Veterinarian-client Relationship Research Articles

Assessment of owner perceptions of caregiver burden, veterinarian-client relationship and satisfaction with the provider in canine pruritus: An experimental vignette study.

Complicated treatments for skin disease are linked to owner-caregiver burden and poorer perception of the veterinarian-client relationship, regardless of disease severity. Using experimental vignettes, we explored the impact on owner perception of the interaction of treatment complexity and skin disease outcomes. We hypothesised that: (i) vignette conditions involving injection therapy would result in lower burden, better veterinary-client relationship and greater satisfaction relative to multimodal therapy conditions; (ii) the vignette condition of injection therapy with a completely effective outcome would be superior to all other conditions; (iii) ineffective vignette conditions would be inferior to all other conditions; and (iv) the vignette condition injection with a mostly effective outcome would be similar or superior to the multimodal therapy with a completely effective outcome condition. Three hundred and nine owners of pruritic dogs recruited from a general veterinary practice, pet-related podcast, or social media dog allergy group. Participants were presented with six counterbalanced online vignettes representing three levels of treatment effectiveness (Completely Effective, Mostly Effective, Ineffective) and two treatment regimens (Multimodal, Injection). Measurements of participant perceptions of caregiver burden, veterinarian-client relationship and satisfaction were recorded. Injection with perfect outcome was superior to other conditions (p < 0.001). Conditions with poor effectiveness were inferior (p < 0.001). Comparison of Injection with a mostly effective outcome to Multimodal treatment with perfect outcome yielded small-to-medium effects of preference for the latter in veterinarian-client relationship and satisfaction (p < 0.01); no difference was observed for caregiver burden. When good effectiveness was assured, injection was preferred (p < 0.001). Owners preferred a Completely Effective outcome and were prepared to select the Injection regimen or Multimodal therapy to achieve this; Injection was preferred when effectiveness was assured.

‘Brave Enough’: A Qualitative Study of Veterinary Decisions to Withhold or Delay Antimicrobial Treatment in Pets

Veterinarians sometimes prescribe antimicrobials even when they know or suspect that they are unnecessary. The drivers of this behaviour must be understood to design effective antimicrobial stewardship interventions. Semi-structured interviews were conducted with 22 veterinarians who treated companion animals in Australia. The Theory of Planned Behaviour was used to organise interview themes, focusing on a decision to withhold antimicrobial therapy in the absence of a clear indication. Many background factors influenced antimicrobial-withholding decisions, including the veterinarian's communication skills, general attitudes towards antimicrobial resistance (AMR), habits and energy levels. Client awareness of AMR and the veterinarian-client relationship were also important. Beliefs about the consequences of withholding antimicrobials (behavioural beliefs) were dominated by fears of the animal's condition deteriorating and of failing to meet client expectations. These fears, weighed against the seemingly distant consequences of AMR, were major barriers to withholding antimicrobials. Normative beliefs were primarily focused on the expected approval (or disapproval) of the client and of other veterinarians. Control beliefs about the difficulty of withholding antimicrobials centred around client factors, most importantly, their capacity to adequately monitor their animal, to pay for further investigations, or to undertake non-antimicrobial management, such as wound care, at home. The use of antimicrobials by companion animal veterinarians in the absence of a clear indication is often powerfully driven by behavioural beliefs, chiefly, fears of clinical deterioration and of failing to meet client expectations.

Pet owners' and companion animal veterinarians' perceptions of weight-related veterinarian-client communication.

To compare pet owners' and veterinarians' perceptions of veterinarian-client conversations concerning pet weight and identify challenges related to communication about weight. Veterinarians (n = 24) and pet owners (27) in southern Ontario, Canada. 3 veterinarian and 5 pet owner focus groups were conducted with a semistructured interview format. Thematic analysis of verbatim transcripts was conducted. Pet owners valued weight as an important health indicator for pets yet did not expect to discuss weight extensively at every appointment. Owners expected veterinarians to provide options and tailor recommendations when discussing weight management. Owners appeared more concerned with underweight animals, whereas veterinarians focused on obese animals. Veterinarians identified communication challenges, including the perception that owners are uninterested in discussing weight and conversations can become adversarial. Veterinarians reported various benefits and challenges of using humor to address pet weight and emphasized that weight-related conversations often depend on the existing veterinarian-client relationship. Some perceptions of pet owner expectations expressed by veterinarians in this study align with owner preferences, yet several opportunities exist for changes to veterinarians' approaches to weight-related communication with clients.

