Introduction
Preventative healthcare (PHC) appointments are a key component to animal health and welfare,1 offering veterinary teams the opportunity to share information with owners that can help improve pets’ well-being and longevity.2 Even though the majority of pet owners believe that an in-person examination by a veterinarian leads to the best care for their pet,3 the number of client visits have been steadily decreasing over the last several years. Between 2021 and 2023, the number of client visits decreased 2.7% and the number of lapsing patients, defined as those that have not been to a veterinary practice in 14 to 18 months, increased.4 It would appear that many pet owners are trying to avoid or at least postponing visits to their veterinarian.
Many reasons have been suggested to explain this decrease, including cost, geographical accessibility, cultural/language barriers, poor veterinarian-client relationships, and a disconnect between veterinary professionals and pet owners regarding the importance of PHC.5–8 The ability to convey the importance of PHC for pets’ overall health and its effect on the mitigation of preventable diseases is a veterinarian’s responsibility and, therefore, an essential communication skill.9–11
Good communication skills, including the ability to convey empathy and trustworthiness, are the foundation to a positive veterinarian-client relationship, a vital component to successful veterinary care.12 Owners who believe their veterinarian communicates well and feel they receive enough pet care information are more likely to report having a strong positive relationship with their veterinarian and significantly more likely to follow their veterinarian’s recommendations.13,14
Although there have been several studies examining communication during PHC visits5,15,16 and owners’ knowledge and perceptions of vaccinations and parasites,17,18 there remains a need to better understand pet owners’ perceptions and information-seeking behaviors regarding PHC within a broader context. In addition, despite the acknowledged importance of empathy and trust within the veterinarian-client relationship,19–21 there have been no studies exploring the association between the dissemination of PHC information and empathy and trust. This study was designed to address these issues by exploring dog owners’ knowledge and interest level, as well as their primary source of information, for 13 specific PHC topics. In addition, we sought to examine the potential predictive value of owners’ satisfaction with how their veterinarian communicates about PHC topics and perceived veterinarian-related trust and empathy.
Methods
An online, anonymous, cross-sectional survey was developed with Qualtrics. The study was approved by the Colorado State University Institutional Review Board. Survey respondents were dog owners, 18 years or older, who resided in the US. Participants were recruited in June 2024 through Prolific, an open online marketplace whereby respondents receive small monetary compensation for completing surveys. The quality of data collected through platforms like Prolific has been shown to be higher than typical Internet samples and meets the psychometric standards considered acceptable for published research.22
The survey consisted of primarily Likert-scale questions with a free-text box provided to gather any additional comments. Demographic questions included length of time as a dog owner, age, gender, education level, and total household income before taxes over the past 12 months. The survey began with a series of 13 PHC items and asked participants to rate their current knowledge of each item using a 4-point Likert scale from 1 (none/minimal) to 4 (expert). Then, participants were presented with the same list of items and asked to indicate their interest in learning more about each subject using a 3-point Likert scale (1, minimal; 2, moderate; 3, a great deal). The list was presented a third time with directions to indicate their current primary source of information for each item.
Participants were next asked whether they had a primary veterinarian, and those who indicated they did were asked to rate their overall satisfaction with their veterinarian using a 10-point scale from 1 (very unsatisfied) to 10 (very satisfied). The next set of 8 questions asked participants to indicate their agreement level using a 5-point Likert scale anchored by 1 (strongly disagree) and 5 (strongly agree) to statements regarding their perceptions of PHC. These items were followed by 8 statements regarding their satisfaction level with their veterinarian (or the last veterinarian they saw if they did not have a regular veterinarian) regarding PHC. The next set of items asked participants to indicate their agreement level (1, strongly disagree; 5, strongly agree) to a series of statements pertaining to potential impacts of PHC.
