Behind the Client Call: How Radical Honesty Turns Disaster Into Partnership

A few years ago, a healthcare client emailed me in a panic. Her message started with, “Please tell me this isn’t as bad as it looks.” Their daily recruitment dashboard had dropped to zero overnight, and she had senior management asking what went wrong. Before I could finish typing my reply, my phone rang. She wasn’t ready to wait for an email.

We were in the middle of a high-profile rare disease study when the main patient support person we had been working with went on sudden medical leave. She was the key link to the referral network that generated nearly every patient and caregiver lead. Without her, everything stopped, including my heart a couple of times while trying to figure out what to do next. The client had daily updates going to their global VP team, and I could already picture the storm that was about to hit.

I didn’t sugarcoat the situation because there was no way to fix it quietly. I explained exactly what had happened and laid out the options we could pursue. I asked if their internal PSP program could help bridge the gap by reaching out to their own patient community. There was a pause on the line, then she said, “Let me see what I can do.” Within twenty-four hours, their PSP team connected us with a group of healthcare professionals who treated and managed the exact patients we needed. The relief in that moment was real, and what began as a crisis quickly became a shared problem we were solving together.

Over the next few days, the new referrals started coming in, and by the end of the first week recruitment was back on track. When we checked in that Friday, she laughed and said, “I can finally give my VP some good news.” It wasn’t easy, but it reinforced something I’ve learned over the years. Clarity builds confidence faster than reassurance ever will.

Before any tough client call, I take a few minutes with the team. Not to rehearse, but to make sure we’re all grounded in what’s real. It’s the moment where everyone’s reading the room, not just the notes. We talk through what we know for sure, what’s still in motion, and what needs to be confirmed before we speak. I usually ask, “If the client asks this, are we solid on the answer?” If someone hesitates, that’s our signal to fix it before the meeting starts.

Everyone feels the pressure differently, and a short check-in helps align the tone before we walk into the conversation. I always remind the team that our energy sets the temperature in the room. If we show up calm, the client will match that. If we show up anxious or defensive, it spreads fast.

It’s okay to admit when something isn’t ready. Saying, “We’re verifying that now and will confirm by noon,” builds far more trust than guessing or spinning. Clients can handle uncertainty. What they can’t handle is confusion. Consistency isn’t about having all the answers. It’s about showing up steady when the answers are still forming.

Even after more than twenty years in this business, that moment right before the call still gets me. The screen goes quiet, the waiting room spins, my stomach tightens, and for a few seconds every possible outcome flashes through my mind. That’s the part nobody talks about, the heartbeat before the camera turns on.

I’ve learned to manage it by slowing my breathing and focusing on just the first line I’m going to say. Once I start talking, everything steadies. Preparation takes over. The nerves don’t disappear, but they turn into focus.

Humor helps too, but only when it’s real and when you know your audience. Humor doesn’t erase the issue, and it never replaces accountability. It just reminds everyone that we’re people trying to fix something together. For a few minutes, humor makes the weight of the moment easier to carry for everyone involved.

Why Radical Honesty Matters

Clients can handle bad news but what they WON’T tolerate is being blindsided. The fastest way to lose trust is to stall, soften, or spin things in a way that places blame on someone or a recent statutory holiday being the cause. They expect straight talk, especially when things go wrong. If you can’t give them that, they’ll move on fast and they’ll remember why. And that same client could move over one day to another client you work with, and down the rabbit hole you go.

Telling the truth early gives clients a seat at the table when it matters most. It turns tension into teamwork and problems into decisions. That’s how real partnerships are built, and how they continue to grow through moments when honesty and collaboration keep everyone grounded and human. Data, tools, and timelines can always be replaced. Trust cannot, and once it’s lost, most clients don’t give second chances. Radical honesty is what earns that trust and keeps it. It’s the difference between running a project and leading one, and it’s the reason people remember who stood beside them when things got hard.

When everything is falling apart, that’s the moment clients decide who you really are.

Make sure they remember you for the right reason; the team who showed up, the team who told the truth, and team helped them find a way through.

What’s Ahead

In my next piece, I’ll share a very different kind of client story. One that didn’t begin with a crisis but still kept us on our toes.

Halfway through the project, our team had to pivot so fast it felt like changing the tires while the car was still moving. What started as a routine study turned into something much bigger; a moment that reminded all of us why creative thinking and trust really do go hand in hand.

It proved something simple but unforgettable. When the foundation is built on trust, you can take sharp turns at full speed and still cross the finish line together.