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InFocus

Converting wants into needs

How you can get the most out of each consultation

At a recent party, I was accosted by a fellow reveller who, on discovering that I was a vet, made it her mission to disparage anyone associated with our profession. Her biggest complaint centred on the practice dismissing her thoughts about “Bella” and belittling her contribution concerning what might be wrong with her. Not having her views acknowledged had led to her believing that the vet was only interested in her money and not Bella’s illness. On reflection, this was an example of a mismatch between wants and needs, which led me to thinking about the skills to avoid this pitfall.

Making sure that a client’s wants become their needs entails ensuring a genuine collaborative partnership. This involves determining the client’s starting point early in the dialogue. The client may have a medical background; may have dealt with something similar in the past; or, having seen multiple vets for an ongoing condition, the client’s understanding may be very different to that in the notes.

It is wrong to be overly prescriptive here as your own personality will dictate what language you use, but opening the conversation with comments such as “I don’t know how much you know about diabetes in cats” can be helpful. The client may respond with a human experience and following that up with “it would be helpful for me to understand a little of what you know about diabetes from that experience” means we can be more specific and meaningful with our explanation.

Similarly, it is important to ascertain each individual client’s overall preference for information. Research shows that most clients would prefer more information, but this is not always the case.

Furthermore, it is useful to ask the client what other information would be helpful. Frequently, this is something we haven’t thought about. Research shows this is often “What has happened?”, “Why has it happened?” and “What does it specifically mean for my pet?” rather than information about treatment.

Research tells us that clients are more interested in prognosis than diagnosis. It is therefore difficult to predict each client’s individual needs and asking them directly is a way to prevent the omission of important information. Also, failure to ascertain a client’s ideas, concerns and expectations can derail the dialogue.

It is important to relate any discussion to these needs to bring them on board with your agenda; it is imperative that we break any information down into bite-sized pieces using easily understood language. This alone is not enough unless we give the client space, ask what their thoughts are and listen. Otherwise the client is going to feel pushed into a course of action. During our experiential learning sessions, clients often complain about being listened to but of not being heard, because the vet has not summarised their thoughts and concerns back to them.

There are many more skills involved in getting the client on board and turning a want into a need. But unless we check a client’s understanding, we can never be sure that everyone is on the same page. We know from human medicine that only 50 to 60 percent of information is recalled. Phrases such as “I appreciate I have given you lots of information; just to ensure I have explained it thoroughly would you like to recap for me what you need to do between now and when you next see me?” can be helpful.

The skills outlined in this article can turn any want into a need, ranging from dieting to considering a specific surgical intervention or medical course of action.

Christine Magrath

Christine Magrath, BVMS, HonFRCVS, is passionate about clinical communication skills and played a significant role in introducing this topic into the curricula at UK vet schools while working at the Veterinary Defence Society. For this work, she was awarded an honorary fellowship of the Royal College of Veterinary Surgeons in 2009 and the Chiron award from the British Veterinary Association in 2010. Christine has joined forces with Geoff Little and Alan Orme to form In-Communication.


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