Updated: Dec 29, 2019
I read a post the other day that highlighted one of my pet peeves: this vet was upset that a client had contacted her on her personal phone number, and in this vet’s opinion, inappropriately. Unless this is a family member or personal friend of yours, you’re going to get no support from me on this topic.
If you provide your number to a client, there are going to be negatives consequences eventually, and it’s no one’s fault but your own. And before we get any farther, while I wholeheartedly do not believe in this practice, during my ten years of practice I slipped up a few times, and I almost universally regretted it.
As a whole, vets are especially skilled at not establishing boundaries, and amazingly there are indeed consequences to this behavior. However, there is some hard data on this exact topic. I have found this conversation to be a bit controversial in the past, but we’re scientists, so we’re going to discuss the actual research. Finally, how do you execute this best practice? There are several options and some are definitely better than others, but all offer distinct advantages over offering up your personal number.
It’s hard to color in the lines when there are none
I read this quote recently: “A lack of boundaries invites a lack of respect,” and I thought it summed up our profession’s boundary problems well.
I feel like we’re an ironic bunch: many of us were drawn to this field because we’re not too fond of the human species (we got some karma on that one, huh?), but deep down, we’re secretly people pleasers. We want everyone to be happy with our service, and we can’t stand to have people mad at us. Do correct me if I’m wrong. But sometimes when we’re trying to please clients, we overdo it, in this case to the detriment of our own well-being.
When you give out your phone number to a client, do you tell them how to use it? I know the very few times I did, I barely skimmed the surface on rules. Or perhaps you know them very well, and expect that they should just “get it.” Social customs are pretty obvious, right?
But the truth is, no one knows exactly how and when you want to be contacted but you. You know those days when you’re on your deathbed? Do you want to be discussing Fluffy’s diarrhea? Or do you want to be telling your good client how to pull their necrotic dystocia calf in the middle of Disneyland? But your client thought you told them to call them anytime, right? No – these should be handled by someone else if possible. Honestly, sometimes you’re in a terrible mood, and those days you probably should be interacting with clients minimally.
What are the veterinarian results of these sort of interactions? It varies. Further exhaustion. Tolerance sometimes. Rage, which I’ve seen many times. Awkwardness. Avoidance. But are any of these fair when you told the client they could contact you on this number? I don’t think they are. The client only did what they thought you told them. They might not have listened well or contacted you too often or at an ungodly time of night, but the bigger mistake is that you (and I) didn’t set the boundary. We’re the professional, so I’m giving the win to the client on this, every time.
Let’s also make no confusion on this point: giving a client your client your personal number is mixing business with pleasure, and that’s a big no-no, even with friends. Don’t believe me? Check out this article from Harvard Business Review, which has some good tactics for totally separating the two!
What’s the right answer for this conundrum?
I was interviewing for my associate position once, when I had an interviewee point out her perceived flaw in my phone policy. I was freshly coming off an incident where a client didn’t know to call the main business number for an emergency, as the previous associate had given them her personal number – even though that associate was supposed to direct all calls to the main number. I had tightened up the phone policy after that.
The interviewee explained to me that as she grew up, she always could reach her equine vet directly, and if I remember correctly, the other practices she interacted with operated the same. She clearly was astounded that I should practice in such a manner. I knew then that we had major philosophical differences, but more importantly, I’d like to ask: shouldn’t we be questioning “how things have always be done?”
I’m not really a status quo person. I mean, I’m pretty sure it’s a good thing that continual medical advancements have led to, for instance, babies no longer spaced out on cocaine and heroin (while maybe a bit of an accessibility downer for the rest of us I guess?). In the instance of this discussion, if there are options out there that make our lives better, but still reasonably take care of the clients’ needs, shouldn’t we be moving in that direction?
Let’s take a look at the evidence: Should clients be able to contact their veterinarian 24/7?
The argument for 24/7 contact:
Patients love it. On the human side, patients really like being able to contact their doctors directly, with 72% thinking their doctor cared more about them if they could do so, even when no interaction occurs.
It reduces visits – which is actually a good thing! In fact, it actually reduced office visits, especially when telemedicine was an option. If you have not yet explored telemedicine, it’s actually pretty interesting. I personally didn’t understand it and thought it was crossing legal boundaries, but it is not – if you are using it properly. It is actually a great way to replace these exact conversations with clients and get compensated for doing so, which you should be doing. Telemedicine can be a win/win for both the practice and clients.
The argument against 24/7 contact:
Yes, there are abusers. The human studies show that 0.6% of patients are responsible for 23% of calls – but this makes them easy to identify and address. In my personal experience, abuse was extremely rare, and I cannot even think of a prominent incident as I am typing this. So, I’m going to say this argument’s a wash.
