Trust, faith and confidence all describe the high regard one person has for another. These qualities are essential for veterinarians to maintain a good stable working relationship with our clients. Trust means a client believes in their vet’s work and that he or she will do the right thing. Faith is more to do with the inner qualities of the vet — that he or she is a good person and that the client likes him or her. Both these qualities can be established fairly quickly, perhaps after a visit or two. Confidence, on the other hand, which depends more on a person’s repeated experiences with the vet, can take a long time to establish.
So while the confidence that a pet owner or farmer has in their vet might have taken many years to develop, a single incident can wreck this wonderful relationship instantly. Sometimes the incident is the result of an unfortunate mistake or a bad decision by the vet, while at other times it may just be bad luck. Or a loss of confidence can be brought about by a different interpretation of an event or poor understanding by the client of the complexity of some of the issues we deal with. Too often, however, a poor outcome is simply the result of bad communication and perhaps a lack of empathy shown by the vet.
During 40 years of being a veterinary practitioner I have lost the odd client. It happens to us all. Sometimes I have no idea why. You just don’t see that client any more and you hear that he or she now uses another vet. It could have been due to a loss of trust or confidence in my abilities or it could have been simply because that person just liked another vet more.
In my early days in practice there were far greater opportunities for things to go wrong. Not only was I inexperienced but I was also having a go at doing everything in all species. As vets, every one of us can probably think back to an incident that makes us inwardly shudder, that we wished we had managed better, and that lost us a client.
One of the great advantages of working in a smaller rural area is that after you have been there a while you know most of your clients, and when they ring you for advice or help they do so with confidence that you will do the right thing, otherwise they would ring another vet. They are prepared to listen and accept what you tell them. On the other hand people who don’t know you ring anticipating a good outcome, hoping that you will immediately respond the way they expect you to. Sometimes when you don’t react the way they are hoping you will they are disappointed. Occasionally you can lose a potential client before you have even met them.
One evening around 8 p.m., while on after hours duty and just settling down to my evening meal with Chick and our two children, I received a phone call.
‘Hello. Peter Anderson speaking.’
‘My pet rat needs to be put to sleep.’ It’s a boy and he is straight into it. No mucking around with any formalities.
‘Oh dear. And what is wrong with your rat?’
‘He’s old and he’s got a big growth on his face.’
Clearly neither of these things had developed between the clinic closing at 6 p.m. and now. It is hardly an emergency and the rat can wait until tomorrow. ‘OK. That’s no good. Would you like to bring him in tomorrow morning?’
After no immediate reply but some muffled voices in the background I again asked, ‘Will tomorrow morning suit you?’
Another pause and then, ‘I want to have him put to sleep now.’
He was obviously conferring with a higher power.
‘Well, I could see your rat soon and do the job but I’m afraid that will cost you $50 if you want me to look at him tonight.’
Again there is no immediate reply and then a furious-sounding woman comes on the phone. ‘What do you mean you won’t look at my boy’s pet tonight? I’m disgusted with your attitude.’
Naturally I was a little taken aback by this response but replied as calmly as I could. ‘I’m sorry but I didn’t say I wouldn’t see him. I told your boy I could but it would cost him $50. I am not spending the next hour driving over 20 kilometres and opening up the clinic and putting his old rat to sleep with a condition that isn’t an emergency and that could wait another 12 hours — for nothing.’
I thought that was reasonable but she was getting really angry now and was on a roll. ‘What sort of vet are you? The last time we had to have a rat put to sleep the vet did it straight away and it didn’t cost anything. I’m disgusted. You are a disgrace to the vetinry profession. I’m going to report you to the vetinry council.’
After that outburst I was momentarily stuck for words, but that didn’t matter because the phone went dead in my ear. I went and sat down for my dinner somewhat bemused. I didn’t really enjoy my meal after that.
We never did see the rat and I never did hear from the vet council. I have heard that rats make great pets but for some reason I have never been a great fan of this idea. Nevertheless my response would have been the same if the pet had been a cat or dog — I think!
The rat’s owner’s mother lost faith in me being a nice kind person before I had even met her. I certainly hadn’t lived up to her expectation that I would solve their problem by immediately coming and putting her boy’s poor old rat out of his misery — for nothing. I suspect it never occurred to her that I, too, like to sit down at the end of the day and have a pleasant dinner with my family, rather than driving to the clinic and opening it up for a non-emergency.
I remember a night in my early days of practice when I convinced Chick that we should go and watch a good movie that was on at the theatre. She is not a great fan of movies, unless they are exceptional, because when the lights go out she tends to fall asleep … I was always keen on Westerns in my younger days and naturally thought everyone else was too, including Chick. During our courtship, to give her a great night out, I would invest my meagre student allowance in a couple of tickets to the movies and get thoroughly engrossed in the cowboys and Indians, totally oblivious to the fact that Chick had fallen asleep among all the gunfire.
So it was an achievement to get her to this film. Just before the lights went out an elderly couple I knew moved along the row and sat down immediately in front of us. I remembered them well because I had treated Steph, a little bichon frise of theirs, a couple of weeks earlier. They were very worried because their little dog had been ‘off-colour’ for a day or so and I remembered it showed some abdominal pain and had a slight temperature and some diarrhoea, but really did not appear to be too ill. The dog responded well to an intravenous anti-inflammatory, becoming more relaxed and appearing happy enough. Despite the owners’ continuing concern I sent them home with some antibiotics for Steph, reassuring them that it was just a mild upset tummy and she had probably eaten something that didn’t agree with her. I also remember they weren’t that happy when they left, mumbling something about it being nonsense that she would have eaten something she shouldn’t have.
