Veterinary teams which understand and promote clinical nutrition and demonstrate in-clinic behaviors consistent with this conviction will benefit their clients, their practices and, most importantly, their patients. Proper nutritional management is one of the most important factors in maximizing pet health, performance and longevity, in addition to managing disease conditions.

 Most veterinary healthcare teams recognize that nutrition is important to their patients’ health and want to make the best food recommendations. Additionally, clients want what’s best for their pets and for them to live long, healthy lives. Then why is communication around pet foods so difficult?

Addressing a Difficult Topic

The pet food category is a multi-billion-dollar industry with an overwhelming selection of pet foods available. The healthcare team may feel uncomfortable or lack confidence in having a conversation about specific pet food choices. Food can be a touchy subject, and clients may have very strong emotions about the food they prefer to feed and what they think is best for their pets. Additionally, there are multiple pet food myths and nutrition trends that have muddied the realm of pet food. There are massive amounts of information on pet foods on the internet, and it can be very difficult to discern fact vs. myth vs. trends, which can be dangerous to a pet’s health. 

Making a pet food recommendation that best supports that particular pet’s health should not be a quarrel between what the veterinarian knows will support their patient’s health and what their client wants or believes is the best food for their beloved pet. Through consistent use of core communication skills and involvement of the entire healthcare team, you can connect with your clients, overcome some of the more challenging pet food barriers, build nutritional confidence in your entire team, and make the nutritional recommendations that you feel best support that pet’s health and respects your client’s preferences. 

From every media outlet, as well as family members, pet stores, etc., clients are inundated with information about foods for their pets. So, when they come to the veterinary healthcare team with the question, “What should I feed my pet?” how does one answer? The healthcare team should embrace this question and be open to and encourage dialogue. The fact that this question is asked shows the owner is interested in proper nutrition for their pet and wants a recommendation from the veterinary team.

Know Your Resources

In 2011, the World Small Animal Veterinary Association (WSAVA) published Nutritional Guidelines.² And, in 2021, The American Animal Hospital Association (AAHA) published updated Nutritional Assessment Guidelines for veterinary practices.¹ These guidelines were developed to support veterinary healthcare teams in the development and implementation of nutritional management protocols tailored to the individual needs of the patient. 

Both associations, with the assistance of veterinary nutritionists, veterinarians, veterinary technician specialists in nutrition and credentialed veterinary technicians, have developed tools to help healthcare teams educate clients on what they should feed their pet. These tools were developed to assist the veterinary team in determining what the pet should eat as well as offering a resource to help make a specific nutritional recommendation. 

As with any recommendation, the veterinary healthcare team must do the research. When investigating the question, “How do I distinguish one food from another?” look for answers to the following: 

• Is the pet food manufacturer’s contact information available on the product for the veterinary team and pet owner? 
• Does the pet food manufacturer employ full-time veterinary nutritionist(s), veterinarians and credentialed veterinary technicians? 
• Where are the foods produced and manufactured? 
• What are the specific quality control measures to guarantee product consistency and quality? 
• Will the manufacturer provide a complete nutrient analysis for the pet food in question—above and beyond the guaranteed analysis? 
• Has the product undergone research? And are the results published in peer-reviewed journals?

These initial questions aid the team in determining if the product is made by a reputable and knowledgeable company. They also help determine if the manufacturer follows strict quality control measures. 

Nutritional Adequacy Statement by AAFCO

In addition to researching the quality behind products, the team should research the Association of American Feed Control Officials (AAFCO)³ nutritional adequacy statement included on pet food labels to help determine the following important facts:

1. Is the diet complete and balanced? All wellness foods should be complete and balanced.
2. If the food is complete and balanced, for which life stage is the food intended?
   • Nutrient profiles and feeding trial requirements for growth, reproduction and adult maintenance are provided by AAFCO.
   • The healthcare team should be aware that foods listed as formulated to meet the AAFCO profiles for all life stages must meet the minimum nutrient levels for both growth and adult maintenance.
3. What method was utilized to substantiate that the food is complete and balanced?
   • AAFCO feeding trials:
     • Were the products fed to the intended species and intended life stage?
     • Does the product label state, “Animal feeding tests using AAFCO procedures substantiate [Product Name] provides complete and balanced nutrition for [life stage(s)]”?
   • AAFCO nutrient profiles:
     • Do the foods meet AAFCO nutrient profiles by formulation or by analysis of the finished product?
     • Does the product label state, “[Product Name] is formulated to meet the nutritional levels established by the AAFCO (Dog or Cat) Food Nutrient Profiles for [life stage(s)]”?

Formulated foods are manufactured so the ingredients meet specified levels, either based on the recipe or on analytical testing of the finished product, without testing.

The healthcare team should be educated and proactive when discussing nutrition with clients. There are differences amongst manufacturers, products and life stages, and veterinary team members should not be afraid to ask the questions. This will allow the team to present a researched and educated nutritional recommendation, and be prepared to provide the best recommendation for each specific patient that visits the veterinary hospital. +

References:

1. Cline M., Burns KM., Coe JB., et al. (2021) AAHA Nutrition and Weight Management Guidelines for Dogs and Cats. JAAHA 57:4, 153-178.

2. Nutritional Assessment Guidelines. (2011). WSAVA Nutritional Assessment Guidelines Task Force. J SMALL ANIM PRACT 52:385-396.

3. Association of American Feed Control Officialss, AAFCO Official Publication 2022.

Resources:

www.petnutritionalliance.org 

www.wsava.org/nutrition-toolkit

www.AAFCO.org

The post Answering the Age-Old Client Question: “What Should I Feed My Pet?” appeared first on PetVet Magazine.

My family member had tagged me, then sent a private message. I could almost hear the panic in her voice as she reached out to me, a veterinary professional, asking “Is this true?!? I give this to my dog!” 

This isn’t the first time a viral story or pet health trend has been brought to me for a second opinion. Veterinary professionals are often faced with questions from clients who have heard or read something that runs contrary to our medical advice. These conversations can be opportunities to strengthen the client-veterinarian relationship and build a bond of trust, empathy and caring. 