You do lose personal freedom. This is the main problem I want to address, and I see it as having two separate parts: the “on-call” nature and the “personal infringement.
On-call: On-call, for me, was one of the hardest parts of practice, and I’m not alone. I felt that I could never turn myself off – I had to always be ready to go at a moment’s notice. I couldn’t go outside of my call zone, couldn’t commit to anything that I couldn’t escape within a few minutes or where I couldn’t find a quiet place to talk on the phone. For some years, this was a 24/7/365 gig. Others, it was 50/50. This lasted for a decade until I sold my practice in 2018. Perhaps some people have found better coping mechanisms than me for on-call life, but being available even strictly by phone still carries the inability to disconnect and unwind, and there is a significant downside to this that cannot be overlooked.
Personal infringement: On the other hand, there’s what I’m going to call “personal infringement” – that’s your work life inappropriately creeping up on your personal life. How does that happen? Giving out your personal phone number or email address. Clients friending you on social media. Clients finding out where you live or show up at your house. Worst case, it can be criminal. Best case, I got some alpaca socks and some soup when I was sick. Still don’t know how they found me, so those gifts had a slight layer of creepy, although they were appreciated and those alpaca socks were nice. In this area, you may not have full control, but you do have a lot of control to be minimizing hassles in your life. You need to act proactively here. You may not have problems in this category now. You may not even realize you have issues when you actually do. This is preventive medicine to protect what should be yours – your private life. It’s not a matter of if, it’s when. I don’t care how much you like them or how good of a client they are.
You have to create a new system and train the clients. This doesn’t sound like a bad thing? However, it requires the guts to stand up to your clients when they’re resisting the change. If you don’t insist on full implementation for everyone, the whole exercise is a bit pointless. Here is why all clients should be following the same rules. They will automatically know:
Exactly who to contacting at any time, without thought.
Who to contact when they have an emergency.
Understand what the main phone number is for your practice.
Unexpected questions at any time will be directed to the main number instead of you (see Fluffy diarrhea), and your system should be set up to automatically handle this, which we’ll talk about below.
Finally, no one is considered more special than another. This is a business, your clients are not your friends, and you should be treating them all via the same procedures (okay, MOM).
Some final questions to ask yourself to see if changing is something you're considering or you're still not sure:
Do you have emergency coverage or not?
If so, they can probably just call emergency line. Done!
If not, have them call through main number, route to whomever is “on-call” to field after-hours calls. We’ll talk about how to set this up below.
Contingency planning (If you are currently having clients call personal phone numbers):
Ask yourself if clients have clear expectations in the following situations. Consider that clients often do not read emails, follow social media, read physical mail, or even remember your main phone number. They may not even have access to the internet or know how to use it to locate you.
What happens when someone is on vacation?
What happens when someone is sick?
What happens when someone leaves the practice?
What happens if someone’s phone battery is dead?
What happens if someone really doesn’t want to talk that day?
What happens if an employee becomes disgruntled?
What happens if you sell the practice?
All of the above can lead to inability of clients to reach the practice if they only have an individual’s personal phone number. While some solutions may be as simple as temporarily forwarding the employee’s personal number, most are not that easy. Your ultimate goal is that a customer should be able to reach someone 24/7 regardless of these issues above. I would strongly recommended that the practice owner should have full control of phone numbers in case of an emergency, either through business phones, phone trees, forwarding, or digital numbers.
So, let’s answer the question finally: Do clients REALLY need to talk to their vet of choice at any given time? I personally don’t think so.
In a multi-doctor practice, there is no valid reason why the on-call vet cannot field questions, with my only hesitation being concierge-type practices (and I would only consider yourself one if a client is explicitly paying for such service – if there’s any confusion, either you’re not, or clients need to start paying you for this service).
As a general rule of thumb, giving clients extremely clear expectations combined with excellent customer service should overcome any problems with which doctor they directly speak after hours.
Why not just give clients what they want? Because it’s a fine balance between customer satisfaction and veterinarian burnout. It’s an inverse relationship: as the vet’s availability increases, the client’s happiness goes up, while the vet’s happiness decreases. At some point, you’re going to lose the benefit of constant availability because you’re going to have a really unhappy vet, especially over time.
How do you implement a centralized call system?
There are many variations that allow clients to contact a veterinarian whenever they need to without giving out a personal phone number.
As stated above, I would strongly recommend a centralized calling system, pictured left. In such a system, the owner is only provided with one phone number to use at any time. It is the hospital’s responsibility to automate that phone number to direct the customer’s inquiry to the right place.
The alternative is a decentralized system, also pictured below, where the customer has the option to call either the main number or the number(s) of whichever employees they may or may not have. While that does put more control over communication into the hands of the veterinarian/staff, it takes it away from the hospital, while also burdening those veterinarians with communications that can likely be handled by central staff.
