Difficult clients: causes and solutions

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A lecture at the 2024 AVMA Convention explored the connection between workplace incivility and “terrible” clients

Photo: Jadon Bester/Adobe Stock

Photo: Jadon Bester/peopleimages.com/Adobe Stock

These past several years have seen a significant increase of client discontent and incivility,1 according to Debbie Boone, BS, CVPM, president of 2 Manage Vets Consulting, LLC—a veterinary practice management consulting company—with employees feeling overwhelmed by the demands of managing upset clients. But what if employees are the ones “creating ‘terrible’ clients”?

In a lecture at the American Veterinary Medical Association Convention in Austin, Texas, Boone talked about the causes of difficult client behavior. Boone postulated that difficult clients are in fact, often a reflection of the behavior they encounter during interactions with employees.1

Emotional contagion

Boone began her lecture defining the term ‘emotional contagion,’ which she used as the framework for her session. She described emotional contagion as the “phenomenon of having one person’s emotions and related behaviors directly trigger similar emotions and behaviors in other people.”1 According to Boone, early research on emotional contagion discovered that the foundation of this social contagion is interpersonal contact and mimicry, such as nonverbal cues like tone of voice, gestures, and facial expressions.

This finding means that negative behavior from staff will lead to negative behavior in clients because of the brain’s predisposition to mirror and mimic others.1 “Mimicry comes natural to humans because of the mirror neurons in our brain,” explained Boone.

Leaders and workplace incivility

In her session, Boone explained the crucial role practice leaders play in workplace behavior. “Practice leaders with high emotional intelligence create positive work environments,” she emphasized. “You're the role model. You set the tone for the behavior of the entire team. And those same models who are toxic, they also are spreading the toxicity through the rest of the team.”

Boone shared insight from the book The Cost of Bad Behavior: How Incivility Is Damaging Your Business and What to Do About It, by professors Christine Porath and Christine Pearson, which explores toxic and uncivil behavior in employees. “I highly… recommend it for all practice owners and leaders, because if you think that tolerating bad behavior is better than releasing or addressing the problem employees, you're going to be shocked at the actual dollar cost to your business of ignoring that,” said Boone.

Some examples of workplace incivility highlighted in the book include1:

  1. Taking credit for other people’s efforts
  2. Talking down to other people
  3. Not listening
  4. Not saying ‘please’ or ‘thank you’
  5. Belittling others’ efforts
  6. Failing to return phone calls

However, Boone explained that much of negative workplace behavior is a result of poor training and low emotional intelligence from practice leaders. “A full 60% of incivility occurs from the top down—it’s part of a power play. And the problem with these behaviors is they tend to kind of cascade down the line to the people of less and less stature, until finally, it's at the front line where your customer service team is now presenting that behavior to your client, and you wonder why the client is behaving badly,” said Boone.

“We are often, because of poor training; low emotional intelligence; and lack of awareness in our own mental fatigue, creating terrible clients, and then we have to deal with the consequences of them,” she continued.

Moreover, being in a bad mood can impact a medical professional’s ability to provide good medical care, according to the lecture. A 1993 assessment of a radiologist found that being in a positive mood enhanced the radiologist’s accuracy.1 “Positive mood has a far-reaching effect on work, performance, supervision, decision making, and even on team members voluntarily acting for the good of your organization,” said Boone.

As explained by Boone, drivers of uncivil and negative behavior include stress, negative emotions, a lack of community, reliance on technology, and lack of self-awareness or ignorance. “Incivility usually arises from ignorance and not malice.” Boone said, quoting Porath. “People lack self-awareness,” Boone said. According to research, 95% of people believe they are self-aware, but only 10% to 15% actually are.1

What can be done for the staff?

In her lecture, Boone gave advice for training employees to decrease workplace incivility, thus reducing client incivility. She suggested tools that help increase self-awareness, such as having cameras or mirrors near the workstation, and recording videos or calls so faculty can observe their conduct and make adjustments.1

Boone also recommended teaching visualization skills, like how to focus on positive client interactions and knowing when to zoom out during conversations with conflict. “What I want to do is… pull my focus back [and]… work to diagnose the situation by asking myself the following questions: What is this person feeling? How did I miscommunicate to set this conflict in motion? Why do they feel like they need to defend themselves? Where did their fear or feeling of disrespect originate. What can I say to deescalate this conversation?” Boone explained.1

Reference

Boone D. Terrible clients—toxic team. A cause and effect or a mirror? Presented at: American Veterinary Medical Association Convention; Austin, TX; June 21-25, 2024.

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