Effectively communicating with your clients

The successful ability to efficiently collect diet histories, convey appropriate health messages, and discuss client concerns about the safe feeding of pets requires excellent communication skills. In addition to understanding what the client wants for their pet, thorough nutritional interviewers gather information pertaining to animal factors, dietary factors, and feeding management factors. With the expansion of the Internet, increasing advances in medical care, and the health concerns associated with pet food recalls, small animal clients are looking to veterinarians for guidance and information on dietary recommendations in ever increasing numbers. Evaluating current information on changes in the pet food industry should be a periodic learning objective for all members of the veterinary health care team. Consistent, effective communication between veterinarians, their staff, and their clients can improve compliance, increase satisfaction levels, and improve patient outcomes.     

Survey of veterinarians' recommendations for treatment and control of intestinal parasites in dogs: public health implications

A systematic, random sample of 450 small and mixed-animal practitioners was selected from the client list of a prominent veterinary pharmaceutical and animal health company. A telephone survey was conducted, using a standard questionnaire, to assess whether current veterinary practices concerning prophylaxis and treatment of canine roundworm (Toxocara canis) and hookworm (Ancylostoma spp) infections are adequate to prevent transmission to human beings. Analysis of results focused on 3 questions related to prevention: practitioner's frequency of client education regarding zoonotic potential of roundworms and hookworms, pup age at which veterinarian recommends first anthelmintic treatments, and proportion of veterinarians recommending prophylactic drug administration for pups and nursing bitches. Despite the proven association of household pet dogs and human toxocariasis, only a third (148/450) of veterinarian respondents routinely discussed the potential zoonotic hazards of canine roundworms with their clients. A total of 29% (130/450) of veterinarians surveyed either never discussed these potential hazards or discussed them only when asked by their clients. With regard to anthelmintic treatment practices, 31% (140/450) of veterinarians surveyed recommended that pups first be examined and treated for intestinal parasites within 4 weeks of age. Thirty-three percent (163/450) recommended first examination and deworming at 5 to 6 weeks of age, and 36% (163/450) suggested that it be done at or after 7 weeks of age. Less than half (208/450) of veterinarians administered anthelmintics prophylactically to at least some pups and dogs. Sixty-four percent (287/450) of respondents recommended routine testing and treatment of nursing bitches.(ABSTRACT TRUNCATED AT 250 WORDS)     

AAFP and ISFM feline-friendly handling guidelines

BACKGROUND: The number of pet cats is increasing in most countries, often outnumbering pet dogs, yet cats receive less veterinary care than their canine counterparts.(1) Clients state the difficulty of getting the cat into a carrier at home, driving to the clinic, and dealing with the fearful cat at the veterinary clinic as reasons for fewer visits.(2) Educating and preparing the client and the veterinary team with regard to respectful feline handling is necessary in order to avoid stress and accomplish the goal of good health care. Without such preparation, feline stress may escalate into fear or fear-associated aggression. The resulting stress may alter results of the physical examination and laboratory tests, leading to incorrect diagnoses (eg, diabetes mellitus) and unnecessary treatments.(3-5) Without compassionate and respectful handling by the veterinary team, clients may feel the team lacks skills and compassion, or does not understand cats. Injury may occur to the cat, client and/or veterinary team.(6) Clients who want to avoid stress for their cat may avoid veterinary visits or choose another practice instead. GOALS: The use of feline-friendly handling techniques should reduce these problems. Handling is most successful when the veterinary team adapts the approach to each individual cat and situation. The goal of these guidelines is to provide useful information for handling cats that can lead to: ? Reduced fear and pain for the cat. ? Reinforced veterinarian-client-cat bond, trust and confidence, and thus better lifelong medical care for the cat. ? Improved efficiency, productivity and job satisfaction for the veterinary team. ? Increased client compliance. ? Timely reporting and early detection of medical and behavioral concerns. ? Fewer injuries to clients and the veterinary team. ? Reduced anxiety for the client.     

Readability Evaluations of Veterinary Client Handouts and Implications for Patient Care

Health literacy and readability are important considerations for veterinary medicine, as veterinarians commonly distribute brochures, leaflets and info-graphics to explain health related issues to pet owners. Educational materials that are poorly comprehended by the intended audience could result in negative, unintended consequences. Thus, the National Institutes of Health (NIH) and the American Medical Association (AMA) have recommended readability levels for text on health information be targeted between the fourth and sixth grade levels to accommodate a highly diverse public. In the context of veterinary medicine, an increased awareness among veterinary professionals and educators regarding readability scores and the tools available to generate “easy-to-read” text would likely benefit client adherence with veterinary recommendations, client satisfaction with their veterinarian, and ultimately, pet health.Therefore, the goal of this study was to evaluate the readability levels of a sample of popular client handout materials prepared expressly for veterinarians to download and distribute to their pet-owning clients. Results indicate that 9 of 10 client brochures were written above the recommended sixth grade reading level. Recommendations for improving readability are provided.     

