The Exam as an Owner Communication Tool

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Credit: Courtesy Wisconsin Equine

Credit: Courtesy Wisconsin Equine

Clients have a plethora of choices when it comes to which equine veterinarians they use. On what criteria do horse owners base such decisions? The AAEP Touch program (touch.aaep.org) surveyed 6,000 horse owners, including breeders, trainers and farm managers. One of the most important attributes valued by those surveyed is a veterinarian’s ability to communicate well with clients. 

Equine practitioners have many opportunities for client communication. Foremost among these is the time and interaction spent with a client during the examination process. With the horse in front of you along with the client, you have a remarkable opportunity to develop a rapport with that client. Such one-on-one communication is the foundation for establishing a long-term veterinarian-patient-owner-trainer relationship. Here are some tips to making the exam process work best as a communication tool.

The Initial Steps

Using the exam as a means to focus not just on the horse, but also on your client, helps to make the client feel special and valued. Familiarize yourself with names—of the horse, the client and any other person who might accompany your client during the veterinary visit.

If this client is already part of your practice, then be sure to review the horse’s medical record prior to the visit so you not only sound familiar with the case, but also actually know the details. This is especially important if more than one veterinarian in your practice has seen the horse in the past. Continuity from the previous visit comes through asking the client follow-up questions to bring you up to date on the horse’s circumstances and progress, and it is important to identify the client’s current expectations for the coming season.

If you’ve never met the client before, then this is the opportunity to query him/her about riding pursuits, expectations and equine management practices on the farm. As you discuss these issues, you’ll probably get a feel for how knowledgeable that person is about horse care. This gives you an opening for delving a little deeper into areas that you suspect could benefit from more attention, and to make appropriate recommendations.

Usually, such conversational detours are welcomed as educational information, with the client recognizing your care and concern to better the horse’s living and management situation.

If you’ve ever had the privilege of meeting an MD who is more of a holistic thinker, then you might recall that at the initial meeting for a physical exam, he or she first wanted to know about you, your lifestyle, your activity level and your life satisfaction. This is no different from what we need to know about our equine patients in order to make the best-informed decisions; the client is the source through which you can garner this kind of information.

Once you’ve moved past the preliminary formalities between people at the time of the exam visit, acquaint or reacquaint yourself with the horse. Most practitioners recognize that hands-on touching and stroking reassures the horse about you. It also gives an owner a sense of caring and compassion when the vet interacts with the horse, both with touch and voice—especially if done in a kind, gentle manner. For many, these animals are part of their extended “family,” and clients respond well to your inclusion of the horse as a sentient being involved in the exam process.

Your clinical skills are important, but remember that clients really notice how well you interact with both them and their horses. In addition, the horse is likely to be more cooperative when it is reassured that you intend no harm. All in all, this makes for a more relaxed working session, with the horse doing what is asked without much drama. A quiet exam without having to handle a fractious patient limits distractions to the client.

The Exam

Equine practitioners actually should have another job description besides medical professional: conversationalist. This doesn’t mean you have to make chitchat about your personal life, or that of the client; it means that it is best to converse with the client about your findings as you progress through the horse’s exam.

Each owner wants to know—and has a right to know—what you are thinking and about your findings, both the normal and the abnormal elements of the exam. So discuss things with the owner as you evaluate the horse, explaining issues and concepts (when necessary) in each step. This engages the client as a participant rather than simply an observer.

Encourage questions just as you ask questions to fill in historical details on the horse’s condition. When the client speaks, be sure to listen. If you don’t understand the impacts of the horse’s issue on the owner’s future plans and expectations, be sure to ask, so you have clarity that helps to inform your decisions and your approach to treatment and rehabilitation.

For some, the horse is part of their business pursuits and income; it is important to understand how your recommendations fit into their showing/training/breeding schedule plans.

When possible, have another person (your technician) handle the horse so the owner can focus all of his/her attention on you. Hopefully he/she will have put the cell phone aside, found someone to watch the kids, and will refrain from interacting with other horse owners in the barn while you assess the horse.

