Cold-call communication

When Dr. Bogart arrives home more than an hour later than she told her family to expect her, it is difficult to tell who is more upset: the veterinarian or her family. Her daughter is annoyed that her carefully prepared casserole is overbaked. Her son complains because he could have stayed longer at his friend’s home working on a school project. Her partner gives her “the look” that translates, “Another unscheduled phone call or walk-in?”

Because quality communication skill plays such an important role in successful practice, veterinarians who master it soon become aware of the costs of this skill as well as its benefits. During her scheduled office hours, Dr. Bogart has minimal trouble taking time to talk to clients she knows will a) concisely describe the animal’s problem, b) carefully listen to her recommendations, and c) reliably implement them. Although she sometimes may feel put out by such calls when these negatively impact her other activities, for the most part she can justify any inconvenience because these people are good clients.

It is the rambling, unscheduled calls that wear Dr. Bogart down. While her family becomes increasingly irritated by her tardiness, she finds herself on an emotional roller coaster as she listens to Ms. Gabrieli talk about her 19-year-old cat, Fidelio. The veterinarian fully understands that her geriatric client is terrified of losing her only companion even as Ms. Gabrieli faces failing health herself. But Dr. Bogart also knows that Fidelio’s many complex and overlapping problems make it impossible to give his owner the kind of definitive answers she wants in response to her random phone calls. Furthermore, she knows that Ms. Gabrieli knows this because they have discussed this many times — providing the client’s memory remains reliable. Although the woman seems lucid enough when she calls, the practitioner cannot rule out the possibility that her client’s memory might not be as good as it used to be.

Unsolicited or cold-calls from clients like Ms. Gabrieli can be stressful for practitioners because they may elicit all kinds of conflicting emotions. Dr. Bogart appreciates that her client loves Fidelio and cannot bear the thought that he could die. She also recognizes that Ms. Gabrieli is very lonely. Consequently, the veterinarian does not feel that she can refuse to take the client’s calls. But at the same time, Dr. Bogart knows that doing this reinforces the client’s behavior. It also means taking time away from other clients and patients, as well as sometimes denying herself the necessary restorative benefits of interactions with family and friends.

In situations like this, repeatedly asking the client to set up specific phone appointments often does not work because doing so does not address the client’s loneliness. Compare this to Dr. Bogart asking Ms. Gabrieli to keep a journal of Fidelio’s daily activities. This includes how often and how much he eats and drinks, what he eats, how often he uses the litter box, details about his urine and stool, his sleep patterns, how much interest he shows in his surroundings, including his interest in play. At that time, the practitioner also sets up a specific time for Ms. Gabrieli to call “so that we can go over what you’ve discovered and make any changes necessary to help Fidelio.”

Although playing a more active role in her animal’s health hopefully will add more meaning to the client’s life, this is not mere busywork to keep the client from bothering the veterinarian. It also guarantees that when the practitioner talks to the client, the client will be able to provide more meaningful information about the animal.

Cold-calls from long-standing clients like Ms. Gabrieli can stress even the most patient and saintly practitioner. At their worst, they may drive frustrated veterinarians to make comments to the client that they later regret. Or they may take out their frustration on colleagues, staff, or family members after-the-fact. But be that as it may, at least the veterinarian has the consolation of knowing that these clients genuinely care about their animals and want to do their best to help them, regardless how little that may be.

“True,” admits Dr. Bogart. “Even if Ms. Gabrieli’s current willingness to keep a journal and call at specific times to discuss Fidelio wanes over time, it’s impossible to deny how much he means to her. Plus once I know this approach has merit, I can adjust her ‘assignments’ to keep her busy and me better informed.”

Another group of cold-callers create even greater communications challenges for practitioners. Unlike the Ms. Gabrielis of the world, these people are not clients, never have been clients, and often vanish as soon as they get the service they want from the veterinarian. Like most practitioners, Dr. Bogart would not refuse to see an animal experiencing a true emergency, regardless how demanding or inconsiderate the owner might be. But when someone she does not know calls or drops in and expects her to immediately provide some non-emergency service strictly for that person’s own convenience, she flounders.

“No matter how I look at it, I consider it a no-win situation for me,” she acknowledges. “Before I even open my mouth I have to dissipate all kinds of negative emotions and assume a reasonably professional demeanor. I also know that, if I give these people what they want, I can’t rationalize denying that same service to them or others in the future. That makes me feel even more abused. But even if I never see them again, I worry that they may tell others in the area that I refused to help them and their animals. That could hurt my business. Regardless what I do, I never feel like I’m in control of the situation.”

Whereas Dr. Bogart inevitably gives in to the unknown callers’ demands even if she hates herself for doing so afterward, her colleague, Dr. Yanover, takes a more impulsive approach. How he responds depends on his mood and what he is doing when the call occurs. If he is in a good mood and has time, he treats a cold-caller the same way he would one of his regular clients. But if he is in a bad mood for any reason, e.g., facing a packed schedule or in dire need of some sleep after a series of legitimate night emergencies, these people will feel the full force of his anger.

Obviously neither of these responses is optimal. Allowing strangers to treat her like a doormat eventually will take its toll on Dr. Bogart as well as her family. Whereas her established relationship with clients like Ms. Gabrieli enables her to rationalize giving in to their demands, she feels no such allegiance to unknown cold-callers. Consequently, each such interaction leaves her feeling frustrated and angry for hours afterward. And although Dr. Yanover’s venting may make him feel better, his staff members and others around during his angry outbursts or those who hear about them may wonder if he treats animals the same way.

In these situations, preparation pays big dividends. Preparing a basic response to unknown cold-callers and then practicing it to the point that it flows naturally when these situations arise places the veterinarian in a position of authority from the beginning. In this scenario, Dr. Bogart’s first response to a request for immediate non-emergency care is to thank the person for their interest in the clinic. Then without giving the other time to respond, she continues with, “We work on an appointment-only basis to ensure that all of our patients and clients get the best care. Because this isn’t an emergency, may I set up an appointment for you and your dog so the staff and I can give you the benefit of our full attention?”

In addition to enabling the practitioner to respond in a professional manner, the essence of a carefully crafted response can be repeated as many times as necessary for the cold-caller to get the message. Admittedly there may be those self-absorbed individuals who become angry and frustrated when they cannot manipulate the practitioner. But because the practitioner truthfully defines ensuring optimal care for the animal as the reason for the policy, it is easier for her to stand firm and politely terminate the conversation.

In The Temple of Glas, 15th century monk John Lydgate wrote, “You can please some of the people all of the time, you can please all of the people some of the time, but you can’t please all of the people all of the time.” Accepting this reality will enable practitioners bedeviled by known and unknown cold-callers to prepare strategies that, at best, will re-educate and, at worst, discourage these people in a professional manner. This will enable those in private practice to sustain quality patient and client care, as well as their own well-being.