Pula, the lost lurcher.

While I was working at a small animal practice in England, a  kind Samaritan dumped a lost lurcher (type of rough looking greyhound) with a broken leg on us one Wednesday. I phoned the RSPCA who referred us to the town council. On Thursday a man from council phoned back, asking us to go ahead with the required surgery. I operated on Friday - a long and difficult bone plating. With much perspiration and perseverance I achieved a pretty good fix. I did not even mind missing lunch for the 5th day that week, I felt such a warm glow of achievement.

 

At some point during the surgery a man arrived to empty the freezer where dead bodies are kept. We were surprised to see him as he normally arrived on a Monday before we start work. He told us there had been a change in schedule. So he collected seven dead fish, two dead budgies and a rotten rabbit and left with his loot. (We were attached to a pet superstore). Watch this space.....

 

The dog woke up and had a hearty meal a few hours later. I took him out to sniff the trees before closing time, but he preferred to flood the surgery floor instead. After we left, his dinner passed through his intestinal tract as all good dinners do and he spent all night smearing it across his kennel walls. The next morning I took him out for a walk, leaving the poor nurse to deal with the mess. The dog, whom I had named Pula (Setswana for blessing), because we would be blessed if anyone actually paid for his treatment, sniffed the grass, greeted the passers-by, and had a large bowel motion just after we returned to the surgery.

 

There was work to be done, so Pula was returned to his kennel against his wishes. He vocalized his objections very loudly. The store manager complained that his customers would complain. Every spare minute we had, we tried to console Pula. We had several walks, pleading sessions and even a few firm requests to BE QUIET! Most of the day we could not hear ourselves think. Sunday was much the same. By Monday our nerves were sufficiently frayed to resort to the use of tranquilizers for the dog - though we needed it more, especially when another freezer man arrived and declared that the Friday freezer man was a fraud. A body snatcher on the loose?

 

By Tuesday the pet store staff were beginning to take an interest in Pula and started taking him outside during their staggered tea breaks. The dog was delighted with his new friends and admirers and we had peace at last. When they brought him in on Tuesday evening, he was gambolling like a calf, ecstatic with all the attention. The following morning Pula was raring to go out again. We did our customary walk to the bushes resulting in Pula soiling the surgery floor on our return as usual. Then he stood quietly to have his temperature taken and bandage changed before trotting expectantly to the cupboard where his tablets are kept. He had grown accustomed to the fact that he regularly received them with a tasty snack. The only thing we could not teach him was how to be quiet in his kennel. I was delighted when the shop staff came and asked if they could take him out again. When I checked on him later he was surrounded by friends and well wishers - even the staff from the shop next door were visiting him regularly.

 

Late Wednesday morning the council's dog warden arrived - being towed in by a large woman from a dog sanctuary. She introduced herself. As she is named after a bodypart, let's call her Mrs Bodypart. She sailed into my consulting room uninvited, demanding to know everything about the dog's treatment. I explained that due to the initial open fracture and severe bruising, the wound was still oozing and the bandage would have to be changed every 48 hours. When I asked whether she would be comfortable doing this, she declared huffily that she had been "doing this" for 35 years. Then she said it was not normal to change a bandage so frequently, she had never come across it in 35 years of dealing with dogs and implied that we were just doing it for the money. I patiently tried to explain that no, an open fracture accompanied by severe bruising was not normal, but given the abnormal state of affairs, we had no other choice but to change the bandage frequently. I did not tell her that my salary remained the same, whether I did a lot of work or a little work, and given the choice I'd rather do a little work, but this dog was my friend in a foreign land, and hey, the way he greets me in the morning is payment enough.

