The Business of Practice: Handling Dissatisfied Clients and Setting Boundaries

Clients can make or break an equine veterinarians practice or spirit. Learn more about handling these issues.
vet client

Clients can make or break an equine veterinarian’s practice or spirit. In this podcast, we talked with Lisa Kivett, DVM, MS, DACVIM, owner of Foundation Equine, a four-doctor, exclusively equine practice near Southern Pines, North Carolina, about dealing with dissatisfied clients. We also talked about boundaries and how they fit into this issue.

In Episode 67 of this podcast, we spoke with Dr. Kelly Zeytoonian about Finding and Firing Clients. This episode with Kivett talks about the daily struggles to deal with those clients who might be causing you stress personally or financially.

Types of Client Dissatisfaction

Kivett said sometimes the dissatisfaction from clients is obvious. This can include not paying a bill or sending emails, phone calls or texts. This can escalate to aggression from the client.

“That’s potentially the most high-stakes reaction,” noted Kivett. “In those situations, you need to leave immediately to ensure your safety or ask them to leave. You need to maintain physical safety” for yourself and your staff.

“The other end of the spectrum [are clients who give you the] cold shoulder,” she said. Kivett said with those clients, you have to engage them.

“If you are level-headed and curious, you might learn something important,” noted Kivett.

She offered several tips on how to re-engage these clients and get to the bottom of the issues.

“When you are threatened with a lawsuit or board complaint, turn it over to your insurance,” she recommended.

Editor’s note: Checkout this article about the AVMA PLIT Trust on Veterinary License Defense: Don’t Practice Without It!

Addressing Client Issues

Kivett had some great tips for addressing client issues. These ranged from “ghosting” you to bad social media and Google reviews.

When dealing with clients in person who have issues, Kivet discussed controlling our own body language. She also said veterinarians need to “learn which conversations you can have now and which you need to deal with later.”

She provided examples of how to prepare for dealing with dissatisfied clients. This might range from “box” or “square” breathing. (Editor’s note: see more in the article “Are You Managing Stress, Or Is Stress Managing You?”)

Learn from the Doctors

Kivett recommended that veterinarians watch a five-minute video on the “Universal Upset Patient Protocol” created for human physicians to prevent burnout.

“Every time I have used this, it has worked,” said Kivett. “You need to go through it ahead of time to be prepared.”

Boundaries and Clients

“If your client is not happy with your personal boundaries, I find it doesn’t really help to talk about it,” stated Kivett.

She said you might just have to settle for a statement such as, “Unfortunately, this is what we are able to provide at this time.”

She warned against using the word “policy,” as she has found it is “incendiary” to clients.

If your boundary is that you don’t take non-client emergencies, then you say, “At this time we are unable to take non-client emergencies,” said Kivett. “Don’t open the door to discussion.”

Sentinel Clients

Sometimes practices have clients who are chronically dissatisfied, noted Kivett. That doesn’t mean you should “fire” them as clients. “They are the sentinel chickens,” she said. “They are always disgruntled, but their complaints are often valid. If they express it, others might be feeling it.”

She cautioned that you just don’t let these clients go too far in their dissatisfaction so that it becomes an issue for you or your staff.

About Lisa Kivett, DVM, MS, DACVIM

Lisa Kivett, DVM ,MS, DACVIM, owns Foundation Equine Clinic in North Carolina. She is a North Carolina native with a background riding hunter/jumpers and dressage horses. Kivett attended North Carolina State University for both undergraduate and veterinary studies. During veterinary school, Kivett’s research focused on equine reproduction and embryo transfer.

Following graduation from NC State in 2007, Kivett completed a rotating internship in equine medicine and surgery at Louisiana State University followed by a three-year residency in equine internal medicine at Auburn University. As a resident, Kivett worked under the guidance of highly trained specialists to hone her skills in neurology, cardiology, neonatology, gastroenterology, respiratory medicine, musculoskeletal disorders, ultrasound, endoscopy and more. During that time, she also earned a Master’s in Biomedical Sciences. Kivett’s Master’s thesis involved a prospective scientific study of the effects of phenylbutazone (“Bute”) and firocoxib (“Equioxx”) on equine lameness. She obtained board certification from the American College of Veterinary Internal Medicine in 2013.

Kivett is an adjunct professor at NC State and teaches veterinary students in their final year of training. She is currently a board member for the North Carolina Equine Assisted Specialized Transport and serves as the advisory veterinarian for Sandhills Horse Rescue and North Carolina Specialized Mobile Animal Rescue Team. Kivett is an active member of the American Association of Equine Practitioners and the American Veterinary Medical Association. She lives with her husband, two children, three dogs and five horses in Southern Pines. During her free time, she enjoys trail riding and spending time at the beach.

Disclaimer: This content is subject to change without notice and is offered for informational use only. You are urged to consult with your individual business, financial, legal, tax and/or other advisors with respect to any information presented. Synchrony and any of its affiliates, including CareCredit (collectively, “Synchrony”), make no representations or warranties regarding this content and accept no liability for any loss or harm arising from the use of the information provided. All statements and opinions in this article are the sole opinions of the author and roundtable participants. Your receipt of this material constitutes your acceptance of these terms and conditions.

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