Compassionate care: Providing good medicine involves more than clinical knowledge and skills. You must also demonstrate kindness
and concern. (Warren Diggles Photography/Getty Images)
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At the time we penned this Diagnote about caring, we became aware of the problem of critical shortages of several drugs commonly
prescribed by veterinarians and physicians. What would you do if a life-saving drug required by one or more of your patients
suddenly became back-ordered or was no longer being manufactured? How would your clients respond? Sounds improbable? Please
consider the following headline in the Sept. 25, 2011, Star Tribune: "Drug shortage is a crisis." Because we are members of a profession that cares about others, we decided to combine the topics
of caring about others with drug shortages in this four-part series.
As veterinarians, our clients expect us to have attained and maintained our professional competence in terms of diagnosis,
prognosis and treatment of various diseases. This is often considered the science of veterinary medicine. Ethics demand that
we not let ill-concieved treatment jeopardize the welfare of our patients. But our effectiveness in caring for patients is
not guaranteed by mastering the knowledge and technical skills of the science of veterinary medicine. We must also develop
and use attributes that demonstrate to our clients that we care about our patients. This is encompassed by the art of veterinary medicine. Many of our clients won't care how much we know, until
they know how much we care. This prompts the question, "How do our clients recognize that we care?"
Speaking
What are some important qualities that will clearly signal to our clients that we sincerely care about them and their companion
animals? One is the ability to communicate. It is a distinct art to discuss medicine in the language of a nonmedical person.
We must speak to our clients in a way that is helpful, without giving the impression that we are talking down to them. Our
conversation should be gracious as well as sensible. Our clients will feel our respect for them if we speak in a dignified
and caring manner. In some situations, what we say may be less important than how we say it. To paraphrase Hippocrates, our
words should "first do no harm." Thought and practice are often required to express the right things in the right way.
Listening
Effective communication involves more than our speaking abilities. It also is vitally linked to our ability to listen. In
addition to developing our IQs, we must develop our EAR-Qs. Too often we do not listen with the intent of understanding (empathic
listening) because we have developed the habit of listening with the intent to reply (reactive listening). Empathic listening
is motivated by the intent to understand and demonstrates our respect for, and appreciation of, our clients and their companion
animals. We should listen to understand the meaning of words, noting the feeling with which they are said. To be effective
listeners, we must also take note of what our clients do not say. Before we contradict our clients, we must try to understand
them. In the long run, good listeners usually earn greater trust and confidence from their clients than good talkers.
Showing kindness
Kindness is another quality that will signal to our clients that we deeply care. Kindness encompasses the desire to take active
interest in others and to demonstrate our interest by helpful acts in addition to considerate words. We show kindness by being
friendly, gentle, compassionate, gracious, generous, patient, considerate and hospitable. Kindness also makes us considerate
of our clients' viewpoints, especially when they differ from our own. It is kindness that attaches itself to a mission until
its purpose in connection with that mission is realized. If, after application of our scientific knowledge and skills, we
cannot take away our clients' concern or frustration caused by the pain or suffering of our patients, we can demonstrate our
willingness to share them by our actions.
However, our kindness should not be motivated by self gain or profit. We must use caution not to think of every solution in
terms of the bottom line. Ethics call us to put the interest of our patients above our own financial interest. We must not
lose sight of the fact that by definition the veterinary profession has a service rather than a profit motive.
Developing trust
Heartfelt caring also results in trusting relationships that enhance our ability to provide highly effective patient care.
Clients are most likely to listen to our interpretations of the causes of their concerns—and listen to our recommendations
of options to solve them—when they understand how cooperating or complying with a request or a suggestion will benefit them.
Pulling it all together
Returning to our theme question, "How do clients recognize how much we care?" Their expectation that we are professionally
competent is a given. But more is required. For some, caring may be more important than curing. Thus, we must use care not
to be more concerned with the study of diseases than the study of patients. When all is said and done, caring can only be
measured by the action it prompts.
Part two of this four-part series will encompass the answers to the following questions: What would you do if a life-saving
drug required by one or more of your patients suddenly became back-ordered or was no longer being manufactured? How would
your clients respond?
Dr. Osborne, a diplomate of the American College of Veterinary Internal Medicine, is professor of medicine in the Department of Small Animal
Clinical Sciences, College of Veterinary Medicine, University of Minnesota.
Dr. Nwaokorie recently completed his MS and is pursuing a PhD at the University of Minnesota.
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