Working in a quiet area of the barn (or your clinic) facilitates this type of one-on-one, focused attention. In a busy boarding barn, try to schedule appointments for times with the fewest distractions and the least chaos—not during feeding hours or stall cleaning chores, not when the kids have congregated at the barn after being let out of school, and not when hired barn personnel are clamoring for the horse owner’s attention, as just a few examples.

You have a busy schedule coupled with unexpected emergencies, but it is courteous to figure out a way to hold off interruptions while you are working with a client. Have your technician field your pager or phone calls, or put your phone or pager on vibrate when engaged in a conversation with your client. That person wants your undivided attention just as much as you want his or her attention.

Clients want to feel that you are giving them as much time as they need during the appointment rather than feeling like you are rushing to head off to the next appointment. Every horse owner understands about the need to respond quickly to life-threatening emergencies, but for those “emergencies” that aren’t as time sensitive, focus on the person in front of you, not the one on the other end of the phone. (You probably know how it feels when you visit a retail store and begin talking to the person at the counter, only to have that person answer the phone and disengage entirely from you.)

That other person will get his or her turn once you have properly finished with the exam and the discussion that you have started on the premises. Many horse owners take time out of their life schedules (work, school, kids, etc.) to meet you for their horses’ exams, and their time is valuable, too. When you make them feel valuable, it pays dividends in your working relationship.

The Follow-Up

In order to consider an appropriate treatment plan, you’ll want to know what plans and expectations your client has for the horse in the upcoming months. This information might color the prescribed strategy going forward, so it is important to include the client in this conversation and in any management and treatment decisions.

Once you have evaluated the horse and discussed a diagnosis and treatment plan with your client, set an appointment for a recheck or re-treatment, and outline for the client what you might do in that next visit, depending on the response of the horse during the intervening time.

It is always wise to follow up verbal communications with written instructions and comments. Once you’ve finalized the medical record, it helps to send (by email, fax and/or mail) a summary of the day’s visit—the exam findings and treatment plan—to the client, so he or she has the facts in a hard copy, especially if your visit entailed some complicated information. This solidifies your conversation in the owner’s mind and eliminates misunderstandings of what you did or did not do, say or imply.

Resources

Communication in the health professions is of such great importance that formal training is being offered at veterinary schools and following graduation. If you are unsure of how to best use your communication skills as a tool, there are resources specifically devoted to such veterinary interactions to help you learn.

One such resource is the Bayer Animal Health Communication Project (found at veterinarycommunication.org). A grant by Bayer to the Institute for Healthcare Communication (IHC) has fostered a project that is committed to “addressing gaps in communication skills training within schools of veterinary medicine and in the practice community.”

Modules are available for teaching communication skills (veterinarycommunication.org/modules/modulelanding.php). The project has provided professional development to faculty members from schools of veterinary medicine in the United States, Canada and Australia. The veterinary colleges at both Michigan State and Washington State Universities, as well as the University of Calgary, have been invested early on in presenting such programs to their students.

The AVMA PLIT (Professional Liability Insurance Trust) also recognizes the critical role that communication plays in effective veterinarian/client relationships, especially as it relates to reducing liability claims that result from misunderstandings and poor communication. The AVMA’s information on communications can be found at pethealthpartnership.org/communications.aspx.

While many of the tools on that website are aimed at small animal practice, there are general lessons to be gained from these educational tools that might be applied to any species regarding client communication. In addition, both the AAEP and the AVMA sponsor in-depth communications seminars at their annual veterinary conventions.

The Benefits

With thoroughness in the exam and the communication process, your clients will appreciate your diligence and concern for their horses’ welfare as well as the fact that they feel respected as part of the “team.” Making yourself available for questions and taking the time to offer thoughtful and easily understandable explanations imbues them with a sense of trust and respect for your expertise and leadership in their horses’ care. Trust leads to loyalty, with clients willing to make the investment in your knowledge and advice. With greater respect and loyalty, you’ll likely see better client compliance with your recommendations.

Take-Home Message

The bottom line is that through excellent communication skills, you can help develop client satisfaction and long-lasting client relationships. Ultimately, the horses receive the best in care from both you and your clients.