Addicted to Anecdotes

It can be hard to understand why some clients trust a random story on the internet or the experience of an acquaintance more than what we perceive as sound medical science. We may even take it personally, feeling like the client values “them” over “us.” However, the truth is more complicated… 

Several studies suggest the human brain has evolved to remember and assign value to personal experiences and anecdotes over facts and statistics. This effect becomes exaggerated in stressful or emotionally charged situations. A study published by the journal Organizational Behavior and Human Decision Processes found that anecdotes hold the most sway and facts the least, where medical and personally relevant issues are concerned. This may be due to the ease with which the average human brain remembers stories, as opposed to statistics and data. It may also be a reaction to the information overload of our modern society. 

There is something about a personal experience we are innately drawn to. A separate study on the power of anecdotes explains, “Statistics can be doubted and countered with other statistics, but first-hand experiences have an aura of unimpeachability.”¹

Interestingly, people may be blind to their own bias in favor of anecdotes. The aforementioned study found that the majority of participants self-reported preference for facts and statistics when establishing believability. However, when put in face-to-face interactions with strangers holding opposing viewpoints, these same study participants rated those sharing subjective experiences as more trustworthy than those presenting objective information. This was especially true when they viewed people sharing what the study refers to as “harm-based” experiences, where someone witnessed or experienced injury or suffering. 

So, how does this come together to impact client-veterinarian interactions when discussing contentious information? 

If a client expresses concern based on a harm-based anecdote—whether from a stranger on the internet, acquaintance or family member—it is going to be very difficult to shift that person’s perception by sharing facts about safety and efficacy of the product or procedure they are afraid of. What should veterinary professionals do when faced with a cautious client?

Listen and Acknowledge

The first thing we should do is listen to the client’s concerns. At a minimum, we should engage in active listening when clients are speaking. Active listening entails filtering out distractions, not interrupting and responding to the speaker at appropriate times. 

In situations that have the potential for disagreement, we should practice deep listening. Deep listening differentiates itself through a commitment to understanding the speaker’s perspective. This is the type of listening most associated with trust-building and conflict resolution. There are entire courses teaching deep listening, but some of the foundational elements include:

• Listening without judgment.
• Being self-aware and quieting your internal monologue.
• Paying attention to the speaker’s non-verbal communication.
• Make understanding (not responding) the intention of your listening.

Listening in this way can not only help you understand the client’s concern, but it can also help calm any defensiveness veterinary professionals may feel in a situation where our medical expertise is being questioned. Deep listening can help us hear what the client is really saying rather than internalizing their distress as a judgment of our practice. It can help us see the source of their anxiety not as lack of trust, but as deep love and responsibility for a cherished family member. 

It is also important to acknowledge the emotions evoked by an anecdote a client is sharing—even a second-hand one. If a client says, “I read that someone’s dog died from that medication,” we can’t scientifically verify that information, but we can and should acknowledge that loss as a tragedy. Truth matters less in this situation than empathy. Rather than focusing on facts that we’re not able to establish, we can best move forward by addressing the real and immediate feelings present in the room.

Have a Conversation

Once you have listened to the client’s concerns, you can begin a conversation. Ask what the client would like you to do for them and their pet moving forward. Their response can guide your approach. If they say they’d like you to dispel their fear, then that opens the door for you to share your knowledge and experiences regarding the pharmaceutical or procedure being discussed.

 Conversely, they may say they never want to expose their pet to the product/procedure in question. Knowing this allows you to focus on effective and safe alternatives, if they exist. Let the client guide the direction in which you move forward. This is putting your deep listening into practice. The client will see you value what they shared, which builds trust and establishes you as teammates working in the best interest of their pet.

The Right Resources

If the client is interested, offer suggestions of where to find quality veterinary material on the internet. This gives them autonomy and a way to navigate the abundance of information available online. Left to their own devices, most people are prone to a phenomenon called “confirmation bias.” This means people will tend to ignore evidence against their preconceived notions and specifically look for, consume and remember evidence supporting them. Social media capitalizes on confirmation bias with its algorithmic content selection, making unbiased information even more difficult to access. 

Steer clients who want accurate, verified veterinary information toward reputable websites such as those hosted by accredited veterinary organizations, veterinary teaching academies or veterinary-sponsored, independent institutions. Encourage them to double-check any information they encounter on blogs, group chat sites or social media with one of the recommended resources, or by speaking with a qualified veterinary staff member at your practice. Make sure clients know you are available and willing to discuss any questions or concerns they have about their pet or veterinary care in general. 

As veterinary professionals, we know we are not only caring for animals. In order to do our jobs well, we must also help pet owners make important decisions regarding their pets. The best outcomes arise from a strong sense of trust and teamwork with the pet at the center. Seeing hard conversations as opportunities rather than oppositions helps set the stage for a professional relationship that benefits all involved +

References:

1. Kubin, E., Puryear, C., Schein, C., & Gray, K. (2021, January 5). Personal experiences bridge moral and political divides better than facts. PNAS. https://www.pnas.org/doi/full/10.1073/pnas.2008389118

Resources:

• 4 Types of Listening: Exploring How to Be a Better Listener. (2021, June 4). Maryville Online. https://online.maryville.edu/blog/types-of-listening/
• Kasriel, B. E. (2020, March 4). Deep listening: Finding common ground with opponents. BBC News. https://www.bbc.com/news/health-51705369
• Noor, I. (2020, June 10). How Confirmation Bias Works. Simply Psychology. https://www.simplypsychology.org/confirmation-bias.html
• Walton, A. G. (2020, April 8). In Stressful Times, People Listen More To Anecdotes Than To Facts, Study Finds. Forbes. https://www.forbes.com/sites/alicegwalton/2020/04/06/in-stressful-times-people-listen-less-to-facts-more-to-anecdotes/?sh=667368ab6a43
• Weir, M., & Buzhardt, L. (2022). Finding Reliable Internet Sources for Pet Care Information. VCA Animal Hospitals. https://vcahospitals.com/know-your-pet/finding-reliable-internet-sources-for-pet-care-information

The post Fact or Fiction: How to Handle Cautious Clients appeared first on PetVet Magazine.

The heart has its own way of communicating. In our companion animals, it’s the language of unconditional love, non-verbal connections and often instinctive or intuitive gestures. But when it comes to communicating with our fellow human beings, it can be a more complicated issue. There are words, visual cues, body language patterns, voice tonality differences and overall emotional vibes that come into play.

When delivering heart-centred communications in a veterinary clinic, emergency center or specialty practice, there are many things to consider. For instance, timing, responding instead of reacting, economy of words, generosity of heart, tempo of speech and, finally, non-verbal cues that say everything without actually saying a thing all need to be taken into consideration. Animals in the wild depend on their instinctive mastery in these areas, but we humans need some training and strategies to master this art of communicating from the heart. 

