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Most complaints you’ll face in your career will not be about something you did, but about something you said. Or didn’t say, or because of how you said it, or how it was heard, perceived or interpreted.

Ah yes, communication – the final of the three Cs that will help you build trust.

Excellent communication is the cornerstone of trust in any relationship. Get it wrong and the entire thing can come tumbling down. In fact, the entire CTR-C framework is built on good communication.

But here are a few communication hacks that directly relate to building trust.

Listen

When we think of communication, we usually think of what to say and how to say it, but tend to forget about that thing that makes up – or should make up – at least half of every exchange we have: shutting up and listening.

And I mean really listening – without formulating your response in your head, or going through your differential diagnosis list while the client is speaking.

Listen carefully to exactly what the client is saying, and what he or she is not saying. Ask questions to get him or her to speak more, not less, so you can listen more.

This is a skill that takes time to develop and will take more time to delve into than this article permits, but suffice to say a large portion of the complaints I have dealt with in my leadership role stemmed from clients not feeling listened to.

Are you listening? Good. Let’s move on.

Speak

Speak the truth (also known as the no BS rule)

The good old white lie, the half-truth, the confident statement of “fact” based on nothing but personal opinion and a desire to just get home. I have witnessed masters of BS in action in many a vet clinic – and I got fairly good at it myself.

The scary thing is that many clients love a confident BSer – and even worse, you’ll eventually fool yourself.

But it is toxic to your team, erodes your professionalism, will reduce your enjoyment of your job over time, and, one day, your perfectly packaged parcel of poo will be revealed for what it is and is likely to explode in your face.

Keep your promises

We make promises to our clients all the time – from the implied big promises that come with your degree and our values as a profession, such as care, empathy, prevention of suffering and speaking
for those who can’t speak; to the explicitly stated small daily promises, such as “we’ll call you tomorrow with the blood results” or “you can pick her up at 5pm”.

Broken promises damage relationships. The latter group of promises may seem trivial, but neglecting these leads to death by a thousand cuts when it comes to any trust that you’ve managed to build.

Look, no one’s perfect – sometimes I promise my children I’ll watch a movie with them on a Friday night, only to be called out to work (or to the pub…). Stuff happens.

They key is to acknowledge the slip, apologise, and promise to do better. For example: “I promised we’d phone you with an update this morning and we didn’t – I’m sorry. I’m sure you were very worried. I’m blocking off time now for tomorrow’s telephone call.”

If done right, this can sometimes even strengthen the bond.

This also means you need to be very wary about making promises you can’t deliver. Most of us are people-pleasers, so we tell people what we think they want to hear. Setting unrealistic expectations sets us up to disappoint our clients, and puts us and our teams at risk of burnout.

Instead of “we’ll be done with surgery by 4pm and I’ll telephone you immediately after” when you know the day is likely to go crazy, try: “I’m aiming to be done by 4pm, but if we get emergencies it may be pushed back a bit. I’ll call you as soon as I’m done, but if you don’t hear from me you can presume it’s all good news. Feel free to telephone to check in any time, and once I’m happy that Fluff-nuts is stable and comfortable, I’ll sit down with a coffee and we’ll have a long chat. Does that sound good to you?”

Remember – the goal of our series is to have problem-free, complaint-free consult. It is very unlikely that a client will hold on to any serious feelings of anger, or allocate blame or complain about someone they like and trust. The client who is on your side may complain to you when a fissure arises in the trust, but the intention will generally be to restore trust, not to hurt you.

You want your clients to trust you. Trust me.

Welcome back to the series on the CTR-C method for complaint-free consults.

My previous post covered the first essential step in perfect consults – establishing a connection. Now, let’s look at the next essential thing our clients want to feel in their dealings with us – trust.

Think about your own dealings with other professionals – whether you’re buying your morning coffee, having new down lights installed by the local electrician or booking your spinal surgery. Somewhere in your head the following questions are probably floating around:

• Do you know what you’re doing?
• Will you do your best work for me?
• Are you telling me the truth?
• Are you going to try to screw me over?

Well, your clients are asking the same questions. So how do we address their unspoken concerns?

The great news is that because you’ve already established a connection with them, they desperately want to trust you. They like you, and they want you to be the vet to fix their problem. Now, let’s cement that connection by establishing trust.

In keeping with our theme of acronyms, let’s look at the three Cs of establishing trust – Confidence, Competence and Communication.

Confidence

How do you expect your clients to trust you if you don’t trust yourself?

Clients can sense uncertainty like a Labrador retriever senses treats in a pocket. They may still smile and be nice, but they’re probably thinking “I think I need to look for a real vet…” Does this mean you’ll only be able to have perfect consults once you’re a few years into practice and know everything?

The truth is that experience does indeed do a lot for your confidence, but it’s also true that it’s entirely possible for a recent graduate to be confident, just like it’s possible to be five years qualified and still struggle with a serious lack of confidence.

