• 1.

    Shaw JR, Adams CL, Bonnett BN. What can veterinarians learn from studies of physician-patient communication about veterinarian-client-patient communication? J Am Vet Med Assoc 2004;224:676684.

    • Search Google Scholar
    • Export Citation
  • 2.

    Coe JB, Adams CL, Bonnett BN. A focus group study of veterinarians' and pet owners' perceptions of the monetary aspects of veterinary care. J Am Vet Med Assoc 2007;231:15101518.

    • Search Google Scholar
    • Export Citation
  • 3.

    Coe JB, Adams CL, Bonnett BN. Prevalence and nature of cost discussions during clinical appointments in companion animal practice. J Am Vet Med Assoc 2009;234:14181424.

    • Search Google Scholar
    • Export Citation
  • 4.

    Shaw JR, Adams CL, Bonnet BN, et al. Use of the Roter interaction analysis system to analyze veterinarian-client-patient communication in companion animal practice. J Am Vet Med Assoc 2004;225:222229.

    • Search Google Scholar
    • Export Citation
  • 5.

    Beckman HB, Frankel RM. The effect of physician behavior on the collection of data. Ann Intern Med 1984;101:692696.

  • 6.

    Marvel MK, Epstein RM, Flowers K, et al. Soliciting the patient's agenda: have we improved? JAMA 1999;281:283287.

  • 7.

    Rhoades DR, McFarland KF, Finch WH, et al. Speaking and interruptions during primary care office visits. Fam Med 2001;33:528532.

  • 8.

    Baker LH, O'Connell D, Platt FW. “What else?” Setting the agenda for the clinical interview. Ann Intern Med 2005;143:766770.

  • 9.

    Mauksch LB, Dugdale DC, Dodson S, et al. Relationship, communication, and efficiency in the medical encounter: creating a clinical model from a literature review. Arch Intern Med 2008;168:13871395.

    • Search Google Scholar
    • Export Citation
  • 10.

    Abood SK. Effectively communicating with your clients. Top Companion Anim Med 2008;23:143147.

  • 11.

    Silverman J, Kurtz S, Draper J. Skills for communicating with patients. 2nd ed. Oxford, England: Radcliffe Publishing, 2005.

  • 12.

    White J, Levinson W, Roter D. “Oh, by the way …”: the closing moments of the medical visit. J Gen Intern Med 1994;9:2428.

  • 13.

    Roter DL, Hall JA, Aoki Y. Physician gender effects in medical communication: a meta-analytic review. JAMA 2002;288:756764.

  • 14.

    Kaplan SH, Gandek B, Greenfield S, et al. Patient and visit characteristics related to physicians participatory decision-making style results from the medical outcomes study. Med Care 1995;33:11761187.

    • Search Google Scholar
    • Export Citation
  • 15.

    Beach MC, Roter DL, Wang NY, et al. Are physicians' attitudes of respect accurately perceived by patients and associated with more positive communication behaviors? Patient Educ Couns 2006;62:347354.

    • Search Google Scholar
    • Export Citation
  • 16.

    Shaw JR, Bonnett BN, Adams CL, et al. Veterinarian-client-patient communication patterns used during clinical appointments in companion animal practice. J Am Vet Med Assoc 2006;228:714721.

    • Search Google Scholar
    • Export Citation
  • 17.

    Shaw JR, Adams CL, Bonnett BN, et al. Veterinarian-client-patient communication during wellness appointments versus appointments related to a health problem in companion animal practice. J Am Vet Med Assoc 2008;233:15761586.

    • Search Google Scholar
    • Export Citation
  • 18.

    Burack RC, Carpenter RR. The predictive value of the presenting complaint. J Fam Pract 1983;16:749754.

  • 19.

    Boyle D, Dwinnell B, Platt F. Invite, listen and summarize: a patient-centered communication technique. Acad Med 2005;80:2932.

  • 20.

    Coe JB, Adams CL, Bonnett BN. A focus group study of veterinarians' and pet owners' perceptions of veterinarian-client communication in companion animal practice. J Am Vet Med Assoc 2008;233:10721080.

