Friday, April 21, 2017

Lock Down At The Veterinary Clinic.

Twice. This has happened twice in about 4 years. The vet clinic has gone into lock down over a client showing up enraged and threatening us..


There are safety and terrorist drills that every place of business, social meeting area, community gathering place and institution needs to practice. Sadly, this also includes the veterinary hospital.

Both cases of lock-down were eerily similar; an enraged client came in seeking immediate action after their phone calls to the clinic were not answered quickly enough. The phone calls were belligerent, accusatory, demanding, threatening and intimidating to the girls at the front desk. The front staff are not naive to difficult phone calls. They tried to explain that the messages had been delivered and that someone would get back to them. This wasn't an acceptable answer.

The phone calls start as short and frequent. They quickly (within hours) escalate to demanding and threatening. The avalanche has started and you should expect the rest of the catastrophic destruction to follow.

The next action was to show up at the clinic enraged. Their anger has turned into threats and demands in person and with immediate expectation of engagement.

There is nothing you can say or do at this point other than to call the police. You don't know what these people are capable of and you cannot diffuse this situation and concurrently take care of your business. From my perspective I am also responsible for the health and safety of the other clients, staff and patients in our care. I don't dare risk their emotional or physical safety, and my ego doesn't believe I am a superhero who can swoop in to save the day. I have learned to NOT ENGAGE.

There is a back story to the culmination of these lock downs, (of course), they all went a little like this;

New pet parents arrive with Amish puppy mill, OR, Craig's List, puppy a few weeks earlier. It is very apparent to everyone that they are unprepared and uninformed about the cost, care, and responsibility of owning a pet. All routine pet services are explained in detail, associated costs provided and many are dismissed as being "not needed" or "too expensive". It is not uncommon, nor unreasonable to space out vaccines, visits, services and instructions for new pet parents rather than try to overwhelm and scare them away. We take our time and break the whole process into little easily digestible pieces. These visits take a huge amount of time and energy. They are also vitally important for the safety, well fare and well-being of these clients and patients. As is customary for us we offered brochures on products (preventatives are often confusing and difficult to understand the value of with new parents), and vaccine schedules. Written personalized instructions go home with the owner along with pre-booked next appointments. In this particular case I also strongly encouraged enrolling in a puppy/new pet classes. Phone numbers and recommendations are also given for these. We go to great lengths to provide a safety net and support network to new parents.


There are vet visits where you feel like a pre-puppy/pet-selection process should be law. There should be a screening process, an application, a review of the home and a waiting period. This requires time and patience. You can buy an Amish/Craig's List puppy/pet cheap and get them quick.

The clients admit to their pet purchase because they had been turned down by all of the rescues. People may castigate the potential adoption process but it has its purpose and reason and is often correct in their assessment of adopters.


Not everyone should have a pet. They are not little neatly packaged ready to go inanimate creatures. They are the worst example of Ikea's "lots of assembly required" challenges. They have needs. Their needs have zero respect for yours. There is no ideal time for a broken bone, infection or acute diarrhea episode. When they happen (and they always do) the unprepared new parents with angst and disdain always behave the same.. Anger, yelling and excuses about a "defective pet." (I cannot even tell you how many times I have had this discussion).

What I have to politically say nicely is "All pets come with and will have medical and/or behavioral challenges." They are intelligent, intuitive, needful beings. They need help with the challenges of life like all of us do."

BUT,

What I want to say is; "What the hell were you expecting? A pre-programmed self sufficient robot? Of course they cry for attention. Of course they will poop and pee in your house if you haven't trained them. Of course they need love and exercise!"

The worst cases of new pet parent failures end in death. I have come to know this, fear this, and see this. If you don't put time and attention into your children they fail to adapt to society and are ill-equipped to live happily in it. The behavior issues turn from disappointment to cast away outside to surrendering at the shelter to euthanasia appointment. It is the awful reality of property that fails to serve its owners purpose. Or, it turns into an anxious pet who bites or lashes out, which turns into death by euthanasia, or, abandonment which in too many cases causes death by predation or designation of "unadoptable" which subsequently leads to euthanasia.