I’ve had to work quite hard on my confidence, so here are my favourite confidence boosting tricks.

Appear confident

This one is close to “fake it till you make it”, but I’ve learned about a much better way of looking at it: “Be it till you see it.”

If you consciously adopt the posture of a confident person – standing straight, shoulders back, chest out; like your gran told you – not only will others perceive you as confident (and, therefore, trustworthy), but you’ll also convince yourself.

An upright confident posture plays around with your serotonin levels to make you feel more confident; you’re tricking your brain into thinking: “We’re standing up straight – we must be feeling confident.”

And when others perceive you as confident and start treating you like someone worth respecting, you’re subconscious will notice this, which sets a lovely little hormonal feedback loop into motion.

Be confident about your intentions, skills and training

A confidence grows from being clear with yourself and others about your intentions, even when you don’t have all the answers and skills.

And let’s be clear – you will never get to a point in your career where you know everything. Ask any specialist and he or she will tell you the more he or she learns, the more he or she realises so much exists that he or she doesn’t know.

So, when you’re faced with that conundrum in the consult room and feel like a total fraud, you’re not alone. But be confident about what you do know, and be clear about your Intention to help and figure it out, no matter what it takes.

Be confident about your plan (sometimes this may mean, for example, finding an excuse to leave the room to sit somewhere quiet and scribble down a plan on a notebook). For example:

“Wow, this is a tricky one. I’m not 100% sure what’s going on here, but we’ll get to the bottom of it. Here’s what we’re going to do… And if I still haven’t figured it out I’m going to phone Dr X, who is the guru on this.”

Remember, you’re not an idiot. You’ve graduated from one of the toughest university courses, and you’ve proven you have problem-solving skills and grit, which is an unbeatable combination. So back yourself a little bit.

There’s one more important confidence builder, but it deserves its own heading as the second C of trust. So, the next part look at how to leverage Competence as a confidence and trust building tool.

Earlier this month, I closed a big chapter of my career when I sold my shares in the emergency clinic I started almost a decade ago.

Any big change lends itself to a period of reflection, and I’m enjoying looking back at what I’ve learned from the experience as an emergency veterinarian and team leader.

Clinical challenges

One lesson I was taught and retaught – and taught again until I finally understood – is that the biggest challenges we face in clinical practice do not come from the animals.

Clinical error or poor patient outcomes will happen, of course, but these account for a fraction of the stresses and misery we deal with. We’re pretty well equipped to deal with those.

Miscommunications and complaints, on the other hand – that’s what will keep you up at night.

Communication challenges

The nature of the work in emergency practice tends to amplify many of the challenges we face in general practice: unpredictability, potentially life and death cases, long shifts, and, of course, highly emotional people.

The majority of clients who present to you in an emergency setting are first-time clients. You don’t have pre-existing relationships and established trust to build on. Add to this the fact people who come to you at night are usually not there because they planned to be, but because something bad has happened. This means they are often frazzled, scared, worried, angry and tired. It’s a recipe for conflict.

So, you learn the skills needed to deal with it, or you don’t last. What follows is what I’ve learned.

Acronyms

Doctors love acronyms – and nowhere do we love them more than in emergency practice: GDV, MVA, MLK, CPR, the ABC (or CAB) of resuscitation…

When the shit is hitting the fan, you need all the brain space you can get.

I love any tool that makes it easier to remember what you need to be doing. With this in mind, I’ve made an acronym to help me remember what I need to do for problem-free client interactions.

Rather than relegate these as secondary “soft skills” with vague guidelines, I put these up there with those other critical acronyms. It should be part of our first principles of practice. I call it CTR-C.

What is CTR-C?

From dealing with client feedback and complaints during my time as team leader, I’ve realised most complaints are preventable if you tick a few boxes. CTR-C lists those boxes. It’s not so much the information we give to to our clients in our dealings with them, but more about how we make them feel.

The vast majority of complaints I deal with arose from situations where the following client needs were not met:

• connection
• trust
• reassurance
• clarity

The order of these four needs is important, as each builds on the one preceding it.

When someone feels a connection with you, he or she is unlikely to criticise your decisions – even if your decisions turn out to be wrong.

He or she will also be emotionally receptive to trusting you, despite the fact he or she hardly knows you. Without trust, your job of caring for his or her pet will be exponentially harder – and feelings of connectedness greatly facilitates feelings of trust.

Many situations in veterinary practice bring with them a lot of uncertainty and some very powerful emotions. It is vital clients feel reassured that you have their best interests at heart, and that they made the right decision to trust you.

Finally, clarity – I put clarity slightly separate from the others as it does not build on the other three, but, rather, circles back to re-enforce them.

Series

I can (and possibly will) write a book about each of these, but the next few posts will cover some tips on how to achieve each of these in a limited time period and under less than ideal circumstances.

• This article was first published in 2020