The next series of questions consisted of a revised version of the Wake Forest Physician Trust Scale (WFPTS).23 The WFPTS was originally designed to measure levels of patient trust in primary care providers. The WFPTS consists of 10 items that employ a 5-point Likert-type rating scale from 1 (strongly disagree) to 5 (strongly agree). Total scores on the WFPTS are obtained by summing the 10 item scores (reverse-scored for negative items), with a range of 10 to 50, with a higher score indicating more trust. The measure was modified for the current study by exchanging the word doctor with the word veterinarian and including a reference to one’s pet versus one’s own health. The mean of the 10 items in the current study was 34.36 (SD, 3.86), with a median of 34.0. This can be compared to a mean of 40.8 obtained by Hall et al23 from a national sample. Internal consistency reliability in the current study was α = 0.909 (ω = 0.909), similar to that reported by Hall et al23 (α = 0.93).
The next series of questions consisted of a revised version of the Consultation and Relational Empathy (CARE) Measure, used to measure perceived empathy.24,25 The CARE Measure has been utilized in over 40 studies to assess healthcare providers’ empathy.26 The possible range of the CARE Measure is 10 to 50, with higher scores indicating higher perceived empathy. The scale consists of 10 items and uses a 5-point Likert scale (1, poor; 5, excellent). The CARE Measure total score is calculated by summing the 10 items with a possible score of 10 to 50, (reverse-scored for negative items), with higher scores reflecting greater perceived empathy. The measure was modified for the current study by exchanging the word doctor with the word veterinarian. The mean sum of the 10 items in the current study was 41.07 (SD, 7.99), with a median of 42.0; this is similar to the mean score of 40.8 and median score of 41.0 reported by Mercer et al.25 Internal reliability in the current study was high (α = 0.957; ω = 0.957).
The survey then asked participants to indicate how often they take their dog to the veterinarian for wellness or PHC. They were then asked to indicate what impact, if any, they felt yearly (or twice a year for senior dogs) wellness or preventative care visits had on a series of health-related areas using a 4-point Likert scale (1, no impact; 4, significant positive impact). Participants were asked to rank order the importance of 9 factors when deciding on a veterinarian (1, least important; 9, most important). Lastly, participants were asked whether they were aware that some veterinarians are paid on production or a combination of salary and production and whether compensation type impacted the trust they had in their veterinarian to act in their dog’s best interest or in their veterinarian’s recommendations for testing/diagnostics and treatment. Open-text boxes for comments were included.
Statistical analysis
Descriptive statistics were calculated for most questions. Chi-square tests were used to examine differences in proportions of various responses based on various demographic factors. Multiple logistic and ordinal regression models were used to predict trust scores (WFPTS score), empathy scores (CARE Measure score), and participants’ reported frequency of wellness or PHC visits. All analyses were performed with a commercial statistical package (SPSS Statistics, version 28.01; IBM Corp). Statistical significance was set at P < .05.
Results
A total of 738 participants completed the survey, all of whom were dog owners living in the US. Regarding gender, 361 participants (48.9%) self-reported male, 365 (49.5%) self-reported female, and 12 (1.7%) self-reported other. The majority of the participants were dog owners for more than 5 years (587 [79.5%]). Most participants had a bachelor’s (266 [36.0%]) or graduate degree (127 [17.2%]), were between 31 and 40 (252 [34.1%]) or 41 and 50 years of age (144 [19.5%]), and reported a total household income of < $100,000 (471 [63.9%]) from the past 12 months. Most owners reported having a regular veterinarian (637 [86.3%]). Those who reported having a regular veterinarian reported moderate to high satisfaction (7 or above; 567 of 637 [89%]). For further analysis, the satisfaction scores 1 to 6 (70 [10.9%]) were combined into 1 level, creating 5 levels of satisfaction (Supplementary Table S1).
