6 tips for better behavior discussions
If you’re like a lot of veterinarians, discussing pet behavior during an exam gives you a very specific unpleasant feeling in the pit of your stomach. Clients are often similarly averse to such conversations out of a fear of being judged.
Because avoiding behavior issues can be harmful to both the pet and the client, it’s imperative that you risk leaving your comfort zone. But before you do, take the time to learn some skills that can make the conversation more comfortable.
At a recent CVC session, Sara L. Bennett, DVM, MS, DACVB, a behavior consultant in Fort Branch, Indiana, and Sharon Campbell, DVM, MS, DACVIM, of Zoetis, presented six veterinarian-client communication skills that can guide you through a behavior conversation from start to finish.
1. Ask open-ended questions. Bennett, who used to be in general veterinary practice before becoming board-certified in behavior, says she used to ask this question during appointments: “Is there anything about your dog’s behavior you’d like to discuss today?” This question gets you to the heart of the issue quickly and accurately—which can actually increase your efficiency. In fact, studies in human medicine show that doctors who ask open-ended questions don’t spend any more time taking history than those who ask closed-ended questions.
This approach also honors clients as experts on their pets’ behavior and gives them a chance to have their concerns validated. Clients who feel more involved and understood will also be more satisfied and compliant.
When it’s time to narrow in on the specifics, ask questions in a way that assumes imperfect behavior. For example, asking “How often does Max urinate outside the litter box?” or “When does Otto steal food?” rather than “Does Max pee outside the litter box?” avoids shaming clients about their pet’s behavior, which can lead clients to withhold information.
2. Tune in to nonverbal behavior. Bennet describes verbal communication as what a person thinks and nonverbal communication as what a person feels. Pay close attention to clients’ nonverbal communication during the exam to get a good idea of how they really feel. If a client says it doesn’t particularly bother her when Bowser barks at other dogs during walks but then she starts to fidget, cross her arms or pet Bowser more aggressively, chances are she’s not being completely forthright. This is the time to gently probe for more information.
Your nonverbal communication matters, too. To avoid appearing judgmental and to encourage conversation, sit down, resist crossing your arms and be mindful of your facial expressions.
3. Show empathy. Bennet recommends naming and appreciating your client’s predicament to build trust and rapport. Your client may not be getting much support from family or friends regarding the pet’s problem behavior, so a little warmth and understanding from you can go a long way (example: “I understand that this is frustrating. It seems like you’re caught between a rock and a hard place.”).
It’s also important to encourage empathy toward the pet. Many clients are angry with their pets when they come in with behavior problems, so learning from you that Sophie is not being defiant when she pees on the rug or chews on the sofa—she’s actually terrified of being alone—can completely change the client’s attitude and acceptance of treatment strategies.
4. Practice reflective listening. Reflective listening involves repeating back, in your own words, the content or feelings behind a person’s message. It not only helps the pet owner feel understood, it gives you a chance to clarify the problem and test that you’re understanding it correctly. If you say, “It sounds like you’re worried Max’s thunderstorm phobia is never going to be controlled,” the client can confirm, “Yes, that’s it exactly. I don’t know if he’s ever going to get better.”
5. Try summarizing. Check your client’s understanding of what’s been discussed thus far before moving on to the physical exam. Highlight important points and restate agreements made during the conversation. Summarizing is useful as a transition point when paired with signposting.
6. Use signposting. Bennett says signposts—statements that let the client know where the conversation is going—are like a conversational GPS and are one of the most valuable tools in her communication kit. Often Bennett’s clients will come in and start pouring out their hearts in distress and revealing important details about the pet’s problems before she’s gone over the basics.
Bennett uses signposting to keep things organized. For instance: “Let’s back up a little bit. First, we’re going to take a basic history. Then I’d like to discuss your dog’s general personality before getting into specific incidents that have occurred. Sound good to you?” Or “We’ve talked about diagnosis, now we’re going to move on to treatment. Are you with me so far?”
Bonus efficiency tip: Don’t be afraid to charge for your time. One of the biggest objections general practitioners have to behavior is that it takes too much time. Bennett’s response? Charge for it! You’re the expert and your time is valuable, even if your knowledge is coming out of your mouth rather than through use of equipment, products and techniques.
When Bennett was in private practice, she says she reached a point where she could not handle one more thunderstorm conversation on the way to the receptionist’s desk. Despite some skepticism that she would get anywhere, she started to respond with, “You know what? This is a really important discussion and we need some time to talk about it. Let’s book another appointment so we can go through everything in detail.” To Bennett’s surprise, “It worked! They booked the appointment and came back—and they paid for it!”
So don’t let a phobia of behavior talks keep you from diving in to this important area of veterinary practice. Sharpening up a few communication skills, charging for your time and, if you’re out of your depth, referring to someone more qualified (see the list above), can help ease your clients’ mind, ease your patients’ spirits, and boost your practice into a whole new area of growth.