What does it mean to communicate from the heart? 

I find myself considering the opposite, by asking, “What isn’t communicating from the heart? What has to be absent?”

In this day and age, an unprecedented time with the global pandemic, people have felt restricted, isolated and limited. The impact of this ever-changing “wait and see” situation has caused people to be more internalized and less emotionally demonstrative. Behind our clinical masks, our communication and outward expressiveness are limited. Although our hearts reside within us, somehow the pandemic has restricted its “expressive blood flow” to others.

All the while, trips to the vet and emergency services have been short-staffed and full of over-worked, compassion-fatigued, burned-out veterinary professionals. How is it possible for clinics—with some still experiencing Covid-19 restrictions—to be able to offer exceptional service that’s both heart-centered and efficient at the same time?

To do so, all members of the clinic team need to stay tuned into their hearts in order to manage their own wellness from day to day, but also so that they can collaborate with and assist team members and clients from a heart-based core.

Nurses and vet techs are kept on their feet and running to and from vets to clients and back again so often, one wonders where they can get their energy reserves to make it through each day. I believe that our energy is circular like a bio-feedback mechanism. We give energy and it comes back to us. For nurses and vet techs, the ongoing, daily demands require an adequate store of energy. Daily stressors can be effectively managed when we tune in to our energy, and mold and shift our attitudes and emotional states.

What if you imagine that instead of being energetically drained, you are filling yourself with energy, then sending it to your client (the receiver) and then back to you, in a perfect flow; unstuck and fluid. There is no communication apprehension or the accompanying physical symptoms like a racing heart, wet palms, sweating, nervousness or feeling mentally frazzled that sometimes occur when communicating with difficult clients or anticipating their reactions to delivery of bad news. When you free your energy, it is lighter, not burdensome, and generates more of the same.

The opposite is also true. That is, when we are hesitant, it’s easy for energy get stuck inside us. This can occur since we may fear we don’t have the time to discuss all the important details with our client, so we rush through the discharge, or we choose clinical words and hide behind them to keep a distance from the client.

What is actually needed is confidence and reframing of the conversational experience. When going from a moment of treating a pet (a non-verbal animal), to having to explain details to a highly-verbal, highly-anxious pet parent, this can be a quick and abrupt transition from one language to another. And this can cause stress. Breathe, adjust and realize you are someone who is speaking two languages: animal and human. 

We must get clear on what is needed, which is compassion for both and recognizing that they need similar and different things. The similar things that both pet and pet parent need are compassion, tenderness, kindness and patience. The differences may include a pet parent who needs repetition or clarity from you, and planning to go “verbal” after using your silent observation and diagnostic skills with the pet.

It is also important to let go of any fear of pet parents and what they may represent. You may have been “traumatized” by angry, hostile or blameful pet parents so your natural proclivity is to avoid them or decrease the length of time you interact with them. But by creating clear boundaries, improving your skills in explaining clearly and with limited clinical terms, and expressing your feelings, the negative emotions associated with pet parent interactions can be greatly decreased. 

When we feel seen and appreciated, we offer more of ourselves since we don’t fear being stepped on. And when we communicate from our hearts, not only do others feel our compassion and empathy, but we feel it, too. Kindness is something that costs nothing but gives so much. +

The post Communicating from the Heart appeared first on PetVet Magazine.

Cases like these can have devastating consequences on the mental health of the veterinary team. Learning to navigate these difficult situations is essential to maximize patient welfare, maintain client connections and preserve the mental health of all team members. 

Here are some tools that can be used by veterinary team members when faced with these challenging cases:

1. Prioritize compassionate communication.

Navigating the conversations surrounding euthanasia is considered by many veterinarians to be more stressful than the act of performing the euthanasia.¹ Prioritizing compassionate communication and a client-centered approach has been shown to improve client perceptions of end-of-life conversations in both human and veterinary medicine.² But what does this look like in the veterinary practice?

Client-centered communication involves establishing a relationship between client and veterinarian, and expanding the conversation beyond medical topics to include lifestyle and social topics. In the case of an end-of-life discussion, these conversations could include discussion of the client’s beliefs around euthanasia, their ability to provide hospice care for their pet, the role the pet plays in the client’s family and the client’s expectations for what a peaceful death looks like for their pet.

We must make every attempt to connect with the client and give them opportunities for input. Use of open-ended questions to elicit the client’s concerns, questions and feelings is essential. Combining these with expressions of empathy can strengthen their impact. For instance, you might say, “I know that this is not what you were expecting to hear today. Can I answer any questions about Lucky’s kidney disease for you?” or, “I know euthanasia is very difficult to consider when you love Lucky so much. Can you tell me what you’re thinking/feeling right now?” 

Once we have asked these questions, we must stay present in the conversation. Listening to the client’s response without being distracted by thoughts of other patients, how far behind schedule we might be or what we will say next will ensure we do not miss important information. A client may share information that can open an opportunity for connection—or at least an improved understanding—such as the fact that this pet previously belonged to their late partner or that they do not believe in euthanasia. We can build on the conversation to devise a plan that is in the best interest of the pet while respecting the client’s emotional limitations.

While we may feel frustrated when the client does not accept our recommendation for euthanasia, we must control our own feelings and avoid passing judgement. Staying aware of our nonverbal communication is especially important during these conversations as we can easily expose our feelings with our facial expressions, body language or tone of voice. 

2. Provide multiple perspectives.

For some clients, hearing the same information and recommendations from multiple sources can help them to understand the true severity of their pet’s condition. In some cases where I feel that I am missing a connection with the owner, I will excuse myself from the room by saying, “I know this is difficult to consider, and I’d like to give you some time to think, if that’s okay.” Most clients are grateful for this opportunity. 

I will often then send an experienced veterinary nurse in to check on the client after a few minutes and allow them time to speak with the client. Many clients will elicit the opinion of the nurse, especially if they have met them in previous visits. Sometimes my nurses have been the ones to guide clients to the decision to euthanize. 

I have also offered to call specialists or talk to other doctors in the practice to determine if there are any other suggestions for treatment. In some cases, owners have requested referral to the specialty hospital to meet with the specialist in person. In these cases, I try to encourage a direct transfer from my hospital to the specialty center to avoid prolonging pain or suffering for the pet. 