A new model for companion-animal primary health care education

The majority of graduates from veterinary schools in the United States and Canada join companion-animal practices. In most schools, their clinical learning and client interaction experiences occurred primarily in referral teaching hospitals. These specialty hospitals play an essential role in the veterinary care continuum by providing advanced training, clinically-based research, and sophisticated diagnostics and procedures. However, they are not ideal as the principal setting for preparing veterinarians to bring value to the primary health care practices that they join. A new model for companion-animal primary health care education and service delivery has been developed at the Ontario Veterinary College, University of Guelph. The nine integrated programs, which have defined learning objectives and outcome assessments, include communication, nutrition, rehabilitation, behavior, welfare, One Health (ecosystem approach to health), preventive and general medicine, good citizenship, and research. The learning experience begins with first-year student veterinarians and takes place in a practice setting with paying clients from the community. Significantly, the students are learning in an environment that emphasizes the importance of the client experience, teamwork, and practice management while ensuring quality health care for patients. The future of companion-animal primary health care and the optimal preparation of veterinarians are critical issues for the veterinary colleges and profession. Enhanced research into new models for primary health care education and service delivery is urgently needed.     

Predictors of owner response to companion animal death in 177 clients from 14 practices in Ontario

OBJECTIVE: To identify predictors of grief and client desires and needs as they relate to pet death. DESIGN: Cross-sectional mail survey. SAMPLE POPULATION: 177 clients, from 14 randomly selected veterinary practices, whose cat or dog died between 6 and 43 days prior to returning the completed questionnaire. PROCEDURE: Veterinary practices were contacted weekly to obtain the names of clients whose pets had died until approximately 200 clients were identified. Clients were contacted by telephone, and a questionnaire designed to measure grief associated with pet death was mailed to those willing to participate within 1 to 14 days of their pet's death. The questionnaire measured potential correlates and modifiers of grief and included three outcome measures: social/emotional and physical consequences, thought processes, and despair. Demographic data were also collected. RESULTS: Approximately 30% of participants experienced severe grief. The most prominent risk factors for grief included level of attachment, euthanasia, societal attitudes toward pet death, and professional support from the veterinary team. CONCLUSIONS AND CLINICAL RELEVANCE: Bivariate and multivariate analyses highlighted the impact owners' attitudes about euthanasia and professional intervention by the veterinary team had on reactions to pet death. Owners' perceptions of societal attitudes, also a predictor of grief, indicate that grief for pets is different than grief associated with other losses.     

An analysis of the demand for and revenue from companion animal veterinary services in Australia between 1996 and 2026 using industry revenue data and household census and pet ownership data and forecasts

OBJECTIVE To examine the potential impact of household demographic and pet ownership trends on the demand for and revenue from companion animal veterinary services in Australia. DESIGN The size of the market for companion animal veterinary services was estimated by creating a model using assumptions derived from the revenue equation. The model was verified and validated through sensitivity analyses and comparisons between model outputs and available industry data. RESULTS The model provided outputs similar to alternative industry estimates and suggested that revenue growth in recent years has been much stronger than demand growth. Under the assumptions used in this model, forecast changes to household numbers and types are less important than pet ownership trends in determining the potential demand for and revenue from companion animal veterinary services. Forecast trends in household types and relatively stable pet ownership in the future will lead to growth in demand for companion animal veterinary services in real terms of approximately 1.2% per annum to 2026. CONCLUSION The market for companion animal veterinary services in Australia is mature and growth in demand is expected to remain low over the forecast period. For most veterinary practices within this environment, growth in revenue will be a function of growth in average client fees.     

Twenty Years of Experience with Dairy Herd Health in Ontario

This article expresses observations on planned herd health for dairy cattle, based on experience gained in the Ambulatory Clinic practice of the Ontario Veterinary College. The author and his colleagues, especially Dr. R.A. Curtis, have initiated and delivered a preventive medicine approach to veterinary practice in the teaching program and teaching practice for the past 20 years. In addition, herd health presentations have been made to veterinary associations in every province in Canada and to many breed associations and producer organizations. The Canadian food animal veterinarian and his clients have been informed at meetings and by the media of the need, objectives, methods and benefits of dairy herd health and many veterinary practices now offer programs to their clients. Herd health has become a household word in Canada's dairy practices and dairy farms.

