Enhancing Veterinarian–Client Relationships With Competent Communication

Communication is paramount to veterinary care and affects client adherence to recommendations, thereby directly affecting patient care and health outcomes.¹ In fact, communication has profound implications for the veterinary team, clients, patients, and the practice; thus, competent communication leads to development of strong, long-lasting interpersonal relationships central to veterinary success.

Competent communication in veterinary medicine involves developing rapport and building relationships with clients (and colleagues) based on trust. Trust is the client’s perception that you are sincere, honest, benevolent, and credible. Competent communication also leads to employee satisfaction and wellbeing,^2,3 as well as client satisfaction and loyalty.^4-6

The key factor for developing a strong veterinarian–client relationship is competent communication, particularly an emphasis on relationship-centered care that prioritizes a partnership and shared decision-making to provide optimal care for the patient.⁷ This article discusses the value of relationship-centered care, the skills that facilitate competent communication, and how meeting client expectations can lead to increased adherence.

Relationship-Centered Interactions

Relationship-centered interactions are important for developing trust between the veterinary team and clients and achieving a positive public perception of the veterinary profession. Relationship-centered interactions acknowledge that the quality of the relationship between veterinary team members and the client is central to patient care.

Relationship-centered care is a collaboration between the veterinarian and client, whereby both parties share information as they work together regarding the pet’s care. Veterinarians provide information and education regarding diagnostic and treatment options and state their professional recommendations. Veterinarians also acquire information from clients about their preferences, goals, and needs. A relationship-centered approach leads to client satisfaction by empowering clients to be engaged in a partnership of care, thereby improving client adherence to recommendations and increasing positive patient outcomes.

Competent Communication and Core Skills

Relationship-centered care is facilitated through competent communication that builds reationships based on trust. Four core communication skills promote relationship-centered care and trust: open-ended inquiry, reflective listening, nonverbal cues, and empathy.⁸

Open-Ended Inquiry

Open-ended questions give clients the opportunity to provide complete information rather than limiting them to simple “yes” or “no” answers. Open-ended questions often begin with “how,” “why,” or “what.” These questions encourage clients to share a broad range of concerns and background information. Clients expect to be asked questions that will lead to proper care and to be asked about their values, needs, and expectations.⁹ After the veterinary team, including veterinary nurses, has gathered all information the client has shared, the veterinarian can follow up with funneled questions (questions that focus on specific points) to clarify and gather additional details.

Reflective Listening

Listening is a strong indicator of one’s communication competence. Clients cite veterinarians’ listening skills as a key indicator of caring, concern, and emotional support.¹⁰ Active listening includes focusing on the client, being attentive, and reflecting back on what you hear and see. Listening without interruptions allows clients to finish their thoughts completely. Reflective statements should paraphrase the client’s thoughts and feelings in your own words to demonstrate a desire to understand and allow the client the opportunity to clarify, confirm, or correct your interpretation.

Nonverbal Cues

Nonverbal cues include voluntary and involuntary body language, spatial relationships, and paralanguage. Body language includes facial expressions, gestures, eye contact, and posture; spatial relationships include space and distance; and paralanguage includes tone of voice, rate of speech, volume, vocal segregates (e.g., uh, um, ah-ha), and pauses.

Reflective listening requires attention to nonverbal cues, your own and the client’s, especially because nonverbal cues are related to emotions. Nonverbal cues are bidirectional: Clients convey their feelings through facial expressions, posture, and tone of voice, and veterinarians communicate to clients through their own nonverbal cues.

Nonverbal cues may be congruent or incongruent with the verbal message. Examples of how to communicate competently through nonverbal cues are leaning forward, making eye contact, and head nodding. Rapport and trust are also facilitated by sitting at the same level as the client, often side-by-side, to communicate an equal partnership of care. Additional indicators of care and concern that positively affect clients’ perceptions of veterinarians as trustworthy and credible are sitting in silence, when appropriate, and communicating in a warm tone of voice.

Empathy

Empathy is the ability to appreciate another’s feelings and perspectives. It involves genuine attention to another’s concerns, acceptance of those concerns, and a caring response. Empathy enhances clients’ feelings of being valued. Examples of empathy include acknowledgment and responding to what the clients say, statements of genuine concern and interest in the clients’ needs, supportive responses expressing reassurance, attempts to clarify messages to better understand the clients, and expressions of positive feelings by complimenting clients on their care for their animal. Collectively, empathy and reflective listening facilitate mutual understanding between the veterinarian and client.

Using Competent Communication to Increase Client Adherence

During all veterinary visits, clients want to be respected; understand the issues, problems, and recommendations being made; and feel like they are having a positive experience. During more challenging appointments, clients also need to manage uncertainty, have a sense of control, and feel supported.¹⁰

Beyond the 4 core communication skills (which are integral to respect, mutual understanding, and a positive experience), clients also have expectations regarding the presentation of information. Specifically, to minimize uncertainty, clients expect information about diagnosis, treatment and recommendations, and costs to be presented up front in understandable terms.^9,10 They expect to be provided multiple diagnostic and treatment options along a spectrum of care that considers their animal’s age and prognosis, including the pros and cons of each option.⁹ This information empowers them to be an active partner in the decision-making process, which ultimately enhances the likelihood that they will adhere to recommendations.

Communication affects the bond between clients and their veterinarian, and highly bonded clients are more likely to adhere to veterinary recommendations.⁵ Clients are most likely to adhere to a treatment plan when they have experienced a positive interaction with the veterinarian, coupled with a discussion of options and recommendations, followed by a clear action plan, all of which will ultimately benefit the patient.

Summary

Veterinarians can strengthen the veterinarian–client relationship by incorporating open-ended questions to learn more about the client’s thoughts, needs, goals, and constraints and then listening without judgement to their perspective. Throughout the interaction, pay attention to the client’s nonverbal cues and reflect back what you hear and see. Empathizing with clients acknowledges their concerns and normalizes their experiences and emotions.

When explaining information, it can be helpful to assess a client’s knowledge related to a specific veterinary problem and tailor your message to that level of knowledge or prior experiences. Use simple language at a slow pace, and be prepared to repeat information and explain it in different ways. Drawing analogies to human medicine or incorporating other metaphors can help enhance understanding. Provide information in small bits and then assess the client’s understanding. Invite questions and sit in silence to allow the client time to process the information.

Competent communication and strong interpersonal interactions between the veterinarian and client enhance development of relationships built on trust. Enlisting clients in a partnership of care through open-ended inquiry, active listening, attention to nonverbal communication, and empathy results in more satisfied veterinary team members and clients and healthier patients.