    • Search Google Scholar
    • Export Citation
  • 21.

    Kurtz SM, Adams CL. Essential education in communication skills and cultural sensitivities for global public health in an evolving veterinary world. Rev Sci Tech 2009;28:635647.

    • Search Google Scholar
    • Export Citation
  • 22.

    Radford AD, Stockley P, Taylor R, et al. Use of simulated clients in training veterinary undergraduates in communication skills. Vet Rec 2003;152:422427.

    • Search Google Scholar
    • Export Citation
  • 23.

    Adams CL, Ladner L. Implementing a simulated client program: bridging the gap between theory and practice. J Vet Med Educ 2004;31:138145.

    • Search Google Scholar
    • Export Citation
  • 24.

    Gray CA, Blaxter AC, Johnston PA, et al. Communication education in veterinary education in the United Kingdom and Ireland: the NUVACS project coupled to progressive individual school endeavors. J Vet Med Educ 2006;33:8592.

    • Search Google Scholar
    • Export Citation
  • 25.

    Mills JN, Irwin P, Baguley J, et al. Development of veterinary communication skills at Murdoch University and in other Australian veterinary schools. J Vet Med Educ 2006;33:9399.

    • Search Google Scholar
    • Export Citation
  • 26.

    Shaw DH, Ihle SL. Communication skills training at the Atlantic Veterinary College, University of Prince Edward Island. J Vet Med Educ 2006;33:100104.

    • Search Google Scholar
    • Export Citation
  • 27.

    Professional competencies of Canadian veterinarians: a basis for curriculum development. Guelph, ON, Canada: Ontario Veterinary College, 1996.

    • Search Google Scholar
    • Export Citation
  • 28.

    Lloyd JW, Walsh DA. Template for a recommended curriculum in “Veterinary professional development and career success.” J Vet Med Educ 2002;29:8493.

    • Search Google Scholar
    • Export Citation
  • 29.

    Kurtz SM, Silverman J, Benson J, et al. Marrying content and process in clinical method teaching: enhancing the Calgary-Cambridge guides. Acad Med 2003;78:802809.

    • Search Google Scholar
    • Export Citation

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Analysis of solicitation of client concerns in companion animal practice

Laura M. A. Dysart BSc1, Jason B. Coe DVM, PhD2, and Cindy L. Adams MSW, PhD3
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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.

Abstract

Objective—To examine veterinarian solicitation of client concerns in companion animal practice.

Design—Cross-sectional descriptive study.

Sample—20 veterinarians in companion animal practice in Eastern Ontario and 334 clients and their pets.

Procedures—Beginning segments of 334 appointments were coded for a veterinarian solicitation (open- or closed-ended question) used to elicit client concerns. Appointments including a solicitation were analyzed for completion of the client's response and its length. The association between veterinarian solicitations at the beginning and concerns arising at the closure of the interview was examined.

Results—123 (37%) of the coded appointments contained a veterinarian solicitation, of which 93 (76%) were open-ended and 30 (24%) were closed-ended solicitations. Client responses to a solicitation were interrupted in 68 of 123 (55%) appointments. Main reasons for incomplete client responses were veterinarian interruptions in the form of closed-ended questioning (39/68) and noninterrogative statements (18/68). Median length of time clients spoke before interruption was 11 seconds (range, 1 to 139 seconds; mean, 15.3 seconds; SD, 12.1 seconds). The odds of a new concern arising during the closing segment of an appointment were 4 times as great when the appointment did not contain a veterinarian solicitation at the beginning of the interview.

Conclusions and Clinical Relevance—Not soliciting client concerns at the beginning of an interview increased the odds of a concern arising during the final moments of the interaction. This required the veterinarian to choose among extending the appointment to address the concern, ignoring the concern at a possible cost to client satisfaction, or deferring the concern to another visit.

Contributor Notes

Dr. Adams' present address is Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada.

Supported by Medi Cal/Royal Canin Veterinary Diets.

The authors thank William Sears for statistical assistance.

Address correspondence to Dr. Coe (jcoe@uoguelph.ca).