When the customer is stressed

Erika Picciolo
Leadership & Organizational Development Manager
Learning & Development, Ethos Veterinary Health
Posted on 2020-02-26 in Client Care

In this post, we look at the Harvard Business Review article, “When the Customer Is Stressed.”

In any industry, customers assessments of quality, value for price paid and willingness to recommend to others are all influenced by emotion. This is especially true in the veterinary industry, which is considered a high-emotion service. As the article states, these services trigger strong feelings before the service even begins.

Let’s take a deeper dive to gain insight into what may lead to emotions and what we can do to help support our clients.

Outlined below are the key points, as well as reflection opportunities and team discussion questions.


“The foundation of excellent care is and always will be the quality of the diagnosis, the treatment plan and the clinical services. But compassionate, sensitive delivery matters a great deal in shaping the reputation of a care organization and distinguishing it from competitors.”


High-emotion services

High-emotion services may elicit intense feelings for the following reasons:

Lack of familiarity with the service being delivered.
Visiting the vet for any reason, let alone a highly emotionally charged reason such as a terminal illness or euthanasia, is unfamiliar to many people. Their closest comparison is what they’ve experienced in human medicine which, as we know, has some stark differences.

Lack of control over the performance of the service.
One difference between veterinary and human medicine is the role finances play prior to care that is provided. Bills aren’t something that are handled after the fact, once emotions have regulated and the success (whatever this looks like) of the treatment has been initiated and completed. Not only might our clients feel a lack of control over what they can afford, but many of them also do not have a frame of reference to know what recommended services are need to do vs nice to do, other than what we tell them. This is unfamiliar to them and we must first establish trust.

Major consequences if things go wrong.
Treatments and procedures come with risks, sometimes minimal and sometimes severe, which we review with our clients prior to approval of those services. That conversation frequently covers the primary educated-guesses for what is going on, various tests to determine which of those is most likely, potential anticipated treatments and the associated finances. It can be an overwhelming amount of information, particularly for those clients who are experiencing strong emotions. If a client approves a non-emergent surgery and, for whatever reason, the patient experiences an adverse event, this can lead to feelings of regret, guilt and anger.

Complexity that makes the service a black box and gives its provider the upper hand.
“My primary differentials are a spinal cord tumor or disc herniation. We’re going to need to run a CBC/Chem and get thoracic radiographs before the MRI. Sammy will be under anesthesia and we’ll inject contrast.” How much of what was communicated in this was understandable to you, someone who works in the industry? What do you think that means in terms of a non-medically trained client? Using technical or industry-specific language can elicit negative thoughts and feelings for our clients, which may inhibit their willingness to ask important questions at the risk of sounding uninformed or looking stupid.

Reflection Questions

Think of a time, perhaps when you were a child or before you started working at a hospital, when you brought a sick pet of yours to the vet.

  • In what ways were you pleasantly surprised? (Perhaps you got your pet’s bloodwork back within a few hours, compared to what would have taken nearly a week with your doctor.)
  • In what ways were you taken aback? (Perhaps you, like me, worried that going to “the back” was an indication that something was seriously wrong.)

Think of a time when you felt you weren’t in control of how to move forward with a service.

  • How did you feel?
  • How did you communicate how you felt with the individual you were working with? How were you impacted by his or her communication?

Think of a client you’ve spoken with, perhaps while picking up ashes, who voiced regret over a treatment they either did or didn’t pursue for their pet.

  • What did that look like?
  • What did that sound like?
  • How were you able to respond in a way that supported that client?

Think about a time you didn’t understand something that an expert or a superior told you; someone whose opinions you respected and admired.

  • How willing were you to admit confusion?
  • How comfortable were you asking for clarification?


Identify emotional triggers

The article states that the initial emotional trigger is a need for the service. In other words, the first trigger is the referral to our hospitals or the realization that an ER is needed. We are likely not involved at that time. When the client arrives, our performance, promptness, appearance (calmness, competence and promptness) and communication can either heighten negative feelings (anger/fear) or exceed their expectations.

Reflection Questions

Think of a time where you were able to have an emotionally charged conversation with someone, a client or coworker preferably, and end the conversation in a more neutral place. Put yourself back in that place.

