Lead the way: 7 steps to boost acceptance of your medical recommendations - Veterinary Medicine
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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.



In their book Made to Stick: Why Some Ideas Survive and Others Die, the authors, Chip and Dan Heath, stress that using technical jargon is a barrier to communication with people not in the know. Clients may not say, "I don't understand that term," but if you listen with your eyes, you may see their posture change or their brows furrow when you say, "polycythemia rubra vera," or "thoracolumbar." These terms are appropriate when talking to colleagues or writing medical records, but when communicating with clients, saying "too many red blood cells" or "middle of the back"is clearer.

Even when numerous preventive measures or diagnostic or treatment options are available, there is still generally one agreed upon best option—and that is what you should recommend. While clients want to be involved in medical decisions, they are rarely prepared to appreciate differences among the options presented. So if veterinarians offer multiple options, we must make it clear that the options are not interchangeable. A fractured pelvis might best be resolved by using plate fixation. Perhaps, an external fixation device would also be appropriate. But you need to explain to clients the benefits and disadvantages of each option.

All options might be presented but not on equal footing. The preferred option should be presented as clearly superior. Then comes the hard part—be quiet and let the client speak. There may be a long and awkward silence, but stick it out. Either clients will accept your recommendation and you will have achieved concordance, or they will ask for another option and you start over again. So make your best recommendation and give the client a chance to say, "yes."


Avoid statements such as, "Studies have shown that this situation responds best to this recommendation 53% of the time." Instead, personalize the recommendation and say, "While no one can predict what will happen in any case, I am comfortable that this recommendation gives Scout the best chance for a full recovery." Broad recommendations are great, but Mrs. Jones is concerned about one thing: What is the best thing you can offer to keep her pet healthy, happy, and comfortable? So personalize your recommendations to make it clear you think they are in her pet's best interest.


"I will have the technician discuss parasite prevention with you" may be more than what many veterinarians are doing, but it sends a signal to clients that the discussion is not worth your time. If a recommendation is worth making, it is worth the time to make it, explain it, and advocate for it. Certainly, team members play a key role in clarifying the recommendation and in helping facilitate adherence to the recommendation through reminders and inquiries. Most important, team members can facilitate client adherence to your recommendations by walking the talk and honestly reporting that they follow your recommendations.

Consider statements such as "Mrs. Jones, I know how important Scout is to you, and I want to be sure we do all we can to protect her from serious diseases that can shorten her life and some that can potentially cause diseases in your children. Heartworm preventives are effective and have the added advantage of preventing internal worms that can cause disease in people. I strongly recommend that we start Scout on a monthly product that will help you and me keep her healthy. Do you have any questions I can answer? Can I count on you to stick to this plan with our help?"

This one-time discussion explains what you advocate and why you feel so strongly about it. You are acknowledging possible concerns and offering your support.


One thing veterinarians have over Internet pharmacies and web-based resources is a relationship with clients, so it is important that we foster these relationships by communicating with clients regularly. In today's practices, it is not uncommon to have 25% to 30% of office visits unscheduled. Why not use those lulls to call clients and just say, "Howdy." Seek other opportunities to reach out, such as surprising clients with a chat in the waiting room. An offer of a cup of coffee or juice or a cookie is always welcome.

Websites are great, but when did you last update yours? Clients are likely to be linked into social media, such as Facebook, Foursquare, and Twitter. Chances are you have someone on your staff who would be great at handling social media contacts and tweets to keep your message in front of your clients.


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