How is weight loss addressed by veterinarians today vs. 10, 20 or 30 years ago?
Buffington: Obesity is more common now than years ago. Veterinarians are starting to look more broadly at obesity therapy, addressing
the whole problem, including increasing activity for owners and pets. Obesity is now recognized as a more complicated problem,
with many more contributing factors than once thought. The focus today is on individualizing care for the patient. We appreciate
that every obese patient may not have the same cause or require the same treatment.
Has client compliance in these cases improved in the last decade?
Buffington: Client compliance really depends on excellent communication between the veterinarian and the pet's caregiver. Veterinarians'
appreciation, interest and use of effective communication techniques have increased dramatically in the last 10 years.
What are some specific ways a veterinarian can improve client compliance?
Buffington: Listen to your clients, and work with them to shape solutions that work for their particular situations. Share responsibility
for the outcome with clients. For example, ask owners, "What do you think is the best approach for controlling your pet's
weight?" Clients can often offer the best solutions based on what goes on in their houses. A veterinarian cannot get this
valuable information without asking.
What I tell clients is, "Here's my understanding of the situation." I'll proceed to feed back to them what I heard them tell
me. Then I'll ask, "Have I got this right?" If so, I'll tell them, "In my experience, clients who have had similar situations
have tried these solutions. I don't know what will work best for you — maybe one of these will work, maybe none will. These
may get you thinking about what will work best for your situation." I then give clients a chance to select a strategy or come up with some ideas of their own.
This approach exemplifies the difference between compliance and adherence. Compliance is something you do because "I say so."
For adherence, you do it because you want to, and because you understand the value. Because people can sustain adherence longer
than compliance, I always try to craft a plan based on what is in the client's best interest. This doesn't work for all scenarios,
however. For instance, for the rabies vaccine, you don't want to have a conversation about what to do. Clients have to do
this — it's the law.
With adherence, it boils down to the notion that you want clients to do something because they can, and because it will help
them if they do.
Has the thinking on client compliance and communication by the veterinary community evolved over time?
Buffington: I'm afraid that some veterinarians still expect people will do things because they tell them to. With our clients, to get
them to act, we have to convince them that it's in their best interest.
I'm a big fan of praising owners and telling them they're being great pet owners just for seeking care. I tell them my recommendations
for obesity therapy are only a guess based on my clinical experience. I can tell the client to try to feed a particular diet.
If an animal's body condition changes in the direction we want, then we guessed well. If it doesn't change, we guessed wrong,
and we will try something else until we succeed together.