WE ALL HAVE SPENT AT LEAST FIVE YEARS studying veterinary medicine, but there are many times in our careers when we wish we had spent a bit more time studying human psychology.
The daily tightrope walk of negotiating different clients’ expectations and attitudes to costs and intervention levels is always tricky. Occasionally we fall off this narrow path and get it wrong: this happened to me a short while ago and led me to realise how little I understand and can predict people’s behaviour and feeling, including my own.
It was what will be to many of you a fairly typical scenario. A client with limited funds decides to buy a trophy breed dog which is prone to just a few problems, in this case a bulldog.
At the end of a busy Saturday, the owners arrived with the dog showing quite mild signs but what could have turned out to be a serious problem over the next few days.
I saw them in consult and during the course of the examination for this they also made a complaint about some skin treatment that was prescribed (and seemed to be working) from their previous visit, for which they had not paid. Alarm bells were ringing in various medico-legal and accounting departments in my head.
After examination and treatment for the current malaise, and in view of potential further treatment needed, and bearing in mind the outstanding debt already on their account for the skin and other items, I brought up the issue of payment.
I politely asked if they had considered, before they bought the dog, what they would do to pay veterinary bills if the dog got ill?
“We had looked at insurance, but it was too expensive,” they told me, “but don’t worry, we can pay at the end of the month.”
This sentence “We can pay at the end of the month” is synonymous with “The cheque is in the post” and “My partner will pay next week” and other variants we all know and which are merely expressions of intent for indefinite prevarication.
It just so happened by good fortune it was near the end of the month this time and I mentioned this to my client, with predictable results. Maybe the end of another month, I thought to myself.
I mentioned a local charity clinic that might be able to help if needed, but nonetheless booked them a re-examine the next day with us. The dog was treated and they left with an even bigger debt than before, got into their nearly new family car and drove away.
The following week a complaint came in from them about my rudeness and the way I dealt with them. Should I have just not bothered bringing up payment at all and shrugged it off as a bad debt? Did I do the wrong thing by, as the senior partner said, “…making them consider a few home truths”?
There were two things about all this I don’t really understand: one is the way people take on these animals with no consideration of the costs involved. There is nothing new here, I know, but I still don’t understand it.
I just think that, much as I might want to, I wouldn’t go out and buy a 1980s Porche 928 and then when (not if!) it breaks down turn up at my local garage and just expect it to get fixed and worry about that money stuff another time.
I might buy a cheap runaround and expect a bit of leeway, but not if I had deliberately bought something I knew was unreliable and expensive to maintain.
I know that we obviously have a duty of care to the animal, but a pet is a discretionary purchase and one with in-built problems (bulldog, old Porsche – take your pick), even more so. I am sure my local garage would help a hard-up family fix a five-year-old Ford Focus, but if that same family came in with a Porsche 928 and said they need it to get to work…?
The other thing I was surprised about is how bad I felt about it. I have staff wages and bills to pay, and if I never asked for money I would feel a lot worse about sacking staff or cutting their wages than I would about asking clients for payment. But nonetheless I felt terrible.
They had no real grounds for complaint, but they obviously were upset about it and were not just using it as an excuse not to pay. I knew I had done nothing wrong as a vet – the animal was treated and further appointments booked with no consideration of payment or absence of payment – but I still felt bad.
I think vets do have quite thin skins when it comes to complaints generally. Part of this is the fear of the RCVS that is instilled from undergraduate days and can be quite debilitating for some. I have worked with a few vets who practise a very defensive form of medicine because of this.
It was with interest, then, that I read of the latest RCVS trial for alternative dispute resolution based on an optician’s complaint service: the Optical Consumer Complaints Service (www.opticalcomplaints.co.uk).
The veterinary version on trial is the “Veterinary Client Mediation Service” and will function in the space between professional misconduct and negligence. It is a voluntary trial and let’s hope none of us gets to try it out. And remember to contact the VDS immediately any complaint from them or the RCVS is lodged.
Vexatious complaints are faced by all professionals: for example, the disgruntled teenager accusing his or her teacher of something inappropriate has the potential to ruin the teacher’s life even if the complaint is entirely groundless.
The MoD faces a new industry of lawyers pursuing claims against servicemen and women. “Our legal system has been abused to level false charges against our troops on an industrial scale,” states the Defence Secretary, with more than £100 million being spent on Iraq-related enquiries and compensation.
One decorated army major currently faces prosecution for manslaughter despite previously being cleared after a two-year investigation [i newspaper, 4th October].
The power of a complaint as wielded by the public is a curious thing. Although in this country we are supposedly innocent until proven guilty, just receiving a complaint and having it considered and investigated can be an upsetting experience and brings with it a personal feeling of guilt, and often a public perception of actual guilt. After all, where there is smoke…
My last example of being bewildered by human behaviour came one lunchtime. It’s not a veterinary one but chimed with the common experience of passing on your five years of training and years of experience to clients to have it ignored in favour of someone-they-met-down-the-pub’s opinion.
I was cycling home, where my wife and I have lived for four years. We live down a dead-end lane on the edge of a small village. I passed my wife walking up the other way: “There’s some people down there a bit lost,” she said. “I showed them where we were on the map and tried to help but they didn’t really want to listen.”
I caught up with the group of three retirees in hiking gear and debating over a 1:25,000 map. “Can I help?” I asked.“No, we are fine,” came the reply. I had reached the end of the lane and waited a bit. “OK, we are a bit lost,” admitted one and I duly went through on the map where we were and pointed out how to get to where they were heading.
They begrudgingly thanked me and set off back up the hill. As they went I heard one say to another about my wife: “That woman we asked, well she had no idea where she was, did she!”