Managing the Informed Client

Veterinary clients are ever more educated and opinionated about the care their animals receive—and their ideas don’t necessarily match ours. Some clients have more background knowledge than others and, in communication terms, we refer to these as ‘informed clients.’

Traditionally, this client is exemplified by the breeder who has shown Bichon Frise bitches for decades, or the horse owner who works in health as a wound care nurse. Nowadays, the internet plays a key role in informing our clients. A recent study by Kogan et al.¹ shows that nearly three-quarters of veterinary clients use the internet to locate pet health information at least occasionally.

In a perfect world, veterinary clients with access to such knowledge would make clinical communication easier but, in reality, there are often differences in opinions that can cause conflict.

So, accepting that exclaiming “Just take my word for it!” doesn’t tend to work…

What options do veterinary professionals have in working with informed clients?

A good starting point is to find a way of empathizing with your client. Picture yourself at a visit to your local mechanic. He looks under the bonnet, sucks his teeth and informs you that you have a serious engine problem. It’s a big job, needs to be done immediately and it will cost the guts of $1,500. Are you going to say “Sure! You’re the expert. Let’s do that!”?

Maybe instead you’ll call Uncle Ray who knows everything there is to know about cars. Perhaps you’ll stand outside the mechanic’s office and Google ‘cylinder head gasket’ on your Smartphone?

It all comes down to a question of trust. If we trust someone’s judgment, we tend to follow their recommendations. If not, we need more convincing. Let’s look at some of the communication techniques that we can use to facilitate trust and to help ‘meet minds’ with the informed client.

Four Ways To Meet Minds With Your Informed Client

1. Assess the client’s ‘starting point.’

What do you think your client already knows about a disease or condition? It’s important to gauge where your client’s level of expertise lies. If we pitch our information too high we can lose our client in the jargon. Pitch it too low and we risk patronizing them. Clues about a client’s starting point come from the conversation. You may hear them drop a medical term into the discussion. Perhaps their body language tells us something, for example, the expression on a client’s face that makes us slow down or reword an explanation?

Tuning in to these clues has some merits but nothing replaces actually asking the client outright, “So, the blood results suggest to me that Snapper has a condition called hyperthyroidism. Have you heard of this before?”

2. Actively encourage the client’s thoughts and opinions…then listen.

Evidence from human medical communication² shows that exploring the patient’s perspective improves compliance. We can use questions to explore the client’s thoughts and beliefs. For example, “It sounds as if you’ve done a lot of research into vaccinating her. What’s your take on what you’ve read?” Make sure that you give the client space to talk and that you don’t dismiss his or her thoughts and opinions out of hand.

For those that argue that there is not sufficient time for such questions in the veterinary consultation, I’d ask you to consider how much time—and energy—wasted when trying to convince a client to do something that they simply don’t believe in. If you can explore the rationale behind a client’s opinion, then the chances are you’ll reach an agreed plan more quickly.

3. Share what you’re thinking.

By telling the client what you’re thinking, out loud, you are encouraging their involvement. The key is to give your rationale plainly, without pulling rank. Take the example of a 4-year-old Abyssinian cat with a raised, raw lump on her flank. Other skin pathology is present, and you are thinking flea allergy dermatitis. The client, however, has voiced her fears of something more sinister. You say, “I hear that you’re worried about a tumor, and that could definitely be on the list. At this moment I’m thinking an allergic response is more likely.” But you don’t stop there, you continue with your observations, “The reason why I think this is because of the other signs such as the scurfy coat, which you can see here when I part the fur, and the fact that flea allergies are very common in a cat of this age.”

Which mechanic would you prefer, the one that says “Trust me, it’s your radiator—I’ve seen hundreds of these things!” or the one that cracks open the bonnet to show you the cracked fins or the leaking coolant?

4. Seek your client’s participation.

The informed client thrives when you enlist them in the care of their own animals. In the example above you can suggest websites and articles on flea allergic dermatitis that they can examine before the next consultation. In this way the client gets to feel part of the team; they are encouraged in their own research.

No discussion of the informed client would be complete without looking at the influence of the internet. As noted earlier, most veterinary clients turn to the web at some point which is, in itself, not shocking news. However, if you worry about pet owners’ motivations for doing online research, you’re in for some good news. According to Kogan et al., it appears that most clients visit sites on the web out of “curiosity” or to clarify information given to them by their veterinarian¹. Only 2% of those surveyed said that they used the internet because they didn’t agree with—or believe—their veterinarian.

Dr. Lori Kogan, Associate Professor at Colorado State University, says, “The fact [is] that people want to use the internet as a backup to their veterinarian. They are not looking to replace their vet, they just want to be more active pet owners.” Dr. Kogan believes that the internet prescription is the way forward with tech-savvy clients. She explains, “By internet prescriptions, I mean ‘prescribing’ actual websites that clients can go to for more information. I think that veterinarians can play a very active role in this process by giving written directions to appropriate websites for their clients. It shows support for the education of the client and the fact that the veterinarian is open to discussing the information that clients find online.”

So, the next time your client visits with an armful of printouts from TopPetDoc.com, resist that knee-jerk urge to say “Just take my word for it!” It doesn’t work on you and it won’t work on your clients. With a little time and effort the interactions that you have with your informed clients will be some of the more rewarding ones in your day.

References

¹ L.R. Kogan, R. Schoenfeld-Tacher, A.A. Simon & A.R. Viera (2010) The Internet and Pet Health Information: Perceptions and Behaviors of Pet Owners and Veterinarians. The Internet Journal of Veterinary Medicine. Volume 8 Number 1

² J. Silverman, S. Kurtz & J. Draper (2006) Skills for Communicating with Patients. 2nd edition. Radcliffe Publishing.