Today's clients are different, but in many ways you've never consider, they might be the same as they've ever been. Delve into two important ways veterinary clients fear the wrong action far more than no actionand what you can do about it.
Fear, loss aversion and status quo bias can make us afraid of the wrong things and lead us to poor decisions. (Photo: Getty Images)“Faith, hope and love, but the greatest of these is love.” - 1 Corinthians, 13:13
You'll notice guilt is not on that list, but guilt is huge.
Loss is one of the most pervasive of all human experiences. Seeking to avoid loss has a powerful allure and silently plays into almost every decision we and everyone around us makes.
Loss aversion is a terrific source of both emotional motivation and terrible error-one of many such tendencies hijacking our brains and pushing us toward poor choices. That includes veterinarians, veterinary team members and, yes, pet owners.
The comfort of doing nothing
People tend to deeply fear taking regrettable action. Acts of commission come with a high emotional price tag. If something bad eventually happens “on its own,” then it was apparently unavoidable … meant to be … God's will … fate. But if we take action that results in a loss, then we can't avoid the associated blame, not only from ourselves but also from other stakeholders.
When we take no action, we're protected by the comfort and safe haven of the status quo. Who can blame us?
“It was like this when I got here.”
“It's not my fault.”
The status quo bias is a powerful force in our lives, a bastard child of loss aversion.
The case of the bulldog's tumor
I called a client recently to give pathology results for a tumor we removed from the paw of his bulldog Churchill. (I'll change the names to protect the innocent, loving pet owners.) By the time Churchill showed up in my practice, the tumor had already been determined by another veterinarian to be a squamous cell carcinoma. I remember standing in an exam room as Churchill's owner told me, “We need to do everything we can,” while his relative stood behind him drawing her hand horizontally across her neck emphatically miming the word “no” over and over.
His relative stood behind him drawing her hand
horizontally across her neck ...
I assumed the pet owner's relative was concerned that he was spending too much money on a lost cause. At some point in the conversation I intimated that my wife (a veterinarian herself who has been my partner in life and in practice) and I had raised bulldogs for more than 12 years. Suddenly, everything changed. Turns out the problem wasn't the money (yeah, I know-surprising, right?). The problem was she believed bulldogs couldn't survive anesthesia. When she learned we were experienced with anesthetizing bulldogs, she was all for taking action. Their status quo bias about the safety of anesthesia kept them from taking action and let the tumor grow large unnecessarily.
These are intelligent, well-intentioned pet owners who care deeply about Churchill. Even so, their fear of regrettable action became a self-fulfilling prophecy of poor results. The allure of the status quo won out even though the status quo was obviously undesirable.
The case of the bad-mouthed Yorkie
Imagine you're presented with an 8-year-old Yorkie with horribly neglected teeth. You wonder how anyone could have such an odiferous mess inside a home, let alone in a person's bed. You dutifully produce a treatment plan to address the issue. But the client “loves him too much” to allow the treatment to go forward.
You explain that the Yorkie will likely end up with kidney disease or another related problem, assuming he doesn't have such a problem already. But the pet owner is steadfast. If her dog gets kidney disease, then it was unavoidable, bad luck, just something that happens to dogs, but if her dog dies under anesthesia during a dental procedure then she's responsible for his death. This isn't necessarily a well-reasoned, conscious decision for her-it's a feeling she has tied to how bad each outcome would make her feel.
If her dog gets kidney disease, it was unavoidable, bad luck ...
but if her dog dies under anesthesia then she's responsible for his death.
The veterinarian likely hopes the client can weigh actual relative risks and likely outcomes instead of relying on her gut reaction of irrational fear based on nothing. I suspect many people highly bonded to animals live in constant fear about everything that could hurt or kill their pet. We aren't going to save them from the dark side in a 15-minute veterinary visit, but neither should we give up in shining the light of facts and reason on the situations. Some pet owners may listen to reason-which is the only (albeit anemic) way to combat irrational fear.
People tend to feel that taking action comes with risk while taking no action is a solid way to avoid risk. Of course, try telling that to a ship load of people heading toward an iceberg or a woman whose dress is falling off about to become an embarrassed YouTube star, or to a person with a Yorkie with horribly neglected teeth.
The case of the irrational human-that's you, me and everybody
Why we do what we do
Kinda jazzed about our shared subconscious motivations and irrational thinking? Here are Dr. Jim Kramer's favorite books on the subject ...
Predictably Irrational: The Hidden Forces That Shape Our Decisions by Dan Ariely
The Invisible Gorilla: How Our Intuitions Deceive Us by Christopher Chabris and Daniel Simons
The Power of Habit: Why We Do What We Do in Life and Business by Charles Duhigg
Blink by Malcolm Gladwell on why the best decisions are sometimes so hard to explain to others
Thinking Fast and Slow by Daniel Kahneman on the two systems that govern our thought: the fast, intuitive and emotional; and the slower, more deliberate and more logical. (Better know which one you need!)
How We Decide by Jonah Lehrer
Nudge: Improving Decisions About Health, Wealth and Happiness by Richard Thaler and Cass Sunstein
200% of Nothing: An Eye-Opening Tour Through the Twists and Turns of Math Abuse and Innumeracy by A.K. Dewdney
Innumeracy: Mathematical Illiteracy and Its Consequences by John Paulos
Why Smart People Make Big Money Mistakes and How to Correct Them: Lessons From the Life-Changing Science of Behavioral Economics by Gary Belsky and Thomas Gilovich
Freakonomics: A Rogue Economist Explores the Hidden Side of Everything by Steven Levitt and Stephen Dubner
The Human-Animal Bond and Grief by Laurel Lagoni, Carolyn Butler and Suzanne Hetts
Loss aversion and the status quo bias are invisible forces that affect all of us. They're unconscious tendencies caused by innate autonomic responses inside our brains that occur without our knowledge. But we can work to overcome them if we're conscious of the power they hold over our thoughts and feelings.
Like the owners of Churchill the bulldog, sometimes we can analyze the actual risks involved of action vs. inaction and make better decisions. Like the Yorkie's owner, sometimes we're too emotional to be won over with reason. We can't save everyone-but that doesn't mean we shouldn't try.
Once we veterinarians and veterinary team members recognize the power of loss aversion we can provide leadership and guidance to help keep others from crashing against the rocks of the status quo bias. We can listen and learn what's frightening or bothering a particular pet owner and help evaluate actual risks and likely outcomes, instead of relying on feelings of perceived risks. And we can make decisions in our own lives based on actual likely outcomes instead of invisible automatic reactions ruled by irrational fear.
Jim Kramer, DVM, CVPM, is a Veterinary Economics Editorial Advisory Board member and a partner at Columbus Small Animal Hospital in Columbus, Nebraska.