The previous column explored the need for praise as it affects staff within the veterinary practice. Although it would be nice to think otherwise, the reality is that this same phenomenon affects some clients, too.
“No problem,” Dr. Pauley announces. “I can easily inject frequent praise into my examination sound track.”
If only it were so simple! While it is true that even the most taciturn practitioners can learn to sprinkle their client conversations with praise during an examination, the challenge is in filling this need after the client leaves the clinic, or the veterinarian leaves the barn. As far as why practitioners would want, let along need, to do this, a word sums it up: compliance. In the past, multiple columns have explored the limits traditionally imposed by clients on their relationships with their animals that may undermine compliance. For this segment of the client population, repeated injections of praise may also be necessary throughout the treatment process to ensure its success.
For older practitioners and those younger ones raised outside the culture of praise, the idea of meeting such a need in their clients is even more exasperating and frustrating than the idea of fulfilling a similar need in their colleagues or staff members.
“Sometimes it takes everything I’ve got to properly diagnose the problem and formulate the best treatment for every case I see in a day,” Dr. Pauley points out. “If I have to provide praise and encouragement throughout the treatment process… Well, I don’t know where the time or energy to do that is supposed to come from.”
Other practitioners find the concept difficult for more personal reasons. “I normally spend a fair amount of time interacting with my clients, because I see a lot of chronic cases, plus most of my clients live in my area,” admits Dr. Pauley’s associate, Dr. Rosario. “But I’m not good with words and I think some lame attempt at praise would be worse than none at all.”
That both of these clinicians’ concerns are reasonable goes without saying. The question is whether the consequences that result when such praise is not forthcoming justify the effort needed to make any changes. Regarding those consequences, we know from the discussion regarding employees and praise that, when needed praise is not received, people who need it may seek employment elsewhere. But although this may result in inconvenience and even financial hardship for the practice owner, for the most part, animal care will not be compromised because the void created can be filled in some other way. Until a permanent replacement arrives, those remaining in the practice may have to work longer hours or temporary help may be hired. In some circumstances, clients may be referred, or choose to move, to other practices to maintain a standard of quality animal care.
However, when clients need praise to fuel their fulfillment of the treatment process, its lack can have life-long negative consequences for the animal. Whether clients who find themselves in this position reduce or suspend treatment altogether commonly depends on 3 factors. The 1st factor is the complexity of the treatment; the more complex the treatment, the more praise some clients may need to accomplish it. This complexity might take the form of juggling nutritional, exercise, and insulin requirements for a diabetic animal, or enlisting help from family members to hold a fractious donkey while the animal’s abscessed foot is soaked.
The 2nd factor that may cause praise-seekers to give up is the duration of the treatment. In general, the shorter the duration, the less praise needed to sustain the client throughout it. Ms. Carmody considers medicating her dog’s infected ears for 2 wk with nary a word of encouragement from the veterinarians or their staff a thankless job, but she gets it done. However, when it comes to treating that same animal for a chronic, but not life-threatening, skin infection, the lack of praise soon erodes her commitment to the daily medication, weekly baths, and life-long dietary changes.
Both of these factors are additionally problematic because both are relative. What strikes veterinarians as a simple treatment may seem like a very complex one to clients who are used to being praised for accomplishing the simplest tasks. For example, Ms. Carmody believes that just remembering to hand-feed her animal a palatable medication ranks as a major accomplishment. Routine bathing plus transitioning her pet to and maintaining it on a special diet strike her as tasks of heroic proportion requiring all kinds of outside reinforcement and support. Meanwhile, Dr. Rosario sees these same tasks as routine.
Similarly, Dr Rosario considers a 7- to 14-day treatment period so basic that summoning the wherewith to accomplish it barely warrants mention. That those who need praise would view this same interval as an arduous, seemingly endless, medical marathon never crosses her mind.
The 3rd factor is the client’s relationship with the animal. If the relationship is good, it will help to dissipate any negative effects of praise-deprivation and the treatment will be accomplished. However, if the relationship is marginal to nonexistent, it will take even more praise to ensure the animal’s proper treatment. At its worst, the negative feelings that the lack of praise evokes may cause the client to resent the animal, which, in turn, will undermine the relationship and the treatment process even more.
So what can busy practitioners do to meet these clients’ needs? For starters, recognize that a need for excess praise arises from a lack of self-confidence. Because Dr. Rosario recognizes the benefits confident owners confer upon their animals, she can justify mustering the resources to make remarks designed to build client confidence more readily than she can justify dispensing gratuitous praise. Rather than giving Ms. Carmody a hearty, but vacuous, “What a great job you’re doing!”, the veterinarian tells her exactly how her conscientious care is aiding her animal’s recovery: “Look how well that raw spot on Sparky’s back is healing. And feel his coat. It’s not nearly as dry as it was. He’s acting so much better, too. All of that thanks to your hard work and commitment to him.”
The veterinarian’s coupling of praise for the client with concrete evidence of the results of her efforts produces a trinity of benefits. First, she satiates the client’s immediate need for praise. Second, by linking praise to something Ms. Carmody can actually observe on her animal, Dr. Rosario provides her with visual cues that will enable her to summon the memory of his praise later. Third, the client can share the concrete evidence of her and her animal’s success with friends and family, who may further praise her.
Breaking down more complex treatments into smaller components may also benefit praise-needy clients. Granted, by doing this it may take his client longer to get her diabetic animal’s glucose levels stabilized than Dr. Pauley would like, however the confidence the owner develops as she succeeds in these lesser endeavors will limit the amount of fortifying praise she’ll need from the veterinarian over time.
Literature in the form of a pamphlet or handout, providing owners with support on any toll that the animal’s condition and its treatment may take on them, can help to prevent clients from feeling abandoned. Unfortunately, many veterinary handouts are written more like veterinary textbooks, focusing completely on the animal and the treatment. Nary a word appears regarding the client’s critical role in the treatment process and how much the veterinary staff appreciates that person’s willingness to conscientiously fulfill it. Such a glaring oversight may defeat clients with a high praise requirement before they even begin.
Owners of animals with chronic conditions may benefit additionally from interaction with others whose animals are experiencing the same problem. While always the case, this is especially true of those clients lacking confidence who need more support in general. When Drs. Pauley and Rosario established support groups within their practices, they provided their clients with a local support network, as well as avoiding the problems that may occur when people seek such reinforcement via chat groups on the Internet.
A final option involves adapting an assessment technique used in animals to clients. Much has been written about determining an animal’s level of pain and then treating it accordingly. Perhaps the time has come to offer that same service to clients, relative to their ability to fulfill their animals’ treatment. If Dr. Rosario routinely asks, “On a scale of 1 to 10, how do you feel about your ability to provide this treatment?” and a client replies, “Between a 2 and a 3,” that signals a far greater need for clinician support for this client than for one who replies, “About a 9.”
At this point, veterinarians needn’t involve themselves in time-consuming discussions of all possible options to lessen their clients’ emotional pain. All they need to do is to ask the one question that will validate the importance of the client’s role in the treatment process, as well as the clinician’s willingness to support that person throughout that endeavor: “What can I do to help?”