: A critical skill, empathy enables team members to communicate understanding and appreciation of a client’s feelings or situation. When a pet owner’s state of mind and opinions are overtly acknowledged, the common understanding creates rapport.
• Support: It begins when clients believe and feel that the veterinary team cares about them and their pets. Teams can show support by expressing concern, understanding and a willingness to help. This action includes using empathy statements.
• Sensitivity: The final step in building rapport with clients involves using sensitivity and kindness during embarrassing topics, such as financial limitations or the client’s fear of being judged as an unsuitable pet owner. The latter concern is a significant barrier to pet care and one almost impossible to recognize unless the client volunteers it. I learned about it after examining an emaciated dog. The client said she feared me judging her for her dog’s poor condition. She thanked me for my kindness, nonjudgmental approach and support. Her admission shocked me because I hadn’t detected fear or hesitation in our interaction.

The Health Care Journey

Before the pandemic, veterinary hospitals made positive strides in practicing client-centered medicine, meaning the agenda and goals for a visit were set mutually by the veterinarian and pet owner. Client perspectives were elicited, and pet owners enjoyed an active voice in shared decision making. The result was an interactive, collaborative relationship.

The pandemic extinguished the trend in many practices, as curbside care and time constraints minimized client participation in exams. The result was a shift from relationship-centered care to a veterinarian-centric model where the doctor controlled the tone and pace of the visit and the diminishment of the client’s voice.

To build rapport with clients, make them active participants in their pets’ health care journey. Veterinary hospitals also must embrace relationship-centered care again. This objective can be accomplished by:

• Sharing thoughts: Invite the client to talk about their observations during the visit and their goals for the pet. Practical skills to encourage the interchange of ideas include asking open-ended questions, pausing and listening reflectively.
• Explain and support clinical recommendations: Empower clients by educating them about the “why” behind pet care options. Doing it helps clients understand the team’s perspective, treats the pet owner as an individual, and incorporates the client’s needs and values in shared decision making.

As the poet Maya Angelou said, “People will forget what you said, people will forget what you did, but people will never forget how you made them feel.”

It’s time for veterinary practices to get back to prioritizing and building client relationships and treating pet owners as honored guests. That’s the other half of the story. How will you write the ending?

HOW TO BE A BETTER COMMUNICATOR

These skills support client-centered interaction and build relationships.

• Ask open-ended questions to understand the problem from the client’s perspective. An open-ended question cannot be answered with “yes” or “no.” It usually starts with “what” (“What concerns do you have today?”) or “how” (“How did Ruby end up living with you?”). Statements that invite more explanation are included in this skill set, like “Tell me more” and “Anything else?”
• Communicate empathy to help acquire an understanding of the client’s situation and feelings. Remember to supportively share that understanding, and pause to allow the client to feel your sensitivity. Examples of empathy statements include “I can see how worried you are; how can I help?” and “Wow, that’s tough.”
• Use partnership statements to merge the team member (“I”) and client (“you”), creating a team (“we”). Examples include “Let’s work together to come up with a plan” and “We have some options.”
• Practice reflective listening, which happens when you restate what the client said or the emotion behind the words. It verifies that what you heard is what the client meant and demonstrates that what the pet owner said is important and understood. Reflective listening statements sound like, “Let me make sure I have this right” and “You are concerned about …”
• Direct the client to what you are about to say and why. Signposting is the verbal equivalent of waving a flag, and it helps increase the client’s comfort and lessens anxiety. One example is, “Phoebe, Humphrey is an adorable kitten. During today’s visit …”
• Summarize what a client said. Doing so verifies that the information is accurate and identifies any missing information. Summarization is often used when obtaining a patient history or explaining a treatment plan. An example would be, “Mr. Moore, Remington first began limping in his right hind leg three days ago after he chased a fox out of the yard. At first, he wouldn’t put weight on his leg, and in the past day, he has begun putting his foot on the ground but not walking the leg. Anything I missed?”
• Pause to elicit the client’s perspective and to allow pet owners to feel your empathy for them and their situation. First, listen to comprehend. That means rather than thinking about your next question, hear what the client says. After the client speaks, wait three or four seconds to allow the pet owner to say something more or to feel your support and understanding. Two ways to use this skill include “I can see this is hard for you.” Pause. “Would you share your thoughts with me?” Also, “A lot is going on with Casey.” Pause. “How can I help?”