Speak Volumes Without Saying a Word

Veterinarians can boost their nonverbal communication skills to improve relationships with clients.

Understanding and managing nonverbal communication is critical in learning how to effectively partner with your team and clients. Arnd Bronkhorst Photography

“Understanding and managing nonverbal communication is critical in learning how to effectively partner with your team and clients,” said Wendy Hauser, DVM, owner of Peak Veterinary Consulting. This statement carries weight in the communications training that Hauser does with veterinarians since, as she pointed out, “nonverbal communication comprises 80-93% of all communication.”

Positive nonverbal communication cues include your smile, confident eye contact, appropriate head nods and laughter, body position and genuine facial expressions—all of which convey empathy, emotional support and reassurance to clients. These are cues your clients look for in an authority figure and which help you build a good relationship with them. Multiple studies conducted by Jane Shaw, DVM, PhD, and others indicate that veterinarians who improve their communication skills see improved client adherence, more positive client feedback and more career satisfaction.

Make or Break

“Imagine a veterinary health care team member making a preventive care recommendation in which he doesn’t believe, but he is following practice ‘policy.’ The team member might not make eye contact, might use a tone of voice that conveys that he doesn’t agree and might have closed body language, such as crossed arms. Despite the spoken recommendation, the client will believe the nonverbal message rather than what is said by the team member,” Hauser said.

In short, said Shaw, who leads the communication curriculum and FRANK communication workshops at the Colorado State University Veterinary Teaching Hospital, nonverbal communication can make or break the message you’re delivering. “It’s how we express the authenticity of our message,” she explained. “Nonverbal communication can be your saving grace when your words are not as articulate as you’d like. You can mess up your word choice, but they still get your message through the nonverbal.”

If your face flushes or your eyes well up with tears, you can’t prevent these normal, human reactions. Clients might appreciate this aspect of your humanity when it is connected genuinely to your message. However, as Shaw pointed out, “When your nonverbal messages are not connected with your verbal messages, the client can see you’re sending a mixed message.”

If you were in your client’s position in the example above—being given a message in which the speaker clearly doesn’t believe—your confidence in your veterinarian might not be high, and your follow-through might not be strong.

You Can Improve

“Veterinarians should match their nonverbal cues to the gravity of the situation,” Hauser said. “It would not be appropriate to deliver a poor prognosis with an upbeat tone of voice and a huge smile. By using emotional intelligence, which is the awareness and management of your own emotions as well as recognizing the emotions of others, nonverbal behavior can be appropriately matched to the needs of the client.”

Simply paying attention to the matter of nonverbal communication and making yourself aware of the importance of these small, usually unintentional, cues can improve your nonverbal skills. Take your—and your team’s—nonverbal communication skills to another level with this advice:

React to client cues. Failing to read your client is a missed opportunity, Hauser noted. It’s your chance to drive home your message.

Shaw pointed out that equine veterinarians are skilled at recognizing their patients’ nonverbal communication cues—a horse’s pricked ears, the whites of its eyes or an aggressive stance—and you can learn to pick up on those of your clients, as well. She illustrated this idea with one situation that you probably see every day: “Clients say ‘I understand,’ but then they break eye contact and maybe appear nervous.” This is your client’s way of not wanting to admit that he or she doesn’t actually understand. If you can learn to pick up on and react to those cues—in this case, offer further explanation—you can improve not only communication with your client, but also client adherence and patient-care success.”

Another common nonverbal cue from clients is apparent in continual cell phone use. “In such a situation, I would ask the client if everything was OK, since they were checking their phone so much,” Hauser said.

Mirror clients’ emotions. The concept of mirroring emotions isn’t to say you should panic when your client is panicking, but you shouldn’t be smiling and laughing, either. On the other hand, if your client is smiling and laughing—in an appropriate situation—by mirroring that person’s enthusiasm, you can help to build a stronger bond between you.

“In emotionally charged situations, taking the time to pause and breathe can be helpful in understanding the client’s needs and in defusing the situation,” Hauser said.

Maintain an open posture. Interacting with clients in a farm setting is more casual than interacting in an office setting, but it’s just as important to pay attention to your body language.