Participants’ current knowledge level of PHC
Participants were asked to report their current knowledge level (none/minimal, some, quite a bit, expert) regarding 13 preventative care topics. The topics with the highest percentage of participants reporting they knew quite a bit or were an expert included the importance of mental engagement (537 [72.8%]), how to assess their dog’s everyday quality of life (514 [69.6%]), vaccines (507 [68.7%]), and parasites (470 [63.7%]). Participants reported the least knowledge about diseases related to their dog’s breed (307 [41.6%]), how to care for their dog’s teeth at home (300 [40.7%]), and senior care (276 [37.4%]; Table 1). When the associations between the length of dog ownership (up to 1 year, > 1 to 3 years, > 3 to 5 years, > 5 years) and knowledge level for the 13 items were assessed, the topics with significant differences included teeth care (χ2 = 17.29; P = .008), senior care (χ2 = 19.05; P = .004), vaccines (χ2 = 15.88; P = .014), and parasites (χ2 = 16.75; P = .010). For each of these topics, participants who owned their dog a year or less were less likely to report knowing quite a bit or being an expert when compared to participants who reported owning their dogs for longer periods of time.
Dog owners’ reported knowledge of 13 dog-related preventative healthcare (PHC) topics.
| Dog-related PHC topics | Knowledge level | ||
|---|---|---|---|
| None/minimal | Some | Quite a bit or expert | |
| The importance of mental enrichment (eg, engaging toys, games, ways to feed) | 16 (2) | 185 (25) | 537 (73) |
| How to assess your pet’s everyday quality of life | 34 (5) | 190 (26) | 514 (70) |
| Vaccines (rabies, distemper, etc) | 18 (2) | 213 (29) | 507 (69) |
| Parasites (ticks, fleas, etc) | 30 (4) | 238 (32) | 470 (64) |
| The importance of routine diagnostic tests to prevent future suffering and save money (eg, bloodwork, fecal samples, urine analysis, etc) | 72 (10) | 241 (33) | 425 (58) |
| Weight issues (how to prevent weight gain, how to lose weight safely, what exercise is safe/recommended) | 47 (6) | 272 (37) | 419 (57) |
| How to care for your dog’s nails (how to trim, how often, etc) | 52 (7) | 272 (37) | 414 (56) |
| How to groom your dog for optimal skin health | 78 (11) | 292 (40) | 368 (50) |
| How to care for your dog’s ears (how to clean, how often, etc) | 112 (15) | 289 (39) | 337 (46) |
| Who to consult for a behavior problem | 119 (16) | 287 (39) | 332 (45) |
| What diseases your dog’s breed may predispose your dog to (what to keep an eye on, what to test for) | 147 (20) | 284 (39) | 307 (42) |
| How to care for your dog’s teeth at home (eg, assess changes in eating habits, ways to clean besides brushing, etc) | 95 (13) | 343 (47) | 300 (41) |
| Senior care (mobility, comfort, quality of life, health markers) | 149 (20) | 313 (42) | 276 (37) |
Data are presented as number (%) of participants.
Participants’ interest in learning about PHC
When participants were asked to indicate their interest (none/minimal, moderate, a great deal) regarding the same 13 preventative care topics, the topics for which the largest percentage of participants indicated a great deal of interest included how to assess their dog’s everyday quality of life (329 [44.6%]), importance of mental enrichment (300 [40.7%]), diseases related to their dog’s breed (287 [38.9%]), and senior care (276 [37.4%]). The areas of least interest included parasites (197 [26.7%]), who to consult for a behavior problem (169 [22.9%]), and weight issues (168 [22.8%]; Table 2).
Dog owners’ reported interest in learning more about dog-related PHC topics.
