Transparency and unconditional positive regard in veterinary medicine

This doctor and dog owner seem to be hitting it off, but is the veterinarian really sharing with transparency or actively listening with unconditional positive regard? (stock28studio / stock.adobe.com)

In a trio of sessions at Fetch dvm360 conference in Kansas City, speaker Ryane Englar, DVM, DABVP (canine and feline), put the lie to the old idea that communication skills can't be learned.

“They said, ‘You're either born with good communication skills or not,'” said Dr. Englar, an assistant professor at Kansas State University College of Veterinary Medicine. “But there's a lot of science behind communication.”

In the last of her three sessions, “The power of transparency (with clients) and unconditional positive regard (with everyone you know),” she discussed studies from human healthcare showing that better communication leads to greater patient satisfaction, improved treatment adherence, increased retention and increased potential for referrals. When communication failed, patients said, they felt unheard and were less adherent to recommendations, less likely to show up for follow-up appointments and more likely to submit malpractice claims.

“If they feel you didn't hear them,” Dr. Englar said of these human patients, “they're less likely to come back.”

The same is likely true of your veterinary clients. In her own small studies, Dr. Englar found that cat and dog owners want to know that their veterinarian has expertise, can problem-solve, will translate complicated medical issues into easy-to-understand language and, last but not least, show interpersonal skills.

In her pilot study looking at clients' perceptions of veterinarians' interpersonal skills, she identified two big gaps: transparency and unconditional positive regard. How would you rate in these?

Being transparent

Defining transparency as “openness about medical procedures, procedural issues or errors,” Dr. Englar encouraged attendees to think about ways this shows up:

• Wait times and delays in diagnosis or treatment. For example, explain that an emergency will delay a wellness appointment or that care may take a while.

• Office hours and availability. Calibrate expectations about what happens if a patient must be left receiving IV fluids but your practice isn't staffed overnight.

• Diagnostic unknowns. Explain that test results aren't clear and you just don't know yet.

• Abilities and skill sets. Assess what you feel capable of undertaking when it comes to procedures and treatment-and be honest. “At the end of the day, it's your license and up to you to feel comfortable,” Dr. Englar said.

• Medication errors. Let pet owners know as soon as possible about wrong medications or improper doses. “Don't just hope they never find out about it,” Dr. Englar cautioned.

The benefits of such transparency with pet owners were clear from the verbatims gathered in Dr. Englar's surveys pf cat and dog owners-they appreciated the chance to anticipate obstacles, be prepared for what came next and have time to react to difficult or unexpected news.

Showing unconditional positive regard

Dr. Englar also discovered from pet owners' concerns that they were (indirectly) asking for something mental health professionals say is crucial to healthy relationships: unconditional positive regard.

“Each person, each one of us, is an individual,” Dr. Englar said. This means everyone deserves unconditional positive regard-team members and clients alike. “We're unique. We come at life from our own perspectives. And we shouldn't label people as ‘difficult' or ‘bad' without considering their perspective.”

When encounters become difficult, ask questions to find out why people are acting the way they are, whether it's anger, fear, frustration or some other hot emotion in the moment. If you judge too quickly, and pet owners perceive that, they may not be honest about their own ignorance or mistakes they've made at home that may be affecting a patient's health.

If you find you've gotten to the bottom of a client disagreement and you can't seem to find an easy solution to help the patient, try finding new common ground by asking two questions: (1) What are you and the pet owner trying to achieve? (2) How can you work together to achieve it?

With this approach, you and your clients are much more likely to focus on the pet (rather than your own emotions)-and your patients are much more likely to receive the care they need.