Of course you already know that crossing your arms produces an unwelcome vibe, but you might stand with arms crossed anyway, simply out of habit. (Don’t do that!) Likewise, having your hands in your pockets might be a comfortable way to stand and talk, but, as Shaw pointed out, it looks like you’re not confident. Try hooking just a few fingers in a pocket or belt loop instead, or occupy your otherwise dangling hand by holding something else, like a clipboard or a lead rope.

If you are standing with your client, looking at him or her head-on with squared shoulders can appear confrontational. Shaw suggested softening your stance and appearing less domineering by taking a step away with one foot to open up the angle between you.

If your client is sitting—on a tack trunk, for example—Shaw suggested pulling up a hay bale or finding another way to comfortably be on his or her level for your conversation.

Be respectful. As your true intentions are liable to show via nonverbal communication, your frame of mind and your attitude toward your client are ever-important, before you even meet with him or her.

“Some very doctor-centered nonverbal cues that are destructive to the doctor- client relationship include paternalistic behaviors, such as forceful tones of voice and finger shaking,” Hauser said.

These are behaviors to become mindful of and to correct immediately.

Be aware of fidgeting. “What are you doing with your hands?” Shaw asked. She said that many of the veterinarians and students she works with identify as being fidgety. Jingling pocket change or clicking a pen are fidgets that can be subconscious to you, but distracting to your client. A widget can send the message that you’re nervous, distracted or in a hurry.

Understand cultural differences. You could appear to be intimidating or rushed if your client doesn’t share similar communication styles. If you’re from the New York City area and you move to Kentucky, you might find that you speak faster and louder than your clients. If you’re from a family with Latin American roots, you could have more boisterous conversations than someone who from Idaho. Whether a cultural or an individual trait, “awareness of the tone, volume and pacing of the spoken word is one way that veterinarians can improve nonverbal behavior,” Hauser said.

Observe interactions. “Are your nonverbal cues detracting from your verbal message?” asked Shaw. The best ways to find out are to videotape interactions with clients (with their permission); ask peers for observation and feedback; other a client survey focusing on communication; and seek consultation. Hauser, Shaw and other consultants other communication training.

Take-Home Message

All of these unspoken cues indicate your trustworthiness and empathy, which is important to clients. The next time you’re tempted to rub your forehead, cross your arms or let out a fatigued sigh during a client conversation, consider the nonverbal cues you’re sending, then adjust your message to communicate what you really mean.

Studies Show…

These examinations of communication improvement in companion animal veterinary practice show increased client adherence and satisfaction, as well as improved doctor satisfaction:

• “Outcomes assessment of on-site communication skills education in a companion animal practice,” Jane R. Shaw, DVM, PhD; Gwyn E. Barley, PhD; Kirsti Broadfoot, PhD; Ashley E. Hill, DVM, MPVM, PhD; Debra L. Roter, DrPH; J Am Vet Med Assoc, Vol 249, No. 4, August 15, 2016

• “Veterinarian satisfaction with companion animal visits,” Jane R. Shaw, DVM, PhD; Cindy L. Adams, MSW, PhD; Brenda N. Bonnett, DVM, PhD; Susan Larson, MS; Debra L. Roter, DrPH; J Am Vet Med Assoc, Vol 240, No. 7, April 1, 2012

• “Effect of veterinarian-client-patient interactions on client adherence to dentistry and surgery recommendations in companion-animal practice,” Noureen Kanji, BSc, MSc; Jason B. Coe, DVM, PhD; Cindy L. Adams, MSW, PhD; Jane R. Shaw, DVM, PhD; J Am Vet Med Assoc, Vol 240, No. 4, February 15, 2012

• “Analysis of solicitation of client concerns in companion animal practice,” Laura M. A. Dysart, BSc; Jason B. Coe, DVM, PhD; Cindy L. Adams, MSW, PhD; J Am Vet Med Assoc, Vol 238, No. 12, June 15, 2011

• “Impact of the owner-pet and client-veterinarian bond on the care that pets receive,” Todd W. Lue, MBA, PRC; Debbie P. Pantenburg, BS; Phillip M. Crawford, MS; J Am Vet Med Assoc, Vol 232, No. 4, February 15, 2008

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