24 Feb 2021
Nicola Ackerman offers advice on how to master the art of talking to reluctant clients, and the importance of this “soft skill” in gaining compliance.
Nicola Ackerman
Job Title
Image: © Pixel-Shot / Adobe Stock
Communication is one of the most important aspects of our job, whether that is within the team you are working with or with clients.
Communication skills are exceptionally important and are commonly classed as a “soft skill”. These skills can be difficult to master, but you can improve on them. Recognising you need to improve is half the battle.
Not all clients will agree with everything we communicate in a consultation. Many varied reasons will exist for this, such as:
A lot of psychology is wrapped up in how to “sell” an idea to someone and get him or her to come along on the customer journey with you. In the veterinary industry we sometimes use the word “compliance” to describe this process, but for an owner to be compliant you have to make a recommendation in the first place. This recommendation could be for a surgical procedure, weight loss, a specific diet, ear cleaning products or a diagnostic procedure.
Do we have reluctant clients, or do we have clients who haven’t understood or accepted our recommendations because we have not communicated them in a way that they can process?
When broaching a tricky subject with reluctant clients, it is important to think about how we conduct our consultations. Hollins (2017) described the “learning pyramid”, which is also referred to as the cone of experience. None has been proven to be correct, but there is a huge degree of sensibility that we learn from more active means than passive.
The numbers are designed to be rough guidelines, but do highlight this point:
Telling someone that the food he or she is feeding a pet is appropriate, or telling him or her that the pet isn’t at the correct body condition score (BCS) is going to sit in the 5% being lectured at category.
When having a discussion with someone about nutrition, engaging with him or her will hit the 50% (10 times as much information) and showing him or her how to conduct a BCS will hit the 75% category.
Getting someone to go home and show family members how to conduct the BCS will reach 90% retention of the information.
Think about visual aids – what handouts and diagrams can we use? It’s a digital age – websites and YouTube videos hold a vast amount of easily accessible information. It isn’t just what we say, but how we say it and how we convey the information that is important.
Use the word recommend. When we talk to clients, we are conveying a huge amount of information, but it might not seem it to us because we are so au fait with the terminology and its application. You need to almost bullet point what you are conveying.
Using the word recommend gives very strong weight to what you are saying. For example: “I recommend that Fluffy sees the nurse for weight loss clinics” or “I recommend that we look at the range of options for the management of Fluffy’s kidney issues.” Recommendations need to be clear and not open to misinterpretation.
Once we have made a recommendation, the owner needs to accept that recommendation. If the pet owner doesn’t recognise that Fluffy is overweight then he or she is not going to accept the recommendation to attend nurse clinics for weight loss. Communication hasn’t been effective in conveying the reasoning behind Fluffy being classed as overweight.
The acceptance of a concept, an idea or recommendation can be achieved in many different ways, and it does depend on the underpinning knowledge of the pet owner and the professional relationship (the bond) the owner has with the practice.
We all know clients who will do everything that is recommended without having to even explain why we are doing it. This could be due to previous experiences with the practice; they have built up trust with you. They respect the knowledge that you have, and know that you have their and their pet’s best interests at heart.
With all consultations and nurse-led clinics, it is important to monitor and follow up on the progress of clients. Making a clear recommendation to clients is key.
The CRAFT model (panel) was developed in 2009, which shows that for compliance to occur, the follow through aspect of the equation is required. This can be achieved by all different forms of communication with an owner – a telephone conversation, email, text or repeat consultation.
Compliance = Recommendation + Acceptance + Follow Through
A good clear recommendation is required, along with acceptance from the client that the recommendation that was made is required. The follow through is needed as many clients will accept the recommendation, but compliance is poor due to many factors including forgetting, money, time or the recommendation not being clearly made.
(American Animal Hospital Association, 2009).
Discussing with the owner at the time of the initial consultation which form of communication works best for him or her can really aid in the future.
If you research how to communicate with reluctant customers/clients, many lists and suggestions exist – all of which can be adapted to the veterinary setting. These are recommendations on how to convince someone to say yes from an online source; they can be easily adapted for an obesity clinic, for example:
Viewing an acceptance as someone receiving and understanding the intended message can also be viewed as learning something. We can relate how we convey a message by looking at how people learn things. Learning styles go in and out of fashion all the time, but the concepts behind them do hold some merit.
Some people do learn better by being shown something (show them how to perform a BCS), some need to understand the theory behind what you are describing (give them internet links, leaflets and so on), some will need to review what you have told them by discussing with others (allow them time to do this) and some need visual cues (diagrams, pictures, flip charts).
You don’t know the learning style of each client, so you will need to cover all the bases.
Have confidence in your recommendation. Would you recommend the same thing if it was your pet in the same situation? Believe in yourself and your knowledge; having that assurance in what you say really is reflected in how it is conveyed to the owner. That confidence does come across and will help you with that recommendation.
Many nurses are in the situation where they want to improve their skills with consulting and increase their confidence when undertaking these clinics. Confidence is not something that can be learned like a set of rules; confidence is a state of mind. Positive thinking, practice, training, knowledge and talking to other people are all useful ways to help improve or boost your confidence levels.
Confidence comes from feelings of well-being; acceptance of your body and mind (self-esteem); and belief in your own ability, skills and experience. Low confidence can be a result of many factors, including:
Confidence is not a static measure; our confidence to perform roles and tasks can increase and decrease. Some days we may feel more confident than others.
Many occasions exist where the author will have made a recommendation (Fluffy needs to start a weight loss plan) and the owner has accepted that needs to occur, but it still might not happen. Why is this?
It comes down to motivation. How many of us start with well-meaning New Year’s resolutions to have ditched them by February? Weight loss clinics are a classic example of this. Losing weight is exceptionally difficult – if it was easy we would all be at our ideal bodyweight and the dieting industry wouldn’t be worth the billions of pounds worldwide.
Providing motivation could be termed providing support and encouragement. It can be surprising how a few words can provide someone with the motivation he or she needs to keep going. You might not think it yourself, but to that owner it could make all the difference.
