Worldwide medical and scientific journal for animal health professionals
Veterinary Focus

Issue number 1 Communication

Communication is a clinical skill (part 2)

Published 20/02/2020

Written by Miguel Ángel Díaz , Iván López Vásquez , Cindy Adams and Antje Blättner

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One of the key skills in building relationships with others is the use of empathy. Empathy is referred to as the essential building block for extending compassion. That said, of all the skills used in a consultation, empathy is the one most often thought by learners to be a matter of personality trait rather than skill. Certainly one of the first steps in communicating empathy is the internal drive to truly want to understand the client’s perspective along with relevant communication skills to relay this knowingness. Although some of us are more naturally empathetic, skills necessary for empathy can be learned.

Communication is a clinical skill (part 2)

Key Points

It’s not good enough to think empathetically. You must communicate it as well.


Empathy requires the use of a 3-stage approach:

  1. Appreciating another person’s predicament or feelings by seeking to gather an understanding of their situation
  2. Communicating that understanding back to the person
  3. Pausing – coming to a full stop to let the other person absorb what has been said and give them the opportunity to say more or just feel your concern

Unlike sympathy that is more of a feeling of pity or concern outside of the client’s actual feelings or predicament, empathy is not only about being sensitive but overtly communicating that empathy to the client (Figure 1). It’s not good enough to think empathetically. You must communicate it as well. Use of empathy at appropriate times is a strong facilitative opening for clients to share more of their thoughts and concerns. This information is vital for understanding the client and working toward outcomes for the patients that take client’s concerns into consideration.

Empathy simply means that you identify and acknowledge your client’s emotions. You don’t need to share their emotions (which would be called “sympathy”) but you must acknowledge them.
Figure 1. Empathy simply means that you identify and acknowledge your client’s emotions. You don’t need to share their emotions (which would be called “sympathy”) but you must acknowledge them.

Empathetic statements are supportive comments that specifically link the “I” of the veterinarian and the “you” of the client. They both name and appreciate the client’s affect or situation. Verbal empathy is strengthened when accompanied by empathetic non-verbal communication, including facial expressions, proximity, touch, tone of voice, or use of silence.


  • “I can appreciate you were not anticipating the cost that it is going to take to get Riley back to his old self.”
  • “I can hear that you are very excited to have a new puppy.”
  • “I sense this is a frustrating situation for you.”
  • “I can tell that you are very attached to Barney and you want what is best for him.”

It is not necessary to have shared the same experience as the client, nor do we need to feel that the situation would be difficult or evoke the same feelings for us. It is necessary to see the situation from the client’s perspective and communicate understanding back to the client.

Antje Blaettner

“7% is the proportion of consultations where vets expressed empathy (study on 300 appointments).”

Antje Blaettner

Building a relationship is vital to the success of every appointment and use of empathy is central to building the relationship. That said, research reveals that in 300 small animal visits (150 well animals, 150 sick animals) veterinarians expressed empathy in only 7% of appointments 1.

It is estimated that empathetic opportunities exist in the majority of appointments but they are largely overlooked. It has been shown that communication training with physicians made a significant difference in a physician’s empathetic expression during patient interactions 6 months after the training 2. It’s clear that empathy can be taught, learned and integrated into clinical practice. Given the profound impact that empathy has on relationship development, it’s worth investing in.


  1. Shaw JR, Adams CL, Bonnett BN, Larson S, Roter DL. Use of the roter interaction analysis system to analyze veterinarian-client-patient communication in companion animal practice. JAVMA 2004;225(2):222-229.
  2. Bonvicini KA, Perlin MJ, Bylund CL, Carroll G, Rouse RA, Goldstein MG. Impact of communication training on physician expression of empathy in patient encounters. Patient Educ Couns 2009;75(1):3-10.
Miguel Ángel Díaz

Miguel Ángel Díaz

Miguel received a degree in Veterinary Science in 1990. After working at several clinics he opened his own clinic in 1992 Read more

Iván López Vásquez

Iván López Vásquez

Iván comes from a family of veterinarians; his father and older brother share the same passion. He obtained his degree from the Universidad de Concepción Read more

Cindy Adams

Cindy Adams

Cindy Adams is Professor in the Department of Veterinary Clinical and Diagnostic Sciences at the University of Calgary, Veterinary Medicine, Read more

Antje Blättner

Antje Blättner

Dr. Blättner studied in Berlin and Munich and after graduating in 1988 she set up and ran her own small animal practice. Read more

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