Veterinary Family Practice
The evolution of the role of pets in human affairs has opened new opportunities for veterinarians, especially those in family practice. Owners become deeply attached to and care about the health and well-being of their companion animals. Their expectations for veterinary care are becoming similar to the care ideally provided in human medicine, particularly as high-tech medicine expands within veterinary specialties. In addition, the current increased importance of animals changes the nature of veterinary practice to include the entire family, and a sophisticated level of family support is expected by many clients. The style and emphasis of companion animal practices have shifted, as reflected in the term “veterinary family practice.”
Practices that include the entire family build lifelong relationships with families and their animals. Clients look forward to consistently seeing the same veterinarian. A new animal brought into the family is the occasion to discuss the animal’s life cycle with the family and provide an overview that can optimize the likelihood of a positive human-animal relationship with few behavioral problems. Veterinarians no longer just treat the animal; emotional needs of the family are addressed along with the medical needs of the pet.
Many families with companion animals have young children, particularly families that have both a dog and a cat. Animals are acknowledged to play a central and formative role in children’s lives. In some studies, pet-owning preadolescents scored higher on measures of self-esteem and autonomy. Practitioners may consider incorporating children into their communications with the family and making it easy for families with children to be comfortable during veterinary visits (eg, providing a play area in the waiting room or planning for children to be present in or visibly near the examination room). Hospitals providing extended care for animals with complex diagnostic procedures and treatment plans that require hospitalization sometimes find entire families coming in to offer support to the animal, perhaps spending hours with the pet; these hospitals may want to plan accommodation for such families.
Providing areas for relaxation, softer light in public areas, and comfortable seating in exam rooms without barriers from the medical staff are some features that improve client satisfaction. Impeccable cleanliness also matters. Veterinary practices that exhibit these values demonstrate the understanding that medical interventions carry emotional consequences and that medical competence and providing emotional support go hand-in-hand.
Studies have shown that communication has a key role in the owner-pet and client-veterinarian bond, because it affects the care pets receive. Effective communication significantly affects the loyalty of the pet owner to the veterinarian. Pet owners are more concerned with the health and well-being outcomes for the animal, whereas veterinarians often emphasize time and services in their communications. Clients value the genuine love and interest veterinarians show for the animals. The veterinarian's empathetic concern expressed through effective communication builds relationships with clients and enhances client satisfaction. Focus groups have revealed that clients expect veterinarians to educate them, explaining important information clearly and in various formats. Clients want to be provided options and offered a respectful partnership with the veterinarian in the health care of their pet. They expect interactive, two-way communication that includes listening and asking relevant questions. Clear recommendations and effective communication of their rationale also lead to better adherence to medical and treatment plans.
A strong owner-animal bond is associated with greater attention to veterinary care. Owners feel strongly about the quality of life of their pets, as revealed in studies involving surgery or medical problems of pets. Owners want effective pain management for the animal before, during, and after surgery, including spaying or neutering, even though they may not wish to administer such medication at home. People feel that a good quality of life for their pets includes mobility, play or mental stimulation, health, and companionship. Owners of dogs with heart disease expressed extreme concern regarding their inability to subjectively assess whether their pet is suffering. Teaching owners to assess and improve the animal's quality of life is an important aspect of veterinary care and client education. Veterinarians and owners can use a quality of life scale (eg, the HHHHHMM Scale to monitor the pet's hurt, hunger, hydration, hygiene, happiness, mobility, and more good days than bad) as an aid in assessment. A strong majority of owners indicate they would trade their pet’s longevity for quality of life. Among variables of quality of life, the pet’s ability to interact with the owners was the most important.
Good communication skills also build strong client-veterinarian bonds, and successful veterinarians pay close attention to their nontechnical competencies, including interpersonal relationship-building skills. Such skills enable veterinarians and staff members to facilitate clients’ understanding of medical situations and preventive medicine throughout the animal's life, from encouraging clients to attend puppy socialization classes to preparing clients to provide palliative care or deal with end-of-life issues. Follow-up communication can also improve client adherence, which is generally lower than believed by veterinarians. Curricula for veterinary students increasingly include opportunities to develop communication skills, allowing students to practice engaging clients, asking open-ended questions, offering reflective listening and empathy, educating clients, meeting clients’ and patients’ needs, and emphasizing support and partnership.
Despite optimal communication skills, research has unfortunately shown that veterinarians inevitably encounter owners who are inattentive, neglectful, over-involved, or completely cost-driven, as well as pets that are uncontrolled, dangerous, or dirty, adding to medical and emotional problems. Almost all veterinarians feel they were not prepared by their education and training to deal with such nonmedical issues. Making plans in advance and developing specific protocols for interventions can prepare the veterinary staff with strategies for these situations.