Client education keeps door open for compliance

Jul 01, 2003

Client compliance is directly related to client understanding. Clients should not be expected to accept that which they cannot understand or see value in. Simply put, if you spend enough time educating a client on the need for a particular service or product, he or she will generally accept it. This sounds easy, but it requires looking into other issues first.

Identify and address your clients' barriers to compliance In order to educate a client effectively you must first identify the barriers to compliance. Is it financial concern, is it fear of anesthetic complication or is it due to a lack of perceived value in the recommendation? Once the barrier has been identified it can be addressed. Each client will likely have a different barrier and that barrier must be identified and addressed through education before compliance can be expected.


Table 1. Compliance Issues
For example, let us look at a recommendation for a dental prophylaxis made on an annual vaccination visit. After examining the pet the doctor recommends scheduling a prophy. Upon hearing the recommendation the owner appears uninterested and blurts out, "What do I care how pretty the teeth look?" Obviously the owner has missed the medical message and needs to be educated on the long-term effects of bacterial infection in the mouth. Or the client shows reservation stating, "I have heard that anesthesia is needed and that sounds dangerous to me!" In this situation the owner needs to hear reassurance about safety precautions, such as thorough pre-anesthetic exam and blood screening. Or the client complains about the fee, "Why should I spend $120 on my dog's teeth? That's more than I spend on my own teeth!" This client needs to hear the rationale about how preventative medicine is cost effective in the long run. Recognizing the barrier and properly addressing it will make for enhanced compliance.

Build a trust connection Second, education must come from a position of having the client trust their relationship with you. Without this strong client bond, education may fall on deaf ears. Yet client trust develops over time. Practitioners build trust with their clients early in the relationship such as during the puppy or kitten series or a comprehensive first-time visit. Demonstrating a dependable, sincere, and caring attitude is critical in developing this bond. Once this bond has been developed, gaining client compliance becomes a much easier task.

This may be more difficult to accomplish in a multi-doctor practice. Here, efforts also must be focused on staff uniformity in client education. The entire practice team should carry the same message. Failure to recognize this need will contribute to a lack of trust, and compliance with recommendations will be lessened.


Dr. Gwen Schlueter of Sulphur Springs Veterinary Clinic, St. Louis, Mo., is demonstrating periodontal disease to a client. Notice that the client is not holding his own pet for exam, thereby freeing him to better visualize what the doctor is demonstrating. Restraining and assisting is dental hygienist Lori Pogue, who will further explain and schedule needed procedures once the initial exam is completed.
Maintain a position of credibility Third, credibility of the educator, whether it is the doctor or a member of the support staff, is important. Clients are more likely today to make judgments regarding the doctor's level of knowledge on an issue by comparing it to information that they have pulled off the Internet. Compliance will be minimal if the practitioner lacks credibility, fails to demonstrate thoroughness, or fails to accurately educate the client. It is valuable for clients to become aware of doctor and staff continuing educational accomplishments. Over time clients should become aware that their doctor (and associated staff) are knowledgeable and current on their information. Education thereby becomes anchored to a foundation of credibility.

Demonstrating thoroughness is important in being credible. To illustrate, consider a situation where a client presents a pet with an illness. In scenario one, Dr. Hurried takes a superficial look at the pet and immediately makes a recommendation for hospitalization and a complete laboratory work up. Only a very loyal client would be compliant to Dr. Hurried's approach. Contrast this to scenario two where Dr. Methodical took a more thorough approach by attentively listening to the client, carefully reviewing patient history, noticeably doing a thorough physical examination and then engaging the client in creating a plan of action. Using this protocol, most clients would be readily compliant with the veterinarian's recommendations.


Table 2. Methods To Educate & Stimulate Compliance
Build value for compliance through education Having a solid foundation based on trust and credibility, the client will at least listen to the recommendation but now the doctor must spend time and effort building value to their recommendation. Clients should not be expected to blindly accept a recommendation; nor should they be expected to accept something that does not appear to be of value. Educating the client on the need for compliance will endorse the value and lead to compliance.

All too often practitioners are disappointed when clients do not eagerly accept their recommendations. They are angered by the client's quick refusal and may even give up the cause, ultimately subjecting the pet to less-than-adequate care. What they should do is spend more time and effort educating the client on the reasoning behind the recommendation, engaging the client in the process. Each client's level of interest and comprehension will differ and should be easy to recognize.