Article

Introduction

The complexity of veterinary medicine extends beyond clinical expertise, demanding a high level of communication proficiency to address the diverse needs of clients and to ensure optimal patient outcomes. In contemporary veterinary practice, the interaction between the healthcare team and clients plays a central role in determining clinical success. Effective communication fosters trust, increases adherence to treatment plans, and ensures that client concerns are fully addressed. However, despite its importance, communication training has often been underemphasized in veterinary curricula and professional development programs (1). This article seeks to offer some pointers to help veterinary nurses/technicians improve owner compliance, for example, when it comes to advising about weight management for their pet.

What makes for an effective consultation?

Two recent studies have provided valuable insights into improving communication in practice: one highlights the effectiveness of onsite communication training (1), while the other investigates the benefits of soliciting client concerns early in any consultation (2). Together they offer actionable strategies for enhancing veterinary-client interactions.

While veterinary education has incorporated communication training in recent years, transitioning these skills into practice remains a challenge, particularly for experienced practitioners. A robust study conducted in a Denver-based practice demonstrated the transformative impact of onsite communication skills training, with a year-long program that combined interactive learning modules, individual coaching sessions, and video reviews to foster client-centered communication (1). Post-training analysis revealed that veterinarians had doubled the amount of lifestyle and social data gathered during consultations, and in addition the frequency of partnership-building communication increased by 1.5 times. Clients in turn shared 1.4 times more lifestyle-social information and expressed 1.7 times more emotional statements, reflecting a shift towards a more open and collaborative dialogue (1). The benefits extended beyond individual consultations; improved communication skills translated into enhanced team dynamics within the practice, reduced instances of miscommunication, and better adherence to treatment plans.

The solicitation of client concerns at the start of an appointment has emerged as a critical determinant of consultation efficiency and client satisfaction (Figure 1). A detailed study of 334 veterinary appointments revealed that only 37% included explicit solicitation of client concerns, leaving a significant gap in the consultation process. When veterinarians employed open-ended questions, clients were more likely to articulate multiple concerns, enriching the diagnostic and therapeutic dialogue (2). However, interruptions by the clinician were a common barrier, with most occurring after just 11 seconds of client speech; these interruptions often precluded the full articulation of client concerns, potentially compromising the effectiveness of the consultation. Appointments that lacked initial solicitation were four times more likely to encounter new concerns emerging at the end, underscoring the importance of early agenda setting (2). Basically, effective solicitation benefits both parties: it provides the veterinary team with a clearer understanding of client priorities and concerns, while clients feel heard and valued. Moreover, aligning expectations early in the consultation reduces the likelihood of misunderstandings and enhances overall satisfaction.

How can we improve communication?

The findings from these studies highlight a significant opportunity for advancing veterinary practice through improved communication. While newer graduates may have an advantage due to recent training, experienced practitioners can benefit from structured interventions to address ingrained habits and adapt to evolving client expectations (2). Practical recommendations include:

1. Systematic use of open-ended questions: Initiating consultations with open-ended questions can encourage clients to articulate a comprehensive list of concerns, providing a solid foundation for subsequent discussions (1), as discussed below.
2. Active listening and agenda setting: A deliberate effort to listen without interruption fosters trust and ensures that the consultation proceeds in an organized manner.
3. Continued professional development: Incorporating communication skills training into routine professional development can sustain improvements and adapt to changing practice demands.

 

How can we obtain a good history?

Veterinarians and veterinary nurses/technicians receive information from clients when taking a history, interpret that information, and then make recommendations based in part on how that information is interpreted. Improving our communication skills will improve compliance, which in turn will improve our patient’s health, quality of life, and perhaps even increase the patient’s lifespan. As with other aspects of clinical work, when it comes to advising on weight management and nutritional recommendations, the goal is to educate and influence the client to follow our advice. Therefore, when taking a patient’s history, ask the owner open-ended questions regarding the pet’s current diet, i.e., questions that need more than one word or a “yes/no” response, and that require more explanation or narrative to answer (Figure 2). So the question “Does Lady like chicken flavored canned food?” only requires a “yes” or “no” answer, but asking the open-ended “What flavor of canned food does Lady like?” will provide you with more information on what she likes – and possibly what she does not like.

