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What is your client thinking?
What is your client thinking and why should you care?
  1. Zoe Belshaw

Abstract

Zoe Belshaw is coordinating our new series that gives an insight into what clients’ experiences are and how you can help them. Here, she outlines how the series came into being

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Do you want to get involved?

  • We will be happy to receive any feedback or suggestions for future columns. If you know a client who might be interested in writing for us, please direct them to the information on the Vet Record website http://vetrecord.bvapublications.com or contact us at vet.clientview{at}bmj.com. We will read any submissions and provide editorial support but we cannot guarantee to publish everything we receive.

  • See our first contribution ‘Labour and love for Mr Pink’ on p 518.

Sometimes, clients do baffling things. They don’t administer a course of medication they’ve already paid for. They say ‘I’ll think about it’ when you advise them to treat the worst dental disease or lameness you’ve ever seen. They don’t make a small change to their animal’s husbandry that could prevent an expensive problem. Then there are those who are disproportionately grateful for a euthanasia consultation that really didn’t go to plan and those who want to spend money you know they can’t afford on a very ill animal that you’ve told them you can’t fix.

When my own elderly dog became ill, I realised I was one of those clients. I paid for tablets then didn’t finish the course. I avoided using treatments that might have made a difference because of the tiny risk of side effects. I struggled to make the simplest changes to my dog’s home management but spent money on things that I knew in my heart of hearts probably wouldn’t help. And I realised just how tough it can be to look after an ill animal. To have the daily worry of whether his needs would fit around my own busy work schedule. To not be able to see friends at weekends because the dog can’t be left on his own for long. To have to make the decision about what time on what day I’d choose to end his life. It turns out that the mix of guilt, love, frustration, the fear of being judged and the fear of doing the wrong thing can be a pretty paralysing combination.

Recognising where to improve

That experience led me to a PhD looking at how vets and owners make decisions about dogs with osteoarthritis. I found that usually vets and owners wanted the same thing – a happy dog that lived a comfortable life for as long as possible. However, both vets and owners expressed a great deal of frustration with what happened during some consultations involving osteoarthritic dogs. Both talked about things they wished the other knew but due to time pressures, misunderstandings, judgements and assumptions on both sides of the consulting room table, those conversations didn’t happen. As a result, working together on the best possible outcome for the dog sometimes stopped being the focus, and there appeared to be negative emotional impacts for both vet and owner. I thought shining a light on the human aspects of veterinary medicine could be valuable.

Usually vets and owners want the same thing

The BMJ runs a column called ‘What your patient is thinking’. It features short pieces written by patients, describing experiences that they think are relevant to doctors. They offer powerful insights into the patient perspective and often spark fascinating debate among medical professionals, illustrating the power of a single voice. I approached the Vet Record earlier this year to ask if the team would consider something similar. They agreed, so today we’re launching a new column, which includes a box highlighting what you need to know. Each month, clients, and occasionally veterinary surgeons, will explore different experiences of animal ownership. While most will focus on a single species, we hope the human elements addressed in each column will be of interest to veterinary professionals in all sectors.

Our patients have the best chance of living happy, healthy lives when we work in partnership with their owners – our clients. We need to understand our partners’ perspectives and priorities. We hope this column will help.

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