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Can Vet J. 2010 October; 51(10): 1163–1164.
PMCID: PMC2942060

Bottom-up communication

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As often happens at veterinary meetings, four former veterinary school classmates meet for dinner to reminisce about the past and update each other on what is going on in their respective lives. Naturally the conversation turns to their work.

“I really enjoy being in practice,” readily admits Dr. Wimby. “I’ve learned a lot and the clients are great. The only problem is that the practice owner has the communication skills of a rock. I swear the whole place could collapse and the most he’d do is grunt.”

“How I envy you!” Dr. Edelman exclaims. “The guy I work for micro-manages everything and constantly preaches to us about the most trivial or self-apparent subjects. It’s maddening because the staff is well-qualified and works well together. We’d get so much more done and be much happier doing it if he’d just shut up and let us do our work!”

“Well, at least you two know where you stand with your employers,” chimes in Dr. Sanchez. “Mine is very nice, a highly skilled veterinarian and the clients all love her. But she’s so wishy-washy the employees walk all over her. It drives me crazy!”

“Hah!” laughs Dr. Fererro ruefully. “I’d trade my boss for one of yours any day. Mine always says exactly what’s on her mind without giving any thought to how the staff or clients might take it. The rest of us feel disloyal about apologizing for her behavior, but we would have lost some good staff members and clients if we hadn’t.”

In spite of the fact that most practice owners recognize the value of quality staff communication skills as these relate to employee harmony and efficiency and client satisfaction, some may experience a blind spot when it comes to their own expertise in that area. For some, just owning a practice with multiple employees is proof that they engage in quality communication. Or so they tell themselves. But as conversations like the above make clear, this may not necessarily be the case.

To say this is a thorny problem for employees is putting it mildly. Regardless of the specific communications deficit the practice owner possesses, pointing out one’s employer’s faults is not a task most employees relish. When the four former classmates discuss the possible hazards associated with this, they come up with two primary ones: their employers could fire them or make working for them difficult. Aside from their employer’s poor communication skills they do enjoy their work, and do not want to risk losing their jobs. If their employers retaliated in some way that made working in the practice uncomfortable for them, that would destroy the good feelings that currently make their employers’ flaws tolerable.

At this point it appears that the employees are trapped in a no-win situation. But is this necessarily the case? Sadly, in some instances this may be true. There may be some practice owners whose confidence level is so low that they cannot tolerate criticism of any kind. When criticized, they immediately go into the fear-fight mode. However, these practitioners’ responses to criticism in other areas would most likely provide clues to this tendency that would forewarn employees considering this approach.

Of the practice owners described, Drs. Grunt, Jabber, and Wishy-Washy are the least likely to respond in this manner. Granted all of them initially may feel somewhat put out when criticized by a subordinate, but then most people do. Dr. Grunt, however, is not given to public displays of emotion or hasty actions. Consequently, while this does not necessarily mean that he would not fire or chastise someone who criticized him, he most likely would not do it in a fit of temper — which is what his associate fears the most. Dr. Jabber would probably move quickly from any feelings of annoyance to addressing his own problem with the same time-consuming enthusiasm with which he addresses everyone else’s. And because Dr. Wishy-Washy tends to drag her feet when it comes to any practice-related issue, it is unlikely that she would respond either precipitously or vindictively to well-meaning employee criticism when it is given or later.

Of the four, Dr. Speak-First-Think-Later poses the biggest immediate threat to any associate who would criticize her. On the other hand, her forthright if sometimes injudicious and insensitive communication style precludes any grey areas. Whoever criticizes her will know exactly where he or she stands as soon as they do so. This is not the case with the other three practice owners. Their employees might add guessing about how any such declaration affected or will affect their relationship with their employers to their list of reasons not to bring the subject up in the first place.

So what is a concerned associate to do? The short answer is to either choose to do something or choose to do nothing, and willingly accept the consequences of either choice. The worst approach for the individual as well as the practice is to be afraid to say anything and inwardly seethe any time the practice owner displays the negative behavior. In addition to any detrimental effects the latter approach may have on the subordinate’s physical and mental health and, by extension, that person’s work, it also may lead to spontaneous blowups during which the legitimate message may be lost in emotional ranting.

Once the decision is made to confront the practice owner, the next question is how to do this in the most professional way. For some the “safety in numbers” approach holds the most appeal. If a group of employees meets with the practice owner, it would be more difficult for that person to deny there is a problem or to blame any one person in the group for bringing up the subject. Or so the theory goes. In reality, the more people involved, the more difficult it may be to ensure the desired message gets across. For example, another staff member may see this as an opportunity to bring up some annoying habit Dr. Grunt has that has nothing to do with his lack of communication skills. As soon as that happens, the practice owner rightfully could feel he is under attack. In another possible scenario, those who pledged support prior to a meeting may start to back-peddle or even align themselves with the practice owner during the meeting.

All this does not mean that group efforts will not work. However, their power does not come from the number of people involved; it comes from the unified message they convey. Because of this, it is better to have a few people communicating a clear and concise message than a large group conveying a message that lacks coherence. Also, in a practice situation and all democratic dogma to the contrary, confidential criticism received from a small group that consists of associate veterinarian(s), the office manager, and head technician has a better chance of being received objectively than if the entire staff were privy to this assessment.

Returning to the need for any message to be clear and concise: this is no place for associates to believe the right words will magically occur to them when the need arises. If the practice owner’s perceived communications problem is sufficient to undermine the efficiency of the staff and success of the practice, then it warrants a well-planned response. The content of such a response should be worked out and even practiced in advance. Few things can undermine a legitimate discussion of another’s communication deficits more than an unorganized, time-consuming critique. Those resistant to hearing such a message could rightfully find this kind of presentation at least ironic and possibly grounds for dismissing the message entirely.

Additionally, the message should include a pledge to help the practice owner address the problem if such help is desired. For example, when Dr. Grunt’s associate broaches the subject, she volunteers to discharge his patients for him because she knows his lack of communication at such times is particularly troubling to his clients.

Also and as with any message its bearer believes worthy of consideration, a specific time should be arranged to meet with the practice owner. This is not the kind of subject to bring up in casual conversation or when that person has other obligations.

After putting in all the effort to ensure the message is conveyed in the clearest and most professional and courteous manner, do not despair if there is no immediate change in the practice owner’s behavior. We all communicate in the way we do because it works for us. When someone points out that it does not work for them or others, why this is true may not be immediately clear to us. Even if it is, it may take time to decide whether the benefits of making the requested changes exceed the time and effort necessary to do so.

Raising the subject in the best possible manner is the best any employee can do. What happens after that is up to the employer.


Use of this article is limited to a single copy for personal study. Anyone interested in obtaining reprints should contact the CVMA office (gro.vmca-amvc@nothguorbh) for additional copies or permission to use this material elsewhere.

Articles from The Canadian Veterinary Journal are provided here courtesy of Canadian Veterinary Medical Association