Posts Tagged ‘client communication’

The Cookie Thief!

December 18, 2011

I have the good fortune of lecturing professionally, and what I most enjoy presenting is the topic of communication between veterinarians and their clients. In every communication lecture I emphasize the importance of empathy. This involves veterinarians putting aside any preconceived notions and judgments about their clients so they can better recognize how their clients are feeling and what they are truly needing. In order to drive this point home during my presentation, I usually recite a poem I adore called, “The Cookie Thief.” While preparing a lecture earlier this week, it dawned on me that you might like this poem as well. Enjoy!

The Cookie Thief

A woman was waiting at an airport one night, with several long hours before her flight. She hunted for a book in the airport shops, bought a bag of cookies and found a place to drop.

She was engrossed in her book but happened to see, that the man sitting beside her, as bold as could be. . .grabbed a cookie or two from the bag in between, which she tried to ignore to avoid a scene.

So she munched the cookies and watched the clock, as the gutsy cookie thief diminished her stock. She was getting more irritated as the minutes ticked by, thinking, “If I wasn’t so nice, I would blacken his eye.”

With each cookie she took, he took one too, when only one was left, she wondered what he would do. With a smile on his face, and a nervous laugh, he took the last cookie and broke it in half.

He offered her half, as he ate the other, she snatched it from him and thought… oooh, brother. This guy has some nerve and he’s also rude, why he didn’t even show any gratitude!

She had never known when she had been so galled, and sighed with relief when her flight was called. She gathered her belongings and headed to the gate, refusing to look back at the thieving ingrate.

She boarded the plane, and sank in her seat, then she sought her book, which was almost complete. As she reached in her baggage, she gasped with surprise, there was her bag of cookies, in front of her eyes.

If mine are here, she moaned in despair, the others were his, and he tried to share. Too late to apologize, she realized with grief, that she was the rude one, the ingrate, the thief.

Have your preconceived notions about someone ever been completely upended? Do you think your veterinarian has preconceived notions about you?

Happy holidays to you and your loved ones,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.

Advertisements

Does Your Veterinarian Hear Your Concerns?

July 18, 2011

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.  On average, they are interrupted by their physicians within 12 to 23 seconds. Research has also documented that physicians often mistakenly assume that the first or only concern expressed by their patient is the main concern or only concern.

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!”

 

Best wishes for good health,

Nancy Kay, DVM
Diplomate, American College of Veterinary Internal Medicine
Author of  Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, and your favorite online book seller.

Frankly Speaking

December 6, 2009

In 2001, the Journal of the American Veterinary Medical Association stated, “Veterinarians’ responsibilities have expanded to include the mental health and well-being of their clients as well as their clients’ pets.”  For me, this came as no great surprise.  Having graduated from veterinary school in 1982, I’d already learned that if I wasn’t taking good care of my clients’ emotional needs, it was far more difficult to take good care of my patients’ health needs.  Admittedly, it took me a few years to catch on to this notion.  During my formative years, I recall thinking that good client communication would be a “slam dunk”.  After all, I fancied myself to be a good teacher and a nice person.  It didn’t take long for me to realize that the “medicine part” was becoming a whole lot easier than the “client part.”

Thus began my avid interest in the art and science of client communication.  I read whatever I could get my hands on (not much in the veterinary literature at that time) and attended communication workshops. I began studying my clients, trying new tactics and techniques, and asking questions of them not necessarily directly related to their dog or cat (Kleenex consumption increased exponentially).  I founded and continue to facilitate a community Client Support Group (talk about a front row seat in terms of understanding what is going on in our clients’ minds) and have enjoyed teaching client communication skills to local and national audiences.

The unfortunate fact of the matter is that few veterinary colleges provide any formal client communication training to their students- doesn’t make much sense does it?  One of the schools that doesn’t overlook this important subject is Colorado State University.  Here veterinary students receive fabulous communication training via the Argus Institute (www.argusinstitute.colostate.edu).  This organization’s stated mission is “to strengthen veterinarian-client-patient communication and support relationships between people and their companion animals.” In addition to providing formal client communication training to CSU veterinary students, the Argus Institute also makes communication training available to veterinarians.  These workshops are called FRANK (based on the notion of “frank” communication), and the emphasis is on relationship-centered care, an approach that emphasizes collaboration and shared decision-making between veterinarian and client.  Pfizer Animal Health was involved in the creation of FRANK in 2007 and continues to generously fund this program.

I just completed my first FRANK training workshop- what a fabulous experience.  I left the program feeling invigorated, renewed, and eager to apply what I had learned. The majority of the workshop time was spent in small groups within simulated exam rooms.  Professional actors played “the client,” each getting in character with their assigned emotional agendas (they were awesome and totally believable).  Everyone took turns as “the veterinarian” during these mock office visits.   The interactions were videotaped after which respectful, constructive critique was offered within the small group setting. We worked on several communication skills including delivery of empathetic statements, maintaining focus on the “common ground” (the well being of the patient), reflective listening, facilitating silent pauses (time for clients to gather their thoughts), disclosure (sharing stories of our own that might parallel what the client is emotionally experiencing), and asking open-ended questions (allows the client greater opportunity to share their stories).

A veterinarian can be a sensational surgeon or a dandy diagnostician, but such skills may wither on the vine if he or she is not a successful communicator.  More than ever before, people are becoming savvy consumers of veterinary medicine and better effective medical advocates for their pets.   My sense is that these wonderful trends will drive the awareness that client communication training for veterinarians is profoundly important.   Frankly speaking, I think it’s about time!

Wishing you and your four-legged family members a joyful and healthy holidays season.

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller.

Order  a copy of Speaking for Spot personally signed by Dr. Kay – http://www.speakingforspot.com/purchase.html

Join our email list – http://speakingforspot.com/joinemaillist.html

Look for us on Twitter – http://twitter.com/speakingforspot

Become a Fan of Speaking for Spot on Facebook

Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross