"Few professions enjoy the public confidence that veterinarians experience."
This statement appeared in Veterinary Economics in 1997 (volume 38; page 40) is supported by the authors of the 1999 KPMG-LLP study of the veterinary profession, which stated
in part that, "Veterinarians rate very favorably in public opinion among their clientele relative to other occupations (physician,
accountant, chiropractor, lawyer, dentist, teacher and pharmacist)" (JAVMA 215; 161-183, 1999).
Pet owners rank veterinarians first in compassion, honesty, and trustworthiness, second in intelligence, and third in level
of education and technical proficiency. Horse owners rank veterinarians first among all these professional organizations with
respect to intelligence, level of education (tied with physicians), compassion, honesty, trustworthiness and technical proficiency.
However, there is recent evidence that some individuals may be losing confidence in those of us who practice veterinary medicine.
For example, in April of 2002, DVM Newsmagazine (volume 14, page 6) published a letter written by a pet owner concerned about the cost of veterinary care stating in part,
"I once trusted veterinarians. I don't now." In response to an article in the July 2003 issue of Consumer Reports entitled, "Veterinary Care Without the Bite," the July 2003 issue of DVM Newsmagazine (volume 34, page 45 contained the following statement: "If veterinarians are preoccupied with the almighty dollar, it would
appear that the trust clients hold for veterinarians would be jeopardized."
In this regard, we may be facing the same dilemma already encountered in a greater magnitude by physicians. According to one
authority, "Medicine has long been one of our most trusted social institutions. In recent years, all social institutions,
including medicine, have fallen from public trust." (J Oklahoma State Med Assoc 94: 46-54, 2001). Another author stated, "The
commercialization of medical care, conflicts of interest, media attention to medical uncertainty and error, and the growth
of managed care all challenge trust." (Milbank Q 74: 171-189, 1996).
A matter of trust
These statements prompted me to reflect on the meaning of the word "trust," and also to reflect on what should be considered
to gain and sustain our clients' trust. (This essay was adapted from commentaries that were published in JAVMA 203; 1390-1391,
1993, and JAVMA 221: 936-938, 2002).
How would you define the word "trust?" Webster's dictionary defines trust as confidence in the honesty, integrity, reliability
and justice of another person. Trust is one of the highest forms of human motivation.
Trust, or lack of it, is the root of success or failure in relationships with clients, colleagues, employees, employers and
organizations, such as pharmaceutical firms and veterinary medical associations. In a climate of trust, veterinarians and
clients can work cooperatively to establish shared objectives of patient care and to seek reasonable ways of achieving them.
Ironically, it usually requires many positive actions for us to earn and maintain our clients' trust, yet their confidence
in us can be undermined if they perceive that even one of our actions is uncaring or self-serving.
Ethics remain important
How can we build and sustain trust in our relationships with others? Of course, the answer is by being trustworthy. We can't
have trust without being trustworthy.
Trustworthiness in turn is based on ethical principles including the principle of character (what we are as persons), and
the principle of competence (what we are able to do as persons). For example, if you have faith in my character as a person,
but not in my competence as a veterinarian, you may trust me as a friend, but you may not trust me to provide you with needed
veterinary services. Alternatively, you might trust my intellectual and technical competence as a veterinarian but lack confidence
in my character.