At some point in this timeline a frustrated owner starts providing clues that the relationship is not mutually reciprocating of adoration. The parent cannot understand and assist the pet and the pet is still desperate for love and attention but unable to articulate their needs and wants, IF the vet, or pet professional doesn't intercede at this point it will cause a shortened cheated life for the pet.

Here is where our lock down happened. The new pet parents told us on multiple occasions to multiple people that he didn't want this pet. It is not uncommon for vets, and vet staff, to hear clients disparage and complain about their pets care and cost of care in front of us. Perhaps they do it to try to complain indirectly about the bill? Perhaps it is poor coping skills? Regardless, I am not able to ignore it. I have been heartbroken too many times to not intervene.

After an odd peeing incident and a heated visit with the dreaded "defective" label being thrown out as a reason to not pay, and not wanting the pet. I called to offer help and try to explain that these things happen. I attempted to explain that "perhaps she needs more time, more training and help? We are here to help her, and them. We can't do one without the other." What I feared was that her "odd behaviors" were a direct result of the anger and angst they felt toward her?

The next day the client shows up unannounced to leave her. "She is too much work and too expensive." The client is in such a rush he doesn't want to wait to sign papers. (You cannot just drop off a dog at a vets office). To be honest we only take them to get them into a rescue to try to save their lives. At almost every shelter in the country a surrendered pet is a most often designated a "euthanizable" pet. These pets pay for their humans inadequacies and instabilities.

Three days later the phone is ringing, the messages are stacking up, and a few hours later a very angry guy is at the front desk making demands.

It was lunchtime and my sister (our hospital manager) and I were out to get a few minutes of much awaited spring time sunshine. What the client didn't know was that I, the practice owner, had just returned from hospice vigil and hadn't been at the clinic for a few days. It is not something I felt I needed to share, but, it is not outrageous for a phone call to take a day, or even two, to be answered when they do not include patient health care requests.

The client was so belligerent that my mom (cleaning the clinic that day) hid in an exam room and called my dad to come rescue her.

Texts to my sister and I quickly escalated to phone calls for help.

"Call the police NOW! And, lock all of the doors" imagining them fearing for their safety as they were unable to diffuse the demanding lunatic in the front office.

That's my advice for every out of control situation. You just call the police. Let them try to manage the person who is not willing to talk like a mature adult. Never escalate, never engage, and never allow anyone to make you feel threatened.

The police arrived as the client departed. There is now a record outside of yours to corroborate your concerns. If you are worried enough inquire about a restraining order. It is a the best way to protect your business, your self, and your staff while at work. You also will benefit from having a police officer present at the time of request.

"If they show up again call us. We are one mile away. We will send extra patrol cars to visit today and tomorrow. We can even post one to stay if you need us." It was the most consoling offer of protection and peace we could have gotten. It was the only thing that allowed us to stay open the rest of the day.

Where am I in all of this? I am back to being afraid of people who will harm you if they feel embarrassed and/or not in control and the collateral turmoil of not trying to save the pet in the middle. It is the world we live in. Where guns are prolific and temper tantrums happen in traffic, workplaces and even school yards.

A phone call from their lawyer followed. "They want their dog back. They have had a change of heart." Lawyers ALWAYS get involved. If you are lucky, they get involved early. Lawyers at least have boundaries and repercussions if the client is a psychopath. Any, and every, mediator should be welcomed. It is yet another barrier to becoming engaged with an unknown unpredictable person. It is a way to provide leverage and pressure. Every vet needs to have a lawyer on retainer, or at least PLIT insurance. Call your lawyer as quickly as the hairs on the back of your neck take notice. The point about "not engaging" also includes passing the buck when appropriate.

My reply; "My job is to take care of my patients. I am still here to take care of them. The pet is in a home with people who love her and they don't want to give her up. It was stated to us on multiple occasions to multiple staff members that your client did not want this pet. I also need to notify you that the police were called when your client threatened the staff would not leave after being asked to. The police were called to the clinic to remove him and are on alert to return if he does. The clinic went into lock down because the staff was so afraid."