| Dog-related PHC topics | Interest level | ||
|---|---|---|---|
| Minimal | Moderate | A great deal | |
| How to assess your pet’s everyday quality of life | 88 (12) | 321 (44) | 329 (45) |
| The importance of mental enrichment (eg, engaging toys, games, ways to feed) | 127 (17) | 311 (42) | 300 (41) |
| What diseases your dog’s breed may predispose your dog to (what to keep an eye on, what to test for) | 133 (18) | 318 (43) | 287 (39) |
| Senior care (mobility, comfort, quality of life, health markers) | 139 (19) | 323 (44) | 276 (37) |
| How to care for your dog’s teeth at home (eg, assess changes in eating habits, ways to clean besides brushing, etc) | 151 (21) | 352 (48) | 235 (32) |
| How to groom your dog for optimal skin health | 155 (21) | 350 (47) | 233 (32) |
| The importance of routine diagnostic tests to prevent future suffering and save money (eg, bloodwork, fecal samples, urine analysis, etc) | 186 (25) | 324 (44) | 228 (31) |
| How to care for your dog’s ears (how to clean, how often, when, etc) | 166 (23) | 358 (49) | 214 (29) |
| How to care for your dog’s nails (how to trim, how often, etc) | 222 (30) | 313 (42) | 203 (28) |
| Vaccines (rabies, distemper, etc) | 233 (32) | 305 (41) | 200 (27) |
| Parasites (ticks, fleas, etc) | 182 (25) | 359 (49) | 197 (27) |
| Who to consult for a behavior problem | 296 (40) | 273 (37) | 169 (23) |
| Weight issues (how to prevent weight gain, how to lose weight safely, what exercise is safe/recommended) | 259 (35) | 311 (42) | 168 (23) |
Data are presented as number (%) of participants.
Participants’ opinions pertaining to PHC
When participants were asked a series of questions related to their general perception of preventative care, 704 participants (95.4%) agreed that “preventative care improves the overall health and well-being of my dog”; 691 (93.6%) agreed that “providing preventative care for my dog is a good investment in my pet’s long-term health”; 687 (93.1%) agreed that “providing preventative care for my dog can help prevent my pet’s future pain”; and 683 (92.5%) agreed that “providing preventative care for my dog can help prevent serious health issues” (Table 3).
Dog owners’ reported feelings about PHC.
| Statement | Disagree | Neutral | Agree |
|---|---|---|---|
| I feel that PHC improves the overall health and well-being of my dog. | 5 (1) | 29 (4) | 704 (95) |
| I feel that providing PHC for my dog is a good investment in my pet’s long-term health. | 3 (< 1) | 44 (6) | 691 (94) |
| I feel that providing PHC for my dog can help prevent my pet’s future pain. | 6 (1) | 45 (6) | 687 (93) |
| I feel that providing PHC for my dog can help prevent serious health issues. | 6 (1) | 49 (7) | 683 (93) |
| I feel that providing PHC for my dog leads to fewer emergency visits. | 32 (4) | 90 (12) | 616 (84) |
| I feel that providing PHC helps me avoid unexpected veterinary bills. | 27 (4) | 101 (14) | 610 (83) |
| I feel that providing PHC for my dog saves me veterinary expenses in the future. | 25 (3) | 108 (15) | 605 (82) |
Data are presented as number (%) of participants.
Participants were next asked their views of the potential impact of yearly wellness or preventative care visits (or twice a year for senior dogs) on several areas pertaining to their dog’s health and well-being. The factors viewed as most likely to be significantly impacted included early detection of certain diseases (380 [52.5%]), improving their dog’s quality of life (332 [45.8%]), and increasing their dog’s lifespan (305 [42.6%]; Table 4). The responses for the 8 impact items were summed (1, no impact; 2, minimal positive impact; 3, moderate positive impact; 4, significant positive impact), and this impact score was used as a predictor in the regression model predicting how often participants took their dog to the veterinarian for PHC. Two questions were included to assess the impact of PHC information on participants’ feelings of anxiety and control. The majority of participants reporting feeling that knowing more about their dog’s PHC reduces their overall anxiety about their dog’s health (634 [85.9%]) and helps them feel more in control (665 [90.1%]).
