Everyday challenges
This chapter will cover some difficult situations that a vet practitioner can face...
Published 06/02/2020
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We are convinced that good communication with the pet owners and with the staff can contribute to a balanced life and help prevent burnout and other psychological disorders. This is an unexpected but very true reason to improve communication skills. This section explains the many benefits of effective communication.
Medical knowledge is not all. If you can’t communicate properly, you won’t find contentment nor will you satisfy your clients. Effective communication is also a clinical skill.
Mrs. Shirley, an 83-year-old woman, is the owner of Keiko, a 13-year-old cat suffering from chronic kidney disease. She is described as a very apprehensive and somewhat “fussy” client by the hospital team, who often misunderstand and have conflicts with her.
Everything started to change six months ago when Victor (the veterinarian) came to work at the hospital, Mrs. Shirley began to prefer him and today she brings Keiko to see him.
The question all his colleagues have been asking is: How is it possible that Victor is her favorite? He is the youngest professional on the team, he is not a feline specialist, nor does he exactly have the most clinical experience.
The medical director wanted to find out why. He asked Mrs. Shirley on one of her visits: “Why do you prefer for Victor to see Keiko all the time?” Her answer was quite simple: “I like to talk to him because Victor seems happy, I can tell that he loves what he does, and he is friendly with me and with Keiko. He encourages me, and we understand each other... and Keiko has been doing very well these last few months under his care”.
This type of response should not surprise us, because good communicators generate excellent interactions that have many benefits for themselves, their clients, patients, work teams and their workplace.
The emotional well-being of veterinarians is a fundamental aspect of their professional success and effective communication is a way to get there (Figure 1).
It is an unfortunate reality that in veterinary medicine the incidence of burnout and suicide is over the average of the population 1.
Burnout is an emotional state of excess built-up stress for an individual, to the point where they “can’t face” the daily situations they experience 2 and can feel exhaustion, cynicism and declining competence. People can even reach a state of “learned helplessness”, where they feel like there is nothing they can do to get out of it 3 4.
Although the reasons and causes behind this could be explored more deeply, it’s better to take an optimistic approach and look for solutions.
These days, human “happiness” or “well-being” (which are considered to mean the same thing in this document) is strongly supported by positive psychology, which promotes the scientific study of positive emotions and the positive characteristics of people and positive institutions 2 5.
Happiness is “frequently experiencing positive emotions and infrequently (though not absent) experiencing negative emotions” 2 6.
Being happy does not necessarily mean going around with a smile on your face, but rather it means appreciating and knowing how to optimistically explain daily experiences, without forgetting that life will continue to test you and that positive emotions are needed to carry on.
Today it is known that positive emotions undo the physiological effect of negative emotions 2 10.
Have you ever asked yourself “How happy am I?”
If you rate high on the scale of well-being, the benefits would help you to avoid burnout.
Here you can see some of them:
a. High personal competence. Happy people tend to have a higher self-esteem 6.
b. Better physical and mental health. Well-being may affect health by enhancing short-term responses (e.g., increasing immune response and pain tolerance) and long-term functioning (e.g., better cardiovascular fitness and longer life) or by buffering the effects of short-term stressors (marked by high-level stress responses and heart reactivity), and long-term illness (e.g., slowing disease progression and increasing survival) 7.
c. Longevity. The effect sizes for Subjective Well-Being (SWB) and health are not trivial; they are large when considered in a society-wide perspective. High SWB adds 4 to 10 years to life compared to low SWB) 8.
d. Better productivity, relationships and job satisfaction. Positive moods at work predict lower withdrawal and organizational retaliation and higher organizational citizenship behavior, as well as lower job burnout 6.
Mrs. Shirley said the following about Victor: “I like to talk to Victor because he seems happy, I can tell that he loves what he does, and he is friendly with me and with Keiko. He encourages me…” Experts say that “your client’s perception is your reality”, so this client’s comment must be taken very seriously.