Why am I posting this? Well, because we have been threatened before. Threatened with lawsuits, physical harm, and intense harassment. I have had to go so far as to get a restraining order, (it takes four visits to the police and courtroom to get), and I know what the consequences to my patients are if I don't offer to help. I also feel compelled to share this story with other vets and vet staff to try to encourage them to say something when a client states they don't want their pet, threatens abandonment, physical harm or personal injury. Do not ignore a threat, ever! Document and get backup corroboration to support the claim immediately. This case has multiple entries in the medical record to support the statements made in both our presence and in phone calls/email exchanges. I was granted a restraining order because I had emails and witnesses to support the threats made.

Do I think this is the end of this? NO, I don't. I think this man doesn't take "No" lightly. I think that in some cases standing up for your staff and protecting the people you care about makes you a target. I also think this blog allows me a place to post fears, concerns, and educate all of us about how behaviors influence outcomes.

How hard it is to stick your neck out with people who threaten and intimidate? How easy it is to turn a blind eye on your patients to spare your butt? Vets have to ask themselves this question every single day. It can break you. I have had to become comfortable with repercussions in order to stay true to my ethical code of my obligation to caring for my patients. It is not a code my profession shares publicly. I also think that veterinarians deal with the a ridiculously ambiguous fundamentally unfit status of pets being deemed "property". It denies us ability to intervene, advocate and make meaningful life saving pleas. At will on demand euthanasia is a viable option to every pet owner. If I push to hard every patient can be euthanized, and some clients will do so just to spite and hurt others. That is absurd and reality.



Here are my tips for preparing your staff for potential Lock Down scenarios;

1. Never engage. Ever. The minute you feel threatened or that the situation is out of control just pick up the phone and dial 911. You don't have to warn the client, you don't need to explain, and you should never apologize. Just pick up and dial. Every front desk employee has a phone at their fingertips.

2. Start recording the event. Any other staff member should discreetly pull their phone out and hit record. Evidence will save you time and money.

3. Have a protocol in place. Get people outside. Lock doors so others don't walk into the heated situation as it boils over. And, never call in more civilians. The police are your only call.

4. Get photos. I had to get a restraining order on a client under daily psychiatric care who was threatening to kill someone. Of course he didn't exist in any social media platforms and has never had a photo of himself taken (that I could find).. It is harder to alert the staff to call the cops if he shows up if only a few staff members know him by face. We were given make and model of the cars the owned to post for staff's attention.

5. Stay on the phone with the police dispatcher. They can help you to keep calm and be safe.



End note; I really never imagined that being a vet who cares so much about pets would leave me to having to decide whether to stand by protecting their lives would leave me sitting in the cross hairs of my own. We live in a dangerous and unpredictable world. It shouldn't be governed by so much pervasive fear and hate, that's not what our pets bring us, that's simply humans.

Where is JVC going to go to help deal with the ever increasingly hotheads who are making the job of an underpaid vet assistant question why they stay? We will be adding video surveillance to the hospital. They will be in every public space, including examination rooms, and parking areas. We are also recording telephone calls. Too often I have a receptionist find me frantically befuddled to notify me that a "very difficult, angry client" is on the phone. Many of these phone calls include threats, harassment, profanities and requests they cannot acquiesce to. I ALWAYS take these calls. Overwhelmingly the client is nice as pie to me. There is some unwritten excuse to being able to be rude to the staff and nice to the doctors. For every client who does so I ALWAYS ask the client if they were rude to the staff? I know that most clients are put off that I ask, but, I explain that we are never rude to clients and it is expected this is reciprocated in return. Every single client had provided a firm and disgusted "NO!" For the repeat offenders they are given a written letter of warning and at the third infraction; fired. Every practice owner needs to both protect their staff AND hold clients to a standard with consequences. No vet staff member is ever paid enough to allow or tolerate abuse.



Clues to Lock Down worthy clients; (Note; I am not a psychologist AND I am way out of my vet hat boundaries.,, But, these have been my experiences. I add them as personal reflections).

