{"id":24309,"date":"2023-08-01T00:00:45","date_gmt":"2023-08-01T00:00:45","guid":{"rendered":"https:\/\/todaysveterinarybusiness.com\/?p=24309"},"modified":"2023-07-26T22:51:08","modified_gmt":"2023-07-26T22:51:08","slug":"bad-news-talk-the-talk-0823","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarybusiness.com\/bad-news-talk-the-talk-0823\/","title":{"rendered":"How to Deliver Bad News to Clients"},"content":{"rendered":"<p style=\"font-weight: 400;\">Periodically, veterinarians and other team members must convey sad or devastating news. For example, I\u2019ll never forget telling a young man that his 2-year-old golden retriever had a broken femur and pelvis. He couldn\u2019t afford the expensive surgery the dog needed. That was one of many instances when I had to deliver bad news. The situations are stressful and disheartening for everyone. Clients might react with tears, denial, anger, blame, guilt, shock or profound grief. Our teams dread sharing awful news and might not know how to handle a pet owner\u2019s emotions.<\/p>\n<p style=\"font-weight: 400;\">Let\u2019s look at best practices in different scenarios.<\/p>\n<h3 style=\"font-weight: 400;\"><strong>A Patient\u2019s Status<\/strong><\/h3>\n<p style=\"font-weight: 400;\">Telling a client about a pet\u2019s illness, prognosis or death is a common occurrence. For instance, you might have to inform someone that you diagnosed <a href=\"https:\/\/todaysveterinarybusiness.com\/diabetes-success-story\/\">a chronic disease such as diabetes<\/a> or that a pet\u2019s medical condition deteriorated. Even worse is when you report that a beloved companion has terminal cancer or died in surgery.<\/p>\n<p style=\"font-weight: 400;\">Here are the steps that should be part of any conversation focused on upsetting medical news.<\/p>\n<h4 style=\"font-weight: 400;\"><span style=\"color: #008000;\"><strong>1. DO IT IN PRIVATE<\/strong><\/span><\/h4>\n<p style=\"font-weight: 400;\">The setting usually is an exam room. Sit at the same level as the client. A wheeled stool is good, especially when seating is limited. That way, you can be at an angle and maintain a comfortable distance rather than sit directly next to or across from the owner.<\/p>\n<h3 style=\"font-weight: 400;\"><span style=\"color: #008000;\"><strong>2. SIGNAL BAD NEWS<\/strong><\/span><\/h3>\n<p style=\"font-weight: 400;\">This step is called a warning shot, which alerts clients that you don\u2019t have good news and gives them a moment to prepare. You might say:<\/p>\n<ul>\n<li>\u201cI\u2019m sorry I have some bad news.\u201d<\/li>\n<li>\u201cThe news is not as good as we had hoped.\u201d<\/li>\n<li>\u201cI\u2019m afraid the situation is more serious than we thought.\u201d<\/li>\n<\/ul>\n<h4 style=\"font-weight: 400;\"><span style=\"color: #008000;\"><strong>3. ALLOW EMOTIONS TO EMERGE<\/strong><\/span><\/h4>\n<p style=\"font-weight: 400;\">Recognize that pet owners will express a range of emotions. Therefore, give them time to respond to the news. You can validate feelings by saying:<\/p>\n<ul>\n<li>\u201cI can see this is upsetting and makes you very sad.\u201d<\/li>\n<li>\u201cI understand you\u2019re angry about hearing this outcome.\u201d<\/li>\n<li>\u201cYou\u2019ve done so much to care for Hannah. I appreciate that the news is worrisome.\u201d<\/li>\n<\/ul>\n<h4 style=\"font-weight: 400;\"><span style=\"color: #008000;\"><strong>4. CONVEY EMPATHY<\/strong><\/span><\/h4>\n<p style=\"font-weight: 400;\">Remember that empathy means being fully present with someone and giving them the space to display feelings. Your response at this point shouldn\u2019t be about offering <a href=\"https:\/\/todaysveterinarypractice.com\">possible treatment options<\/a> or trying to make the pet owner feel better. I was reminded of that advice when a friend told me her dog had been diagnosed with malignant melanoma. I gave her time to express her worries and love for her special companion.<\/p>\n<p style=\"font-weight: 400;\">Be mindful of your body language when showing empathy. Compassionate nonverbal communication includes a caring look, nodding your head, making eye contact and leaning in slightly.<\/p>\n<p style=\"font-weight: 400;\">Here are excellent empathy statements:<\/p>\n<ul>\n<li>\u201cI\u2019m so sorry to hear about Davie\u2019s diagnosis.\u201d<\/li>\n<li>\u201cI imagine you are worried. We will help you in any way we can.\u201d<\/li>\n<li>\u201cI know this isn\u2019t what you wanted to hear.\u201d<\/li>\n<\/ul>\n<h4 style=\"font-weight: 400;\"><span style=\"color: #008000;\"><strong>5. \u201cCHUNK AND CHECK\u201d<\/strong><\/span><\/h4>\n<p style=\"font-weight: 400;\">Remember that people need time to process bad news, and you don\u2019t want to overwhelm them with too much detail about a treatment or prognosis before they\u2019re ready to hear about it. Start with a few details, then pause to ask an open-ended question such as, \u201cWhat questions do you have regarding what I\u2019ve covered so far?\u201d<\/p>\n<p style=\"font-weight: 400;\">Providing a few small details at a time allows the client to participate in the conversation. You also might need to give pet owners the time to think about how they want to proceed. You could ask, \u201cWould you like to think about your options or call someone?