Posts Tagged ‘Open-ended questions’

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
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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.

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