You say tomato: Veterinary vocabulary makes all the difference in client communication

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Do veterinarians know what they're really saying with the words they choose?

One of the risks of communicating is that sometimes we don't. We use words and terms that we understand, but that clarity may not extend to everyone in the room. Veterinarians are not exempt from this problem. We often use words that are intended to convey a particular meaning, and sometimes two words convey similar intentions. The devil is in the details, and the differences are in the subtleties.

Compliance vs. adherence

One ongoing concern is the reality that medications are frequently not taken as prescribed. Medical care professionals—whether physicians or veterinarians—look primarily to patients and clients as the reason that this occurs. We used to apply the term "compliance" to the fact that clients weren't giving their pets prescribed drugs as recommended. We used the word when there was a willful refusal to follow instructions: "I told you what to do, and you didn't do it!"

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Increasingly, the term "compliance" refers to the medical team's failure to comply with making a recommendation that it has agreed to support. If our standard of care is year-round parasite prevention or quality nutritional guidelines, why are we not complying with our own policy to advocate for what is best for the pet? Just how have we decided which of our clients doesn't deserve to hear what we believe is best?

Perhaps a better word is "adherence." If we're consistent or compliant with our advocacy, more pet owners will undoubtedly accept our recommendations. Unfortunately, the job isn't finished there. Clients may agree with the best of intentions to medicate their pets (or, on the human healthcare side, themselves), but their adherence to the plan is low. Whether we're talking about heartworm preventive for their dog or maintaining control of their own diabetes, adherence is generally less than 50 percent. Compound that with the fact that our compliance with advocating for a particular approach is about 50 percent, and we're down to about 25 percent of our patients getting the care we believe is best.

Wellness vs. preventive healthcare

Recently, we've seen and heard a great deal about prepaid medical care plans in individual veterinary practices as well as at large corporate practices such as Banfield. The Bayer Veterinary Usage Study indicated that a prepaid medical plan allowing pet owners to budget a portion of their pet care would likely stimulate greater utilization of veterinary services. We're seeing a significant interest in prepaid plans, and there will likely be a real increase in client interest if we market and position the plans correctly. Of course, one of the first things that has resulted in a degree of division and confusion within the industry is what we'll call these plans.

It appears that "wellness plans" have the inside track—that's what Banfield calls them. Purina calls its new program a wellness plan, too. Some practices that have or are developing internal plans have called them wellness programs. And yet the most visible professional organization addressing the issue of increasing veterinary care use has decided to call them preventive healthcare plans. Seems a bit like we are doing the old "You say tomato" routine. But if you really consider the product, the service and the role we play as the providers, the name becomes more significant and the best choice more clear. Wellness is a state of health. Healthy is something you are or aren't, but it's not a product with a result. At the same time, preventive healthcare is a product or service you purchase with the end goal being a result—wellness. So no matter how a plan is structured, it provides healthcare with the purpose of preventing disease and resulting in wellness. Most pets are in a state of wellness. What would a client do to improve what the pet already has? What we want clients to do is to protect their pet's health and maintain their wellness with preventive healthcare services.

Consumer vs. customer vs. client

We've all had an unpleasant airline experience—rude ticket agents, uncaring flight attendants and baggage handlers determined to destroy the indestructible. I've flown almost 4 million miles and watched the passenger experience decline into a customer relationship. Once we decide to fly a particular carrier, we have a few expectations. A safe flight, an on-time flight, a fairly priced flight—we used to expect a nice meal, no more. We used to expect a pleasant flight crew, now the experience is nothing to write home about. Some airlines are considering implementing for-pay toilets to go along with luggage fees and $7 cans of beer. Over the years, we've become customers with few (if any) purchasing options.

The veterinary industry has fallen into this same pit—we sacrifice client interaction for the customer transaction. But unlike with air travel, consumers have many opportunities to obtain veterinary care, purchase products and get information. Don't you want them to come to you first?

Although we generally refer to people as "our clients," increasingly we treat them like customers, and the services and products we offer have become commodities. A client may be a customer, but the client-veterinarian interaction is much more likely to be professional advice or services-based—a personal interaction rather than a transaction. It's more relationship-based and so much more likely to be valued by both provider and client.

In order for us to communicate more clearly with each other, our veterinary teams and our clients, we need to choose our words carefully. This will ensure pets are getting the care they need and help us build strong relationships with the owners who love and care for them.

Dr. Paul is a veterinary consultant, a nationally known speaker and a columnist. He is the Principal of MAGPIE Veterinary Consulting. He lives in Anguilla in the British West Indies.

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