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Feedback: a double-edged sword

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SUCCESSFUL veterinary practice is about providing excellent service, and part of that certainly means responding to client feedback. But have we gone too far?

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I am mentoring a new graduate who works for a large chain of practices where, after each consult, the client is sent a computer-generated e-mail linked to a feedback form. Apparently, the feedback – positive or negative – is shared within the practice and any negative feedback automatically results in a meeting with management. The weight of these complaints – and the fact that the new graduate is expected to front up and ‘explain herself’ to the management – left her, as she described it, ‘getting little sleep and not wanting to see clients’. I don't blame her.

I should state that I firmly believe that a good veterinarian should be constantly seeking to improve, and if you ever think you've attained a state of practice perfection it's probably time to move on. But here's the thing: in the last two months my colleague has received no less than three ‘complaints’ from clients. On one occasion, she had told the client that she was not sure about specific treatment for an unusual toxicity and that she would need to consult a senior colleague. This is honest, appropriate and professional behaviour, but the client wrote on the feedback sheet that my colleague was deficient because she ‘did not know’.

The truth is that there are plenty of things that even experienced vets don't know – lots of them. And it is only as we mature professionally that we develop the skill of saying ‘I don't know’ confidently, in a way that implies ‘I am okay with not knowing … and I know it's okay not to know right this second.’ My newly graduated colleague, on the other hand, is the victim of her inexperience. It really made me think that, as senior veterinarians, we need to be role modelling confidence, not pulling up junior colleagues every time a client expresses doubt.

The other danger about soliciting feedback in this way is that it personalises everything. The client might be generally irate because they had to pay more than they expected or because their animal required more care than they anticipated – just as I'm never thrilled when my mechanic points out that my brake pads need changing. Being unprepared for another problem and the added expense, might prime me to take exception to what I ‘perceive’ as the mechanic's smug grin when I settle the account.

Similarly, by making the feedback all about the vet's performance, some of that negativity will inevitably be transferred onto the vet; that is, if the client is generally not happy to pay a bill, then they are more likely to be nit-picking about the vet responsible for it. Some clients might even be negative if they are annoyed about being e-mailed the online survey to begin with!

We know it isn't unusual to fail to meet a client's expectations; plus, how reasonable are some of those expectations in the first place? We're all familiar with the clients who expect us to ‘do everything’ to fix their animals, yet won't pay for diagnostic tests. Nonetheless, the online feedback surveys don't actually solicit information on what the clients' expectations might have been.

So is it valid to use this information in a performance review? It doesn't seem so. What we say to the client in the consult room, and the client's recollection of events, can be very different. Yet, this feedback might still be used to chastise, control and bully a vulnerable young veterinarian.

Far from promoting better service, such a system risks making veterinarians feel increasingly anxious when interacting with clients. Or, as happened in this case, driving an enthusiastic young vet to seek a position in a more supportive practice. That's one way to give your employers feedback!

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