1. They are usually new clients. Never people you have seen and known for years.

2. They have seen multiple practices over multiple years.

3. They provide red flags at every single interaction. Pay attention to the little voice that tells you to be careful.

4. They do not provide small talk unless it is somewhat uncomfortable and moderately inappropriate. Like asking for your private information, or, disparaging others to find a common enemy.

5. They seem to exist on the ends of the spectrum. Either too nice, or, too angry. You never know which you are going to get?

6. The pet goes from happy and jubilant one visit, to afraid and shy the next. ALWAYS pay attention to the pets and the kids. They tell you what you need to know.

Here is a reference from Psychology Today on Dangerous Personality traits. The men of this blog possess many (or all of them). Please read this article if you are a woman, vet, vet staff, person, employee, anyone and everyone.


Footnote; None of the photos in this blog are of the pets involved in these cases. The situations and scenarios are collected experiences based on previous situations within the clinic. Names have been omitted and references to actual clients have been altered to protect the staff from further harassment and client instability and instigation.

About me;
I am a small animal veterinarian and the owner of Jarrettsville Veterinary Center in northern Harford County, Maryland. We are here to help you and your pet at every step of their lives. Please check out our amazing Facebook page JarrettsvilleVet. Or find our 2017 Jarrettsville Vet Price List here.

If you would like to learn more about pet care or ask a free pet related question please visit Pawbly.com. It is free to use and open to all of those who love pets.

If you want to help others and you have experience with pet care please join us on Pawbly.com. Pet care is about helping others and we are built on this alone. I also have educational videos on YouTube, or @FreePetAdvice.

And of course we hope that you will Please always Be Kind to every living creature.

41 comments:

  1. Oh my God. I'm so sorry this has happened to you. What's with people these days? And the poor animals...I wish it was law that every potential adopter has to go thru a home inspection and a questionnaire, but that will never happen. Hang in there, you have some great followers who admire you and wish you the very best. Roberta in California

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    1. Thank you Roberta!
      I sincerely (more than you will ever know!!) appreciate your kindness and notes of concern.. wishing you all the best!
      Take good care!
      Sincerely,
      krista

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  2. How horrible, and I'm sorry this happened. I hope these people come to their senses.

    I am sure the women (not girls) on the front lines as your front desk staff appreciate knowing that there is a plan

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    1. Many thanks! I hope that the whole staff knows that I will always be there for them... just as I want to be for my patients and clients.. how it gets contentious and dangerous I do not know... except that perhaps there are deep emotional ties to our families and pets are a part of that.. but to threaten? And dump at the clinic without asking for help first? I just dont know??
      take care,
      xoxo
      krista

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  3. Good job, Doc! You all are the best!

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  4. I'm sorry that you and your staff had this situation to deal with and evenore sorry for their 'pet'

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    1. thank you for reading.. this pet is in a loving and stable home,, there is a happy ending for her.
      take care,
      sincerely
      krista

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  5. Krista, you never cease to amaze me. You are truly my hero. YOU are a mighty woman. Be safe!

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  6. So sorry to hear what you have to put up with! I could never imagine doing anything like that, much less to my vet! I'll keep you in my prayers!

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    1. thank you,, take good care of yourself,, and thanks for taking the time to read and leave a note.. my best to you all

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  7. Be safe. I'm so sorry this has happened to you.

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  8. Thank you for this! I am a volunteer at a no-kill shelter and work the front desk. Found this very, very helpful.

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    1. thank you for all you to do to help pets. be safe and take good care of yourself. we need lots more people like you!
      XOXO
      Krista

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  9. I find your statement "At almost every shelter in the country a surrendered pet is a most often designated a "euthanizable" pet." highly offensive. It shows how sadly uninformed you are about the efforts shelters make to modify behavior problems, correct medical issues and get animals into homes or breed rescues. I have been in animal shelter management for 10 years and am aware that veterinary staff, as well as shelter staff, take a lot of abuse from owners through no fault of our own. I would encourage you to look explore the sheltering world to avoid making disparaging comments in the future.