Dog owners’ reported feelings about the impact of PHC.
| PHC impacts | None/minimal impact | Moderate positive impact | Significant positive impact |
|---|---|---|---|
| Increases early detection of certain diseases | 75 (10) | 269 (37) | 380 (53) |
| Improves your dog’s quality of life | 93 (13) | 300 (41) | 332 (46) |
| Increases your dog’s lifespan | 113 (16) | 298 (42) | 305 (43) |
| Increases your dog’s ability to remain happy | 140 (19) | 300 (42) | 283 (39) |
| Prevents future pain your dog might experience | 104 (15) | 335 (47) | 271 (38) |
| Increases your dog’s ability to remain active | 137 (19) | 327 (45) | 262 (36) |
| Increases your dog’s ability to maintain (or achieve) a healthy weight | 177 (25) | 304 (42) | 241 (33) |
| Helps to recognize any pain your dog might be experiencing | 116 (16) | 362 (51) | 235 (33) |
Data are presented as number (%) of participants.
Current source of PHC information
Participants who reported they had a primary veterinarian (n = 637) were asked to indicate their current primary source of information for each of the 13 preventative care items. Veterinarians were the primary source of information for all topics with the exception of mental engagement (owners rated their own experience as a pet owner higher). The topics for which the largest percentage reported that veterinarians were their primary source of information included vaccines (544 [85.4%]), importance of routine diagnostic testing (503 [79.0%]), parasites (417 [65.5%]), and weight issues (364 [57.1%]; Supplementary Figure S1).
Perceptions of their veterinarian’s role related to PHC
Participants were asked their agreement level to a series of statements about their veterinarian’s role in providing PHC information. Most participants reported that they would prefer to receive their PHC information about their dog from a veterinarian versus other sources (590 [79.9%]), they trust a veterinarian’s advice on PHC more than information from other sources (628 [85.1%]), would like a veterinarian who is proactive in reminding them about their dog’s PHC needs (654 [88.6%]), and feel that taking the time to talk about their dog’s preventative care is an important consideration when choosing a veterinarian (632 [85.6%]). Most also agreed that when veterinarians talk to them about PHC for their dog, it makes them trust them more (599 [81.2%]; Table 5).
Dog owners’ reported perceptions of veterinarians and preventative care.
| Statement | Disagree | Neutral | Agree |
|---|---|---|---|
| I would like a veterinarian who is proactive in reminding me about my dog’s PHC needs (eg, vaccinations, check-ups). | 8 (1) | 76 (10) | 654 (89) |
| Taking the time to talk to me about my dog’s preventative care is an important consideration for me when choosing a veterinarian. | 9 (1) | 97 (13) | 632 (86) |
| I trust a veterinarian’s advice on PHC more than information I find from other sources (eg, online, friends/family). | 12 (2) | 98 (13) | 628 (85) |
| When veterinarians talk to me about PHC for my dog, it makes me trust them more. | 29 (4) | 110 (15) | 599 (81) |
| I would prefer to get my PHC information about my dog from a veterinarian versus other sources (eg, internet, friends/family). | 26 (4) | 122 (17) | 590 (80) |
Data are presented as number (%) of participants.
Satisfaction with veterinarian regarding PHC
Participants were asked to indicate their agreement level with 8 items pertaining to how their veterinarian shares PHC information. The majority of participants agreed with each of the statements, reflecting positive feelings about their veterinarian in regards to the dissemination of PHC information (Table 6). The statements with the highest level of endorsement included “I feel confident in my veterinarian’s knowledge and expertise in PHC for my dog” (653 [88.5%]) and “my veterinarian takes the time to thoroughly answer all my questions about PHC” (632 [85.6%]). The responses of these 8 satisfaction items were summed (1, strongly disagree; 2, disagree; 3, neutral; 4, agree; 5, strongly agree) to create a satisfaction variable to use as a predictor variable in the regression models.
