Dear Second Opinion,
My colleague and I split our weekday clinic shifts; I cover the first half of the week, and she covers the second half. We try to ensure patients are scheduled with their regular clinician, but we inevitably end up seeing each other’s patients on occasion. Sharing cases can create confusion for clients because of slight variations in the way we practice. For example, we have different approaches when it comes to the duration of antibiotic therapy for canine UTIs.
I respect my colleague’s medical decisions and trust their judgement, but it can be confusing for clients to be offered multiple treatment options. How can I clearly explain these treatment differences and maintain a gold standard of patient care?
Sincerely,
Catching Clients in the Crossfire
Dear Catching Clients in the Crossfire,
Well done for recognizing how these situations can damage client relationships. Worst-case scenarios occur when colleagues have conflicting approaches and clients are caught in the middle. Rather than explaining differences to clients, it can be helpful to implement a consistent strategy for managing client relationships across the practice.
The practice can choose to bond clients to a primary clinician or to the practice as a whole.
Bonding Clients to a Primary Clinician
This strategy allows clinicians to manage their own cases and can strengthen the relationships between individual clinicians and their clients. It can offer high clinical autonomy and personal fulfillment for clinicians; however, client loyalty to the practice may be limited, and they may become frustrated when their clinician is unavailable.
The practice should have a plan in place for cases in which the primary clinician is out of the office and one of their clients requires assistance. Will staff contact the primary clinician (who has agreed to be available), or will a colleague step in to cover the case? Documentation requiring both the primary clinician and colleagues to record client discussions, anticipated next steps, and long-term management plans is critical. Documentation can ensure continuity of care and limited disruption from the client’s perspective.
To avoid serious damage to the client relationship, it is also important that the primary clinician fully support recommendations made in their absence. Sending a simple email to the client stating, “My colleague filled me in on Fluffy’s condition, and I agree with their assessment. Please keep me updated on how she does this week,” can go a long way in easing client concerns.
To support bonding clients to primary clinicians, you and your colleague would defer to each other’s original treatment plan. If a problem arose, it would be clear whether to reach out to or step in. If a colleague does have to deviate from the original treatment plan, you would each support the choices made.
Benefits to the Clinician-Bonded Strategy
High clinical autonomy
May be more personally fulfilling for clinicians
Drawbacks to the Clinician-Bonded Strategy
Client retention is dependent on clinician retention
Infringes on clinician work–life balance
Requires veterinary staff to track provider-specific protocols
Bonding Clients to the Practice
This strategy allows clinicians to work collectively, helping ensure seamless patient care and building client trust in the entire team. It aims to ensure interactions with one clinician support and enhance the client's relationship with the entire practice, support a healthy work–life balance, reduce the risk for client loss due to clinician turnover, and alleviate the difficulty of tracking multiple provider-specific protocols.
Strong leadership and regular discussions are needed so clinicians are equipped to provide the same approach for common presentations. Cases that deviate from the practices designated approach should be thoroughly documented, as failing to do so may cause confusion for staff and risk clients feeling unseen if they have to reiterate their concerns.
To support bonding clients to the practice as a whole, you and your colleague would follow a shared approach for common presentations (eg, antibiotic therapy for canine UTIs) and would meet regularly to review these approaches. Any deviations would be documented in individual patient records, ensuring seamless care from the client’s perspective.
Benefits of a Practice-Bonded Strategy
Improved client loyalty
Improved work–life balance
Reduced mental load for clinicians and veterinary staff
Drawbacks of a Practice-Bonded Strategy
Requires agreement and accountability in case management
Failure to recognize and document deviations from protocols may leave clients feeling unacknowledged and undervalued
Conclusion
Each of these strategies offers benefits to clients and clinicians. I am confident you will select the strategy that works best for your practice and team.
Sincerely,
Sarah Wolff, BVM&S