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    1. Hello,
      I by no means intended to be disparaging.. I write a lot about shelters.. about how much they are needed and how difficult it is for them to be the safety net.. I also have incredible empathy and awe in how many of you keep helping pets regardless of how difficult the case, and how terribly mankind has failed them in the past. I do not intend to insinuate or assume that you don't do all that you can to save every single animal. BUT, I do recognize that my vet clinic can help our clients and patients so that surrender due to economics, or treatable issues is not a reason to give up a pet. Shelters should never be forced to make hard decisions based on space.. I wish this were the case. Perhaps if every vet provided a safety net before the shelters did there would be more space for more pets in need? That's where I am trying to help,, and that's where I am trying to educate both my peers and society. I applaud and appreciate all that you do and I wish you the very best in saving every pet who crosses your path.
      Sincerely
      Krista

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    2. Thank you for your reply and THANK YOU for trying to prepare owners for the responsibility of pet ownership. That is a challenging undertaking. I had a discussion with one of our shelter veterinarians a few weeks ago because community vets were referring animals with major medical issues for surrender to the shelter instead of having the difficult euthanasia discussion with the owner. That just forced us to make the decision and allowed the owner to abdicate their responsibility to their pet. I really appreciate that you are working to make a difference.

      Delete
  10. Dealing with psycho idiots is exactly why I have a concealed carry permit.

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    1. be safe out there..
      thank you for reading

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  11. This comment has been removed by a blog administrator.

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  12. We have had numerous close calls and one extremely serious, and potential deadly situation at our small clinic. I really hope this will hit home and shake some souls! Thanks for sharing!

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    1. Stay safe, and know that you are not alone... With love and warm wishes,, and much gratitude for all you do to help animals.. krista

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  13. Important, relevant read in this society. Thank you for putting it all out there. The horrible part of the hard truth is, people that shouldn't have pets usually also shouldn't have children. I am so sorry that you have had to suffer all this.

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    1. Hello,
      Thank you for reading and for taking the time to post your thoughts. I agree with you on all counts.. and you hit the nail on the head with this too... take care and thanks again.
      krista

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  14. Please keep us updated on how this settles. In the past decade, I have come across a few of these clients. They all share the same traits! Plus, they get so angry when we won't give them free service. They say: "well, aren't you the owner? Why can't you just not charge these fees? You guys are highway robbers, already making so much $."
    And yes, the only way is to call the police. We've even had one woman get physical!

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    1. Hello Elaine,
      I'm sorry to hear about your experience and struggles. It's incredibly disheartening to think that people are so willing to be so hard on others, most concerning those of us who are just trying to help. For caregivers there is empathy fatigue, guilt, and being stuck in between ability and lack of resources t provide this,, I give a lot away,, and I find the cost of this is better than the guilt of not,, but it isn't possible for everyone I know.
      I wish you the very best, and hope that you feel safe in your own clinic.. we all deserve that as we fight to make a difference for our patients.

      Delete
  15. my vet is a godsend...available always...when my pitbull coco la roo had her heart attack and i called...got right in...when she passed the next day i got a call and a card ...id never talk down to anyone let alone someone who is there to care for my family member...bless you and stay safe

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    1. Hello,
      Thank you for reading and posting a note.. and please thank your vet from me.. it is a jungle out there sometimes. It is so important to be both appreciated AND valued. I'm sure your vet is just as grateful to have supportive and grateful clients.
      Take care, and tell your vet I said hello!
      XOXO
      Krista

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  16. Thank you for posting this. I am the instructor for Patterson Vet Supplys Communication and Customer Service class. Every class I spend time discussing the dangerous client and the importance of having a plan. One suggestion I offer is to keep a can of hornet spray at the front desk. If someone threatens you with a weapon it sprays 25ft much farther than pepper spray or mace. It is a shame that we have to deal with crazy but it is a fact of life when we work with the public. I am proud of you that you step up and protect your team. So many owners are afraid of a negative online review that they are held hostage by these jerks. I think the public is wise to these reviews when all others are glowing. I know I can spot a pain in the rear from a mile away. Keep on helping those critters.
    Deb Boone

