Dr. Nancy Kay, DVM, a respected veterinarian and author of Speaking for Spot (yes, that's the book I keep nagging you about - have you read it yet?) kindly agreed to have her post re-published here.
Until a few years ago it was darned near impossible to find much in the way of useful research about communication between veterinarians and their clients.
Nowadays, several wonderful studies are surfacing. It’s about time I say, and the results have been fascinating! The newest communication study appears in the June 15, 2011 issue of the Journal of the American Veterinary Medical Association and is titled, “Analysis of solicitation of client concerns in companion animal practice.”
The purpose of this study was to determine what percentage of veterinarians evaluated effectively solicited their clients’ concerns at the beginning of the office visit.
When veterinarians did solicit concerns, the client’s responses were referred to as their “opening statement”.
What we know from research pertaining to human physicians is that only 23% to 28% of patients are allowed to complete their opening statements.
In addition to learning how many veterinarians effectively solicit client concerns, this study also determined if there is a difference in the way clients respond to open-ended versus closed-ended solicitations.
Open-ended questions such as “What brings you in today?” cannot readily be answered by a simple “yes” or “no”.
Rather, they require more expansive, thoughtful responses.
Closed-ended questions such as, “Has Peanut been vomiting?” can readily be answered by “yes” or “no” and may entice a client to focus on what they perceive the veterinarian thinks is important rather than what they are truly concerned about.
Here’s what this study’s researchers learned by reviewing 334 videotaped veterinarian-client office visits:
- Solicitations for client concerns were made in only 37% of the office visits.
- Of the office visits that included solicitations, 76% of the queries were open-ended and 24% were closed-ended.
- In response to open-ended solicitations 76% of clients expressed one or more concerns. In response to closed-ended solicitations, 40% of clients expressed one or more concerns.
- Clients spoke more than twice as long in response to an open-ended solicitation compared to a closed-ended solicitation.
- Clients’ opening statements in response to the solicitation were interrupted by the veterinarian 55% of the time, on average after only 11 seconds!
- Following an interruption, clients returned to and completed their response only 28% of the time.
- Appointments in which the veterinarian did not solicit client concerns at the beginning the office visit were significantly more likely to have concerns raised at the end of the office visit.
- Open-ended solicitations were more likely to occur during “well pet visits” than visits initiated because of a medical issue.
Are you surprised by these results?
I’m a bit surprised by the numbers and, admittedly, as a veterinarian, I’m feeling a bit of professional embarrassment.
This study underscores the fact that veterinarians could be doing a much better job soliciting and listening to their clients’ concerns.
By learning from studies such as these, there is so much potential for greater success, not only in terms of doing a better job for our patients (gaining an accurate assessment of all concerns is certainly in the best interest of the patient), but also in terms of our clients.
Actively listening to their concerns without interruption conveys empathy and what person worried about their best buddy’s health couldn’t use a good dose of that?
As a consumer of veterinary medicine, what is the take home message for you? I hope this data will prompt you to be persistent in expressing all of your concerns to your veterinarian at the beginning of the office visit.
And, if interrupted, do your best to return to your original train of thought!
What is the take-home message for veterinarians?
It is clear that we could and should be doing a much better job consistently asking open-ended questions at the beginning of office visits and then actively listening, without interruption to hear what our clients have to say.
Perhaps before entering the exam room we might remind ourselves of the saying I’ve always loved, “Don’t just do something, stand there!”
Editor's note: One thing that's always worked well for me, whether for the reasons above or simply for the sake of bad memory, is writing things down before the visit. If you come in with a comprehensive list, it will keep you on track. Don't leave the office until every item on the list had been addressed.
DR. NANCY KAY wanted to become a veterinarian for just about as long as she can remember. Her veterinary degree is from Cornell College of Veterinary Medicine, and she completed her residency training in small animal internal medicine at the University of California—Davis Veterinary School.
Dr. Kay is a board certified specialist in the American College of Veterinary Internal Medicine and published in several professional journals and textbooks. She lectures professionally to regional and national audiences, and one of her favorite lecture topics is communication between veterinarians and their clients. Since the release of her book, Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life, Dr. Kay has lectured extensively and written numerous magazine articles on the topic of medical advocacy. She was a featured guest on the popular National Public Radio show, Fresh Air with Terry Gross.
Dr. Kay is a staff internist at VCA Animal Care Center, a 24-hour emergency/specialty care center in Rohnert Park, California. As a way of providing emotional support for people with sick four-legged family members, Dr. Kay founded and helps facilitate the VCA Animal Care Center Client Support Group. She also facilitates client communication rounds for VCA Animal Care Center employees.
Dr. Kay was selected by the American Animal Hospital Association to receive the 2009 Hill’s Animal Welfare and Humane Ethics Award. This award is given annually to a veterinarian or nonveterinarian who has advanced animal welfare through extraordinary service or by furthering humane principles, education, and understanding. The Dog Writers Association of America selected Dr. Kay for two awards. The first was the 2009 Eukanuba Canine Health Award recognizing Speaking for Spot as the publication that best promotes the health and well being of dogs. The second award was for the Best Blog of 2009 (www.speakingforspot.com/blog).
Dr. Kay’s personal life revolves around her husband (also a veterinarian), her three children (none of whom aspire to be veterinarians) and their menagerie of four-legged family members. When she’s not writing, she spends her spare moments in the garden or riding along the beach atop her favorite horse. Dr. Kay and her family reside in Sebastopol, California.
Become a fan of Speaking for Spot on Facebook.
Articles by Dr. Kay:
Even The Best Veterinarian Can Make A Mistake
Reasonable Expectations: The Ability to Discuss Your Internet Research With Your Vet
Finding Dr. Wonderful And Your Mutt's Mayo Clinic: Getting Started
A Different Way to Spay
Making Tough Medical Decisions For Your Dog: Lily's Story
Veterinarians Are People First
Emailing With Your Vet And The Miracle Of Web-based Medical Records
A Word On Second Opinions
Finding Dr. Wonderful And Your Mutt's Mayo Clinic: Getting Started
Making Tough Medical Decisions For Your Dog
It's Your Dog's Health
Does Your Vet Listen To You?
Help! My Dog Is Purple!
Veterinary Drive-Thru: Coming Soon To A Veterinary Hospital Near You!