The spoken and unspoken word - Veterinary Practice
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The spoken and unspoken word

Liz Watkins continues her series with a discussion of the six stages of communication, stressing the need to listen and absorb all the meaning that is offered in the spoken or unspoken word.

CLIENTS come to us with needs and they leave us with solutions. They judge us on the way they are led from the need to the solution.

We speak to clients in an infinite number of different situations: conversations with potential new clients, complaints, bereavement, debt collection, client compliance, and so on. And although the slant, tone and emphasis of these conversations will all be different, the basic structure of the conversation is the same.

It is vital to be aware that clients do NOT judge us primarily on our technical know-how, our state-of-the-art equipment, or our prices: they judge us on our ability to produce the feeling that they and their animal have been well served and well cared for.

The stages of communication are:

  1. Preparation;
  2. Opening the conversation;
  3. Listening;
  4. Confirming understanding;
  5. Communicating an answer;
  6. Summarising and closing.

1. Preparation

When the nature of the conversation is predictable, and especially when it is out of one’s comfort zone, a moment or two of preparation is helpful.

Particularly in the case of complaints, or bereavement, it is useful to run through the main items to remember before opening the conversation. For example, spend a moment reminding oneself not to interrupt, not to be defensive, etc.

2. Opening the conversation

I went to see my doctor a few weeks ago. I had never met him before and he had no idea why I was there. I walked in, and he smiled and looked at me but said nothing. And he stayed silent. To say I was uncomfortable would be understating it.

Eventually, and slightly awkwardly, I had to open the conversation. I was left with the certainty that I was just another patient on the list to be worked through, and not a “person” at all.

Many, if not most, of our clients will be a little nervous when visiting the vets. An appropriate opening says “we care, we understand”.

It’s helpful if you know something about the client, and can open with a personal remark such as “How is the golf going?” Keeping notes on a client’s card as an aide-mémoire helps.

3. Listening

For most people, active listening is a learnt skill – it does not come naturally. It requires an ability to resist any desire to interrupt. Clients will soon work out if you are simply “waiting to speak” or are truly listening.

A person who is “waiting to speak” is concentrating on his or her own agenda and own planned next words, leaving less brain power available for the assessment of content and tone of the client, and allowing crucial words and nuances to be missed.

This doesn’t necessarily mean the listener has to stay silent; it may be appropriate to ask for clarification of a point, but the agenda here stays firmly with the speaker, not the listener.

4. Confirm understanding

Once the client has finished, and pauses, the time comes for checking understanding, and probing more deeply into the client’s meaning. Repeating back the gist of the client’s words helps not only confirm understanding but show that the words have been properly understood.

Interestingly, in research where the (original) speaker’s body language is copied by the (original) listener, and his or her exact words are used when confirming understanding, then the speaker’s satisfaction score measured after the conversation is higher.

This happens because we instinctively like people that we trust, and we instinctively trust people who are like ourselves, and behave as we do.

5. Communicate an answer

Finally the time arrives to give a considered opinion. Speaking clearly, and slowly, without slang, adds authority to an answer. Correct medical terms are usually appreciated, but should always be explained. When we use terms on a daily basis it can be hard to remember that the average educated member of the public may not understand terms like “renal” or “pruritus” and will misinterpret other terms: “acute” and “chronic” both mean “severe” to most clients.

6. Summarise and close

This is self-explanatory and obvious, but can add value. At this time, repetition of the main points will aid memory and increase the acceptance of advice. This is also the time to re-check the client’s understanding and ask if everything is crystal clear.

Readers familiar with the Cambridge-Calgary model of consultations will see a familiar pattern here. Those trained in bereavement will also recognise this pattern, although the “answer” section now becomes “demonstrating support” rather than providing advice. Those dealing with complaints will follow a similar script. Our training modules study this in much more detail than can be given in a short article. If just one take-home message were to be taken from this article, it must be: listen.

Listen actively, without being judgemental, without interrupting.

Listen with the aim of fully understanding the other person’s point of view, his or her concerns and aspirations.

But above all, listen and absorb all the meaning that is being offered in the spoken or unspoken word.

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