When a Client Raises a Concern: Who Is Listening?

What happens when a client raises serious concerns about a regulated professional?

I was a client who raised serious concerns about the conduct of a regulated professional, a veterinarian, to the business where that professional worked. I was not an employee.

I raised concerns involving professional boundaries, a significant power imbalance and conduct that I believed could have implications beyond my own experience. I was directed to the organization's HR manager, who I was told also handled complaints by and involving staff. I contacted this individual. I provided documentation. My concerns were dismissed. When I attempted to communicate further, my communications went unanswered.

This experience raised a bigger question for me: What responsibility does an organization or business have when a client brings serious concerns about one of its regulated professionals to its attention?

A concern involving a regulated professional is not simply a customer-service complaint. It can involve professional standards, conflicts of interest, informed consent, boundaries, and public trust.

The College of Veterinarians of Ontario states:

“Maintaining public trust in veterinary medicine is crucial.”

Its Professional Practice Standard: Conflicts of Interest in the Practice of Veterinary Medicine states:

“The public expects that a veterinarian will use their knowledge, skills, and judgment in the best interest of any animal(s) in their care and that their choice of treatment will be based on objective professional judgment and not by considerations of personal or financial interests.”

It also states:

“A veterinarian is expected to act in a trustworthy manner by being competent, honest, and reliable.”

The College's Guide to the Professional Practice Standard: Conflicts of Interest in the Practice of Veterinary Medicine is particularly clear about concerns raised by clients:

“Real or potential conflicts of interest identified or otherwise raised by clients are to be treated in the same manner as conflicts identified by the veterinarian.”

That matters. It recognizes that a client may be the person who identifies a real or potential conflict in the first place. Under the College's own guidance, the concern is to be treated in the same manner as a conflict identified by the veterinarian and, where it relates to a specific client or animal, documented in the medical record. In other words, a concern raised by a client can be information directly relevant to professional obligations, conflict management, and the protection of public trust.

The Regulator Is Not the Only Part of the Picture

The College has a regulatory role. But that does not mean the organization where a professional works has no responsibility when serious concerns are brought to its attention.

Ontario's Regulation 1093 under the Veterinarians Act identifies professional misconduct that includes:

“Failing to maintain the standard of practice of the profession.”

It also includes:

“Having a conflict of interest.”

And:

“An act or omission relevant to the practice of veterinary medicine that, having regard to the circumstances, would be regarded by members as disgraceful, dishonourable or unprofessional.”

The CVO's Professional Practice Standard: Informed Client Consent states:

“Informed client consent is an essential conversation that occurs between a veterinarian and their client.”

And:

“From a public protection perspective, informed client consent is the basis on which a veterinarian and their client confirm the veterinary service(s) that will be provided in a specific circumstance.”

These are professional standards and obligations that govern the conduct of veterinarians. They exist within a professional relationship built on trust, expertise and a significant imbalance of knowledge, professional authority and power. When serious concerns about that conduct are brought to the attention of the organization where the veterinarian works, the organization cannot simply treat that information as someone else's problem. The regulator has its role. The veterinarian has professional obligations. But the organization also has to decide what it will do when a client brings serious concerns to its attention. That response matters.

Who Is Actually Assessing the Concern?

This is where my experience became particularly troubling. I was directed to HR.

HR has an important role within an organization. But HR works for the organization. It is not an independent regulator. That does not make HR incapable of receiving a complaint. It does raise a more fundamental question when the concern involves a regulated professional: Was the concern assessed by people with the appropriate expertise, perspective and independence to to understand the professional and other concerns being raised.

I provided documentation. My concerns were dismissed. My subsequent communications went unanswered. I cannot speak to the organization's motives or what happened internally. I can speak to what I experienced. And what I experienced left me questioning the credibility of the process itself. That is a serious problem for any organization.

Reputation Is Built in the Response

Organizations often think about reputation when a complaint becomes public.

They should also think about reputation at the moment the complaint is received.

Clients remember how they are treated. Employees notice. Professional colleagues notice. And people talk about their experiences. The reputational risk is not always the complaint itself.

Sometimes it is the response.

An organization cannot control every concern that is brought to it. It can control whether the person raising it is taken seriously, whether the information is properly considered and whether the process is credible. That is not about protecting an organization's reputation. It is about earning it.

The Accountability Question

I have spent more than 30 years advising organizations through change, crisis and reputational risk. One thing I have learned is that organizations rarely get into serious trouble because someone raised a difficult question. They get into trouble when difficult questions are ignored. That is why I believe organizations that employ or operate alongside regulated professionals need to ask themselves some uncomfortable questions:

• When a client raises a serious concern, who receives it?

• Who has the expertise to understand it?

• Who has the independence to challenge assumptions?

• And what happens when the concern involves someone the business or organization knows, trusts or depends upon - perhaps a leader, an owner, or another senior team member?

Accountability is what happens when someone actually uses it.

The regulator has a role. The professional has obligations. The organization has responsibilities of its own. Those roles are different. None should become an excuse for the others to look away. My experience has reinforced something I have believed throughout my career: Organizations rarely face reputational damage because a concern was raised. They face reputational damage because the concern was ignored.

*note: (at the time of writing, the current framework remains the Veterinarians Act and its regulations. The Veterinary Professionals Act, has been enacted but its substantive provisions have not yet been proclaimed into force.)

About the author: 

Catherine Cameron is a Toronto-based Senior Communications Leader and Strategic Advisor with more than 30 years of experience supporting healthcare and social service organizations. Her work focuses on trust, reputation, leadership communication, stakeholder engagement, crisis communications,

and public confidence.