3. Provide resources to the owner.

Objective data can be powerful. Providing quality-of-life assessments help some owners in their decision-making. Two of the assessments I use most often for owners come from Lap of Love³ and the Ohio State University Veterinary School.⁴ Lap of Love’s website also offers excellent client information on end-of-life care that anyone can access, even if there is not a Lap of Love veterinarian in your area. 

Additionally, consider providing resources for grief counseling and pet loss support groups. Some counselors and groups are willing to provide support to the owner prior to the pet’s death and can help them process the decision to euthanize. Most veterinarians are not trained mental health specialists and should not try to fill the role of therapist for a struggling owner. Involving trained professionals in supporting the client can help ease the burden on the veterinary team and ultimately be more helpful to the client.

4. Explore hospice options.

Hospice care and in-home euthanasia services are growing areas in veterinary medicine. For clients who will not euthanize their pet, referral to a hospice veterinarian can provide more support for both client and patient. It is very important that owners understand what to expect in the death process and that they are prepared for the nursing care involved. They should also be advised of subtle signs to watch for in their pet that might indicate suffering or distress.

If there are not hospice veterinarians in your area, do your best to provide palliative care to the patient. Some hospice veterinarians will provide “comfort kits” or “crisis kits” to owners which include doses of medications including anti-nausea medications, anticonvulsants, pain medication, sedatives and other products specific to the pet’s disease process. The goal of these kits is to provide short-term support for the pet, including minimizing pain, anxiety and distress, until the owner can get to a veterinary office.

5. Debrief to protect the mental health of the veterinary team.

Finally, it is essential that team members can debrief after the conclusion of the case, regardless of the outcome. Cases where there is disagreement between the veterinary team and client surrounding patient care can lead to moral distress for the veterinary team. This was defined as “the experience of knowing the right thing to do while being in a situation in which it is nearly impossible to do it” in a 2018 study that explored moral distress in veterinary medicine.⁵ Seventy-eight percent of respondents said that not being able to do what they felt was best for a patient caused moderate to severe distress for them, and 73% stated the same effects were felt by their team members.⁵

Debriefing offers team members the opportunity to discuss the case and their feelings around it. This can ensure that anyone who is upset or distressed about the process or outcome can get the support they need and know they are not alone. 

In a profession with high levels of psychological distress and mental health struggles, having tools and resources for handling situations of moral distress, especially around end-of-life conversations, is crucial. +

References:

1. Matte AR, Khosa DK, Coe JB, and Meehan MP. Impacts of the process and decision-making around companion animal euthanasia on veterinary wellbeing. Vet Rec 2019; doi:10.1136/ vetrec-2019-105540.
2. Borden LJN, Adams CL, Bonnett BN, Ribble CS, and Shaw JR. Comparison of veterinarian and standardized client perceptions of communication during euthanasia discussions. JAVMA 2019;254:1073-1085.
3. Pet Quality-of-Life Assessment. Lap of Love. https://www.lapoflove.com/quality-of-life-assessment
4. How Do I Know When it’s Time? Ohio State University. https://vet.osu.edu/vmc/sites/default/files/import/assets/pdf/hospital/companionAnimals/HonoringtheBond/HowDoIKnowWhen.pdf
5. Moses L, Malowney MJ, and Boyd JW. Ethical conflict and moral distress in veterinary practice: A survey of North American veterinarians. J Vet Intern Med 2018; 32:2115-2122.

The post 5 Tools for Addressing Euthanasia Averseness in Pet Owners appeared first on PetVet Magazine.

When the fourth-year veterinary student assigned to my case stepped into the room, I paced nervously and provided detailed responses to each intake question, showed photos of the blood Sadie coughed up and nervously asked, “Why is Sadie coughing up blood?” Without a reply, the student, who was only in the second week of her very first clinical rotation, squeezed and touched Sadie’s throat and listened to her heart and lungs one more time. I sat down, my leg bouncing anxiously up and down, tapping my hand on my bouncing leg. 

As the students were instructed to do, she asked my permission to take Sadie to the larger exam room where she could do a more detailed exam under the supervision of her teachers. I consented and nervously asked one more time, “Why is Sadie coughing up blood?” 

As the student left, with Sadie reluctantly in tow, she said, “Her trachea is not properly aligned.” And with that, she was gone, and I was left alone wondering, “What does that mean? How is it is even possible to have a misaligned trachea?” I absentmindedly stood in the room stroking my own throat, assessing the alignment of my own trachea, wondering if it was properly aligned.

The Veterinary Education Curriculum

The demands of a veterinary education program are intense. Students are expected to have in-depth knowledge of multiple species in the areas of anatomy, clinical pathology and diagnostic imaging, as well as competence in a wide range of surgical procedures ranging from the more common spays and neuters to more complicated procedures. And now, per a 2004 criterion added by the American Veterinary Medical Association’s (AVMA) Council on Education (COE), students are now also expected to demonstrate competency in interpersonal communication. 

On top of curriculum stressors, veterinary students have to contend with managing debt, a heavy workload and impoverished relationships due to isolation. Given the breadth of the curriculum and external stressors, it is not surprising that veterinary medicine students report high levels of depression, anxiety and stress, surpassing the reported levels of human medical student counterparts. 

Veterinary medicine programs select the most academically-elite and determined students, most of whom have academic backgrounds in applied sciences, animal science or agriculture, with very few coming from liberal arts or social science backgrounds. Yet now that the AVMA has made communication a core competency, students are faced with one more skill to master; one that for many is in and of itself a source of stress, anxiety and apprehension: communication. 

Implications for Communication

Communication is not just about “talking good” and relaying information. Communication is about creating shared meaning, building and maintaining relationships, fostering trust and connecting with others. Experiencing elevated levels of stress or anxiety can disrupt the communication process and exacerbate feelings of communication apprehension, which can lead to impoverished interactions. 

Communication apprehension is defined as “an individual’s level of fear or anxiety associated with either real or anticipated communication with another person or persons.¹” As such, it is a stress response to real or anticipated conversations. It can prompt physiological responses such as increased heart rate, increased perspiration and increased breathing, all of which manifest as visible signs (e.g., face flushing, muscle tension) of our internal distress and emotional arousal. 

