Art of communication

Years of study and knowledge amount to nothing if veterinary graduates fail in the communication department.

It's tough but true. Communication connects you with your patients, their owners and colleagues to share plans, brainstorm on problem solving and transfer information.

How we act, look, dress and smell plays an important role in our physical presentation. But failing to understand differences between people and their communication styles can skew your message. That's why delivery is equally important.

My advice: Learn to communicate to people depending on the many attributes they present to you in practice.

Know your audience

Audience age demographics are typical communication features. Each group might require a different approach to the same message. This can relate not only to the message itself and your means of delivering it but to your body language and personal appearance. Speaker and management consultant Marilyn Moats Kennedy describes the age demographic groups as follows:

Pre-boomers: 57 and older

Boomers: 43 to 56

Cuspers: 34 to 42

Busters: 24 to 33

Nesters: 8 to 23.

Know whom you are talking to, paying special detail to the education and position of your audience. Communication with a client who is a doctor, farmer, lawyer, laborer, housewife, student or child will require different methods.

Your training also has concentrated on communicating with other veterinarians, so be sure the person you are communicating with understands what you are trying to say.

Cultural and educational background should be considered. Be aware of your neighborhood, especially if people from different cultures make up your clientele.

Gender, generally speaking

Much has been written concerning gender differences in communication patterns. It is well-documented that male and female brains differ. Women primarily are right-brain thinkers and men primarily use the left side of their brains. What this means, regarding communication, is that men are able to compartmentalize or separate subjects and emotions whereas females are not as able. Men think and reason in a linear fashion and women tend to draw on many factors, put them together and then draw conclusions. Women have more difficulty than men keeping emotions apart from thought. This results in male directness and female indirectness and affects how men and women communicate. Men want to solve problems and not think about emotional consequences. Women want to give and receive emotional support so they can solve problems for themselves. In a veterinary practice, these differences can lead to problems between men and women working together, particularly in cases of crisis where the male DVM might make snap decisions and not ask for assistance. Understanding these differences will help you communicate with staff members and clients.

Suggested reading

Gender-related differences also are evident in psychological conditions, such as those exhibited by a distressed client.

How to build trust, rapport

Trust and rapport with clients must be established as well as earned. Show interest in your clients' personal lives, compliment them on how they care for their animals and encourage them to ask questions. Let clients know that you care for them and their animals and that your primary motive is not simply collecting your fee.

The same principles work with coworkers and others.

Every communication process is made of four basic elements: sender, message, receiver and interpretation.

The receiver determines the meaning of the message based on many factors, and the most important is trust and rapport that they have with the sender. Before you attempt to communicate, you must first build that trust and rapport with the person you are communicating with.

Most important: Think about what you want to say before you say it. This common advice rings true for all forms of communication.

Preparing to communicate

When it comes to communication patterns, many veterinary practices now employ a team approach. Employees are organized into teams that carry out the functions of the practice and communicate those functions, rather than having one leader directing matters. Learn to be comfortable in either situation.

The right time and place for communication also is important. Consider your relationship with the person you want to communicate with. Are you asking for a raise or trying to settle a difference? Is it an emergency? When is an answer expected?

Preparation is important, since economics of the practice play a role. Depending on the structure of your practice's client appointment scheduling, there will be a time limit on your ability to communicate with them. You will be expected by your employer and clients to work within certain time constrictions. You must be able to understand how much of your time with clients is costing the client and the practice owner. Your income might directly be connected to the amount of money you can produce for the practice and proportionate to the number of cases you can see in a given time. Likewise, the time you will have to communicate with the client will be compromised. This subject should be an important part of your mentoring program in your first practice position.

Avoiding communication conflict

Successful communication depends on your awareness of the communication and personality styles of your audience.

Some practices will carry out personality profiling to help determine how best to communicate with certain individuals.

Learning styles play a role, too. Knowing and understanding your client will help you determine whether to instruct in a visual, verbal or story-telling manner to explain various conditions or treatments, if such use would be helpful.

Be careful not to use too much medical jargon. Try not to talk down to your client by using medical terms he or she might not understand.

Understand and develop the environment for effective communication by taking in consideration the room, noise, distractions, lighting, moods, seating and temperature. Your practice's environment should be conducive to good communication. Answering telephone calls or questions from other staff while you are trying to communicate with a client can be difficult. This is especially true if the situation you are dealing with is emotional.

Try to ensure that the person you are communicating with understands your message. Solicit feedback and try to understand their verbal and nonverbal responses.

If your communication situation involves writing, know your reader. You might be writing for multiple readers with different levels of communication needs.

Use of communication principles

1. Negotiation. This will play a major role in communications with your clients and staff members. Successful negotiations require proper timing and developing trust and rapport with the other parties. Being honest and trusting others helps reduce unnecessary conflict and increases the potential for collaboration and agreement.

2. Problem solving. Whether your practice uses a team or individual approach will determine your role.

3. Conflict resolution and/or management. Resolving conflict will be a major test of your communication skills. Conflict is part of life. Avoiding it can cause additional conflict that is unnecessary and painful. Conflict is healthy when you engage in it to reach a collaborative agreement or new alternative. It becomes unhealthy when it is used to vent frustrations and fears or to control others or the situation.

4. Record keeping. Understanding the importance of and use of medical records for business, diagnostic and legal defense reasons, research records and financial records.

