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Thursday, January 28, 2016

Vet Vs. Client Perspectives

Recently I had an email conversation with someone seeking some advice.  During the conversation he made the following statement:
I wouldn't have characterized this as a mild problem, but that is me. I'm very protective about my girls, and pride myself on being in tune with their wellbeing. I can't even imagine the condition that you see some animals coming in for the first time so it's probably a matter of professional perspective.
He brings up an excellent point, one that I think both clients and vets sometimes forget.  A perspective is very individual and is based on personal experiences in a given area.  What a veterinarian sees on a daily basis is very different from what the average pet owner sees.  We see the best, worst, and everything in between.  Even someone who owns a dozen dogs in their lifetime doesn't compare when we'll see twice that number in a single day.

Let's look at an average case of bloody diarrhea as an example.

Mr. Sanguine sees his dog, Squirt, having diarrhea and there are streaks of blood in it.  Later that day the diarrhea is more liquid and the blood is more noticable.  He worries about the possibility of something serious being wrong, as he's never seen blood in the feces of any of his previous five dogs.  Squirt is acting normal but that blood is freaking out Mr. Sanguine, so he brings is dog to the vet.

Dr. A. Gain sees Squirt.  She collects a stool sample and sees the blood that worried Mr. Sanguine.  But the dog is wagging his tail, bouncing around the room, and has no pain or discomfort on abdominal palpation.  This is the fourth case of blood diarrhea she's seen this week and the second one of the day.When she finds out that Mr. Sanguine gave a new kind of dog treat a few days ago she stops worrying.

Each perspective is correct in its own way.  Mr. Sanguine is justifiably concerned because bloody diarreah is certainly not normal and he's never seen it before.  Dr. Gain sees several cases like this almost every week and isn't worried because of the lack of other symptoms.  Each person is looking at it from their personal experiences, one who has never seen this before and the other who has seen it every week for more than a decade.

There is nothing wrong with either point of view.  The concern of Mr. Sanguine allowed Dr. Gain to properly evaluate Squirt.  Dr. Gain's experience and expertese allowed her to assess that there was nothing seriously wrong with the dog and he could be treated conservatively.  It could easily have been a different situation, where Mr. Sanguine ignored Squirt's problem or Dr. Gain discovered something more serious like early pancreatitis.

This kind of difference in perspective can cause problems, though.  I often have to remind myself that what is normal and common for me isn't for a pet owner.  So while the owner is worrying and possibly even crying I'm shrugging my shoulders and making light of the issue.  Taking too light of a stance can make me seem uncaring or heartless to a client who is really worried.  I may be completely justified in my assessment, but that doesn't help the relationship with the client. 

In a situation like this the ball is in the doctor's court.  It is up to the vet to empathize with the client and show understanding, all while trying to assure the client that it really isn't a big deal.  We as medical professionals need to keep in mind that the client's perspective is not the same as ours because they don't see the same things we do.  It is our responsibility to not make light of this situation and to do what we can to allay their fears.  I'll often tell clients that I see a given problem multiple times per week, as that seems to help them understand that it may not be as big of a deal as they thought.

It's really about being empathetic and understanding people.  Clients should appreciate the fact that vets really do see things differently because of our daily experiences.  But vets have a bigger responsibility to try and see things from their clients' perspective and relate to their fears.