Communication apprehension and its physiological behavioral markers can negatively affect one’s ability to communicate effectively, confidently and clearly with another person. When people experience elevated or clinical levels of stress or anxiety, the interpersonal communication process is disrupted; we are not able to fully attend to others because our focus is inward. This makes it difficult to focus on social cues and offer contextual appropriate responses. 

In professions such as veterinary medicine with heavy interpersonal communication demands, coupled with the inclination to avoid or to limit time, communicating with another person is problematic. This is especially so when attention is split and the primary focus is on making sense of clinical signs and presentation of symptoms. People with high levels of communication apprehension are less likely to be successful in professions that require high levels of communication or interaction. 

In medicine, positive outcomes are connected to communication. A doctor’s skill in effectively communicating with her/his clients is a critical component of the diagnostic process and treatment efforts. Therefore, effective communication with pet owners is necessary to satisfy clients, build relationships with clients, yield better clinical outcomes, enhance business and avoid malpractice.

A Natural Reaction

When the fourth-year student assigned to my case stepped into the exam room, she was breathing noticeably, smiling nervously and unsure of where to stand. Her facial muscles were tense as she began going through all the items on the intake form. She was recording my responses in between chewing on the top of her pen and tapping it nervously on the exam table. Her face flushing, respiration increasing, hands shaking, she reached for her stethoscope. Her body seemed to tense as she knelt on the floor to start Sadie’s physical exam. As she listened to Sadie’s heart and breathing, her eyes darted around the room. With hands still shaking, she stood on unsteady feet, shifting her weight from leg to leg, unsure of what to do or say next. Her eyes never fully met mine as she asked my permission to take Sadie to the larger exam area. This student was showing classic signs of stress and communication apprehension. 

How could I expect her to pick up on my own nervousness when she was in an elevated state herself? I am certain she did not intend to cause me additional concern when she said Sadie’s trachea is misaligned, or that Sadie might have leukemia. She was so focused on mastering the clinical side of veterinary medicine that she failed to attend the interpersonal side of it. 

This is not the reaction of an inept student. This a reasonable reaction to a stress- and anxiety-producing situation when someone is in an environment where the norm is experiencing elevated levels of stress and anxiety. After only three years of classroom instruction and labs, veterinary students spend their fourth year rotating through different services in their college’s veterinary hospital. Because of the breadth of the veterinary medicine curriculum, most of veterinary students’ training is focused on medical content rather than “soft skills” such as communication and positive self-care coping strategies. 

Wellbeing in Veterinary Medicine

The effects of communication apprehension are not necessarily limited to the interaction itself. Communication apprehension could exacerbate an individual’s anxiety or stress, which in turn could influence wellbeing. The practice of mindfulness has garnered much attention in recent years and is considered an inherent human capacity. 

Mindfulness training for health professionals and human medical students has been shown to relieve mental distress. Even brief online mindfulness trainings have shown benefits of decreasing stress among medical students. This brings us to the current breadth of the veterinary medicine curriculum. How can already overextended veterinary students add one more thing to their schedules?

As a communication scholar and a consumer of veterinary medicine services, I understand and support this 2004 criterion added by AVMA’s Council on Education. But I am also aware of the demands of the veterinary medicine curriculum and the negative downstream effects and costs to wellbeing. So, what can we do to better help veterinary students manage stress and anxiety, and subsequently enhance their interactions with veterinary clients? 

Communication scholars can work with our colleagues in veterinary medicine to identify creative ways to integrate communication training into the veterinary medicine curriculum. Partnerships with student counseling services and trained colleagues with interest in self-care can also be pursued. There are opportunities for creative collaborations across each campus with a veterinary college. And these collaborations do not necessarily need to come at a cost of the medical training. 

Medical schools in human medicine have been partnering with colleagues from the social sciences to inform curricular changes for more than 20 years. The positive effects of these collaborations are well documented. Veterinary schools do not need to shoulder the training of their students on their own. In a profession where the natural instinct is to step in and help, it is now time for communication scholars and colleagues with relevant social science backgrounds to step in and help our colleagues in veterinary medicine. Together, we can do better. 

In Conclusion

Happily, Sadie’s trachea was not misaligned, nor did she have leukemia. It was determined that Sadie’s throat was mildly irritated from being intubated during her spay a few days earlier. Stress and anxiety can lead to communication apprehension, difficulty reading others’ social cues and not having enough available cognitive resources to shape contextually-appropriate responses. Stress and anxiety can also lead veterinary medical students (or any medical professional) to hear zebras instead of horses when they hear hooves. +

References:

1. McCroskey, J. C. (1977). Classroom consequences of communication apprehension. Communication Education, p. 78.

Additional Resources:

1. Phang, C. K., Mukhtar, F., Ibrahim, N., Keng, S. L., & Sidik, S. M. (2015). Effects of a brief mindfulness-based intervention program for stress management among medical students: The Mindful-Gym randomized controlled study. Advances in Health Sciences Education, 20(5), 1115-1134. https://doi:10.1007/s10459-015-9591-3

2. Shapiro, S. L., Schwartz, G. E., & Bonner, G. (1998). Effects of mindfulness-based stress reduction on medical and premedical students. Journal of Behavioral Medicine, 21(6), 581-599. https://doi:10.1023/A:1018700829825 

3. Siqueira-Drake, A.A., Hafen Jr, M., Rush, B. R., & Reisbig, A. M. (2012). Predictors of anxiety and depression in veterinary medicine students: A four-year cohort examination. Journal of Veterinary Medical Education, 39(4), 322-330. https://doi:10.3138/jvme.0112-006R

4. Sweet, D. M., Gentile, D., & He, L. (2021). Communication Apprehension and Willingness to Communicate in Veterinary Medicine Students: Implications for Mindfulness and Communication Training. Health Communication, 1-9.

5. UCLA Mindful Awareness Research Center, Los Angeles. https://www.uclahealth.org/marc/ 

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In today’s world, the internet is an organic part of society. It is not something you do, but rather it is integrated into everyday life where people hang, shop, work, market, sell and hire—organically. So, naturally, you decide to take that next step to market your business on the internet, hoping to get new clients.

Hint: This is the beginning of the mistake.

There are a million websites, books and blogs promising step-by-step guidance to internet marketing success. Some even go as far as to promise shortcuts (or “hacks,” as they call them) to quick success. After skimming a few resources and maybe talking to an SEO agency, you decide you found the perfect blog that explains how you can easily market your clinic in just a few steps. So, why not use their free or cheap advice and see what happens?  

