Leading Off: It's not what you know—it's what your clients know

Leading Off: It's not what you know—it's what your clients know

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Apr 01, 2012


Dr. Jason Coe
Relationship-centered veterinary care is a collaborative partnership between veterinarian and client. This relationship is built upon a mutual understanding and an exchange of information, recognizing the importance of the client's perspective in the care of a pet.1 This approach to veterinary care recognizes the veterinarian-client relationship as a fundamental component to successfully delivering veterinary care. A recent study examining the role of clinical communication in clients' adherence to dental and surgery recommendations specifically explored the effect of relationship-centered veterinary care on clients' adherence.2

THE STUDY

In this study, video-recorded veterinarian-client-patient interactions containing a dentistry recommendation, a surgery recommendation, or both were selected from a larger sample of video-recorded veterinarian-client-patient interactions.2 A total of 19 small-animal veterinarians and 83 clients were selected. The video-recordings were analyzed by using the Roter Interaction Analysis System for both verbal and nonverbal communication by the veterinarian and client. Client adherence to the dental recommendation, the surgical recommendation, or both was evaluated by reviewing each patient's medical record about six months after the original study visit.

Overall, 25 of 83 (30%) clients adhered to the recommendations made during the video-recorded visit. The relationship-centered communication score, based on the nature and distribution of verbal communication by the veterinarian and client, was significantly higher (p < 0.05) for clients adhering to their veterinarians' recommendation than for nonadhering clients. In addition, clients adhering to the recommendation were significantly (p = 0.02) more satisfied with their veterinarians after the interaction than those clients who did not adhere.

The study also evaluated the clarity of the recommendation made by the veterinarian. Clients given a clear recommendation were seven times more likely to adhere to the recommendation than clients provided with a recommendation made in an ambiguous manner (p = 0.001).

THE TAKE-HOME

In light of this study's findings, veterinarians may want to ensure they invest in developing an understanding of their clients' perspectives. This includes involving clients in the decision-making process, assessing what they already know, exploring their beliefs and values on the situation, investigating the clients' and pets' living situation, and much, much more. For example, a surgical recommendation that does not take into consideration a client's financial position as well as the client's personal views on the situation runs the risk of failing from the start. Rather, incorporating the client's perspective when making a recommendation is likely to have a much greater chance of success.

Although this study found that when clients are given a clear recommendation they are much more likely to adhere, veterinarians should not take this to mean they should simply employ a paternalistic, expert-in-charge approach to making medical recommendations. Rather, it is likely that a clear recommendation that also incorporates the client's perspective has the greatest chance of success. Therefore, in considering the best recommendation for patients, veterinarians should bear in mind that it is not likely what they know that will affect the ultimate outcome but likely what their clients know that will make the difference.

Dr. Jason Coe is an assistant professor at the Ontario Veterinary College, University of Guelph. He has established an active research program in the area of veterinary communications.

REFERENCES

1. Shaw JR, Bonnett BN, Adams CL, et al. Veterinarian-client-patient communication patterns used during clinical appointments in companion animal practice. J Am Vet Med Assoc 2006;228(5):714-721.

2. Kanji N, Coe JB, Adams CL, et al. Effect of veterinarian-client-patient interactions on client adherence to dentistry and surgery recommendations in companion-animal practice. J Am Vet Med Assoc 2012;240(4):427-436.