One of the most important skills for all recent graduates to learn is how to build client trust and confidence. These are essential in developing a strong veterinary client following. To explore this we interviewed Dr Geoff Golovsky, principal veterinarian at Vet HQ in Double Bay, Sydney.
To build a client following, “Communication is key” says Geoff.
“We’ve been to vet school. We are highly intelligent people. We have a lot of skill, but the problem that let’s so many vets down is that they don’t have the ability to communicate with clients.”
Most vets tend to dismiss the development of this skill as they assume that they will just pick it up on the job. However, in order to excel as a vet, you need to train yourself to communicate your knowledge and advice effectively to each client.
Communication starts with listening and getting to know your clients, not your patients. You need to listen to what they want and what they are asking for. This information is essential in determining how you proceed with a case. Here are two examples from Geoff of how you can adapt your consultations when you know what the client wants:
- A dog comes in with superficial pyoderma. You say, “Your dog has a skin infection. It needs antibiotics. The best thing to do is a sticky tape preparation or a skin scrape.” One client responds, “Oh! How much is that going to cost me?” For this owner, you have given your best recommendation and now you can work backwards. You could respond by saying, “Okay, well let’s try antibiotics. Come back and see me in two weeks. If it’s no better, then we’ll do the skin scrape.” Alternatively, you have a client who responds with, “Yeah, can we do the tests right now?” In that case you would run the tests.
- A dog requires an antibiotic course and the owner is a very busy person with three kids. You need to acknowledge the person is busy and offer what’s convenient. An appropriate response could be, “I know you’re busy so you’re not going to be able to give antibiotic tablets twice a day for two weeks. Let’s give a long acting antibiotic injection instead and I’ll send you a text message in two weeks’ time.” However, you also need to discuss the cost with them, if this is a large dog the injection would be expensive. You offer your client what you think is best for that person. For some clients the convenience would outweigh the costs, but for others it wouldn’t so if they refused this you would then work backwards and give them the next best option.
The way you communicate with each client will be different. Reading their body language can help you know how to communicate with different people. Geoff advises signs to look out for; if the client is looking up at the sky, they’re not listening; if their arms are crossed they may be very resistant; if they are crying they might not be in the frame of mind to make a decision. These signs will determine how you approach and make recommendations to the client. If you struggle with this Geoff recommends doing a communication course, for example the course run by Crampton Consulting.
Building client rapport is perhaps one of the most underrated parts of the consult.
It can be difficult for the more task focused vets. Rapport builds trust and likability. Effectively, if clients like you they will listen to you and if they listen they’re more likely to do what you recommend. Geoff recommends adding notes about the client on their file, their kids’ names for example, so you have something to talk about at the next visit. Simple things, like asking where they are going on holidays when they come in for a vaccination for their dog that’s going into a boarding kennel, will go a long way in getting the client on your side.
When it comes to giving advice and recommendations Geoff has several tips:
- Make sure the client understands you
If the client does not understand they cannot confidently make a decision. This means you need to speak at the client’s level. For example, if a dog comes in with a skin condition, “You’re not going to tell them the dog has a staphylococcus infection. You’re going to tell them it’s got a skin infection, something the owner understands.”
- Limit the number of treatment options
“You’ve all been taught to give your clients every option under the sun. It just confuses them.” You don’t want to give them too many options because they may be overwhelmed and not choose any. “They want to know what you think. They don’t want a list. They want advice.” Limit the options to two or at most three and advise the owner which option you recommend is the best one for their pet.
- Never compromise your standards
Start with what you believe is the best recommendation and then work backwards with the client from there. You never know what an owner will choose and it’s not up to you to determine what they can afford.
- Follow through
Communication does not end in the consult room. After the consult it is important to follow up and ensure the client is clear about the plan. All the vets at Vet HQ will contact the owners of hospital patients twice a day to give them updates. Follow up calls and text messages are also made to outpatients (at Geoff’s clinic the nurses do this). Clients are usually appreciative of these follow ups and this helps build trust.
Geoff gives us two examples to illustrate these tips:
Case study one: Anterior cruciate ligament rupture
I think I learnt from David Lidbetter (small animal surgery specialist) once, “You know a dog has got a cruciate rupture before it comes into your room.” The dog is sitting there with its leg out. You see it walk in and it’s hobbling. It’s a Labrador and it’s overweight. Straight away you know it’s got a cruciate rupture so you go through the examination with the knowledge that that’s probably where you’re going to end up. You can say to the owner, “I’m going to do a full physical examination, but I think I know what’s going on.”
