Difficult client encounters

A difficult client encounter between a veterinary staff member and a client is normally characterised by problematic communication and/or the triggering of unpleasant emotions for either or both parties.

Typical difficult client encounters reported by veterinary professionals include situations where:^1-2

• the client demonstrates negative responses (e.g. anger, aggression) or uses communication strategies which are perceived as ‘rude’;
• internet-(mis)information impedes the conversation;
• a clash between the beliefs and values of the client and veterinary professional occurs;
• the client has a long‘shopping list’of what they would like to address in a visit;
• complex clinical situations with an emotional aspect, e.g. breaking of bad news, discussing veterinary costs.

Whilst there is scant research-based evidence on difficult veterinary-client encounters,^3-4 we can draw insight from human medicine where several decades of work exists. Our human counterparts estimate that approximately one in every six interactions with patients can be classified as ‘difficult’.⁵ It is also recognised that such interactions can have a real and negative impact for healthcare professionals; one US study revealed that physicians who perceived a higher volume of difficult encounters were significantly more burned-out and dissatisfied with their jobs than those reporting fewer difficult encounters.⁶

In human medicine, discourses have evolved from use of the terms‘difficult’or ‘heartsink’patients (which have the potential to problematise – or place blame with – the patient) to those of‘difficult‘encounters/relationships’. The latter term better reflects current thinking, i.e. that the reasons behind difficult patient/client encounters are multifactorial. Three contributing components have been proposed:^7-8

1. Situational issues – time pressures, hectic environment, language/literacy barriers, financial constraints, multiple people in the consult room;
2. Doctor-related factors – personal anxieties, motivations/values/beliefs, tendency to defensiveness, being“overly nice”;
3. Patient/client-related factors – tendency to anger or defensiveness, unrealistic expectations, relationship/bond with animal.

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