Of course, being a professional, you read and implement everything they say. After all, this is written by an SEO expert and the website seems legitimate.

Time passes and not much happens with your marketing results. You check your rankings on some online rankings checker to see if it failed and see you moved up on some keywords and down on others.  Maybe your website is even now ranking for the exact keywords you chose. The problem is, either way, what you know for certain is that you have not gotten any new business.

The first thought is, “Thank God I didn’t spend big money on SEO, it doesn’t do anything for me.”

Hopefully you make it to the second stage called “confusion.” It happens when you just do SEO and then look at Google Analytics and see traffic, but sales were not up in any significant way. Eventually, your brain realizes that maybe it really should have worked because you have heard and read it works for others.

That’s because there is much more to SEO than can be contained in a blog or even one book. There’s a lot missing, and that is the point where SEO meets marketing. SEO is marketing, and that starts with a foundation, math, algorithms, trial and error, science and a strategy. SEO is not a plan, but rather just a tool to help achieve that plan. Expertise to fully wield that tool takes ongoing education and time; the same education and time you already spend staying up on your profession and certifications.

If internet blogs were plans on how to build a doghouse, there would be no strategy and they would only provide a hammer and a picture of the final product.  There’s no mention of all the many other necessary tools. They don’t even tell you how long it will take. There are very few things you can build with just a hammer. You end up with no idea what parts to saw, where to find a saw or even what a saw looks like. Yes, there’s also a chance that you can wing it and build a doghouse successfully, but you have a business to run.  Why waste time when you could be growing your business the right way?

All SEO is not created equal. It’s about seeing your SEO efforts in the bigger picture of marketing and sales and not just ranking blindly. SEO is not magic either. SEO professionals study the market, data and last year’s 900,000+ algorithm changes on a regular basis to know things beyond keywords. SEO agencies learn your business needs, your industry and, most importantly, how Google handles the combination of your keywords, your brand, your website and the competition. You cannot just pick keywords and go rank; it’s a futile exercise if you don’t even know which keywords cause visitors and which cause new clients.  

That is the biggest marketing mistake veterinarians make. You simply do not have the time to market properly. Casual marketing rarely creates a steady flow of clients. It does however create a self-fulfilling prophecy.

There is one shortcut: keywords alone are useless. Marketing is nowhere as tough as getting your DVM, but it does take a lot of knowledge and time. When you dig in, you will see conventional marketing wisdom is much like the myths that clients ask you about in regards to their pets. Looking at keywords as SEO is like feeling a dog’s nose to tell if they are sick. Keywords and their search volume are usually the first SEO metrics (and sometimes the only metrics) many people look at before engaging in SEO. This is an empty piece of information without all the data they aren’t showing.

Let’s say you are a veterinarian (not a stretch here). You wrote a great informational blog post that was designed to answer a frequently-searched pet health question. Nothing wrong with that. It’s a great start, but just a start. It may even get you ranked well. However, the keywords you chose and ranked were incredibly broad. Let’s say the keywords the post ranked for are:

• Dog Health
• Veterinarian Cures
• Dog Health Tips

These may look like great related keywords; however, a longer glance at these terms can easily show what the problem is. The issue is people typing “dog health tips” into Google are not necessarily looking for a veterinarian to help. On the contrary, they’re most likely looking for information on how to do it themselves. This will virtually do nothing for your business unless your website is in the business of telling them how to not hire you…and I don’t think that makes for good business.

The problem is, most do-it-yourself SEO causes rankings, but not sales. Now, I’m not saying ranking for a search like this is all bad. It does bring in potential traffic and can create great awareness. However, you embarked on SEO to increase sales and gain new customers. From a brand awareness standpoint, it’s a win. But, a lot would have to happen before the vast majority of your website visitors from this traffic became paying customers.

When you do SEO, you need to be thinking about the big picture—including the technical aspects, the target market and the sales funnel for starters—not just blogs and online articles.

SEO is designed to take a lead through the stages of the buyer’s journey in order to convert them into a customer. Go ahead and look back at that SEO blog you were reading. I would almost bet that they never mention taking a visitor through the buyer’s journey. They are all about getting ranked.

Doing it on the side may seem like a free effort, but it’s not time well spent at all and doesn’t yield many results. SEO with strategy is designed to take your audience from problem-aware to solution-aware. You should be thinking about how you can get sales and not how to rank. 

For SEO, you must first wear your marketer’s hat. What are your overall goals? How is each piece of new content or strategy bringing you closer to that goal? Don’t think about keywords after your site goes live. Plan your strategy meticulously. +

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You would be forgiven for not getting these names right the first time, but what a story the client will have to tell!

For dogs? The winner was Scarlett No Haira. Some of the 50 runners-up included Sugar Bubbles Fancypants, Madame Squishy Van Wrinkleface and Joan of Bark.

For cats? Edgar Allen Paw took first. A few runners-up included Admiral Turbo Meowington, Ella Whiskers Oreo Hurst and Tika Meowsala.

For the full list (and to see just how hairless Scarlett No Haira is), visit petinsurance.com/wackypetnames

The post You Named Her What? appeared first on PetVet Magazine.

In fairy tales, it always seems like the brave peasant can turn the tables on mean wizards or magical beings just by knowing, and saying, their names. And, if you’re Bible-minded, God makes a big deal about parading every new animal by Adam so he can give them names. 

The act of using a pet’s name isn’t quite as powerful as getting in trouble with Mom, swooning over a crush or beating the mean imp Rumpelstiltskin, but it’s a little bit like that. 

Pet names gain power as people’s affection for their pets grow. Sometimes clients give pets significant names that are really important to family history or their own deep loves and interests. Other times they toss off silly or ridiculous names (“White cat,” “Diarrhea”) that they don’t take too seriously. But even those people always seem to appreciate the power of a veterinarian and their team referring to them by name. 

It’s almost like magic.

Say My Name, Say My Name 

Learning and remembering every new pet’s name during a busy day in the exam room can be a little difficult. But it’s a bigger necessity than ever before to brush up on your memory skills. According to a new survey by Banfield, one in two Gen Zers and one in three Millennials say they adopted a new dog or cat during this pandemic. That’s a lot of new pets rolling in with new names to remember in person and in email!

What might make it easier is that so many people pick the same names (or maybe that makes it harder?) Most of the popular pet names today aren’t very magical. A recent survey of pet adoptions during the pandemic last year found that top names for new puppies were Max, Buddy, Sadie, Murphy and Rocky. The exception is Bella, the heroine in the popular Twilight books and movies, which has been a top pick since the series got popular.