Veterinarians are very strongly motivated by feeling valued, and especially by being recognized by pet owners, their peers and leaders. This boosts their intrinsic motivation, because it is intimately linked to the feeling that they are: “achieving objectives”, “making progress”, “overcoming challenges”, “growing professionally” and “being recognized for it” 9.
Veterinarians who can empathize and build relationships with their clients can achieve better medical results using their skills and thus increase their self-esteem (what they think and feel about themselves) and their self-efficacy (trust in themselves to achieve results).
Although it is clear that Victor is happy about the results he obtains... could it be said that “Victor’s happiness is the reason behind why he communicates better and obtains those results?”
In trying to link personal happiness with effective communication, consider some of the conclusions from Barbara Frederickson’s “Broaden and Build” theory 2 10. She concluded that positive emotions are key for optimal individual and “social” functioning (Figure 2). The happiest people see their social resources grow, because happiness facilitates “establishing new ties and the strengthening existing ones”, which is essential in interactions with pet owners (new and old).
Other resources that are expanded are: intellectual resources (greater ability to solve problems and learn new information), physical resources (greater coordination and strength and better cardiovascular recovery) and psychological resources (greater resilience and optimism).
If a person feels happy, their body language will also show it, which is great because people like to interact with optimistic people. Don’t forget that over 80% of communication is non-verbal, and that happiness can positively impact the three skills of effective communication: content (what I say), process (how I say it) and perception (how are “what I say” and “how I say it” perceived).
The success of expert communicators is backed by scientific evidence 11.
They generate the following benefits in their interactions:
1. Office visits that are more effective for clients, patients and veterinarians
2. Greater precision
3. More efficient with better results for practice and vet
4. Greater support and trust
5. Better coordination of treatment with clients, colleagues, team, etc.
6. Greater satisfaction of everyone involved
7. Better client understanding and recall
8. Better adhesion and monitoring
9. Greater patient safety and fewer errors
10. Fewer conflicts and complaints
A veterinarian who can achieve these benefits will feel a higher “frequency” of positive emotions, “savoring” them in their brains (left pre-frontal lobe), which reinforces and teaches it to think optimistically. He develops positive explanations of his daily experiences (optimistic explanatory style), increasing his self-esteem, self-efficacy, job satisfaction and “engagement” (positive emotional link with their job), cultivating the virtuous cycle of his well-being.
The opposite occurs with colleagues who are less skilled communicators, who won’t obtain such positive results as Victor. They could end up “ruminating” the negative emotions generated, increasing the likelihood of emotional deregulation disorders such as burnout.
The other part of Mrs. Shirley’s comment about Victor provides some good clues “…we understand each other... and Keiko has been doing very well these last few months under his care”.
A client who understands, cooperates and values the recommendations of their veterinarian is someone who “complies with” and “adheres to” the recommended treatments. The patients, like Keiko, also benefit because they receive the best care for their health and wellness.
For a client to feel comfortable with the veterinarian, to trust him, to feel listened to and understood (in terms of their expectations, ideas and feelings), to understand what is being recommended, and for their pet to get better, is without a doubt a dream come true for clients. This is also beneficial for the veterinarian because they have secured the owner’s commitment and “compliance” with their recommendations.
Studies indicate that to increase compliance, veterinarians must be more self-critical and realize that they are not as good at communicating as they think they are. Some of the most frequent complaints from pet owners are: procedures aren’t explained properly; they don’t receive full instructions about the follow-up care for their pet; they didn’t fully understand the findings of the clinical examination; they didn’t realize or weren’t able to understand the patient’s prognosis.
Leaders who communicate effectively with their team generate a positive work climate and better economic results for the company. They seek out, develop and inspire “positive psychological capital” (self-efficacy, optimism, hope and resilience) in their employees.
