Lead the way: 7 steps to boost acceptance of your medical recommendations

Lead the way: 7 steps to boost acceptance of your medical recommendations

Clients are not being intentionally defiant when they forgo preventives or do not comply with your treatment protocol. Instead, it is usually a sign of a communications breakdown.
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Jan 01, 2012


Main illustration by Art Glaser/Getty Images; additional animals and children by Steve Pica
Surveys have repeatedly revealed that what pet owners want from their veterinarians is respect, clear and consistent information and recommendations, and relationships built on trust—the very things that increase acceptance of your medical recommendations. Yet, the thought of discussing ability to comply with veterinary recommendations stirs defensive responses in veterinarians and pet owners alike. Veterinarians are convinced that clients ignore their recommendations because of issues of convenience or expense. Pet owners often feel that the recommendations are not clear or the reasons for them are uncertain.

Part of that defensiveness stems from the unspoken and unpleasant connotations that veterinarians associate with pet owners and the word compliance: "I told you what to do. You chose to ignore me, and now look where we are. I guess you don't care what's best for your pet."

In their book Skills for Communicating with Patients, the authors, Jonathan Silverman, Suzanne Kurtz, and Juliet Draper, present alternatives to the unfriendly terms compliance and noncompliance and introduce instead the terms concordance, implying understanding and agreement, and adherence, implying consistent follow-through. I suggest that veterinarians adopt these terms in their thinking and professional dialogues about their recommendations to clients and their clients' abilities to follow through.

Nevertheless, whether we call it compliance or concordance and adherence, all of us, veterinarians and pet owners, need to realize that we have a virtually identical concern: doing what is best for pets to the best of our ability. And we must do this in a time of economic difficulty and fragmentation wherein veterinary care, services, and products are available from a number of competing sources such as low-cost, not-for-profit, mobile, and emergency care clinics; human or online pharmacies; and pet stores and big-box and online retailers.

To veterinarians, it often seems as if we are giving recommendations or prescribing treatments that would benefit pets—but "the clients just don't listen." Unfortunately, pet owners often feel as if they are given confusing and sometimes conflicting recommendations and are left asking themselves, "What am I supposed to do?" The vital step veterinarians often skip is communication, which is different from simply talking or giving pedantic directions.

I have often caught myself saying, "I care about your pet as much as you do," because I believe that most pet owners who seek veterinary services care deeply. However, pet owners often do not understand the issues at hand, and frequently their ability to provide care is affectd by concerns veterinarians are not aware of. I have come to realize I should have been saying, "I care as much as I think you care." Veterinarians frequently make judgments about clients' commitments without knowing what factors may be behind their decisions. At the same time, we may not always convey the reasoning behind our recommendations.

Most failure by pet owners to follow veterinary recommendations is not willful defiance or even indifference. Failure occurs as a result of a lack of clarity from veterinarians, a lack of understanding by clients, and a lack of joint commitment to achieving the best healthcare outcome.

So what is the solution?

1. FORM A CONSENSUS RECOMMENDATION

The first step toward concordance is forming a consensus recommendation and having all doctors and staff members repeat that recommendation regularly. Frequently, the doctors in a practice have not agreed on wellness care recommendations, and the technicians may ultimately deliver discordant messages about pet healthcare. The greatest barrier to client acceptance of a recommendation is the confusion brought about by inconsistent recommendations. We cannot expect clients to understand and accept inconsistent recommendations.

Some practices I have visited routinely stock all available parasite preventives, all available nonsteroidal anti-inflammatory products, and three or four virtually identical antibiotics. Why? Because stocking inventory is easier than reaching a consensus recommendation.

If a client requests a particular parasite control product, it is either because he or she been guided by an advertisement or because we introduced a new product that we believe is superior but we did not take the time to convert the client. Pet owners generally won't recognize that chemical compositions are often very similar or even identical. The product they request may very well be identical to the one we dispense. We just need to explain it to them.

Tell your clients why you support certain products. Brand recognition is important, but not as important as professional advocacy. The positive influence of professional advocacy on consumer purchasing decisions is why advertisements make statements such as "this product is preferred by nine out of 10 dentists."