This fits with what Shawn Finch, DVM, practicing in Omaha, NE, sees: “Most common pet names? Bella. Also Lucy. Maybe Max for boys.”

Her favorite pet name remains “Joey Cupcake,” a newly-adopted beagle whose first name was picked by an adult and second name picked by a five-year-old.

And, brace yourself, one client in Colorado named his bulldog “Bulls***.” 

“They made the dad change his name for the medical record,” Finch says. “I think they changed it to Spot.”

So, weird names, funny names, profoundly important names; clients like to know that you remember their pet’s name, that you remember them and that they matter.

So, How Do You Remember?

Dr. Jeff Werber, a practicing veterinarian in Southern California, says the pet’s name takes priority.

“I do my best to remember the pet’s name even better than the owner’s name,” Werber says. “When I see people out of practice, there’s nothing better than asking how Luna or Lola or Rosa is doing. It’s priceless as far as building that veterinarian-client bond.”

Even mess-ups can sometimes hilariously cement a client relationship. 

Dr. Finch remembers mixing up names in the exam room once: “This one time, I picked up a super-cute tiny Pomeranian and held her over my head within earshot of mom and said, ‘Who’s the cutest? Is it Willow? Yes, Willow’s the cutest!’

“The client loved it,” she continues. “But, umm, the client’s name was Willow, not the dog. We never speak of it, but she still brings her dogs to see me, so she must be OK with having a dork for a vet,” Finch jokes.

That leads us right into our first tip:

1. Don’t crisscross patients and clients. Finch says she’s noticed a trend where people give pets really human names, and their own names seem more casual. “I have human clients with cute names like Spencer and Calvin, and pet patients with human names like Bob and Pete and Sally,” she shares.

2. Always double-check the record. Why trust yourself? Take a beat before you make the call, write the email or open the exam room door to make sure you’ve got it right. “I read the record every time, which is always right there in front of my face,” Finch says. 

3. Attach the name to a story. Use that old memory trick of attaching the name to an image in your head. Werber recommends making sure to take the time and pay attention when talking to a client about the name for the first time. “If it’s from a foreign language, ask what it means. Ask the story behind the name. Show some care and curiosity,” he suggests.

4. Use the name to go the extra mile. Love the name? Tell the client. Ask where it’s from. Maybe even do a little leg work, like Finch did: “The best was a dog named ‘Khoshekh,’ which I thought I recognized as a character from a podcast drama my daughter listened to. I confirmed that, and when I called his dad, I asked if that was right, and he said in the seven years he’d had the dog, no one had asked him that. It totally made his day and mine.”

5. Don’t mess up the gender. “What’s worse than mixing up names is mixing up the sex,” Werber says. “Sometimes the client will correct you with venom.” Be sure to check the record or double-check “under the hood.”

Your veterinary hospital sees thousands of clients a year, and more pets than people. Clients want to know that you remember them and their pets. So, if remembering names isn’t your thing, take a moment to peek at the client’s record before walking into that exam room or try out some of the above tips. That one little word, which most pet owners hold very near and dear to their heart, can go a long way in helping to build that client-vet relationship. +

The post What’s in a Name? appeared first on PetVet Magazine.

As the authority on pet health, veterinary professionals must advocate for resources that can help new pet parents budget for veterinary treatment—or else we risk seeing a parallel increase in economic euthanasia and a decreasing standard of care.

Proactive Conversations Can Save Lives

While many vet teams do recommend pet insurance, more proactive education is critical to meet the rise in new, inexperienced pet owners. Simply asking, “Do you have pet insurance?” can make clients aware that coverage options exist. 

In my own experience, clients with pet insurance are more likely to say “yes” to diagnostics that can grant more confidence in treatment plans and improve client compliance. And while none of us got into this profession to talk about finances, the reality is that conversations around treatment costs are frequently a point of contention with pet owners when many Americans don’t even have $2,000 in savings. Our best option is to make sure pet owners are thinking about potential costs and exploring financial tools that can help budget for pet health.

A Positive Impact 

The biggest impact pet insurance has on the pet parent, the animal, and even the veterinary team, is that the “level of care” conversation doesn’t have to revolve around costs; instead, we can go straight to the best treatment options.

Our profession is plagued by high rates of depression and suicide in large part because of the constant ups and downs of dealing with economic euthanasia. However, one report cited that clients with pet insurance are over 90% less likely to have to opt for economical euthanasia.¹

Conversations about euthanasia are always challenging and emotional ones to have with pet owners, and the topic might not be something new pet owners and owners of young pets want to think about. That’s why it’s so important to have a conversation early in the client relationship about the cost of veterinary care over the life of their pet. 

One study surveyed over 20,000 pet owners and found that less than 20% would be able to afford a major vet bill without pet insurance.²

It’s also important to note that vet practices see greater annual revenue through insured pets versus uninsured pets.³ 

How to Talk About Pet Insurance (Without a Bias)

In the past, vets may have recommended a single provider or just handed clients a bundle of brochures when discussing pet insurance. The truth is, a one-size-fits-all approach doesn’t work for pet insurance, and handing clients a stack of different providers’ marketing materials isn’t a great experience either. 

From the growing number of providers, it’s impossible to know which specific plan will best fit a client’s unique breed, age and location. Instead, educate pet parents on breed-specific health risks to keep in mind when considering coverage options. Inform clients of resources that allow them to learn about and compare top providers side-by-side. 

Many veterinarians choose to have this conversation during a client’s initial visit and during routine care when pets are healthy and perfect candidates for coverage. Simplicity is key to avoiding analysis-paralysis, and such educational resources have recently emerged.

Modern Solutions

Marketing materials rarely provide the best information about insurance plans, and most people don’t read the fine print. For motivated clients, it can take hours, days or even weeks to compare plans. For unmotivated clients, many will give up on research. Veterinary teams can help by steering pet parents toward unbiased comparison tools and objective marketplaces. 

Such resources streamline the volume of information needed to make an informed decision about pet insurance—and can increase the rate at which clients move forward with a coverage option. There is even a free resource that scores top coverage plans based on the user’s breed-specific health risks and shows the expected lifetime costs of each plan (some plans that are cheaper today may be more expensive in the long run, depending on how the premiums increase over the pet’s lifespan.)