  • What did you do?
  • What did you say?
  • What was your body language like? How did you steer the conversation?


Respond early to intense emotions

In emotional times, the impressions left by service providers are long-lasting and can heighten the impact of a service experience, for better or worse. A failure to recognize and quickly respond to our client’s emotional states can leave them feeling scared, frustrated, powerless and ignored.

  • Prepare client’s for what’s next. In other words, use the core communication skill signposting. Not knowing what lies ahead causes anxiety. The more clearly we can create the picture of what to expect, the better we support our clients. The beginning of every stage of a long-term care, say a transfer to a different specialty for example, is an opportunity to repaint that picture and recommunicate what to expect.
  • Monitor for emotional spikes. While we can’t predict our client’s emotions, we can use the core communication skill of gaining client perspective to check on how they’re doing and how satisfied they are with our hospital and their medical team, as this is can reveal problems underlying the escalation of a client’s emotions.
  • Communicate with care. Utilizing non-verbal communication and empathy, we can have a big impact on anxious clients who are looking for evidence of competence. They can’t easily assess our medical capabilities. What they can assess is our professionalism and our communication, which informs their evaluation of our competence.

Team Discussion

What are some phrases that undermine our client’s self-esteem, confidence or hope?

The article includes an example like, “There is nothing left to do,” and suggests instead saying, “Let’s focus on how well he can live, not how long he will live.”

As a team:

  • Identify these “never phrases.”
  • Develop a plan to eliminate them.


Enhance customers’ control

Time can seem to stand still for clients who need service, but cannot access it. Provide a direct contact and avoid service gaps. They need to know who to contact and how at any given time.

If their pet is discharged post-surgery, do they know what number to call at 1:00 AM?

Oftentimes, even just having that information helps ease their anxiety and helps them feel a bit more in control.

Reflection Questions

Think of a time you or a family member had a serious health concern and, when you called to schedule an appointment hoping for same-day, you were told their next available appointment is two months down the line.

  • How did this make you feel?
  • How much did you feel they cared?
  • How supported by the medical system did you feel?


Hire and rigorously train people who can communicate respectfully

Serving emotionally charged clients can be difficult, draining and downright miserable for the wrong employee. In this role, you’re expected to be able to effectively cope with stress, respectfully communicate with clients and help create trust and confidence.

If you haven’t already, please invest in yourself and your professional development by completing the following communication and self-awareness modules. You’re in the unique position to be our client’s first interaction with our hospital and, typically, our last. Your influence on their experiences cannot be understated. You’re a hero in everyday clothing. Thank you for what you do.

Reflection Questions

Think of a time when:

  • You came home from work and thought, “I love my job.” What happened that day?
  • You ended the day felt like you needed to find something else to do. What happened that day?

Consider this statement: “You must have the emotional capacity (ability to endure others’ stress) and be resilient (ability to bounce back from tough emotional encounters). You must be compassionate, honest and work as a team. To develop trust with clients, you must have excellent communication skills and the strength to engage in difficult conversations.”

  • Does this describe you? Why or why not?


SOURCE: Berry LL, Davis SW, Wilmet J. When the customer is stressed. Harvard Business Review 2015; October. Link to article

About the author

Erika Picciolo has a combined 11 years of experience in general as well as specialty and emergency private practice. Beginning her veterinary career while earning her Master of Arts in Teaching (MAT) and Multiple Subject Teaching Credential from the University of California, Irvine, Erika started as a technician at San Juan Animal Hospital, a small animal private practice in San Juan Capistrano, California.  She quickly realized her passion for veterinary work far outweighed her desire to teach elementary education. After earning her degrees, she relocated to San Diego and began working at Veterinary Specialty Hospital’s Sorrento Valley location in the Medical Oncology department. She soon transitioned to a role in client experience, which led to a position in training and development. After moving to Colorado in 2016, Erika began working as a member of the Ethos national team in learning and development, with a focus on leadership and organizational development.

Erika lives in Colorado with her husband, two adorable daughters, handsome golden retriever, and moody orange tabby cat.  She enjoys hiking, traveling, and spending time with her family.