The smooth consultation (part 2)
Written by Miguel Ángel Díaz , Iván López Vásquez, Cindy Adams and Antje Blättner
This section provides some specific examples of different types of questions (open-ended, closed) to ask owners during consultations, as well as additional advice and practical examples to help you improve your listening skills.
Key Points
The quality of the question determines the quality of the answer.
It is important to ask questions and actively listen until all facts are crystal clear.
Questions & answers
Certainly, there are many questions a veterinarian can and will need to ask the client to collect a case history, but given the limited time available to each client, these questions should be well-considered – the quality of the question determines the quality of the answer. That means: think first about what do I want to know and why? Then formulate the appropriate question!
With the right types of questions you can:
- gain valuable information about the pet’s illness;
- reveal the client’s needs;
- find out the client’s opinions and attitude;
- gently lead clients to a decision.
We must not forget that the client is, on the one hand, a layman, but, on the other hand, he can find a lot of information on all sorts of subjects on the Internet – including the subject of animal health.
This means that clients are often “pre-informed” and come with a self-diagnosis or they present their “internet findings” and would like to discuss them with us. Nevertheless, the client needs our guidance and clear recommendations in order to work with us as a partner to design the best care for their animal.
Basically, there are several types of questions that are well suited for the consultation and can be used for a variety of purposes (Table 1).
Question type & examples | Suitable for... | Not suitable for... |
---|---|---|
Open-ended questions:
So-called “why-questions”, which start with what, which and how:
• What brings you in today?
• What exactly did you notice about your dog?
• How did you give the food?
• What is your opinion on this issue...?
• Which other questions do you have?
|
• Inquiring about client needs and information on symptoms
• In-depth questions to clarify symptoms
• Inquiring about viewpoints and opinions
• Obtaining feedback
|
• Promoting decisions
• In case of lack of time, because the answers are much longer than with closed questions
|
Closed questions are questions that are answered with yes or no:
• Shall we take an x-ray now?
• Is the next appointment tomorrow at 3 o'clock ok for you?
• May I give you a 3 kg bag of pet food?
|
• Promoting decisions: yes or no?
• Guiding a client who talks a lot or when time is running out
|
• Requesting opinions
• Inquiring about information
|
Alternative questions are questions that give the dialogue partner two possible answers:
• Should we perform Plan A with x-ray and blood test or Plan B with x-ray only?
• Would you like to come in at 3 or 5 tomorrow?
• Can I give you a small or a large bag of pet food?
|
• Promoting decisions: this or that?
• Leading the client to a decision where he does not think about whether he wants something at all, but which alternative to take
• Guiding a client who talks too much
|
• Requesting opinions
• Inquiring about information
|
The art of dialogue is to ask the right question at the right time inquiring about the reason for the consultation, as well as the client’s desires and needs, while at the same time not giving the client the feeling of being in an interrogation. How question techniques – together with active listening – can be implemented in dialogue, is shown in the next example dialogue.
Note: the quality of the question determines the quality of the answer!
Listening & understanding
Not only asking the right questions, but also the manner of listening, active clarification and feedback are important to connect with the client in order to really understand him, make suitable offers and win him as a partner. The partnership between veterinarian, practice team and clients is important because it is the basis of a successful business relationship! If the veterinarian alone decides diagnosis and therapy, the treatment itself is probably not worse, but the pet owner is merely the doctor’s assistant and not a genuine partner.
For a high level of compliance and client loyalty, however, it is essential that the veterinarian views the client as partner and aims to achieve goals (therapy, diagnostics, etc.) together with him.
This means that the vet practitioner should:
- ask open questions:
- if he wants to get information and opinions;
- if he wants to inquire about the client’s needs and wants;
- if he wants to clarify something that is not 100% clear;
- if he wants feedback.
- ask closed and alternative questions:
- if he wants to facilitate decisions;
- if he wants to filter out a client trend (Plan A or Plan B?);
- if the client talks so much that concentrated and focused work is made difficult or time runs out.
The following example dialogue shows how the following techniques like asking questions, listening, understanding, clarifying and feedback can be implemented in everyday practice:
- Veterinarian: Mrs. Schmidt, what brings you and Lucky in today?
- Client: Lucky needs to be vaccinated and I wonder if I should have him neutered.
- V: I understand: Lucky will get his annual health check with vaccines. Then you need advice on neutering. Is there anything else I can do?
- C: Yes, please pay special attention to his ears during the health check, Lucky had an ear infection last year.
- V: All right, I have noted that. Mrs. S., can you tell me about your thoughts on neutering Lucky?
Dr. V. asks this question to clarify why Mrs. S. is considering neutering her pet. This information is important in order to respond appropriately to the situation. Moreover, the statement “if I should have him neutered” is anything but clear, i.e., what exactly Mrs. S. means remains initially in the dark. Simply going over it and delivering standard advice ignores the client’s needs and wastes time.
- C: I read that this helps when male dogs are restless, but I was told that animals get fat after neutering.
- V: Please explain in more detail how Lucky is restless.
- C: Well, if there’s a female dog in heat in the area where we go for a walk, he doesn’t obey at all, runs away and once we get back home, he lays at the door and whines all the time.