Including resources on your practice website can make it easy for clients to find more detailed information and third-party comparison tools. However, proactive in-person (or telehealth) conversation is key to making more pet owners aware of treatment financing protection.

We have a window of opportunity to give a larger percentage of the population the resources they need to cover the cost of treatment and ensure their pets live long, happy lives. +

References:

1. AVMA’s Market For Veterinary Services 2017 https://www.avma.org/sites/default/files/resources/2017-econ-rpt4-mkt-vet-services.pdf
2. Fascinating Pet Insurance Statistics from 2019-2020 https://www.pawlicy.com/blog/pet-insurance-statistics-2019-2020/
3. Insurers Say Pet Care Spending, Visits Increase With Insurance https://www.avma.org/javma-news/2016-10-15/insurers-say-pet-care-spending-visits-increase-insurance

The post Are Your Clients Covered? Addressing Pet Insurance appeared first on PetVet Magazine.

You’ve just taken the life of a pet you know well; one you probably nurtured from the first months of the animal’s life. Then there’s the bereft pet parent with whom you also probably share a very caring relationship. You and she chose to end the life of the one being she loved unconditionally. Her pain and grief are bone-marrow deep, as likely are yours. 

Euthanasia isn’t just a painful part of your profession, but also an inevitable one. And the fact that veterinarians are at higher risk for depression than the general population¹ arguably has something to do with the stress and heartbreak of taking a beloved animal’s life. 

Dr. Katja Lang, a veterinarian at the Heart of Chelsea Animal Hospital in New York, affirms that, “euthanasia is emotional, even for professionals who regularly perform it.” And says, “As vets, we get to know the patients, we get to know the clients. So, we’re invested emotionally.” 

You took an oath to “solemnly swear to use my scientific knowledge and skills for the benefit of society through the protection of animal health and welfare, the prevention and relief of animal suffering…” However, no matter how medically necessary euthanasia was; no matter how much the act was a “prevention and relief of suffering,” it’s not how the pet parent experiences it.

Clearly and patiently, you delivered the diagnosis. But she was numb, exhausted and distressed, her heart unconvinced and unaccepting. She will, very shortly, enter the throes of denial and bargaining: Is this really happening? If only I had done… what if we tried…. did the vet really do all he could? To her, as to most of us, knowing and accepting are as different as the heart is from the mind. You’ll be asked many times to explain exactly why her pet’s life was taken. She’ll want to know why the euthanasia absolutely had to be. Of course, you’ll do your best to explain the reasoning. 

And so, the grief journey begins. Gradually the story unfolds of the first cough, the loss of appetite, the call to the emergency vet…days, weeks or even years after a pet’s death, someone is still reliving that day and that moment in your clinic. Because euthanasia has less to do with the mind and everything to do with the heart and soul, those who seek psychotherapy for their pain and sadness are often unsatisfied and unhealed. Few therapists are trained in grief work, almost none are trained in pet grief work and few veterinarians are seriously trained in pet grief work. There are, of course, grief-related studies in progressive veterinarian schools which make a significant difference in how a client is helped to cope with her loss, but the actual, sustained work with the bereaved is usually someone else’s responsibility.

The dominance of the medical model in our society makes it difficult to accept that a broken heart is not a mental health issue. There are pills for depression; none for sadness. And depression is usually where unexpressed, unaddressed grief ends up, for both pet parent and even the veterinarian.

The death of a pet can also trigger the unmourned, unexpressed grief of other deaths, perhaps that of a parent or another loved one, usually from long ago. The goal is not to help the bereaved pet parent “move on” or “let go,” but to help her “move forward;” move toward a belief in a future where she will love another animal again and remember the one that died with more joy than pain.

Seeking closure is another common, unhelpful grief assumption. No one who has loved ever really wants to “close” anything. The goal is reconciliation; reconciling the loss, integrating it into the lives of the bereaved as they move forward. Accepting the reality of the death is absolutely critical for any of this to happen. Without this fundamental step, no progress is possible.

Veterinarians are front-line workers who triage unfathomable grief on the spot, and often into the future. You’re never forgotten. You’re remembered in detail as a blessing and a curse…and you pay a steep price. So, what can you do to make the necessary evil of euthanasia a little easier on your grieving clients?

TIPS TO MAKE Euthanasia EASIER FOR GRIEVING CLIENTS

• “Justifying” a pet’s death by pointing out how necessary and medically called for it was only disenfranchises grief. Believing the necessity of the death is critical but there will be time for these kinds of explanations later. 
• Listen to and answer all your client’s questions, even though some may be repeated over and over.
• Realize there’s nothing for you to “fix” because nothing is wrong.
• You should encourage tears and realize that they’re natural responses to losing a loved one.  Inhibitions to public displays of emotion are harmful. 
• Lean in and close the space between you. In principle, touching and physical contact are taboo, and probably discouraged during the pandemic, but touch is a powerful way to connect and say, “I’m here.” A touch on the arm can be deeply reassuring
• Death can take a long time to be accepted. The body, mind and heart resist the reality—life without life’s companion. Let clients know you’re available to try to answer their questions. Encourage them to make an appointment to talk.
• Because “naming and sharing” are great healers, encourage clients to spend time with understanding, non-judgmental friends and family who will listen to their story no matter how many times they’ve heard it. 
• Leave something of sympathy. Some animal hospitals place a rose or some other flower after the euthanasia. It’s a simple compassionate act that softens the pain.
• Grief never ends, but you may be in a position to say that relationships and love never end either. Ritual actions taken to secure the relationship after death—ceremonies, tree-planting, shrines with photographs and mementos, and art and letter-writing to the deceased pet keep the spiritual connection and memory alive and strong. 
• Encourage self-care and self-compassion. Grief places a huge burden on the mind and body, so self-compassion, self-care and forgiveness are essential prerequisites for the journey. Good advice is to eat well, take grief breaks, go for walks and stay in touch with loving, caring people. 

It’s also important to take your own advice—show compassion to yourself, take grief breaks, spend more time with loving and supportive people, stay healthy and, of course, cry when you need to. Those who have lost a loved one tend only to remember the last days of death and illness, but since we don’t just focus on the end of a movie, suggest that they remember the entire beautiful life that was shared. +

References

1. When Working With Animals Can Hurt Your Mental Health, https://www.sciencedaily.com/releases/2019/08/190809113026.htm

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