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By Cherie T. Buisson, DVM, CHPV
Certified Hospice and Palliative Care Veterinarian

I am a rabid Outlander fan. I’m a rabid book fan in general. I’m almost always delighted to see a favorite book become a movie or TV show. Over the years, I’ve noticed that there are three book adaptation fans: the ones who want the movie to be exactly like the book, the ones who are willing to accept an adaptation but will be disappointed when changes are made, and those who watch with a completely open mind, just so they can see their favorite characters brought to life. I’ll give you one guess which group enjoys adaptations the most.

Oddly enough I’m in the third group. There are some adaptations I can’t stand (I’m looking at you, Watchers), but for the most part, I am thrilled just to see the book on screen. I marvel at the #notmyjamie people who are still freaked out that the main character doesn’t look like what they pictured in their heads. Sometimes, reading what they were expecting, I honestly wonder if they ever actually read the book!

Expectations get us in trouble every time. Managing the expectations of yourself and others can save you a ton of blood, sweat, and tears in the long run. Here are some places where we can manage expectations in the veterinary clinic to make everything run more smoothly.

1. Treatment plans/estimates: I’m still shocked when I encounter teams that don’t provide estimates for all (or almost all) clients. There is no easier way to manage expectations and avoid trouble than this. No client should EVER EVER EVER (do you need another ever??) go up to your glorious CSRs and give them grief because you didn’t tell them what to expect. I’ve heard the argument, “if clients want an estimate they can ask”. Let me tell you, as someone who lives with a person who never asks for an estimate and is often upset over the final bill, don’t make that an option. If a client regularly comes in for a service, then maybe they don’t need an estimate every time. But why set yourself up for failure by assuming a client will be OK with their bill? If their pet is hospitalized, whoever calls them with an update should also update them on the bill. EVERY DAY. Bonus points if you give them a heads up about tomorrow’s bill. Last hint: call it a treatment plan. Let’s take the emphasis off the money and put it on the medicine where it belongs. “Lynn will be in to go over your treatment plan in just a few minutes”.

2. Wait times: If your clinic runs chronically late, there are some things that need fixing. But if you are having an unusual day, have the CSRs try to give your clients a buzz to let them know. Give them the option to reschedule, drop off, or wait. Having options empowers people. Better that they CHOOSE to wait than being FORCED to wait.

3. Understaffing: It happens to all of us way more often than it should. Do you have a plan for when someone calls in sick or goes on vacation? Consider relief technicians or veterinarians. If you have to be understaffed for a day (or more), lighten up the schedule as much as you can so you don’t have unhappy clients. Offer for non-critical cases to reschedule. If they don’t want to do that, let them know there may be a wait.

4. Outcomes: Clients want to know a percentage for how likely their pet is to recover/live/die from their disease. We all know this is incredibly hard to predict. Clients can also be flippant about surgical complications…..until they happen . If clients are going to refuse an e-collar or otherwise be noncompliant, let them know specifically but without drama what the consequences of this decision will be. Have them sign that they understand they are taking a risk and it will be their financial responsibility if it goes sideways. If they give you the impression that they aren’t going to be held accountable, consider declining to perform the procedure.

5. Our personal boundaries: I could write a book on this one! If you know that you don’t function well in certain circumstances, it is incumbent upon you to inform the people around you. For instance, I quickly become nonfunctional without a lunch break. I get hypoglycemic which leads to being forgetful and hangry. I have had to stop working for clinics that are not concerned about lunch breaks. That isn’t a judgment on them or me….it just means it’s an environment that doesn’t suit my physical and emotional needs and abilities. If a client for some reason (and think REALLY hard before doing this) has your cell phone number or the ability to message you personally on email or social media: be sure you set some boundaries. That can simply be that this is for a one-time thing or that if you don’t answer, they need to seek help elsewhere and not wait for you to reply.

There are so many ways in which communication and expectation management can protect us. If you’d like to avoid board complaints, lawsuits, employee issues, burnout and compassion fatigue, this is an excellent place to start. Other than unexpectedly positive patient outcomes, surprises are not a good thing in our profession. If everyone knows what’s going on and what to expect, then there isn’t nearly as much room for conflict. The less conflict we have to manage, the more time we can spend helping people and their pets.