Dog owners’ reported satisfaction with how their veterinarian discusses PHC.
| Statement | Disagree | Neutral | Agree |
|---|---|---|---|
| I feel confident in my veterinarian’s knowledge and expertise in PHC for my dog. | 14 (2) | 71 (10) | 653 (89) |
| My veterinarian takes the time to thoroughly answer all my questions about PHC. | 27 (4) | 79 (11) | 632 (86) |
| My veterinarian provides clear and understandable explanations about the benefits of PHC for my dog. | 29 (4) | 85 (12) | 624 (85) |
| I am satisfied with the information my veterinarian shares with me about my dog’s PHC. | 26 (4) | 92 (13) | 620 (84) |
| My veterinarian explains the long-term benefits of PHC in a way I find easy to understand. | 23 (3) | 115 (16) | 600 (81) |
| I feel confident that my veterinarian’s PHC advice is based on the latest medical research. | 30 (4) | 126 (17) | 582 (79) |
| I am satisfied with the communication and educational materials provided by my veterinarian regarding PHC. | 34 (5) | 128 (17) | 576 (78) |
| The PHC advice from my veterinarian is tailored to the specific needs of my dog. | 49 (7) | 134 (18) | 555 (75) |
Data are presented as number (%) of participants.
Ranked importance of factors when selecting a veterinarian
Participants were asked to rank order a list of 9 items in terms of importance when selecting a veterinarian (1, most important; 9, least important). The top-ranked factor was trust that their veterinarian had their pet’s best interest as their top priority (mean, 3.09; SD, 2.53), followed by cost (mean, 3.51; SD, 2.36) and distance from their home (mean, 4.21; SD, 2.17). The least important factors were payment options (mean, 6.88; SD, 2.46) and the range of nonmedical services (mean, 7.26; SD, 2.30; Supplementary Tables S2 and S3).
The WFPTS
Multiple linear regression was conducted to determine predictors of veterinarian trustworthiness as measured by the WFPTS. The potential predictors included satisfaction with their veterinarians’ handling of PHC and participants’ age, gender, education, and income level. The regression model was significant (P < .001; r2 = 0.408). Significant predictors included satisfaction with their veterinarian in terms of PHC (higher levels of satisfaction predicted a higher level of trust; B = 0.459; CI, 0.417 to 0.502; P < .001) and age (participants 25 years or younger had higher trust scores than those 51 years or older; Supplementary Table S4).
The CARE Measure
Responses to the 10 items in the CARE Measure indicated most participants were satisfied with how their veterinarian communicated with them and demonstrated concern and empathy (Supplementary Table S5). The behaviors noted as excellent by the largest number of participants included “making me feel at ease” (364 of 731 [50%]), “explaining things clearly” (354 of 732 [48%]), and “showing care and compassion” (353 of 731 [48%]). The behaviors rated as excellent by the smallest number of participants included “being interested in me and my pet as whole beings” (289 of 729 [40%]) and “helping me to take control” (235 of 728 [33%]).
Multiple linear regression was conducted to determine predictors of perceived empathy as measured by the CARE Measure. The potential predictors included satisfaction with their veterinarians’ handling of PHC and participants’ age, gender, education, and income level. The regression model was significant (P < .001; r2 = 0.472). The only significant predictor was satisfaction with their veterinarian’s dissemination of PHC information (higher levels of satisfaction predicted a higher level of trust; B = 1.023; CI, 0.939 to 1.106; P <.001; Supplementary Table S6).
Frequency of wellness or PHC visits
Ordinal regression was conducted to determine predictors of how often participants reported taking their dog for PHC visits. The potential predictors included the PHC impact score, the satisfaction with their veterinarians’ handling of PHC, and participants’ age, gender, education, and income level. The regression model was significant (P < .001; r2 = 0.196). Significant predictors included satisfaction with their veterinarian’s dissemination of PHC information (higher levels of satisfaction predicted more frequent preventative care appointments; B = –0.59; CI, –0.088 to –0.029; P < .001), perceived PHC impact (B = –0.099; CI, –0.126 to –0.073; P < .001; higher perceived impact predicted more frequent preventative care appointments), age (B = –0.594; CI, –1.127 to –0.060; participants 25 years or younger reported more frequent preventative care appointments than participants 50 years or older), and income (B = –1.072; CI, 0.466 to 1.679; P < .001), with participants who reported an annual income of ≥ $100,000 reporting a higher frequency of PHC visits than those with incomes < $100,000 (Supplementary Table S7).