\u201d<\/p>\n<h4 style=\"font-weight: 400;\"><span style=\"color: #008000;\"><strong>6. BE COMPASSIONATE AND REALISTIC<\/strong><\/span><\/h4>\n<p style=\"font-weight: 400;\">Unless the pet died, strive to maintain hope and optimism about the outcome. Even if it looks bleak, this step gives a client the time to come to terms with the treatment plan and prognosis.<\/p>\n<p style=\"font-weight: 400;\">Explaining a realistic outcome is critical so the client knows what to expect. Here are examples of what to say:<\/p>\n<ul>\n<li>\u201cI\u2019m hopeful the surgery will successfully correct Oscar\u2019s laryngeal paralysis.\u201d<\/li>\n<li>\u201cIn my experience, this treatment plan can help Bella live comfortably for some time.\u201d<\/li>\n<li>\u201cTreating a dog with congestive heart failure can be challenging. We\u2019re here to help you manage Duke\u2019s medications and care.\u201d<\/li>\n<\/ul>\n<h3 style=\"font-weight: 400;\"><strong>When the Unexpected Happens<\/strong><\/h3>\n<p style=\"font-weight: 400;\">One of the most challenging scenarios occurs when something goes horribly wrong. The situation might call for you to report that the client\u2019s dog ran out the front door and that the team is looking for him. Or maybe someone gave the client\u2019s cat the wrong medication. Or perhaps the team didn\u2019t order an individual cremation, or someone lost the pet\u2019s ashes.<\/p>\n<p style=\"font-weight: 400;\">After you signal the unfortunate news, be direct, clear and transparent that something terrible happened at your practice. State the facts and then explain what someone is doing to correct the problem or help the patient. Let the client know you will do everything you can to avoid a recurrence.<\/p>\n<p style=\"font-weight: 400;\">Be sure to document the incident and client communications in the pet\u2019s medical record. Contact your liability and insurance company if appropriate.<\/p>\n<p style=\"font-weight: 400;\">Bear in mind that the best way to handle such situations is to apologize and express empathy. Use phrases such as:<\/p>\n<ul>\n<li>\u201cI\u2019m so sorry this happened. Please know we\u2019re doing everything we can to help.\u201d<\/li>\n<li>\u201cI can imagine how difficult this is to hear and that you\u2019re worried about Tigger.\u201d<\/li>\n<li>\u201cI understand this is extremely upsetting. We\u2019re looking at our protocols to see how we can prevent future mistakes.\u201d<\/li>\n<\/ul>\n<h3 style=\"font-weight: 400;\"><strong>Discussing the Cost of Care<\/strong><\/h3>\n<p style=\"font-weight: 400;\">Meanwhile, conversations about money can become emotional, particularly if a pet owner isn\u2019t prepared for the cost of care. Such a reaction might happen if a team member failed to outline a treatment plan and associated costs before admitting a patient. Or perhaps the dental bill is double the estimate.<\/p>\n<p style=\"font-weight: 400;\">The best approach to talking about money is to engage in transparent, empathetic dialogue and provide payment options. Here is an example:<\/p>\n<p style=\"font-weight: 400;\">\u201cI\u2019m sorry to tell you that we discovered Ginger had two bad teeth, which required surgical removal using a gingival flap to suture over the extraction site. This means her oral treatment costs more than you expected. I know it\u2019s expensive. We have payment options to help you spread out the cost of care.\u201d<\/p>\n<p style=\"font-weight: 400;\">How well you deliver bad news can affect whether a client stays with your practice. Being truthful and conveying empathy builds trust and enhances loyalty, which ultimately helps more pets get the care they deserve.<\/p>\n<hr \/>\n<h3 style=\"font-weight: 400;\"><span style=\"color: #008000;\"><strong>START WITH \u2018S\u2019<\/strong><\/span><\/h3>\n<p style=\"font-weight: 400;\">Physicians developed the SPIKES Model to help deliver bad news to cancer patients. It also can be used with pet owners. Here are the six steps.<\/p>\n<p style=\"font-weight: 400;\"><strong>S:<\/strong> Setting (Choose the best environment, with all parties present.)<\/p>\n<p style=\"font-weight: 400;\"><strong>P:<\/strong> Perception\/perspective (Ask questions to see what clients know or feel.)<\/p>\n<p style=\"font-weight: 400;\"><strong>I:<\/strong> Invitation (Ask for permission to proceed with a discussion.)<\/p>\n<p style=\"font-weight: 400;\"><strong>K:<\/strong> Knowledge (Convey a \u201cwarning shot\u201d and offer information in small chunks.)<\/p>\n<p style=\"font-weight: 400;\"><strong>E:<\/strong> Empathy\/emotion (Respond with empathy.)<\/p>\n<p style=\"font-weight: 400;\"><strong>S:<\/strong> Summary\/strategy (Be supportive, and discuss the next steps.)<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Empathy and transparency are paramount in any conversation about troubling matters involving a patient.<\/p>\n","protected":false},"author":19,"featured_media":24310,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":0,"footnotes":""},"categories":[407],"tags":[],"class_list":["post-24309","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-august-september-2023","column-talk-the-talk","clinical_topics-client-communication"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.7 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>How to Deliver Bad News to Clients | Today&#039;s Veterinary Business<\/title>\n<meta name=\"description\" content=\"How well you deliver bad news can affect whether a client stays with your veterinary practice. 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