So as an example, if the aim is to make recommendations for getting a dog to lose weight, you can start by asking the owner broad, open-ended questions such as: “Tell me about Lady’s typical day.” Allow the client to reply without interrupting if possible, although if they go too off-track redirecting the conversation may sometimes be required. Then ask clarifying questions as necessary, such as, “When was the last time you changed Lady’s diet?” “Why did you make the change?” “Who is primarily responsible for feeding Lady?” “Who else feeds Lady?” “What treats does Lady get?” “What nutritional supplements do you give Lady?” “What medications does Lady get?” and “How do you administer the medications?”

The goal of taking a nutritional history like this is to learn in detail what the patient is ingesting on a regular basis, what they eat occasionally, the client’s preferences, and any misconceptions they may have (if any) about pet food. Obtaining a complete history requires good listening skills! We naturally know how to hear, but listening is a learned skill, and like any skill we need to develop and practice listening before we can become good at it. Listening requires a commitment to understanding how the other person feels, and also requires that you put aside your beliefs, self-interests and prejudices. When listening, don’t be judgmental or find fault with what the client feeds their pet. Obtain the full nutritional history before making comments or recommendations. Listen to the client’s reasons for feeding a particular diet and any concerns that they might mention with other diet options.

It is also important to use attentive body language. This promotes openness, encourages dialogue, and helps to establish a positive relationship. Maintain good eye contact and lean slightly forward, avoiding using a disapproving or negative facial expression (Figure 3).

Once you think that you have a full nutritional history, paraphrase the important information and ask if your interpretation is correct. Choose your words carefully to avoid appearing to disapprove or to be judgmental of the client’s feeding choices.

Getting the message across

Let’s suppose that you want to advise an owner on the most effective way to help their dog lose weight. Recommend the diet and feeding plan that you believe is the best for that particular animal, but remember it is also essential to consider the owner’s perception of what is the best diet for their pet. It is important to consider a client’s beliefs, preferences, and concerns; how you communicate your nutritional recommendations will be a major factor in the client’s willingness to accept or follow your advice. 

Showing empathy

Empathy is the ability to see something from someone else’s perspective. Empathy statements name and appreciate another person’s predicament or point of view. Listen carefully to the other person’s thoughts, feelings, and values, and imagine what it would be like to stand in their shoes, then use both verbal and non-verbal communication to demonstrate that you fully understand. Showing empathy is a key part of building relationships and garnering trust. Expressing empathy in client communication is uncommon in veterinary medicine; one study found it to occur in only 7% of veterinary appointments! (4).

Communication styles

Communication is a complex skill that requires continued work to improve and to be the best possible communicator. The words we choose, our tone of voice, facial expressions, and body language all influence how our message is received by those we are communicating with. Our communication style, how we best receive information from others, is often the way we naturally present information to others. However, styles vary, and our message may not be received well or understood well by someone with a different communication manner.

Know a client’s personality type 

Having an understanding of how individual personalities relate to interpersonal communication allows us to better tailor our communication to those with different characteristics and communication styles than our own. Created in the 1920’s and based on psychiatrist Carl Jung’s theory of personality types, the Myers-Briggs assessment method is one common method for determining personality types. It consists of eight preferences organized into four pairs of opposites, as shown in Box 1. It helps identify how an individual prefers to take in information, how they make decisions, and whether they have an outer orientation toward action, people or things, or an inner orientation towards ideas, concepts, and abstractions. All personality styles apply to everyone, but one of each preference pair is usually dominant and better developed. 

By now, you may be wondering, how does any of this relate to me making recommendations for my patients? Or how will I have time to determine what personality type each client is before giving them advice? Bear with me, as I’m not suggesting that you try to determine what personality type you are speaking with; my goal is to give you the tools to deliver your message in a way that will reach different types of individuals.

 

Box 1. The basic Myers-Briggs concept.