On-site communication skills education increases appointment-specific client satisfaction in four companion animal practices in Texas.

To assess the impact of a 15-month, in-practice communication skills intervention on client visit satisfaction. 4 purposely selected veterinary clinics, 9 veterinarians, and 930 appointment-specific client satisfaction surveys. The study was designed as a multipractice, preintervention-postintervention study. Practice teams participated in a 15-month communication skills intervention that included interactive group workshops and one-on-one communication coaching with the entire practice. Client Satisfaction Questionnaires were completed 3 months before (mean, 55 questionnaires/veterinarian) and after (mean, 48 questionnaires/veterinarian) the intervention. The impact of the intervention and factors associated with client visit satisfaction were evaluated with mixed logistic regression. Client satisfaction scores were dichotomized owing to extreme negative skewness. In total, 57% (284/496) of clients were completely satisfied on pretest questionnaires, and 67% (290/434) were completely satisfied on postintervention questionnaires. The odds of clients being completely satisfied were significantly higher after the communication skills intervention (OR = 1.56; P = .002). When controlling for the intervention, predictors of client visit satisfaction included appointment type (odds of being completely satisfied were significantly higher for recheck appointments than for preventative care appointments [OR = 1.71; P = .02] and health problem appointments [OR = 1.99; P = .003]) and duration of the veterinarian-client relationship (probability increased by 0.52 with each 1-year increase in relationship duration; P = .008). Results suggested that the client-centered, skills-based communication intervention resulted in increased client visit satisfaction. Findings contribute to current evidence that client-centered communication and duration of the veterinarian-client relationship promote client satisfaction during veterinary visits.

Using the critical incident technique to determine veterinary professional competencies important for enhancing the veterinarian-client interaction.

While previous research has examined components of professionalism that veterinary employers and clients expect in veterinarians, little attention has been paid to practising clinical veterinarians' opinions on important professional competencies that help to enhance the veterinarian-client relationship. This study used a phenomenological approach and critical incident technique to gather the narratives of practising veterinarians in New Zealand about positive and negative veterinarian-client interactions. The intention was to identify the underlying principles of professionalism that resulted in the positive/negative outcomes of those interactions. Twenty-two practising veterinarians were interviewed, and each respondent was asked to recollect and narrate a significant positive and a significant negative critical incident in their career that involved a veterinarian-client interaction within a clinical setting. The professional competencies that the veterinarian believed contributed to a successful or an unsuccessful outcome were elucidated using thematic analysis. Thematic analysis of the critical incident narratives revealed four major themes under the overarching theme of 'building a relationship between the veterinarian and the client': 'accountability and integrity', 'effective communication skills', 'personal wellbeing' and 'quality of care'. The description of the important professional competencies that helped to enhance the veterinarian-client relationship provides a reference for the practising profession to help improve the likelihood of veterinarians enjoying satisfied and successful careers.

Slecht nieuws communiceren in de diergeneeskunde: wat is de goede aanpak?

Slecht nieuws kan gedefinieerd worden als elke boodschap met een nadelige invloed op het toekomstbeeld van de klant. Slechtnieuwsgesprekken komen frequent voor in de diergeneeskunde en de dierenarts-klantrelatie wordt in belangrijke mate bepaald door de manier waarop het slechte nieuws gecommuniceerd wordt. In de humane geneeskunde en meer recent ook in de diergeneeskunde bestaan verschillende richtlijnen om een slechtnieuwsgesprek uit te voeren met minder stress en meer voldoening bij zowel dierenarts als klant. In de uiteenlopende modellen kunnen vijf essentiële elementen gevonden worden. Als eerste is er de voorbereiding van het gesprek, met het creëren van een juiste setting. Vervolgens wordt het perspectief van de klant bevraagd, gevolgd door het kort en direct meedelen van het slechte nieuws zelf en het empathisch reageren op eventuele emoties. Verdere informatie en een planning volgen in kleine hoeveelheden op het moment dat de klant hier terug voor open staat.