Then it comes time for the explanation. It’s an overweight Labrador. We know that the tibial plateau levelling procedures are the best for a cruciate rupture in large breed dogs. How are you going to convince the client to spend, I think the gold standard is $3500 to $5500, for this procedure?
Remember don’t sum them up and immediately think that they cannot afford it. You could say, “I think your dog needs a tibial plateau levelling procedure. I don’t do them so I’m going to refer you to one of my colleagues. It is an expensive surgery. There is another option, the De Angelis procedure, however, I would strongly advise against it because your dog is overweight and a large breed dog so it will be sub-optimal.” You advise them of the costs; $3500-5500 for tibial levelling and $2000-3000 for De Angeles (You should check the estimates for these procedures with your practice principals).
They will want to think about it as it’s a big decision. In the mean time I give them this description to help them understand. Most people have been skiing so I get the client to stand like they are skiing. I explain, “This is how your dog stands, like it’s got ski boots on.” The client immediately feels their knees give way. “Your dog is feeling that all day every day. It hurts!” I then explain to them, “I’m going to turn your dog’s knee from standing on ski boots to standing like a human being. I will remove the sliding forces so that your dog is not uncomfortable every time their leg bears weight.” The ski boot analogy works really well every time.
However, if they then say, “Well, I can’t afford a TTA (Tibial Tuberosity Advancement surgery). I’m going to do the De Angelis,” I explain, “Well, I can’t remove those forces. I can tighten up the leg and you have to be really strict on the leg, but that’s the best that we can do.” And so you work your way backwards with the client.
Case study two: An emergency - Gastric dilation volvulus (GDV)
A GDV walks in the door, the dog is bloated and white. You don’t have time to go through it all with the owner. But you must remember that in an emergency the owner is freaked out. Remember their beloved pet is sick and they may be confused and irrational. My approach is to have a nurse or someone else available. This person takes the client into a quiet room, gives them a cup of tea, explains the situation and says, “We will be with you as soon as we know.” The owner needs to be kept in the loop the whole time. You don’t have time to talk initially so you reassure the client that you will take the animal through and start working on it and will keep them informed. Within 5-10 minutes you need to touch base with the owner through the nurses.
What happens if you don’t have a nurse? It’s very hard to do a GDV without a nurse. If I’m called in at night and realise it’s a GDV I will call someone straight away. Call your boss, your nurse, your partner, anyone available. Place a catheter in as quickly as you can and start controlling the shock. Deflate that stomach. Worst case scenario, get a catheter or trocar into the stomach, you need to get reperfusion quickly.
What do you do with the owner? You can’t have the owner with you in that situation, so say, “I’m going to call for someone straight away, please sit down here [in the consult room], I need to [treat your dog].”
Some people will try to do this by themselves. You just can’t, you need help. If you’re in a practice where you’re expected to do after-hours and there’s no nurse on call, you need to talk to your boss and try to set that up. Or ask one of your nurses, “Can I call you if something happens?” and pay them out of your money for their time, whatever will help get the job done.
So, best way to approach these scenarios; client in the consult room, dog out the back, work on it and call for help.
When you find yourselves in these situations as a young vet, no matter what case it is, effective communication is key. It is a skill that must be learned and practised. By listening to your client, understanding what they want, and explaining your advice so they understand it you can gain your clients trust and confidence and build your own strong client following.
Dr Geoff Golovsky BVSc MACVS (Surgery)
Geoff graduated in 1998 and started his career in mixed animal practice on the NSW South Coast. After nine months he moved to Sydney, sat the GAMSAT medicine entrance exam and became a sailing instructor. After a period of being disillusioned and unhappy he travelled to Thailand and worked as a veterinarian at the University of Khon Kaen as part of the Australian Youth Ambassadors for Development program. It was there that he was re-inspired in veterinary surgery and decided to stay in the profession, which he says is the best decision he ever made. Following that, he worked in small animal practice in London for 2 years. He then returned to Sydney and worked at North Shore Veterinary Hospital and completed his Memberships in surgery. Geoff then established Vet HQ in Double Bay which he built from scratch into a busy four vet practice.