Extinguish the Anger: How to Manage Conflict Before It Escalates

Publication
Article
Veterinarian's Money Digest®December 2017
Volume 1
Issue 5

How to manage conflict and douse flames of discord in your practice before they rage out of control.

Under the law, pets are considered personal property, yet 94 percent of pet owners describe their pets as family members and companions.1 Given the strong bond between people and their pets, it’s no wonder conflicts arise in veterinary practice.

Many practice management consultants recommend good processes for avoiding conflict, but the reality is that disagreements are almost inevitable in the emotional environment of pet health care. Differences in opinion, the inability to understand information and digest directives, and personal beliefs involving the care that should be provided can thwart your best-laid plans and wreak havoc on your business.

This article explores three steps you can take to defuse conflicts that arise with a client or team member and resolve disagreements before they disrupt your practice.

How Conflict Arises

Often, signs of a brewing conflict are missed — understandable in the backdrop of a busy veterinary practice. Nevertheless, when discord goes unnoticed, misunderstanding, misinformation, disappointment and disrespect have a chance to percolate.

The truth is, some veterinary teams have a less-than-ideal bedside manner, and often the front desk staff take their cues from the doctor. This may lead to a culture of conflict avoidance. Not everyone is adept at smoothing the ruffled feathers of a client or staff member. Sometimes small conflicts escalate into full-blown litigation, simply because the parties involved fail to stop talking and start listening.

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Misunderstandings can lead to communication breakdowns, which might be perceived as disrespect on the part of an angry client or staff member. The inability to talk about a problem from the outset inhibits the ability to listen and stokes the fires of litigation.

This past fall, the British Veterinary Association released data from its Voice of the Veterinary Profession survey. A full 85 percent of respondents, which included veterinarians and their staff in the United Kingdom, felt harassed by pet owners.2 Most situations involved money: Clients did not want to pay a fee, expected the fee to be reduced or decided to pay by installment.2 Sound familiar? U.S. veterinary professionals would likely describe similar experiences. How can veterinarians address such problems while protecting themselves from abuse? They need to employ stopgap measures to help them learn more information without inflaming the issues: Stop, drop and roll.

Alternative Dispute Resolution

Unfortunately, in the United States, malpractice insurance companies systematically tell veterinarians to avoid antagonistic conversations altogether or to speak with a client in a friendly manner while exploring possible solutions. Both approaches can lead to serious issues: First, ignoring a disgruntled client or staff member is done at your peril — it may or may not avoid a lawsuit. Plus, disgruntled clients might take to social media to broadcast how they feel, describing what you did wrong and how you wouldn’t take responsibility. That can have an even greater impact on your prac-tice’s well-being than being sued. In the second case, you could create more harm than good if you attempt to engage with an angry client or staff member but lack the proper communication skills or the presence of a neutral person in a confidential setting. What you say could leave you vulnerable to greater liability.

About five years ago, stakeholders in the medical community were interviewed about the reality of implementing the Disclosure, Apology and Offer approach to address medical malpractice situations.3 In this model, health care providers, their institutions and their insurance companies notify patients of unanticipated adverse outcomes, explain the circumstances and measures taken to prevent future occurrences, and offer financial compensation if appropriate. The article confirmed what those working in medical venues already knew — that parties are ready to shift how they handle medical issues arising from services rendered.3 Both sides want to be heard and are ready to engage. They want to acknowledge each other, minimize the trauma of the event and avoid reliving it in litigation.3 Veterinary medical malpractice insurance providers may want to lend an ear to this valuable discussion.

U.S. veterinary malpractice insurance companies do not support allowing their clients to participate in confidential discussions before a lawsuit is filed. Malpractice agents believe that emotional clients may lodge spurious complaints, wasting everyone’s time and money, but this belief thwarts the best possible outome for all the parties and may end in a lost client. The veterinarian might also be displeased with the insurance company for limiting his or her ability to resolve a problem.

Veterinarians can always decide on their own to speak with angry clients or staff members, but if no agreement is reached, the lack of confidentiality protections in personal discussions are tricky.

Confidentiality issues can be avoided if the parties facilitate discussions using alternative dispute resolution. Two types — mediation and collaborative practice — provide a confidential setting, supporting a personal choice by each party to discuss the problem before resorting to litigation.

