Without realizing it, many veterinarians launch into "attack the problem" mode when dealing with a sick or injured patient.
This is, of course, a good thing—except when "attack the problem" means "ignore the client." "Veterinarians have been trained
to focus on identifying the specific problem," says Dr. Jim Kramer, co-owner of Columbus Animal Hospital in Columbus, Neb.
"We're like the white knight swooping in to save the pet from the villain."
Illustration by Steve Pica
Unfortunately, when the white knight concentrates on what needs to be done to rescue the patient in distress, he or she often
forgets that talking with the client is a part of the honor-bound duties as well. And that, in a nutshell, does more harm
for you, the client, and the patient than you might think.
A study published recently in JAVMA* found a gap between the way veterinarians communicate with clients during wellness appointments and the way they communicate
during acute-care or problem-specific appointments. Here are some of the key discrepancies (also see the Related Article "Exam-room
communication: Truth in numbers" below):
> Doctors interacted verbally with a pet twice as frequently during wellness appointments as they did during problem appointments,
and the emotional atmosphere of wellness appointments was generally more relaxed.
> During wellness appointments, doctors used more social talk, laughter, statements of reassurance, and compliments.
> During problem appointments, veterinarians were more hurried and anxious, and they focused most data gathering and client
education on biomedical topics alone.
So what gives? And why do we care? According to Cindy Adams, MSW, PhD, one of the study authors, there are several reasons
behind this discrepancy—and lots of reasons to care, including pet health, client relationships, and your bottom line.
WHY THE GAP IN CHIVALRY?
For many doctors, the thrill of the chase kicks in during problem-focused appointments, Dr. Kramer says. They get to use their
investigative skills rather than just provide a set of routine vaccinations. That sense of urgency, while in many ways necessary
to address the problem, puts a damper on casual conversation.
Another theory: Money is at the root of it all. Consultant and public speaker Shawn McVey, MA, MSW, believes that a problem-specific
appointment raises the specter of presenting the client with a big bill—and that makes veterinarians too anxious to indulge
in relationship-building conversations. "In wellness appointments, there's no conflict with the cost, and a certain friendliness
arises in the absence of conflict," McVey says. "But when large sums of money are involved, as well as the potential for the
death of the patient, doctors get into self-protective mode. They want to find the answer to the problem to validate their
diagnoses, justifying the money they'll charge."
But Dr. Fred Metzger, DABVP, has a different explanation. "I think it's more about the fact that problem appointments take
more of a doctor's time and energy, especially for relatively new graduates," he says. "Wellness exams are easier, though
still vitally important, and you're not as worried that you're going to miss a life-threatening element. You're not thinking,
'I don't want to kill this poor person's dog.'"
*Shaw JR, Adams CL, Bonnett BN, et al. Veterinarian-client-patient communication during wellness appointments versus appointments
related to a health problem in companion animal practice. J Am Vet Med Assoc 2008;233:1576-1586.