It’s not about preventing clients from speaking to vets – it’s about filtering front desk versus medical conversations, having control when there are emergencies, and working in what is actually the best interest of your clients.
If you offer emergency services:
Simply route calls through your emergency line. They can talk to your on-call vet. It really does not need to be any more complicated than that.
If you do not offer emergency services:
For explanation’s sake, let’s assume you’re starting with an after-hours recording just saying you’re closed, and you’ve decided you want to implement a new after-hours on-call system, but only for speaking to clients – in other words, you won’t actually be fielding emergencies.
Decide if you will be doing telemedicine or not. Read more info from AVMA here.
Route all calls through your main phone number.
Phone tree: Set up a phone tree, where clients will select if they need to talk to the on-call veterinarian. The phone tree will have an option where clients can select to talk to the on-call veterinarian. Your options for that are:
- A permanent emergency number (aka a physical phone), which is forwarded to whomever is on call each night.
- A digital number like Google voice, which can be forwarded to whomever is on call.
- A monthly schedule that is set up by an outside company and is automatically forwarded each night. There are many companies that offer this service, but here’s the one that I used – it was inexpensive, and we were very satisfied! With this you can either choose a traditional answering service or direct transfer of calls. We switched over to direct transfer after a few years and much preferred it!
Forward main number to the vet on call. This is easiest and cheapest, but there’s a big detriment – all calls will go through to you, and you’re going to have to listen to every message to find the important ones, even in the middle of the night. I would encourage a phone tree over this, as there are very inexpensive options that allow clients to self-sort (see directly above – I believe we were paying $20 something a month for this option, and clients rarely abused it!)
Finally, once you have your system set up start training your clients on your new policy immediately. Announce it everywhere, put recordings and automatic text replies on any personal phones to which clients may have had access, and make no exceptions. Check out your cell phone carriers for auto-reply services.
Once you start your new system, there are a few important things to remember:
Be consistent. You’ve decided to do this, announced your new rules, and they are in effect on that date. Make no exceptions for anyone, not even those clients that you really like. Nope – not even that one that you’re thinking about right now. If you’re going to do this, do it right.
Quite honestly, if a lot of clients had your phone number, it may even be a matter of changing your number and starting fresh. If you don’t like that idea, you’re absolutely going to have to use the recording and automatic text reply on your phone about your new policy. I think it’s fair to ignore them as long as you are extremely clear with the messages on your phone, and the auto-reply says “AUTO-REPLY” before stating the new policy – you don’t want them thinking you’re a jerk.
Respect yourself. This is your life, your mental health, and you’re also doing this for your clients! You are providing your clients an absolutely reasonable alternative to contacting you personally. If they give you a hard time, consider their qualities as a client: are they even the right client for you? Even high-income clients are not necessarily ones you want to keep around if they make you miserable. I made the choice to let go of one of the biggest barns in my area not because they were jerks necessarily, but because we clearly were not a fit – and I never regretted it.
Extend this policy to all other contact points. Social media? NOPE. Create a totally professional page if they want to interact with you. In an article from a lawyer, her response of choice when she receives friend requests is: "Thanks for finding me, but this site is strictly to help me keep connected with family. I'd love to connect through LinkedIn. Here's my link." I have to say I do like this. If it’s too impersonal for you, you can also just direct them to your clinic’s page.
As far as other hospital staff? They need to refer all calls and social media contact to the hospital. They can just blame “hospital policy.” No need for them to feel bad.
You can create boundaries, respect your own rights, and still not be a jerk. All you need to do is create clear expectations from day one and stick to your guns.
I’ll be honest – I don’t have much of a life outside of my career, which other people might hold as their “sacred personal thing.” But, what I do have is chronic mental health problems in the shape of anxiety and depression, which are exacerbated by stress and lack of sleep. No matter what your reason is, though, I am a firm believer that clients do not have the privilege to be crossing the line into whatever “your thing” is, especially when you’re providing them great service through business channels.
If you’ve been at it long enough, you know this career wears on you. Most of us put a lot of ourselves into it, which is a double-edge sword. But volunteering personal information to business clients is a battle we do not need to be picking when there are perfectly valid alternatives that can still serve them.
So, I plead with you, if you have not already, take the step to create that new boundary with your customers, and make it air-tight. Research backs up that your clients want to talk to you, but all they want is availability, not pillow talk. This week, take the next steps to figure out how you can implement a centralized call system: it might be as easy as Google voice, or a several day set-up of a new phone tree. And then, hold steady on training your clients. Even if there is resistance (I’ve been through it), it goes away!
Go live your best life now!
Yea or nay? Let me know in the comments!