Anyway, come half-time at the movies, something they don’t seem to have these days, I leaned forward and said to the couple over their shoulders, ‘Hi, how are you? Great film isn’t it? How’s Steph doing?’
They obviously knew who they had sat in front of. She didn’t respond but kept looking ahead at the commercials on the screen. He turned around slowly and said to me with obvious bitterness, ‘She died, didn’t you know?’
It had been a good film up until then. I had obviously made a poor decision about Steph, who must have had more than a mild enteritis. Certainly her owners had lost any confidence they had in me but I don’t think they ever trusted me right at the beginning.
Bruce Taylor, my former classmate, a very well respected horse vet and an expert in equine reproduction with extensive experience in the USA, tells a story about a falling out of favour with one of his best clients.
Bruce, a partner in a large mixed practice in Rangiora, was asked by Mr and Mrs Baxter to euthanase their old, very obese male donkey at Ohoka, a nearby district. Their children had all grown up with this donkey Eeyore and he was very much part of the family. The Baxters were very good clients. Bruce had done most of their veterinary work for years and he had an excellent relationship with them. He was definitely their ‘favourite’ vet. It was arranged that the unpleasant task would be done by Bruce on his own at 8 a.m. on a Monday, the Baxters choosing to be well away from home while this was performed. They had also arranged for a digger to come at nine, after Eeyore had been ‘put to sleep’ so he could be put in his final resting place.
After administration of the usual drug, a high concentration of the anaesthetic pentobarbitone, Eeyore duly dropped to the ground and stopped breathing. Bruce then travelled on to his next job, about 35 kilometres away, which would take up most of the rest of the morning. A couple of hours after arriving there he received a call from the clinic and couldn’t believe what he was hearing.
He was informed that Mrs Baxter had returned home only to find Eeyore looking over the fence at her as she came up the drive — very much not dead. The digger had already come and gone without being able to find any body lying around anywhere to bury, so hadn’t dug any hole. To say the Baxters were not best pleased is an understatement. Bruce’s partner was asked to go out and do a ‘proper’ job and Bruce was definitely no longer the favourite vet. He never returned to the Baxters. I guess, perhaps understandably, they lost confidence in him! Bruce was not allowed to forget the incident with the indestructible Eeyore and had to shout beer all round for the partners and staff at the clinic.
Mark Wiseman, the bloke who set fire to a historic barn, went on another farm visit on that same island to see his first sick sheep. She hadn’t moved or eaten for 24 hours. Fresh from vet school, Mark was keen to perform a thorough clinical examination, which he duly did. Apart from the fact that she seemed unable to stand and uninterested in eating he could find nothing wrong with her. She didn’t have a fever, no signs of respiratory disease, no obvious pain, no broken legs or sore hooves, she wasn’t carrying or nursing lambs, nor were there any discharges from any orifices. The farmer didn’t seem keen to spend money on blood tests so Mark had to pronounce that he could find nothing that needed treatment, but if she couldn’t stand or eat the best thing to do was to put her to sleep. The farmer seemed happy with this advice as it cost him no extra money. Mark left with the plan that the farmer would shoot the sheep.
Some weeks later Mark bumped into this farmer who asked him if he remembered the sick sheep he had condemned to death. He told Mark he hadn’t had a chance to do the deed until late that afternoon. However, as he approached the sheep she took one look at him with the gun and promptly jumped to her feet, ran off and had never looked back since!
Mark reckons this was his first lesson that we don’t know all the answers and to never underestimate nature. Sometimes nature just needs a little time to sort itself out, and that thought has stayed with him throughout his career.
I can certainly relate to what happened to Mark; I may have approached it differently but nevertheless not handled it any better. Too often we feel that we are not doing our job or are not seen to being doing a good job unless we give the patient something. Early in my career, when faced with cases like Mark’s, I would on occasions find myself thinking, ‘Buggered if I know what is going on here. What the hell can I give this animal?’ I would usually resort to a shot of multivitamins or general tonic because these would at least be unlikely to cause any harm and they might help. While the farmer with the miraculously recovered sheep may not have been entirely confident in Mark’s abilities he would have been able to dine out at Mark’s expense for many months and I am sure would have been happy to have him back on the property again. On the other hand, if Mark had given the ewe a shot of vitamins, the farmer would have had a very different opinion of Mark’s competence, despite the fact that the vitamins probably had little influence on her recovery.
So a ‘tincture of time’ can be the best treatment in many situations and we shouldn’t be afraid of prescribing it. While vets often feel it is expected that we prescribe something or give some advice, doing nothing should not mean a client loses confidence in our abilities to do the right thing. But it is important we spend the time ensuring clients understand our course of action. Too often it is just easier and quicker to give an animal a jab of ‘this’ or suggest the flock get a drench with ‘that’, with little explanation required.
Communicating our course of action, whatever it might be, is so crucial. Regardless of the outcome it will often mean the difference between a client gaining or losing confidence and trust in us. In the end poor communication with the client is the main reason why there are breakdowns in good vet–client relationships.