- V: Ok, and how does he behave if there isn’t a female dog in heat around?
- C: Then he is the best behaved and most relaxed dog in the world.
- V: It looks like you would both benefit from neutering Lucky. Here´s my suggestion: There is a preparation that is implanted under the dog´s skin and inhibits male hormones. If I implant it, then we’ll have about 4 months to see if Lucky will be calmer around bitches in heat. How does that sound?
- C: That’s a great idea – let’s do it! And then we can still operate him in the end?
- V: Sure, that´s always possible, but then we’ll know if neutering is the right solution. I suggest that we do the health check, vaccination and the ear examination today, and make a new appointment for the anti-hormone implant. Does that work for you?
- C: That’s great. Let’s do that.
In this dialogue, the veterinarian deliberately asks open questions until he is sure that he has enough information to offer a solution that suits the client’s needs and the present situation. He also listens carefully to what Mrs. Schmidt says and clarifies what exactly “restless” means by digging deeper with open questions. This is immensely important, because behind the initial symptoms described by Mrs. Schmidt there could also be a cardiological or internist issue. By asking questions, listening and giving feedback “How does that sound? / How does it work for you?”, the dialogue takes a good and mutually clear, open and satisfying direction (Figure 1).
Note: It is important to ask questions and actively listen until all facts are crystal clear.
Miguel Ángel Díaz
DVM
Spain
Miguel received a degree in Veterinary Science in 1990. After working at several clinics he opened his own clinic in 1992 which grew from a two-person office to a 24/7 hospital with 17 employees. After running his hospital for 25 years, he handed it over to his team in 2017 in order to concentrate exclusively on his great passion: coaching.
Miguel is the director of the company New Way Coaching, aimed at helping veterinarians become better leaders. He has been educating and training veterinarians in Europe, Latin America, and Asia since 2009 in leadership, motivational techniques, effective communication, handling objections, conflict resolution, influence and persuasion. He spends his days giving individual coaching sessions, private training for his clients’ teams, and workshops and conferences for major veterinary sector companies.
Miguel is an International Coach Certified by the International Coaching Community and the Center for Executive Coaching (USA). He is a Certified Trainer for Edward de Bono’s Six Thinking Hats.
He has been an international speaker at conferences in over 10 countries on three continents. He is the author of the book “7 Keys to Successfully Running a Veterinary Practice”, which has been translated into English, Polish, Chinese and Italian.
Iván López Vásquez
DVM
Chile
Iván comes from a family of veterinarians; his father and older brother share the same passion. He obtained his degree from the Universidad de Concepción in 1991, worked a few years at a small clinic and then shifted his career towards sales and marketing, holding several positions at multinational companies in the domestic pet market in his native country.
Since 2008 he has been the executive director of Vetcoach, a business and organizational consulting company that specializes in the pet veterinary sector in Latin America, where his vision is to create “a new standard for the veterinary world”.
Iván has studied marketing, innovation, coaching and positive psychology. Today he is a strategic business consultant in organizational development and innovation, an ORA Coach (Organizational Role Analysis), creator of initiatives to improve the well-being (happiness) of veterinary students and qualified veterinarians, as well as high-value training programs for veterinary companies and their teams on subjects such as management, wellbeing, communication skills and positive leadership.
Iván has written several management articles for veterinary journals and is an international conference speaker in Latin America.
Cindy Adams
MSW, PhD
Canada
Cindy Adams is Professor in the Department of Veterinary Clinical and Diagnostic Sciences at the University of Calgary, Veterinary Medicine, where she developed and implemented the Clinical Communication Program in Calgary’s new veterinary school. She honed her professional understanding of human-animal relationships serving from 1980-1992 as a social worker in child welfare, women’s shelters and the justice system. Animals were frequently involved in that work. Combining the very different perspectives gained from her experiences in social work and a doctorate in veterinary epidemiology, she became a faculty member at the Ontario Veterinary College, University of Guelph (1996-2006). There she designed and directed the first veterinary communication curriculum in North America and pioneered a research program regarding communication in veterinary medicine.
She helped initiate the Institute for Healthcare Communication, Bayer veterinary communication project. Her research has focused on communication education, veterinary-client communication in large and small animal contexts, animal welfare, companion animal death and human grief. Founder of the International Conference on Communication in Veterinary Medicine, co-author of Skills for Communicating in Veterinary Medicine she has presented widely and advised veterinarians, veterinary practice teams and veterinary educators throughout North America, Europe, Australia and the Caribbean.
Antje Blättner
DVM
Germany
Dr. Blaettner grew up in South Africa and Germany and graduated in 1988 after studying Veterinary Medicine in Berlin and Munich. She started and ran her own small animal practice before undertaking postgraduate training and coaching course at the University of Linz, Austria and then founded “Vetkom”. The company provides training to veterinarians and veterinary nurses in practice management in subjects such as customer communication, marketing and other management topics. Dr. Blaettner also is editor for two professional journals, “Teamkonkret” (for veterinary nurses) and “Veterinärspiegel” (for veterinarians).
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