 

Meanwhile Mrs Bodypart was in full sail and demanded to be shown said dog, who happened to be visiting the loading bay. As everyone was momentarily occupied they had chained him to a pallet in full view of where they were working. Pula wagged his tail as he heard my voice. The next moment Mrs B went ballistic about the incredible cruelty and irresponsibility of chaining this poor creature up where he is not receiving any veterinary attention, being watched over by ignorant members of the public. I tried to explain that they were not ignorant, nor members of the public and were very caring. The dog was happy, we weren't ignoring him and anyway if he was indoors he was so noisy that we had to tranquilize him. Hoo Boy, I should not have said that! Now she was off on a new tangent. I tried to defuse the situation by asking whether she would be able to bring the dog in on Friday so that I could demonstrate how I wanted the bandage change done. No, she said, she was not bringing the dog back to this terrible place where he was chained up to pallets. She wanted to see the bandage change now. I tried to explain that doing it the second time in one day would incur unnecessary expense. More ammunition for Bodypart: "This is what it is all about, money....... etc. "

 

By now the "ignorant members of the public" were gathering around, jaws agape. I was afraid a fist fight might ensue if Bodypart kept hurling abuse, so I managed to head her off to the relative privacy of my consulting room. As a precaution, I called a nurse in as a witness and demonstrated the bandage change. This activity calmed me a little and I was able to take a step back and let it all wash over me. I thought about becoming a ferry pilot and wondered if having an engine failure over the North Atlantic could be remotely as stressful as this. Meanwhile the nurse, who in addition to her nursing qualification, had 5 years vet nursing experience and a basic law degree, tried to placate Mrs. B. When I got my engine restarted after a nice adrenalin rush off the coast of Newfoundland and returned to the present, Mrs B was telling the nurse how young and stupid she was and that she knew nothing about anything, let alone dogs.

 

This enraged me, and as I my imaginary near death experience over the ocean had given me courage, I said as evenly as I could: "I appreciate your concern for the dog, but I am very offended by your attitude. We have all done our best to treat him and make him comfortable and happy and we do not deserve such treatment."

 
She left amidst threats of reporting us to the company and anyone else who would listen.
 

We have thought long and hard on how to resolve this problem and have come up with the ultimate solution. We'll lure her in on Friday when Bodysnatcher comes ......

 
 

Dealing with client complaints about colleagues.

What if a client complains to you about a colleague?

Clients may be unhappy with the service, price or result from another veterinarian and come to see you. Occasionally it is much easier to diagnose a condition accurately if the previous vet has already eliminated a few DD’s and the condition is more advanced. Do not be tempted to make derogatory remarks about a colleague, even if you believe he was mistaken. You did not see the case at the time he first saw it, and the client is most likely putting their own spin on it, whether deliberately or due to lack of understanding. Never intentionally belittle a colleague’s competency. It reflects badly on the profession as a whole.

Do not make comments that may be misconstrued by an already disgruntled owner.

Do not say “ we would have approached this case quite differently”, or “your vet does not know what she is doing”. Referral specialists should also not expect general practitioners to know as much as board certified specialists.

You should reserve judgement until you have had the opportunity to investigate your colleague’s conduct fully. Things to consider include the economic restrictions the client may have indicated to the veterinarian, whether or not the client disclosed all the facts required to make a reasonable diagnosis and whether the client was given the opportunity to consider other treatment options before proceeding.

Often a short telephone call is all that is needed to clear up any confusion. One should get the patient’s history from the attending veterinarian as a matter of course. This is necessary both from a medical and courtesy point of view.

Comments from a hurried colleague's less than thoughtful response can plant the seeds of client concern. It is important to remain professional without giving clients unsolicited opinions.

Responses that may be appropriate include the following:

• I need more information to draw any conclusions. I would like to discuss this matter with Dr. X first before commenting on the treatment your pet has received so far.
• The main thing we need to do now, is help your pet. I will discuss your concerns about his previous treatment at a later stage. 
• This appears to be a complex case, and although I may have followed a different approach, it is quite understandable that your vet did what he did under the circumstances.

The intention is not that there should be a conspiracy of silence. Veterinarians are professionals who should take responsibility and be accountable for their actions. Truly irresponsible, negligent or unprofessional colleagues should be reported and dealt with by the Board or the courts. However, veterinarians should consider how their statements and comments will impact on other veterinarians and the profession. Think before you speak!

Dealing with Client Complaints

Even the most dedicated vet in the world will have to deal with client complaints at times. Some may result from misdiagnoses, complications of treatment or surgeries, or unsatisfactory outcomes of cases.  Many result from lack of understanding on the clients part, or poor communication from the veterinarian's side, or simply because the client was not treated with enough empathy, consideration or respect. Money often raises its ugly head.

