The smooth consultation (part 2)

Questions & answers

Certainly, there are many questions a veterinarian can and will need to ask the client to collect a case history, but given the limited time available to each client, these questions should be well-considered – the quality of the question determines the quality of the answer. That means: think first about what do I want to know and why? Then formulate the appropriate question!

With the right types of questions you can:

• gain valuable information about the pet’s illness;
• reveal the client’s needs;
• find out the client’s opinions and attitude;
• gently lead clients to a decision.

We must not forget that the client is, on the one hand, a layman, but, on the other hand, he can find a lot of information on all sorts of subjects on the Internet – including the subject of animal health.

This means that clients are often “pre-informed” and come with a self-diagnosis or they present their “internet findings” and would like to discuss them with us. Nevertheless, the client needs our guidance and clear recommendations in order to work with us as a partner to design the best care for their animal.

Basically, there are several types of questions that are well suited for the consultation and can be used for a variety of purposes (Table 1). 

The art of dialogue is to ask the right question at the right time inquiring about the reason for the consultation, as well as the client’s desires and needs, while at the same time not giving the client the feeling of being in an interrogation. How question techniques – together with active listening – can be implemented in dialogue, is shown in the next example dialogue.

Note: the quality of the question determines the quality of the answer!

Listening & understanding

Not only asking the right questions, but also the manner of listening, active clarification and feedback are important to connect with the client in order to really understand him, make suitable offers and win him as a partner. The partnership between veterinarian, practice team and clients is important because it is the basis of a successful business relationship! If the veterinarian alone decides diagnosis and therapy, the treatment itself is probably not worse, but the pet owner is merely the doctor’s assistant and not a genuine partner.

For a high level of compliance and client loyalty, however, it is essential that the veterinarian views the client as partner and aims to achieve goals (therapy, diagnostics, etc.) together with him.

This means that the vet practitioner should:

• ask open questions:
  • if he wants to get information and opinions;
  • if he wants to inquire about the client’s needs and wants;
  • if he wants to clarify something that is not 100% clear;
  • if he wants feedback.
• ask closed and alternative questions:
  • if he wants to facilitate decisions;
  • if he wants to filter out a client trend (Plan A or Plan B?);
  • if the client talks so much that concentrated and focused work is made difficult or time runs out.

The following example dialogue shows how the following techniques like asking questions, listening, understanding, clarifying and feedback can be implemented in everyday practice:

• Veterinarian: Mrs. Schmidt, what brings you and Lucky in today?
• Client: Lucky needs to be vaccinated and I wonder if I should have him neutered.
• V: I understand: Lucky will get his annual health check with vaccines. Then you need advice on neutering. Is there anything else I can do?
• C: Yes, please pay special attention to his ears during the health check, Lucky had an ear infection last year.
• V: All right, I have noted that. Mrs. S., can you tell me about your thoughts on neutering Lucky?

Dr. V. asks this question to clarify why Mrs. S. is considering neutering her pet. This information is important in order to respond appropriately to the situation. Moreover, the statement “if I should have him neutered” is anything but clear, i.e., what exactly Mrs. S. means remains initially in the dark. Simply going over it and delivering standard advice ignores the client’s needs and wastes time.

• C: I read that this helps when male dogs are restless, but I was told that animals get fat after neutering.
• V: Please explain in more detail how Lucky is restless.
• C: Well, if there’s a female dog in heat in the area where we go for a walk, he doesn’t obey at all, runs away and once we get back home, he lays at the door and whines all the time.
• V: Ok, and how does he behave if there isn’t a female dog in heat around?
• C: Then he is the best behaved and most relaxed dog in the world.
• V: It looks like you would both benefit from neutering Lucky. Here´s my suggestion: There is a preparation that is implanted under the dog´s skin and inhibits male hormones. If I implant it, then we’ll have about 4 months to see if Lucky will be calmer around bitches in heat. How does that sound?
• C: That’s a great idea – let’s do it! And then we can still operate him in the end?
• V: Sure, that´s always possible, but then we’ll know if neutering is the right solution. I suggest that we do the health check, vaccination and the ear examination today, and make a new appointment for the anti-hormone implant. Does that work for you?
• C: That’s great. Let’s do that. 

In this dialogue, the veterinarian deliberately asks open questions until he is sure that he has enough information to offer a solution that suits the client’s needs and the present situation. He also listens carefully to what Mrs. Schmidt says and clarifies what exactly “restless” means by digging deeper with open questions. This is immensely important, because behind the initial symptoms described by Mrs. Schmidt there could also be a cardiological or internist issue. By asking questions, listening and giving feedback “How does that sound? / How does it work for you?”, the dialogue takes a good and mutually clear, open and satisfying direction (Figure 1).

Note: It is important to ask questions and actively listen until all facts are crystal clear.