Trust, feasibility, and priorities influence Swedish dairy farmers' adherence and nonadherence to veterinary advice

The problem of nonadherence to advice is recognized in several professional relationships, including the veterinarian-client relationship. A better understanding of farmer perspectives may help to improve efficiency in veterinary herd health management. This study aimed to qualitatively and quantitatively describe farmers' reasons for adherence and nonadherence with veterinary recommendations regarding preventive herd health measures. We carried out structured telephone interviews about implementation of preventive measures with owners or staff of 163 dairy farms and 6 beef farms. The farms had received an advisory visit by their veterinarian (n = 36), who had documented the preventive measures they had recommended. The interviewer noted verbatim responses to reasons for implementing preventive measures fully, partially, or not at all, and we analyzed these responses thematically. We also conducted a quantitative analysis, in which we calculated descriptive statistics of the proportions of different categories of reasons stated by the farmers. Altogether, 726 preventive measures (range per farm 1 to 17; median 3; interquartile range 2 to 6) were documented. We identified 3 organizing themes related to adherence or nonadherence with veterinary advice: trust, feasibility, and priorities. Overall, the most commonly stated reasons related to trust (in the veterinarian, in the advisory process, or in individual preventive measures). The most common reasons not to follow the recommended advice were related to feasibility. Based on the results, we recommend that, to improve adherence to their advice, veterinarians pay increased attention to farmers' needs, priorities, goals, and motives, as well as to farmers' perceptions of the effectiveness of individual preventive measures. We also recommend that veterinarians need to increase their focus on recommending preventive measures that are practically feasible to implement on farms.

Pilot study of Australian veterinarians and their perceptions and experiences related to online pet health information.

Investigate Australian veterinarians' perceptions of clients' use of the internet to find pet health information. An anonymous online survey was distributed using social media, e-newsletters and veterinary magazines. A total of 85 complete responses were obtained from Australian veterinarians. Most (80%) reported believing that > 80% of their clients have access to the internet at home or work, but 68% thought that the majority of their clients do not understand what they read online. Attitudes regarding the impact of online pet health information on the veterinarian-client relationship were mixed (56% reported negative impact and 33% a positive impact), as well as for clients' use of the internet for information on companion animal health (47% reported negative impact and 38% a positive impact). When asked how often they suggest specific websites to their clients ('information prescriptions'), the majority of veterinarians reported that this is done infrequently. This pilot study highlighted the perception of Australian veterinarians of their clients' use of the internet to find pet health information. It also highlighted the need for a large-scale, detailed survey of Australian veterinarians and their views in relation to pet owners and their use of online information. This should include evaluation of information prescriptions and their potential benefits for clients and patients.

Evaluating Dog- and Cat-Owner Preferences for Calgary-Cambridge Communication Skills: Results of a Questionnaire.

Veterinary client retention by companion animal practices is influenced by whether the client feels connected to the healthcare provider. Effective communication between the veterinarian and the client facilitates that connection. To prepare new graduates for success in clinical practice, many colleges of veterinary medicine are now incorporating communication into the curriculum to emphasize its importance in establishing and maintaining the veterinarian-client relationship. A 2016 focus group study by Englar et al. evaluated dog and cat owner communication preferences for Calgary-Cambridge Guide (CCG) communication skills and concluded that dog and cat owners may have different communication needs. This study was conducted to confirm whether species-based communication preferences exist among veterinary clients. A questionnaire was distributed online and on-site, within veterinary teaching hospitals and private practices. Based upon 215 submissions from dog owners and 166 from cat owners, the communication preferences of dog and cat owners overlap. Both dog and cat owners prioritize reflective listening as the most important foundational CCG communication skill, and both prioritize asking permission as the most important core CCG skill. However, dog owners valued open-ended questions more than cat owners, and cat owners valued empathy more than dog owners. Survey limitations were largely demographic: participants were predominantly female and between the ages of 18-40 years. Survey data may therefore not be representative of the perspective of males and/or those >40 years of age.

United Kingdom Veterinarians' Perceptions of Clients' Internet Use and the Perceived Impact on the Client-Vet Relationship.