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    1. Hello Debbie,
      I appreciate your stopping by to share your advice. We will certainly heed it! I also appreciate your kind words. I find it almost ridiculous to say that the most important lesson that I have learned in being a vet and practice owner is to not be afraid of consequences. I have always been the person who jumps in to take care of others (hence the compelling desire to go to vet school and devoted feminist advocacy) BUT jeez, where did all the crazy demands come from? With threats attached to them?
      I sincerely feel that everyone in vet med will never be adequately compensated for their time and skill set, SO, I am absolutely not going to allow harassment and threats to be a part of their job description. I also feel that I am the only person who can afford a lawsuit, therefore, I always take the heat and anger. I am just not very good at biting my tongue and refraining from profanities.. (I am soo working on that).
      Any bully who tries to intimidate is like catnip to me.. there is some primal knee jerk reaction,, I have to keep repeating to "not engage" but I really dislike mean people.
      As far as reviews go I don't understand the fear? We have almost 5000 FB followers and a 4.9 rating. Our clients know who we are, and they support us. One (or two) angry clients are always met by 20 plus supporters. It is a huge confidence booster!
      I wish more vets would embrace that same courage that compels them to jump into a bleeding abdomen, place a chest tube, and do a C-section on a puppy obstructed mom.. We are brave behind the closed doors, be brave in front of them too.. Our good clients and staff need us to be..
      Take care..
      XOXOX
      Thanks for all you do for all of us,,, I don't know how you always keep your calm welcoming smile on your face, but, I am trying very hard to emulate it.. (I am a BIG fan of your talks!!))
      krista

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  17. Holy Hannah...I'm glad y'all are safe! I hope this client's lawyer fires him, too.

    I'm sorry that happened. :(

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    1. Hello Laura,
      I know,, right?? What the heck? We take this guys unwanted puppy and then get threatened and harassed? What happened to the simple "thanks, clearly I was in over my head, and I need some help with her?"
      PS the client and lawyer are related.. (swear, you can't make this stuff up!)

      Delete
  18. judy granny maloneApril 24, 2017 at 1:18 PM

    Very enlightening post. I REALLY like the advice - if you have any concern at all call 911. Just do it.

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    1. Hello Judy,
      It is the best advice there is.. just dial 911, let them figure it out.. it is the best defense we have,, a good person in blue with a weapon offense..
      take care,
      krista

      Delete
  19. I work at an emergency clinic in texas. It is not uncommon to have a client who is armed. We too have had a few incidents of "please god help us" moments. You are so correct, Don't engage! We had a highly intoxicated client, who after running over his own dog and killing it, blamed us. He proceeded to go looking in his truck for his gun... and we locked down. Be alert, communicate amongst the staff so everyone is alert, and have a designated plan for such incidents. God bless!

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    1. Hello,
      Good ole Texas.. you have to worry that every person is packing and egos are as big as cowboy hats? Frightening.. truly. I am so glad you are all safe.. there is no adequate compensation for drunk, belligerent and "I'm going to go get my gun".. insane.. people are just about insane.
      Take care of yourself always, this job can kill you (in like a million ways).
      XOXOO
      Krista

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  20. I have always worked with the public and have experienced some of these same situations. I would suggest putting in cameras inside your lobby. They can be used for these cases, but can also be used to reflect on animal behavior while waiting to be seen. "He just did it while we were waiting to see you and now he won't do it!" :-)

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    1. Hello,
      Yes, we are placing cameras in all public areas, and now have recording devices hidden so we can capture audio too. I will have to publish a client email that explains we needed to increase costs to all goods and services to add extra surveillance to the clinic.." I'm sure that will go over well.. (sarcasm!)
      Take care,
      Thanks for visiting
      Krista

      Delete
  21. Dr. Christopher Gargamelli, a member of the subcommittee, believes the AVMA is unlikely to revise the policy before the regular five-year review unless scientific literature on the topic emerges. veterinarian omaha

    ReplyDelete