Compensation type
When participants were asked whether they were aware that some veterinarians are paid on production or a combination of salary and production, 573 (77.6%) replied no. A total of 657 (89.0%) reported not knowing how their regular veterinarian (or the last veterinarian they saw) was paid. A total of 44% (326) indicated that compensation type would impact the trust they have that their veterinarian would always act in their dog’s best interest, and 325 (44.0%) reported that compensation type would impact the trust they have in their veterinarian’s recommendations for testing and treatment. Themes in the free-text responses for those who reported that compensation type would not impact their trust level included the following: trust in their veterinarian’s professionalism and assumption of ethical behavior, the view that quality of care and service are more important than how their veterinarian is paid, and the benefits of a long-standing relationship with their veterinarian in contributing to their trust regardless of compensation. Themes for the responses given by those who indicated that compensation type would negatively impact their trust included the following: concern about a conflict of interest, recognition of potential bias, the sentiment that salaried veterinarians are more trustworthy and less likely to upsell unnecessary services, fear of unnecessary procedures, and a strong preference for veterinary care that isn’t influenced by financial incentives.
Discussion
This study was designed to better understand dog owners’ knowledge, attitudes, and behaviors surrounding PHC for their dogs. We also sought to examine the relationship between owners’ satisfaction with how PHC information is disseminated by their veterinarian and perception of their veterinarian’s empathy and trustworthiness. We found it was a significant predictor for each of these items, as well as reported frequency of PHC visits.
When exploring owners’ perception of their knowledge level pertaining to specific PHC topics, we found that owners reported feeling the most knowledgeable about the importance of mental engagement and how to assess their dog’s quality of life, followed by vaccines and parasites. The fact that even though over 70% of owners reported knowing quite a bit or being an expert about mental engagement and assessing quality of life, yet most wanted to learn even more, suggests these issues are of utmost importance to owners. Helping owners understand the connection between their pet’s quality of life and the topics they expressed less interest in learning about (eg, routine diagnostic tests, ear and nail care, and weight issues) could help owners make better healthcare decisions for their pets. A recent study27 has suggested that, supplied with minimal educational information, pet owners are more likely to be concerned and seek veterinary care when their pet displays behaviors that might indicate pain, which suggests that pet owners care about their pet’s health,10 see the value of veterinary care, and want to do right by their pet, but often lack the needed knowledge. It is imperative that veterinarians help owners understand the importance of PHC topics.
When queried about their primary source of information for the 13 PHC topics (with the exception of mental enrichment, for which personal experience was ranked higher), their veterinarian/veterinary team was ranked highest. This, along with the fact that 80% of owners agreed they would prefer to get their PHC information about their dog from a veterinarian versus other sources and 85% noted they trust a veterinarian’s advice on PHC more than information from other sources, suggests that owners look to their veterinarian for PHC guidance. These sentiments echo findings in earlier studies.28–30 It appears that, despite the growing amount of pet-related health information on the internet and social media and the advent of AI (eg, ChatGPT), owners still prefer their veterinarian for pet health information. Another important finding is the fact that 89% of owners indicated that they would like a veterinarian who is proactive in reminding them about their dog’s PHC needs. There are several relatively easy methods to keep in contact with pet owners and help them remember to schedule PHC visits, including automated reminder systems, digital forms, and real-time online appointment bookings.31
In addition to the importance of disseminating PHC in helping promote the health and well-being of pets, the results of our study suggest it impacts owners’ perceptions of their veterinarian. To this point, 86% of respondents noted that taking the time to talk to them about their dog’s preventative care is an important consideration when choosing a veterinarian and 81% agreed that when their veterinarian talks to them about PHC, it makes them trust them more. Furthermore, how satisfied pet owners are with how their veterinarian discusses PHC predicted owners’ perception of their veterinarian’s empathy and trustworthiness. This satisfaction in PHC information dissemination also predicted owners’ reported frequency of preventative care visits.
