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Veterinarian-client-patient communication patterns used during clinical appointments in companion animal practice

Jane R. Shaw DVM, PhD1, Brenda N. Bonnett DVM, PhD2, Cindy L. Adams MSW, PhD3, and Debra L. Roter DrPH4
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  • 1 Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.
  • | 2 Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.
  • | 3 Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.
  • | 4 Department of Health Policy and Management, Johns Hopkins School of Public Health, 624 N Broadway, Baltimore, MD 21205.

Abstract

Objective—To identify communication patterns used by veterinarians during clinical appointments in companion animal practice.

Design—Cross-sectional descriptive study.

Sample Population—A random sample of 50 companion animal practitioners in southern Ontario and a convenience sample of 300 clients and their pets.

Procedure—For each practitioner, 6 clinical appointments (3 wellness appointments and 3 appointments related to a health problem) were videotaped. The Roter interaction analysis system was used to analyze the resulting 300 videotapes, and cluster analysis was used to identify veterinarian communication patterns.

Results—175 (58%) appointments were classified as having a biomedical communication pattern, and 125 (42%) were classified as having a biolifestyle-social communication pattern. None were classified as having a consumerist communication pattern. Twentythree (46%) veterinarians were classified as using a predominantly biomedical communication pattern, 19 (38%) were classified as using a mixed communication pattern, and 8 (16%) were classified as using a predominantly biolifestyle-social communication pattern. Pattern use was related to the type of appointment. Overall, 103 (69%) wellness appointments were classified as biolifestyle-social and 127 (85%) problem appointments were classified as biomedical. Appointments with a biomedical communication pattern (mean, 11.98 minutes) were significantly longer than appointments with a biolifestyle-social communication pattern (10.43 minutes). Median relationship-centered care score (ie, the ratio of client-centered talk to veterinarian-centered talk) was significantly higher during appointments with a biolifestyle-social communication pattern (1.10) than during appointments with a biomedical communication pattern (0.40).

Conclusions and Clinical Relevance—Results suggest that veterinarians in companion animal practice use 2 distinct patterns of communication. Communication pattern was associated with duration of visit, type of appointment, and relationship-centeredness. Recognition of these communication patterns has implications for veterinary training and client and patient outcomes.

Abstract

Objective—To identify communication patterns used by veterinarians during clinical appointments in companion animal practice.

Design—Cross-sectional descriptive study.

Sample Population—A random sample of 50 companion animal practitioners in southern Ontario and a convenience sample of 300 clients and their pets.

Procedure—For each practitioner, 6 clinical appointments (3 wellness appointments and 3 appointments related to a health problem) were videotaped. The Roter interaction analysis system was used to analyze the resulting 300 videotapes, and cluster analysis was used to identify veterinarian communication patterns.

Results—175 (58%) appointments were classified as having a biomedical communication pattern, and 125 (42%) were classified as having a biolifestyle-social communication pattern. None were classified as having a consumerist communication pattern. Twentythree (46%) veterinarians were classified as using a predominantly biomedical communication pattern, 19 (38%) were classified as using a mixed communication pattern, and 8 (16%) were classified as using a predominantly biolifestyle-social communication pattern. Pattern use was related to the type of appointment. Overall, 103 (69%) wellness appointments were classified as biolifestyle-social and 127 (85%) problem appointments were classified as biomedical. Appointments with a biomedical communication pattern (mean, 11.98 minutes) were significantly longer than appointments with a biolifestyle-social communication pattern (10.43 minutes). Median relationship-centered care score (ie, the ratio of client-centered talk to veterinarian-centered talk) was significantly higher during appointments with a biolifestyle-social communication pattern (1.10) than during appointments with a biomedical communication pattern (0.40).

Conclusions and Clinical Relevance—Results suggest that veterinarians in companion animal practice use 2 distinct patterns of communication. Communication pattern was associated with duration of visit, type of appointment, and relationship-centeredness. Recognition of these communication patterns has implications for veterinary training and client and patient outcomes.

Contributor Notes

Dr. Shaw's present address is Argus Institute, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80525.

Supported by grants from Novartis Animal Health and the Ontario Veterinary College Pet Trust Fund.

Presented at the International Conference on Communication in Veterinary Medicine, Niagara-on-the-Lake, ON, Canada, June 2004 and the International Conference on Communication in Healthcare, Bruges, Belgium, September 2004.

The authors thank Anne Valliant for assistance with survey data entry, Jennifer Bedford for assistance with videotechnology, and William Sears for assistance with statistical analyses.

Dr. Shaw.