Richard C. Nap, DVM, PhD, DECVS, DECVCN
Around the world, veterinary students and vets alike are attracted to the profession for emotional reasons. Surveys show time and again that over 80 percent of veterinary professionals had no economic motivation to become a veterinarian. In other words, the decision to study veterinary medicine by veterinary professionals is made from the heart and not from the head. How professional is that to begin with?
At the start, over 250 years ago, veterinarians used to think that they were in the business of treating sick animals. The veterinarian and his wife were sitting and waiting for the farmers to call them for help, because of health problems with horses, cattle and other livestock. Cats and dogs were not in the focus of the owner nor of the vet. At some point in time, not even too long ago, it became clear that the focus of the profession should include the disease prevention. Vaccination campaigns were introduced and nutritional advice became part of the professional services portfolio. Economic motives were the motivator for animal owners to ask the veterinarian for help. The costs of prevention and treatment were balanced against the value of the animal(s).
In many countries less than 50 years ago, the pets entered the house and started to become part of the family. Today that process is going on full speed around the world. Not to the same extent in all countries and not to the same extent in all families, but the overall trend is similar. The pets become part of the family and are often regarded as an extension of the family. Owners are now considered and addressed as pet-parents.
It was recognized that whether dealing with farmers or with pet owners, the relationship with the owners was of utmost importance and having good communication skills became increasingly important. Owners could no longer be instructed to follow orders but needed to be informed and needed to be involved in the decision process about the prevention and treatment protocol options.
With the trend of pets becoming family members, the emotions have entered the process of decisionmaking. Dealing with people means dealing with emotions, but when it comes to the health of loved ones, this aspect becomes even stronger. Often the owners are stressed at the time of the visit and communication capacity is impaired. They don't hear (register) what the veterinarian is trying to say, and they can often not think rationally. They think emotionally, or some would say, they don't think at all. They feel.
The owners visit or call a veterinarian because they have a concern related to the health of their beloved pet for which they seek expert advice. They don't know what is wrong. They have some observations and they may make some correct or incorrect associations with circumstances or events in the history. They are worried and they obviously don't like that, and they are looking for peace of mind. They want the vet to do something that in their perception is adequately dealing with the situation and brings back the confidence and the hope for a good outcome. This outcome might be very different for different owners given the same condition (from a veterinary technical point of view). There is no one-size-fits-all prevention and treatment protocol to fit all owners and all pets. What is the preferred option for one might be far from ideal for another owner.
The responsibility for the decisionmaking on the preferred treatment is with the owner. He or she is the person responsible for the health of the animal or the pet. The veterinarian and her/his staff are responsible for offering the best possible diagnostic and treatment options available. In case these are not present in their own clinic, referral should be advised as an option.
Owners visiting or calling a veterinarian have personal expectations at the beginning of that contact. They are concerned and want the vet and her/his staff to take away these concerns. They do not come to the veterinary practice to find the latest scientific findings and treatment options. The scientific part they cannot judge, and they take it for granted and assume (for sure for first-line general practitioners) that the knowledge and skills levels are adequate. They are looking for a vet that cares about them and their pets, and they like to feel good during and after the visit. They are looking for what they perceive to be optimal healthcare. The famous, now classic quote by a colleague also referring to the situation is that owners "don't care how much you know until they know how much you care." This is about emotions, not about scientific facts.
The task of the veterinarian is to find out what the owners' expectations are and what is or might be wrong with the animal. At the end of the visit, the owners will leave and will evaluate their emotions-loaded visit. They will have a post-visit experience evaluation about the service level provided by the veterinary healthcare team. This will be based first of all on their emotions. How did they feel they were treated? You can have camera registrations proving they were only waiting for 7 minutes, but if they felt it was too long, it was too long. Client perception is reality. Emotions always win over facts in a (heated) discussion.
Veterinarians and their staff are in the business of providing an optimal healthcare experience to their clients.
After careful evaluation of the situation (including health of the animal and background information about the owner), the veterinary recommendation needs to include all relevant preventive, diagnostic and treatment options with their possible pros and cons. The owner has to decide. The veterinarian should never get trapped and make the mistake that many veterinary professionals have made, by pre-judging the owner and only suggesting and offering products and services they think are appropriate for "these people."
It is the responsibility of the veterinarian to offer the best services available in the market and to let the client decide. The role of the veterinarian is to advise and accept and respect the owner's decision. Do not force them to make a choice over the level they are willing and able to afford. However, also do not force them downward by not offering services that they might highly appreciate but are not aware they exist. Not offering the best available service options in the market is a professional mistake in conflict with the veterinary oath and mission.
Once it has been evaluated carefully what the owner needs and wants, the veterinarian needs to make the final step of the process. Close the deal. Don't stop short at offering. Sell the service. It is no use spending all the time and effort to reach this point in the process and then letting the owner go to think it over and decide later. Loaded with your investment they might go and end up in another clinic where the colleague will highly appreciate your services but will not share the revenues. You lose the client. Once all has been said and done, you need to schedule the appointment and deliver the service that you have just agreed is the optimal service for the owner and their pet (or animal).