Leaders who are good communicators optimize their time, hold effective meetings, frequently give and ask for feedback from their team, identify and positively reinforce their team’s valuable behavior and achievements more than their errors. To attain better performance from their employees and prevent them from becoming bored or anxious at work, they inspire them and involve them in challenges (appropriate and stimulating) and invite them to be part of the “flow channel” (positive emotional state produced while doing tasks: that are challenging, that demand concentration, that have clear objectives, that they become fully involved in and become absorbed and immersed in). Every so often they set new challenges such as “C” and “E” (as shown in (Figure 3)).
A team whose members communicate effectively tends towards high performance, follows and better implements medical protocols for their patients and clients, pays attention to details and makes fewer errors. The team members are constantly monitoring each other and giving each other feedback. They become great sources of information, improvements and ideas for the leader and their organization.
Marcial Losada’s Metalearning model showed mathematically that positive connections and interactions in a team improve its performance 10 12. The difference between low-performing and high-performing teams has to do with connectivity and the Critical Positivity ratio. Connectivity is the number of communicational connections between the members of a team. Critical Positivity Ratio is the essential element of creating emotional space.
His conclusion was the Losada Line. When there is a 2.9: 1 critical positivity ratio, the team’s connectivity increases. In other words, when there is 2.9 times more “support, encouragement and appreciation” than “sarcasm, cynicism and disapproval” in interactions between co-workers, the team begins to perform better and becomes a high-performing team. The maximum ratio observed was 5.6:1.
There are many economic benefits obtained as a result of effective communication and value generation in the eyes of the client, depending on the stakeholders involved.
The client receives the best treatment and recommendations for their pet from the veterinarian. Therefore their investments in their pet’s health are specifically focused on the precise diagnosis made instead of purchasing unnecessary products or services as a result of a non-specific diagnosis.
Veterinarians build loyalty through satisfied clients, who perceive these economic benefits. Since pets will have greater wellness and good care as a result of greater compliance and adherence to medical recommendations, clients’ positive perception of their veterinarian’s professional skills is reinforced. They will prefer these veterinarians and recommend them to their friends and contacts.
Clinic owners/managers can use their time more efficiently rather than responding to frequent complaints from pet owner, because their medical team gets clients to adhere to their recommendations and if their company has the recommended services and/or products, more economic benefits will be generated from the demand for them. If people have greater job satisfaction in their daily work there will be less employee turnover, which in turn improves the company’s positioning in terms of client perception and profitability.
Diplomate Positive Psychology. From Emotional Intelligence Institute-Enhancing People, Santiago Chile, 2010.
https://positivepsychologyprogram.com/stress-management-techniques-tips-burn-out/
Peterson C, Maier SF, Seligman MEP. (1995) Learned Helplessness: A Theory for the Age of Personal Control. New York: Oxford University Press. ISBN 0-19-504467-3
Seligman Martin. La Auténtica Felicidad, 2011. Ediciones B. S.A.
Lyubomirsky S, King L, Diener E. The Benefits of Frequent Positive Affect: Does Happiness Lead to Success? Psychological Bulletin Copyright 2005 by the American Psychological Association 2005;131(6):803-855.
Diener ED, Chan M. Happy People Live Longer: Subjective Well-Being Contributes to Health and Longevity. Applied Psychology: Health and Well-being, 2011;3(1):1-43.
Csikszentmihaly M. Fluir en los negocios, Liderazgo y creación en el mundo de la empresa. Ed. Kairos, 2003.
Adams C, Kurtz S. Skills for Communicating in Veterinary Medicine. Otmoor Publishing, Oxford and Dewpoint Publishing, New York 2017.
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 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 is Professor in the Department of Veterinary Clinical and Diagnostic Sciences at the University of Calgary, Veterinary Medicine, Read more
Antje Blättner
Dr. Blaettner grew up in South Africa and Germany and graduated in 1988 after studying Veterinary Medicine in Berlin and Munich. Read more
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