5. Marketing materials. This consists of writing and publishing practice newsletters, client info sheets and other publications.

6. Private practice applications. Grief counseling, communicating in emotionally charged settings, discussing money matters with clients are all special situations requiring communication skills.

7. Education. Either as a presenter or learner, you will continue your education forever. As a presenter, you need excellent communication skills to deliver your message so your audience understands it. As a student, the value of what is being presented will depend on your ability to read or listen to the message and understand it.

Special situations

The first impression of your hospital or clinic can make or break a relationship with a client. Have a pleasant and clean environment that shows your abilities to provide exceptional care, equipment and good staff is essential. As important is the manner in which you and your staff communicate with your clients. Positive, understanding exchanges will make your patients feel welcomed and reassured that their animals are in good hands.

Advertise hospital policies and procedures on information brochures, wall displays, special condition brochures, immunization and other condition reminders, computer generated financial receipts and client satisfaction surveys.

Many clients are becoming more educated regarding treatments to their animals via the Internet and other sources. This will require veterinarians to provide more professional, rapid and comprehensive services. Unless you understand this, accept it and use it in a positive manner you may antagonize a client and lose his or her trust.

Clients must be provided adequate information regarding proposed treatments, risks, prognosis and alternatives that might be available. Provide a detailed list of charges with the written consent forms used to authorize treatment. This is a legal requirement to avoid malpractice. Never promise a successful outcome.

A recent study by the American Animal Hospital Association considered how well clients complied with the preventive and treatment regimes recommended by their veterinarians. Lack of compliance was found to be a major problem, resulting in a high percentage of animal patients not receiving ultimate care. Lack of good communications between veterinarians, staffs, clients and the public was a major factor in this problem.

Resolving differences and misunderstandings require communication. When it comes to complaining clients, grievances usually are financially based, and communication breakdowns almost always are involved. Most often, timely and clear communication will eliminate them. You don't always have to be right. If this is a repetitive problem with a client, consider whether you want him or her as a client. For new veterinarians, there should be a hospital policy on handling these problems that will be discussed during your mentoring period.

Financial constraints bring their own baggage. How do you tell a client that your practice cannot provide service if they cannot afford to pay? How do you, as an employee, reconcile your problem when you know that you could treat or save an animal but you can't because the client cannot afford the services? This can be difficult for the new graduate. Here again, hospital policy should be clear and established, and your mentor should have given you the direction you require.

There will be a time when you have to deliver bad news about a diagnosis or in the case of an accident to the animal. It is important that you understand the bond that exists between the client and their animals. All pet owners will go through a grieving process. How you handle this situation will be difficult but also can be a rewarding experience. Remember that you are not a psychologist, social worker, clergy member or suicide prevention counselor and should only offer support that includes referring the grieving person to those professionals. Your staff will be involved and often affected, especially in cases where a long-term hospitalization occurred.

Communication with employees/employers

Applications and resumes are your first written communication with your potential employer. Your resume should be a picture of you on paper that will make the reader want to meet you in person. It will be one of the most important communication devices you ever use.

The interview will be your first face-to-face communication with your potential employer. You will use your oral speaking skills and, most importantly, your listening skills. Your interview will also demonstrate your non-verbal communication skills and personal appearance. How you demonstrate these skills will be the message you give your prospective employer and will be much more important at that point than your abilities to diagnose and treat disease or do surgery. The interview should also serve as a means for the potential employer to communicate policies and procedures of the practice, salary and other pertinent information to the potential employee.

Employment reviews and performance appraisals should periodically give you the opportunity to discuss your employment with your employer. This review will usually be a face-to-face meeting. As in the interview process, speaking, listening and non-verbal skills will be important and might be judged by the reviewer along with your technical and medical skills.

Hopefully you will never need to experience a termination meeting, but should it occur, be aware that how you listen and learn from what is said and what you say in return will be important as you proceed to your next position.

Every practice should have a written policies and procedures manual that communicate job descriptions, job-related perks such as holidays, health insurance, pet animal care, sexual harassment policies, pregnancy while employed and other employment policies. A common complaint of new graduates after accepting their first position is that they didn't understand what they were getting into. During the interview process, request an opportunity to learn the practice's policies and procedures.

Communications between employees in a busy practice is often difficult and often non-existent. Periodic staff meetings allow the entire staff to discuss common problems. A well-organized and well-run staff meeting allows staff members to air grievances without fear of repercussion.

Mentoring to develop communications skills

As stated in the American Veterinary Medical Association's 2000 Megastudy, which looked at economics, "... there is also evidence that veterinarians and veterinary students lack some of the skills and aptitudes that result in economic success."

There appears to be a gap between education and practice that requires an additional step in the post-DVM education process. A mentoring program can help knock down these barriers.

New graduates tend to talk too much. They try to tell clients all they know about veterinary medicine to impress clients or to cover up a lack of specific knowledge, which can be confusing.

New graduates as well as established veterinarians don't like to charge money. In many practices it will be the veterinarian's responsibility to discuss and decide on the financial aspects of the patient's care. Mistakes like not charging for lab work or smaller services can be costly. New graduates too often put themselves on the other side of the table and decide what they would be willing to pay in that situation. New graduates also want to make decisions for clients and treat and cure every case even when the client can't afford it. They take too much time to process clients as well.

The successful outcome of everything you do, everyone you interact with and your personal satisfaction as a veterinarian will depend on how well you develop your communication skills.