A formal herd health program is an important step to achieving total health management; but maximum returns on investment can only be realized after three or four generations of cattle have been reared on the program.

In conclusion, herd health practice has been a very satisfying aspect of veterinary medicine and a profitable and valued service for our clients. Maintenance of health involves the application of all knowledge and procedures which veterinarians have to offer.

     

A focus group study of veterinarians' and pet owners' perceptions of the monetary aspects of veterinary care

OBJECTIVE: To compare veterinarians' and pet owners' perceptions of client expectations with respect to the monetary aspects of veterinary care and identify challenges encountered by veterinarians in dealing with pet owners' expectations. DESIGN: Qualitative study based on focus group interviews. PARTICIPANTS: 6 pet owner focus groups (32 owners) and 4 veterinarian focus groups (24 companion animal veterinarians). PROCEDURES: Independent focus group sessions were conducted with standardized open-ended questions and follow-up probes. Content analysis was performed on the focus group discussions. RESULTS: Pet owners expected the care of their animal to take precedence over monetary aspects. They also expected veterinarians to initiate discussions of costs upfront but indicated that such discussions were uncommon. Veterinarians and pet owners differed in the way they related to discussions of veterinary costs. Veterinarians focused on tangibles, such as time and services. Pet owners focused on outcome as it related to their pet's health and well-being. Veterinarians reported that they sometimes felt undervalued for their efforts. A suspicion regarding the motivation behind veterinarians' recommendations surfaced among some participating pet owners. CONCLUSIONS: Results suggested that the monetary aspects of veterinary care pose barriers and challenges for veterinarians and pet owners. By exploring clients' expectations, improving communication, educating clients, and making discussions of cost more common, veterinarians may be able to alleviate some of the monetary challenges involved in veterinarian-client-patient interactions.     

Factors associated with client, staff, and student satisfaction regarding small animal euthanasia procedures at a veterinary teaching hospital

OBJECTIVE: To identify factors influencing satisfaction with procedures for small animal euthanasia and to compare the relative importance of those factors among clients, staff, and students at a veterinary teaching hospital. DESIGN: Survey. SAMPLE POPULATION: 18 nonclinical hospital staff members, 13 clinical staff members, 10 veterinary technicians, 19 veterinary students, and 91 clients. PROCEDURE: Participants were asked to complete a survey that was designed to assess satisfaction with various aspects of the euthanasia procedure. RESULTS: Overall response rate was 48% (151/313). Respondents most strongly agreed with the statements that clients should have the option to be present, that having a private place was important, and that employees should be trained to attend to the emotional needs of the client. When asked to place factors in order of importance, those that were ranked the highest included compassionate and caring attitudes of the hospital employees, the option for the client to be present during the euthanasia, and the client being informed and well prepared. CONCLUSIONS AND CLINICAL RELEVANCE: Overall, all groups (nonclinical staff, clinical staff, veterinary technicians, veterinary students, and clients) identified the same factors as being important in the euthanasia of a pet. Results may help facilitate healthy euthanasia experiences.     

Aggressive clients in Dutch veterinary practice

Aggressive clients seem to be becoming more common. This article describes a study in which questionnaires on client behaviour were sent to veterinary assistants and veterinarians in randomly selected practices in the Netherlands. Results showed that 26.4% of the veterinarians and 29.3% of the assistants had experienced aggressive clients in the last year. Age, experience, and sex of the veterinarian or assistant did not influence the frequency with which aggressive clients were encountered. The same was true for the type of veterinary practice (companion animals, farm animals, horses, etc). The risk of encountering aggressive clients was higher among practices in large towns and in practices with a small turnover Of the veterinarians who had encountered aggressive clients at least once in their career, 31% has taken some kind of action after the aggressive encounter Nearly a quarter (24.9%) of veterinary practices have adopted a Risk Inventarization and Evaluation (RI&E) approach to preventing client aggression and 26.6% of practices have adopted another approach. While veterinarians tend not to consider aggression a big problem, they are often open to the suggestion that more attention should be paid to aggression in veterinary practice.     

A survey on the question of how well veterinarians are prepared to predict their client's human-animal bond

In a survey of 63 military veterinary facilities, actual responses from 961 clients were compared with 86 servicing US Army Veterinary Corps practitioners' predictions of the clients' responses. The survey questions were designed to evaluate the degree of human-animal bonding of the military clients. The survey revealed that the effects of human-animal interaction on community, family, and animal health have extensive impact on the military member, the military installation, and the military health care delivery system. Results revealed sociologic and psychologic factors that influenced the quality of life of mobile military members and their families. The survey also revealed that although the newly graduated veterinarians understood the professional and scientific values of their clients, they often underestimated the social interdependence between client and pet. The military veterinarians in this survey were considered to be representative of the new graduate, and the results are relevant to any civilian practitioner concerned with client relations or hiring new graduates.     