The Myers-Briggs framework consists of eight preferences organized into four pairs of opposites; this allows for 16 possible combinations, hence 16 distinct personality types: Extrovert (E)/Introvert (I): The extrovert takes essential stimulation from the environment and the outer world of people and things, while the introvert’s essential stimulation is from within, the inner world of thought and reflection.  Sensing (S)/Intuitive (N): Those with strong sensing tendencies function by taking in information by way of the five senses (sight, sound, touch, taste, and smell), while the intuiting person processes information by way of a “sixth sense” or hunch.  Thinking (T)/Feeling (F): Thinkers make decisions based on logic and objective consideration, but feelers make decisions based on personal subjective values.  Judging (J)/Perceiving (P): Those with strong judging tendencies are decisive, planned and orderly, whilst a perceptive person is flexible, adaptable and spontaneous.

 

Preparing a message for all communication styles 

Considering how people with different personality types differ from our own communication style can help us to think in an alternative “voice”. The process of exploring the needs of different communication styles can significantly help with successful communication. Consider the following questions as you prepare your message:

• What are the major issues or positions, without details, that I will talk about? This will appeal to the intuitive person.
• For each of those major issues, what are the details that support each of those positions? This appeals to the sensing person.
• How could I deliver my feeling data, and what words should I use that would be important to a thinker?
• How should I position my main point so that the intuitive person can see the big picture?
• Am I being clear enough, with details, about what my needs are so I make credible sense to the sensing person?

Follow this outline as you prepare your message to appeal to people of all communication styles. Examples are included in italicized font:

• State your big picture intuitive/thinking point. “Max has gained weight since his last visit.”
• State your big picture feeling point – “Dogs that are overweight are prone to many other health issues.”
• Restate your big picture thinking point – “Reducing the number of calories Max eats each day will be key to him losing weight. I’d like to work with you on a weight loss plan for Max.”
• Present your sensing/thinking details (with supporting data) – “Dogs with weight-related health issues often require veterinary medical care and prescription medications, which can be expensive.”
• Restate your big picture feeling point – “I’d like to work with you on a weight loss plan for Max. Reducing the number of calories Max eats each day will be key to him losing weight.”
• Restate your sensing/feeling details (with supporting data) – “There was a study done where a litter of Labradors were split into 2 groups when they were weaned. One group was allowed to eat as much as they wanted until they were overweight. The other group was calorie restricted and kept at an ideal weight. The dogs in the ideal weight group lived 2 years longer than their littermates that were overweight (3).”

Constructing your message in a manner that will best be heard by people of different communication styles can help to increase client compliance with your nutritional recommendations. Clients that truly “hear” and understand the importance of their pet’s nutritional plan are more likely to follow the plan you create and are more apt to seek your advice if issues should arise.

Conclusion

Communication is a critical competency in veterinary practice, influencing client satisfaction, adherence to recommendations, and clinical outcomes. By prioritizing the solicitation of client concerns and adopting structured communication training, you can enhance the quality of care and strengthen client relationships. The integration of these strategies into practice not only benefits clients and patients but also supports veterinarians in achieving greater professional fulfillment. Veterinary nurses/technicians are ideally suited to promote the best healthcare options and to educate clients and make nutritional recommendations, and understanding how people with different personality types and communication styles receive information is a key factor in tailoring your message to appeal to all types.

 

References

1. Shaw JR, Barley GE, Hill AE, et al. Communication skills education onsite in a veterinary practice. Patient Educ. Couns. 2010;80:337-344.
2. Dysart LMA, Coe JB, Adams CL. Analysis of solicitation of client concerns in companion animal practice. J. Am. Vet. Med. Assoc. 2011;238:1609-1615.
3. Kealy RD, Lawler DF, Ballam JM, et al. Five-year longitudinal study on limited food consumption and development of osteoarthritis in coxofemoral joints of dogs. J. Am. Vet. Med. Assoc. 1997;210(2):222-225.
4. Shaw J, Adams C, Bonnett B, et al. Use of the Roter interaction analysis system to analyze veterinarian-client-patient communication in companion animal practice. J. Am. Vet. Med. Assoc. 2004;225(2):222-2292. 

 

Further reading

Briggs Myers I, Myers PB. Gifts Differing: Understanding Personality Type (Reprint Edition), Mountain View, Ca; Davies-Black Publishing, 1995.

Myers G,‎ Myers M. The Dynamics of Human Communication. New York, NY; McGraw-Hill Humanities, 1991.