That pre-lawsuit process has not been implemented systematically into U.S. veterinary malpractice coverage, but similar models are being implemented in Europe. The Royal College of Veterinary Surgeons (RCVS) is funding a recently approved mediation service.4 The Veterinary Client Mediation Service (VCMS) is free for both pet owners and veterinarians. According to Jennie Jones, a partner at the law firm that administers the service, “Complaints are referred … by clients and practices where the relationship has become strained or communication may be difficult. Importantly, the service does not look at who is right or wrong but focuses on finding an outcome that both parties can live with and bringing an end to the complaint.”4 Findings from a trial period, in which all parties voluntarily agreed to participate, have shown that the VCMS has “allowed greater time and resources to investigate concerns that could constitute serious professional misconduct,” said RCVS Registrar Eleanor Ferguson.4

How can veterinarians maintain a successful business, manage a variety of personalities and keep their malpractice coverage intact? By taking three easy steps: Stop, drop and roll. These tactics give the entire practice the tools to address conflict without jeopardizing malpractice insurance.

Stop

The first step: Stop talking. Listen to what your client or staff member has to say. Have your staff do the same when facing an angry client. Responding with what you believe are correct facts will not serve you, but allowing someone to feel heard will empower you. You will uncover what is really going on in his or her mind.

The idea of being quiet and listening is foreign to many. In her book “We Need to Talk: How to Have Conversations That Matter,”5 public radio journalist Celeste Headlee explained why listening is imperative for good communication. She details the 1982 crash of Air Florida Flight 90 that killed 74 of the 79 people aboard, as well as four people on the ground. Of the black box recording of the conversation between the first officer and the captain before the crash, Headlee wrote, “Most communication experts who listened … concluded that airline co-pilots should be trained to be more direct with their captains.” In reality, Headlee wrote, “we needed to train pilots to listen better.”5

There are three good reasons for listening. First, you may hear about things you need to address in your practice. Second, it allows you to learn about anything going on in a client’s or staff member’s life — such as divorce, sickness or family issues — that is skewing his or her response to your information. Third, when a person is angry, he or she cannot hear you. Valid arguments fall on deaf ears.

Drop

Next: Drop the need to be right. That might be one of the most difficult things for a profes-sional to do. After all, you are the one with the degree, and you know what you are talking about. But, along with stopping to listen, dropping the need to be right is a key step toward resolving conflict.

This does not mean that you are wrong. It may actually empower you to be twice as right. If you stop to listen, you may hear things that help you locate the path of least resistance toward resolution. Rest assured you are not fueling the fire. You are just allowing the other side to tell his or her story fully without interruption. In fact, in many cases, dropping the need to be right and appreciating how someone else feels, without commentary, can simplify finding a solution.

Roll

Finally, let the aggrieved party’s angry words roll off your back. This does not make you a doormat or mean you agree with the complaint. By listening fully and not offering an immediate counterpoint, you refrain from providing more fuel for argument. You might also receive an apology once cooler heads prevail and the enraged party sees just how out of control he or she was and how in control you were — all because you resisted adding fuel to a fire someone else started.

Conclusion

Addressing conflict with team members or clients is difficult and stressful, yet managing impassioned situations before they escalate is key to avoiding potentially significant public relations or financial problems. The simple three-word phrase most of us learned as children can be vital to de-escalating conflict: Stop, drop and roll.

It is important to advocate for yourself in times of conflict. Request permission from your insurance carrier to mediate before you are sued. Doing so places your malpractice provider on notice that you are proactively and confi-dentially addressing a perceived conflict. This notice will maintain your malpractice insurance coverage in the event that mediation does not work and the client or staff member sues.

Ms. Vey Voda-Hamilton is an attorney/mediator and principal at Hamilton Law and Mediation, the first mediation practice to focus specifically on conflicts between people over animals. She is a best-selling author of “Nipped in the Bud, Not in the Butt — How to Use Mediation to Resolve Conflicts Over Animals,” which outlines the methods she uses to address conflict, keep clients and appreciate another’s point of view in a disagreement.

References:

  • The truth about dog people: new survey and infographic tell all. Rover website. rover.com/blog/the-truth-about-dog-people-infographic/. Accessed October 25, 2017.
  • Guthrie A. 85% of veterinary staff harassed by pet owners over money. VetSurgeon.org website. vetsurgeon.org/news/b/veterinary-news/archive/2017/10/06/85-of-veterinary-staff-harassed-by-pet-owners-over-money.aspx. Published October 6, 2017. Accessed October 25, 2017.
  • Bell SK, Smulowitz PB, Woodward AC, et al. Disclosure, apology, and offer programs: stakeholders’ views of barriers to and strategies for broad implementation. Milbank Q. 2012;90(4):682-705. doi: 10.1111/j.1468-0009.2012.00679.x.
  • RCVS Council approves new College-funded mediation service. Royal College of Veterinary Surgeons website. www.rcvs.org.uk/news-and-views/news/rcvs-council-approves-new-college-funded-mediation-service/. Published October 13, 2017. Accessed October 25, 2017.
  • Headlee, C. We Need to Talk: How to Have Conversations That Matter. New York, NY: HarperCollins Publishers; 2017.
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