End-of-life communication in veterinary medicine: delivering bad news and euthanasia decision making.

Given the expectations of clients and the resultant impact of end-of-life conversations on pet owners and the veterinary team, compassionate end-of-life communication is considered to be an ethical obligation, a core clinical skill, and integral to the success of a veterinary team. End-of-life communication is related to significant clinical outcomes, including enduring veterinarian-client-patient relationships and veterinarian and client satisfaction. Effective techniques for end-of-life communication can be taught and are a series of learned skills. The purpose of this article is to present best practices for delivering bad news and euthanasia decision-making discussions. In this article, the SPIKES six-step model (setting, perception, invitation, knowledge, empathize, and summarize) currently employed in medical curricula is utilized to structure end-of-life conversations in veterinary medicine.     

Recommendations on vaccination for Latin American small animal practitioners: a report of the WSAVA Vaccination Guidelines Group

The World Small Animal Veterinary Association Vaccination Guidelines Group has produced global guidelines for small companion animal practitioners on best practice in canine and feline vaccination. Recognising that there are unique aspects of veterinary practice in certain geographical regions of the world, the Vaccination Guidelines Group undertook a regional project in Latin America between 2016 and 2019, culminating in the present document. The Vaccination Guidelines Group gathered scientific and demographic data during visits to Argentina, Brazil and Mexico, by discussion with national key opinion leaders, visiting veterinary practices and review of the scientific literature. A questionnaire survey was completed by 1390 veterinarians in five Latin American countries and the Vaccination Guidelines Group delivered continuing education at seven events attended by over 3500 veterinarians. The Vaccination Guidelines Group recognised numerous challenges in Latin America, for example: (1) lack of national oversight of the veterinary profession, (2) extraordinary growth in private veterinary schools of undetermined quality, (3) socioeconomic constraints on client engagement with preventive health care, (4) high regional prevalence of some key infectious diseases (e.g. feline leukaemia virus infection, canine visceral leishmaniosis), (5) almost complete lack of minimal antigen vaccine products as available in other markets, (6) relative lack of vaccine products with extended duration of immunity as available in other markets, (7) availability of vaccine products withdrawn from other markets (e.g. Giardia vaccine) or unique to Latin America (e.g. some Leishmania vaccines), (8) accessibility of vaccines directly by pet owners or breeders such that vaccination is not delivered under veterinary supervision, (9) limited availability of continuing education in veterinary vaccinology and lack of compulsion for continuing professional development and (10) limited peer-reviewed published scientific data on small companion animal infectious diseases (with the exception of leishmaniosis) and lack of support for such academic research. In this document, the Vaccination Guidelines Group summarises the findings of this project and assesses in evidence-based fashion the scientific literature pertaining to companion animal vaccine-preventable diseases in Latin America. The Vaccination Guidelines Group makes some recommendations on undergraduate and postgraduate education and academic research. Recognising that current product availability in Latin America does not permit veterinarians in these countries to vaccinate according to the global World Small Animal Veterinary Association guidelines, the Vaccination Guidelines Group makes a series of “pragmatic” recommendations as to what might be currently achievable, and a series of “aspirational” recommendations as to what might be desirable for the future. The concept of “vaccine husbandry” is addressed via some simple guidelines for the management of vaccine products in the practice. Finally, the Vaccination Guidelines Group emphasises the global trend towards delivery of vaccination as one part of an “annual health check” or “health care plan” that reviews holistically the preventive health care needs of the individual pet animal. Latin American practitioners should transition towards these important new practices that are now well embedded in more developed veterinary markets. The document also includes 70 frequently asked questions and their answers; these were posed to the Vaccination Guidelines Group during our continuing education events and small group discussions and should address many of the issues surrounding delivery of vaccination in the Latin American countries. Spanish and Portuguese translations of this document will be made freely available from the on-line resource pages of the Vaccination Guidelines Group.     

Avian care and husbandry.

Birds are becoming more popular as pets, and the need for veterinary professionals to learn more about these pets is crucial. This article introduces the veterinary staff to basic information required to provide high-quality care to avian patients. High-quality nutrition for a variety of species and ages is included in this article. The importance of proper husbandry and intellectual stimulation with toys is also discussed. Special emphasis is placed on instructions for clients when making appointments, as well as recognizing signs of illness for both clients and veterinary staff. Capture, restraint, and sample collection are an important part of this article, as well as medication administration, anesthesia, supportive care, preventive care and grooming. A variety of aspects concerning the care of the avian patient are covered for the benefit of the client and veterinary technician.     