Clients have certain expectations of their veterinarians, over and above the knowledge, skill  and equipment required to heal their animals. The presentation of the building, its surrounds and the staff are most important. I have heard of complaints and comments about peeling paint, dead pot plants  barefoot veterinarians, dirty fingernails, blood on the vets elbow, newspaper cutouts reflecting a personal political agenda in a waiting room, waiting room too small, too untidy, smelling of dogs, etc.

It is most important to present your premises and yourself as well as you can at all times! Have mirrors in non public areas  or rest rooms where vets can quickly check their hair before going to see a client. Even a neat ponytail can unravel under a surgical cap, or after a long day at work!  Do check for blood spatters on your face or person as well!
Always dress neatly and professionally, and wear neat, practical closed shoes (preferably not brightly coloured running shoes). Check the underside of your forearms when washing up after surgery or treating messy wounds or animals.

Pay attention to the general appearance, cleanliness and neatness constantly  You may get used to that dead pot plant by the front door, but a client notices it. Everything about you and your clinic should proclaim that you care! Wall decorations should be neat, tasteful and professional. Unlaminated posters soon look tatty. Too many informative posters also look confusing and too busy. Strive to create a sense of calm. Clean up any animal messes immediately. Use air fresheners and have good ventilation in your building if possible.

Most complaints can be avoided in the first place by clear explanations in plain language about an animals condition, diagnosis and differential diagnoses. Make sure that the client understands what you are saying. Use a whiteboard to sketch and explain things. Explain what you believe the best course of action will be for the sake of the patient. Be clear about the planned treatment schedule and its cost. Avoid disclosing only the initial cost, and then surprising the owner with a much higher bill later. If other tests or procedures become necessary during the course of treatment, it is most important to clear these with the owner first.

Keep thorough records.

Speak common words. Many clients do not know medical terminology. Look the owner in the eye when addressing him or her. As a vet we are often focused on the animal, as we should be, but do not forget the owner! They are concerned about their animal, and need to be reassured that you care about them as well.
Touch the animal gently early on in the consult and often. Be kind to the owner and the pet. Encourage questions and answer them. Practice your powers of observation. Examine the animal before rattling off a list of DD's. Keep an open mind - maybe your first diagnosis is not the right one!

Look after yourself. If you are ill, take time off. You may feel it is dedicated to go to work even when sick, but you cannot give your best and your clients will feel that they are not getting their money's worth, plus they do not wish to catch your cold or flu.

When things go wrong and clients complain, it is most important to remain calm and professional and address the problem methodically and quickly. Do not play the blame game and do not try to defend the practice or the vet. Solving the problem effectively can create happy clients and even generate referrals.

1. Respond to the letter, e-mail, phone call, blog post or tweet as soon as possible, no matter how outrageous. Listen to the client carefully to understand the problem, rather than the emotion clouding the issue. Try not to interrupt the client. If a client is making a scene in the waiting room, attempt to move the conversation to a more private place.

2. Attempt to understand the situation. Acknowledge the issue raised. Reiterate the perceived problem as you understand it. Do not take it personally, even if the client is personal and insulting. Do not react defensively, even if you feel wronged. Keep an open mind. Write down anything you think is important and ask questions to clarify the issue. Do not attempt any explanation for the practice's action at this stage.

3.If the practice has a complaint form (it should), complete the form and ensure the client is satisfied with what it says.

