Tough Call

In a recent challenging case, I found myself full of self-doubt when presenting treatment options to a client. It was a rare, almost fluke-y situation that I just didn't have any previous experience with, and some of my colleagues (who I deeply admire and respect) gave me annoyingly opposing opinions.

I had to explain a choice between an expensive surgery or an extended hospitalization stay, both of which carried a decent chance of recovery. To me, it just wasn't clear where the scales tipped when considering the animal's suffering, the owner's emotional attachment, the cost of care, the two prognoses, and possible complications.

Okay, so I had no idea which of these two was the right call, and I had to make a recommendation to someone trusting me to know what I'm doing. You ever see a doctor think that in a medical drama?

But there's a skill I feel lucky to have picked up in practice. It's not something I was ever taught in vet school (at least, not when I wasn't napping). Here it is: when you're full of uncertainty about a case, look the client in the eye, clear your throat, and admit that you have no idea what you're doing.

Sounds crazy, but it's one of the most trust-engendering statements you can ever make. I literally told the client I deal with a case like this about once every five years, and I just didn't have the practical experience to confidently anticipate potential results. Doctors on TV always seem to know what to do, but it ain't like that in reality! Individual case outcomes are notoriously hard to predict.

This is often a tough sell, especially to clients with last names like Zuckerberg. That's fine, there's a pay grade several orders of magnitude above mine where perfection can be found. Fortunately, most people appreciate that show of vulnerability. It can be very tempting to appear overconfident, to "fake it until you make it", but that carries a real risk of disaster when things take an unexpected turn. Mismanaging expectations is a cardinal sin in client communication. If someone feels misled or lied too, their trust might never be recoverable.

Saying, "I don't know" means any outcome is possible. It gets you off the hook! It immediately conveys to my clients that I'm human, just like them. In truth, I actually do know a fair amount about being a vet, very often more than they do. But being transparent about my limitations makes the interaction healthier. It casts off the facade of omnipotence. By acknowledging uncertainty, and being direct about it, we can create a cooperative spirit with our clients. We don't need to be perfect, we just need to do our best.