Pet insurance--essential option?

As Hawn (2) says, "insurance is about risk and peace of mind." She reports that the American Humane Society supports pet insurance because companion animals are able to be treated for disease or accidents that are life-threatening where, otherwise, they would have been euthanized. For veterinarians, she suggests that pet insurance allows them to practice veterinary medicine "as if it were free." It is inevitable that pet insurance will grow as a recourse for veterinary fees. This may be a savior to some families whose budget is stretched to the limit at a critical moment in the health care of their cherished pet. We in the veterinary profession have an advantage over other professions. We have seen the good, the bad, and the ugly of insurance, as it applies to human health and dental care. If we work hand-in-hand with our own industries, collectively we may be able to develop a system that wins for everyone, with fees that allow practice to thrive and growth strategies that accommodate new treatment and diagnostic modalities, as well as consistent and exemplary customer service. The path ahead is always fraught with bumps and potholes. We can be a passive passenger and become a victim of the times or an active driver to steer the profession to a clearer route. Pet insurance is but one of the solutions for the profession; the others are a careful assessment of our fees--charging what we are worth, not what we think the client will pay; business management; customer service; leadership of our health care team; lifelong learning; and more efficient delivery systems. Let us stop being a victim, stop shooting ourselves in the professional foot, and seize the day!     

Survey of western Canadian veterinary practices: A demographic profile

A mixed-mode survey was used to describe the demographics of the veterinary profession in western Canada and to assess the demand for veterinary practitioners. Data were received from 655 practices (response rate = 52%), providing demographic data on 1636 individual practitioners. Most (60%) respondents self-classified their practices as exclusively small animal, while 25% and 4% were mixed animal or exclusively food animal practices, respectively. Across all practices, 77% of practitioners’ time was devoted to small animals and the average mixed animal practice devoted 60% of practitioners’ time to small animals. After accounting for practices that did not respond, there were ~300 full-time equivalent (FTE) vacant positions for veterinary associates; however, only 12% of practices were in urgent need of hiring an associate veterinarian. This report informs both prospective employees and employers on the state of the marketplace for veterinary associates, and provides an overview of the demographics of the veterinary profession in western Canada.     

Veterinary service usage and animal ownership in Ohio, U.S.A.: Results of telephone surveys in 1983 and 1984

A telephone survey of three sub-populations in Ohio was conducted to compare the utilization of veterinary services in 1982 with 1983 and to characterize animal ownership. A response rate of approximately 90% was achieved for all three sub-populations namely (1) food-animal producers, (2) horse owners and (3) pet owners. There was no significant difference between the percentage of respondents using veterinary services in 1982 and 1983. In both years, over 85% of dairy producers purchased veterinary services compared with approximately 62% for beef producers, approximately 70% for swine producers, and over 97% for horse owners. In 1983, approximately 69% sheep producers, 50% of goat producers, 81% of dog owners, 67% of cat owners, 12% of bird owners and none of the fish owners used veterinary services during the previous year. The 1983 median expenditures for veterinary services per farm or household using veterinary services were $465 for horses, $450 for dairy cattle, $111 for beef cattle, $115 for swine, $66 for sheep, $0 for goats, $75 for dogs, $44 for cats and $18 for pet birds. The average number of times animals were seen by a veterinarian varied by species but did not vary much from year to year. For all three groups, preventive services were used more frequently than were treatment and surgical services.     

Cultural awareness in veterinary practice: student perceptions

Australian veterinary classrooms are increasingly diverse and their growing internal diversity is a result of migration and large numbers of international students. Graduates interact with other students and increasingly with clients whose attitudes, beliefs, values, and behaviors differ from their own. An understanding and respect for these differences has an impact on client communication and health care outcomes. The present study explored how students understand and are likely to deal with issues of cultural diversity in veterinary professional practice as well as the educational needs that students feel should be met in regard to preparation to engage productively with diversity in professional practice. The present study also explored the extent to which the rich diversity of the undergraduate student population constitutes an educational resource. A class of final-year veterinary students was invited to participate in a workshop exploring intercultural confidence in veterinary consultation. Twelve groups of six to eight students discussed a fictitious scenario involving a challenging clinical encounter with a client from a different culture. Students were reticent to see the scenario in terms of cultural difference, although they generally recognized that awareness of cultural issues in veterinary practice was important. They also tended to not see their own ethnicity as relevant to their practice. While some felt that veterinary practice should be culture blind, most recognized a need to orient to cultural difference and to respond sensitively. Their suggestions for curricular improvements to address these issues are also included.