4. Offer an apology, regardless of your opinion. You can always say "I am sorry you are upset", "I am sorry you feel this way", "I am sorry, that was not our intention", "I am sorry that this has caused you distress", etc.
In some instances a more specific apology may be seen as an admission of guilt, so from a legal point of view one should be careful. However, the examples mentioned expresses your sympathy and may have a calming effect.
5 Always remain calm and composed and do not raise your voice, In fact it is advisable to speak slower and softer than normal. Do not become irritable, remaining calm will help prevent you from saying something you might regret and which may have detrimental effects for the business. If you do become angry or irritated, tell the client you will call back, and take some time to calm down first.
6. Remain optimistic. Focus on what you can do to help, rather than on what you cannot do.
7. Consider the future of the business. Show genuine concern and a desire to resolve the issue. You do not want to damage the reputation of the business by becoming defensive and retaliating in kind to a rude or unreasonable client.
8. Keep your client in the loop. If you are unable to resolve the situation immediately, let the client know, and then keep them informed of the progress and explain how you are tackling the problem.
9. Own the problem. If you can , solve it yourself. If not, delegate it to the person involved or responsible. If you were the first point of contact the client will want answers from you, so follow up.
10. Work out a similar problem may be prevented in future. Make a note of lessons learnt and adapt protocols if required.
11. If a problem is serious and you are unable to resolve it, consider getting legal advice for impartiality and a new perspective on the problem.
12. If the client becomes abusive or threatens violence, staff should consider their physical safety first. Remain polite, but be firm. Indicate that it might be best for the client to return to discuss the issue when they have calmed down.
Seek assistance from a senior staff member.
If the situation is dangerous, call the police and//or use the panic alarm.
You are there for your clinical expertise and should not be treated as an emotional punchbag. You have the right to be treated respectfully. If this respect is no forthcoming you do have the right to refuse to engage.
13. Get professional help in case of a serious complaint which may go to a board or a court.

Writing a CV for your first job as a vet.

Writing a Curriculum Vitae for a job in veterinary practice.

A CV is a summary in point form of your personal details, your qualifications, academic achievements, skills, experience and interests.

All job advertisements will ask for a CV. Although it is not the only thing considered, a well presented CV is a good start.  It can be of use to sell yourself especially in the "Interests" and "Special skills" sections in a profession where the applicants you are competing with, have the same qualification as you.

Your CV should present well and be free of spelling or grammatical mistakes. It is very important that it is concise, clear and accurate and above all truthful.

Including a photo in which you look neat and professional may help your CV stand out. Use standard, neat lettering. Do not attempt to make your CV stand out with the use of decorative edges, bright colours, etc. Using neat blue headings and bullet points is Acceptable. The CV must both look good (professional) and be easy to read.

Personal information

Your full name
Your address (both at Uni and at home)
Date of birth (optional)
Contact numbers and e-mail address
Marital status and nationality (optional)

Health - if excellent you can make a remark. Any health issues which may impact on the job you are applying for must be disclosed at the interview after the prospective employer has met you and will be able to assess you fairly.  However you do not not need to disclose them in the CV.

Employment and Education History
Tertiary

List degrees and institutions
Unfinished degrees are not listed. You may refer to a course in progress in your cover letter.
List any academic or leadership awards.
List any other training that may be relevant to your career, e.g languages.

Secondary
List institution where you completed high school.
List awards, leadership positions, academic distinctions.
A list of academic results is not necessary.

Special Skills - Any additional qualifications or skills  - computer literacy, First Aid, Hills Nutrition Courses, certificates in anything! Please note that some skills may be more appropriately listed under "Interests".

Professional Employment History 

In the absence of previous employment as a veterinarian, list your major placements and any employment that may be considered "veterinary" or animal related. This would include experience as a vet nurse, or general practice assistant, or even holiday employment in retail or customer service roles. List these experiences in reverse chronological order. Include a brief description or your duties and responsibilities at each job.

Course Related Work Experience
List academic associate practices where you have spent time and give a brief description of the practice type e.g., Companion Animal, Mixed or 85% Small animal and 15% Equine.

Area of Special Interest

If you have special interests or skills, by all means flaunt them. As a new graduate you may have developed a particular interest in an aspect of veterinary work. It is even better if you can demonstrate this. Many practices would for instance like to have someone keen on ultrasound, or exotics, or clinical pathology. You could write a few sentences about your final year electives, but keep it brief.

Hobbies and Interests 
List them all. many employers want to know that you are a well rounded person. If you and a potential employer share certain interests, it could be a plus.

Referees

Three referees are standard. It is acceptable to list more, but they may not all be contacted, so list the "best" ones first.
If you are able to list practicing vets, this may bear more weight than your academic contacts. Your academic contacts may be unwilling to promote one student over another.
You must always get permisson from your potential referees. Most are flattered and delighted to be asked.
Written references are a bonus, but not essential.

REMEMBER TO CHECK YOUR GRAMMAR AND SPELLING METICULOUSLY!