Meaningful Client Communication

(originally published in Veterinary Forum: June, 2001)

For many dog owners, a two-part cartoon by Gary Larson perfectly sums up the problems inherent in human-canine communication. In the first part, the owner of a dog named Ginger tells the dog of her short-comings and what will happen if she doesn’t mend her ways. In the second part, we see what Ginger hears: blah, blah, GINGER, blah, blah. Not surprisingly, the dog only hears her name because that’s the only part of her owner’s remarks that make any sense to her. Perhaps more surprising, a lot of clients feel the same way as Ginger when they listen to their veterinarians.

Veterinary communication errors fall into two broad categories: how we talk to clients and what we talk to them about. If we didn’t learn this in veterinary school, most veterinarians quickly learn in practice that nothing will make a client’s eye glaze over faster than a description of their animal’s problem heavily laced with medical jargon and acronyms. Although some practitioners will continue talking medicalese as a matter of principle, most realize it makes more sense to speak a language their clients can understand. To that end, many clinicians also provide their clients with reader-friendly hand-outs describing various medical problems and treatments.

However, even though we present this medical information in understandable terms, the fact remains that this often doesn’t tell the average client what he or she really wants to know. Ms. Jones doesn’t care what the problem means to us. Nor does she particularly care what the problem may mean to Spotty’s liver or heart, either. She wants to know what the problem will mean to her animal and to herself.

What medical professionals see as signs or symptoms of medical problems, clients often see as changes in their animals’ behavior. Inextricably entwined with these behavioral changes, we find any changes in the human-animal relationship these almost invariably precipitate. For example, when Spotty wakes up Ms. Jones with his coughing in the middle of the night, his behavior angers her and she yells at him to stop it because she needs to get some sleep. When the coughing persists, the memory of her angry outburst makes her feel guilty. When Spotty continues coughing, worry then fear that he may suffer from some serious problem join the anger and guilt elicited by what a scientist would consider an emotionally neutral sign. With each change in emotion, Ms. Jones’s relationship with her pet changes according. Meanwhile each shift in the relationship further stresses the dog and may make any physical problems worse.

Because of all this, Ms. Jones brings Spotty to the veterinary clinic with one goal in mind: to enlist help to stop his cough and bring peace and joy back into her relationship with her pet. When her veterinarian later subjects her to a lengthy discourse on the etiology, work-up results, and proposed treatment for cause of the cough but tells her nothing about if and when Spotty will stop coughing, can we blame her for feeling irritated?

In spite of the fact that all veterinarians and many clients would like to believe that owners would do anything for their animals, virtually all owners maintain limits beyond which they won’t go. As a result, owners naturally want to know what their animals’ problems will mean to them although few, if any, medical texts address this aspect of animal illness or injury. For convenience, we can divide owner limits into four categories:

  • financial
  • time
  • physical
  • emotional

Even though clinicians who don’t want to or can’t knowledgeably discuss the financial cost of treating a particular problem often dismiss such discussions as “unprofessional,” owners for whom this ranks as a major concern will hear little else we say until we address this issue. Moreover, the increased client attention to the rest of our words will more than compensate for any time spent working up ball-park estimates for common problems and getting over any fears associated with communicating cost-related information. Contrary to what some might want to believe, most clients don’t view practitioners who do this as money-hungry; they see them as sensitive to their own needs as well as their animal’s.

The majority of contemporary veterinary clients work or spend a fair amount of time away from home. Consequently, they want and need to know how much time treating their animal’s problem will require. Clinicians who automatically assume that owners will find the time “if they really care about their animals” risk alienating the owner and undermining the treatment process. Those who define any time requirements up front and offer suggestions regarding how busy owners can fulfill them earn their clients’ respect and gratitude.

As the population ages and more younger people suffer from autoimmune and other ailments that may undermine their physical health, owners’ concerns about any physical burden their animal’s problem or its treatment may place on them increase. Most of us would realize the folly of asking an arthritic octogenarian to bathe a rambunctious retriever with skin problems once a week. However, restraining animals for medication, exercising animals with special needs, or getting animals wearing various medical devices into and out of vehicles, up stairs, or through small, crowded apartments strikes many owners as the most overwhelming aspect of their animal’s illness or injury. Discussing any physical demands the animal’s problem might place on the owner before initiating treatment can help these clients enormously.

Finally, clients may place a strong emotional charge on certain kinds of illness, injury, or treatment. Although the trained scientific mind might immediately dismiss this as inconsequential, doing so could greatly undermine the treatment process or even preclude the owner treating the animal at all. It doesn’t matter how we feel about the problem; the important thing is how the client feels about it.

Client communication breakdowns waste both time and energy. By addressing these issues before initiating any treatment, we can enjoy the benefits of quality communication throughout the process.