Taken together, these results suggest that the ability to effectively communicate about PHC offers far-reaching positive effects. Numerous studies13,32–35 have found that positive veterinarian-client communication and interactions have an impact on owner satisfaction, compliance, and adherence to medical recommendations. As a result, communication is considered an essential component of clinical competence.36 Empathy and trust are both fundamental components to successful veterinarian-client communications, and in fact, empathy can help veterinarians gain pet owners’ trust.37,38
Trust is a key component of relationship commitment, an antecedent of loyalty.39 Trust in one’s medical care provider has been shown to affect utilization of services and adherence to recommendations.40,41 It has been suggested that the use of a shared decision-making approach, in contrast with a paternalistic model, may increase owners’ trust levels and improve veterinary care. For these reasons, a more collaborative relationship, one that involves client empowerment, is recommended.33,42,43 Recent studies34,43–45 suggest that pet owners want to be collaborative, equal partners and are looking for a veterinarian to help educate them while respecting their own knowledge and desire to be part of their pet’s healthcare decisions. Owners want veterinarians to help them make informed decisions about their pet’s health, including PHC, by giving them thorough, personalized recommendations.10,13,43,46 Trust in one’s veterinarian is a key component to the success of the shared decision-making approach. In addition, conveying an understanding of and empathy towards owners’ unique situations can help solidify these important relationships. Taking the time to talk about PHC topics can positively impact both perceived trust and empathy, suggesting that this is time well spent.
Despite the importance of PHC discussions, many barriers can make this challenging. Some veterinarians are concerned that suggesting PHC (eg, vaccines, routine bloodwork, etc) may be perceived as a desire to profit from such services.47 The fact that our study found that 44% of respondents felt that the knowledge that their veterinarian is paid on commission would impact their trust in recommended testing and treatment, as well as trust that their veterinarian would always act in their dog’s best interests, suggests that these veterinarians’ fears about owners’ views regarding increased income are a legitimate concern. This only further validates the importance of trust within the veterinarian-client relationship. The fact that satisfaction with how PHC information is disseminated positively predicts trust can help veterinarians realize the importance of making this a top priority.
Time is another major barrier to PHC conversations. Receiving information, however, is the foremost expectation for pet owners and a major factor in predicting pet owners’ satisfaction.13,38,46 Unfortunately, many veterinarians feel the need to rush through PHC visits, leaving owners with unanswered questions and unmet needs.15,46,47 Yet despite these time challenges, most veterinarians do not utilize supportive methods (eg, written materials, recommended sources of information, checklists, etc), to disseminate PHC information.47 While it has been suggested that creating an unhurried environment during wellness consultations and spending more time on education can improve pet owners’ satisfaction,48 we recognize that many veterinarians do not have the luxury of spending extended periods of time with clients discussing PHC. Yet empathetic and informative PHC communication does not have to only be verbal. Written information (eg, brochures/handouts, books, etc) or information prescriptions given during the PHC appointment can help build trust and demonstrate empathy.38,49–51 Whether through verbal exchange or individualized, personal recommendations for additional reading, giving clients the desired amount of information can help reduce uncertainty and increase their sense of control,38 thereby leading to increased satisfaction.19
It should be noted that this study had several limitations inherent in cross-sectional research, including the potential biases of self-selection. In addition, the sample consisted of dog owners within the US with limited age, racial, and ethnic diversity. Future research pertaining to PHC would benefit from a more heterogeneous sample, both in terms of the type of pet owned and owner demographics. In conclusion, this study suggested that the dissemination of PHC could improve animal health and well-being not only directly but also indirectly through its impact on owners’ perceptions of their veterinarian in terms of trustworthiness and empathy.
Supplementary Materials
Supplementary materials are posted online at the journal website: avmajournals.avma.org.
Acknowledgments
None reported.
Disclosures
The authors have nothing to disclose. No AI-assisted technologies were used in the generation of this manuscript.
Funding
This study was funded in part by Preventive Vet, which had no direct contribution or influence on the study design, data collection, analysis, or conclusions.
ORCID
L. R. Kogan https://orcid.org/0000-0002-5816-9672
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