Addressing disappointment in veterinary practice.

THE PROBLEM Despite the best efforts of veterinarians and the health care team, clients occasionally experience disappointment with aspects of care. Examples include perceptions of treatment they and their animal received, expectations for a specific medical outcome, and the costs of veterinary care. In the face of these disappointments, it is natural for the client to wonder about the quality of care that was provided and whether he or she was adequately informed and included in treatment decisions. Veterinary practices want clients to believe that they did the best they could under the circumstances and to conclude that the fee is reasonable for the efforts made on their behalf. This article builds on research and experience in veterinary and human medicine as well as on the broader customer service literature to address the dynamics of disappointment in small animal practices. The article goes on to offer strategies to reduce the frequency and intensity of such disappointments and to resolve them more satisfactorily when they do occur. CHANGES IN VETERINARY MEDICINE Like many other professions, veterinary medicine has undergone rapid change in the past several decades. For instance, there has been a significant gender reversal. Since the 1990s, more than 70% of applicants to veterinary schools in the United States have been female compared with only approximately 5% in the late 1960s [1]. In addition, the typical business of veterinary practice has shifted from an emphasis on food-producing farm animals or large animals to a focus on the ‘‘treatment of animals with no real utilitarian value other than companionship’’ [2]. Veterinary services showed significant growth over the past 10 years, driven by the demand for companion animal care [3]. The average dog owner in the United States spends an estimated $263 in medical expenses per dog each year and has an estimated annual expense of $113 per