The Internet is a commonly used resource for accessing health information. Despite the Internet’s popularity in the human health field, little is known about the Internet’s impact on veterinarians, their clients, and the veterinarian–client relationship. The aim of this study was to investigate the perception of veterinarians from the United Kingdom of clients’ use of the Internet and the perceived impact on pet health and the veterinarian–client relationship. A survey was distributed between January 4 and March 3, 2017, via an online link. In total, 100 veterinarians completed the survey. This study found that most UK veterinarians feel their clients access the Internet to find pet health information, yet often do not understand what they read online. Importantly, 40% of veterinarians stated that the Internet has a negative impact on companion animal health. This small-scale study found mixed opinions regarding veterinarians’ perceptions of their clients’ use of the Internet and the potential impact it has on the client–veterinarian relationship. Research on clients’ actual use of the Internet and their associated perceptions is a next logical step.

Challenges to quality testing for bovine tuberculosis in Ireland; perspectives from major stakeholders

Within the national bovine tuberculosis (bTB) eradication programme in Ireland, concern has been expressed about the quality of testing by veterinarians. However, there is little published evidence supporting this concern,...

Evidence‐based step‐wise approach to managing chronic kidney disease in dogs and cats

To provide a framework for successfully managing chronic kidney disease (CKD) over an extended period of time with the goal of optimizing clinical outcomes by fostering a veterinarian-client relationship that facilitates successful application of evidence-based treatment. Ultimately, CKD results from loss of functional nephrons; however, the specific disease process responsible for this loss usually cannot be determined due to development of chronic changes (eg, fibrosis) and compensatory adaptations that have occurred in the kidneys of patients with CKD. Earlier diagnosis may foster a better understanding of the etiologies of CKD. Diagnosis of CKD is based on establishing loss of kidney function(s) due to primary kidney disease that have been present for an extended time (typically 3 months or longer). The goals of therapy are to: (1) slow progressive loss of kidney function, (2) ameliorate clinical and biochemical consequences of CKD, and (3) maintain adequate nutrition. These goals are achieved by: (1) managing adaptive processes that promote progression of CKD, (2) controlling intake of water, nutrients, minerals and electrolytes, and (3) correcting hormonal deficiencies. The short-term prognosis for dogs with CKD varies from good to poor, while the long-term prognosis for dogs with CKD is generally guarded to poor depending on the International Renal Interest Society (IRIS) CKD stage of the patient. Both short-term and long-term prognosis for cats with CKD may vary from good to poor depending on the IRIS CKD stage. However, prognosis is more variable and unpredictable in cats.

A focus group study of veterinarians' and pet owners' perceptions of veterinarian-client communication in companion animal practice

To compare veterinarians' and pet owners' perceptions of client expectations with respect to veterinarian-client communication and to identify related barriers and challenges to communication. Qualitative study based on focus group interviews. 6 pet owner focus groups (32 owners) and 4 veterinarian focus groups (24 companion animal veterinarians). Independent focus group sessions were conducted with standardized open-ended questions and follow-up probes. Content analysis was performed on transcripts of the focus group discussions. Five themes related to veterinarian-client communication were identified: educating clients (ie, explaining important information, providing information up front, and providing information in various forms), providing choices (ie, providing pet owners with a range of options, being respectful of owners' decisions, and working in partnership with owners), using 2-way communication (ie, using language clients understand, listening to what clients have to say, and asking the right questions), breakdowns in communication that affected the client's experience (ie, owners feeling misinformed, that they had not been given all options, and that their concerns had not been heard), and challenges veterinarians encountered when communicating with clients (ie, monetary concerns, client misinformation, involvement of > 1 client, and time limitations). Results suggested that several factors are involved in providing effective veterinarian-client communication and that breakdowns in communication can have an adverse effect on the veterinarian-client relationship.

Veterinarians can help ease financial, emotional worries . . . .Opposes restoring "star" to veterinary corps. . . . Disagrees with ECFVG process. . . . Call for professional courtesy . . . . Are we eroding the veterinarian-client relationship?

Veterinarians can help ease financial, emotional worries . . . .Opposes restoring "star" to veterinary corps. . . . Disagrees with ECFVG process. . . . Call for professional courtesy . . . . Are we eroding the veterinarian-client relationship?