Recently I have found myself being in the role of a veterinary client while assisting with or accompanying animal owners in companion animal settings.  I am quite aware that setting differs markedly from my professional role in food animal medicine.  None-the-less, I was rather taken aback by the lack of what I considered a universally acquired “Art” of veterinary practice.

The practice of veterinary medicine is certainly scientific based, but its appropriate application is the art of practice. I was formally taught and through experience enhanced my knowledge of the animals and their environment I was choosing to serve. I was instructed to always do a thorough and complete exam of the patient and acquire as much historic information as possible from the client or their agent. I should then be knowledgeable enough to develop a reasonable set of differential diagnoses based on clinical signs and history. These should then be discussed in the language of the client and mutually arrive at an initial course of action and/or treatment.

To me, the key component is communication with the client. It needs to be at a level to be easily understood, but maybe even more importantly, with due consideration of that animal’s role in the client’s setting. It could be an economic consideration regarding a food producing animal or a very emotional consideration regarding a beloved pet. And yes, very transparent costs of service and treatment, as best possible, must also be discussed. 

At this point become a very good listener, answer any of the client’s questions and try to view the situation from the client’s perspective. Though we might suggest a path forward, it is solely that owner’s option to select any degree of further treatment or none at all. That is what I consider the art of practice.

Regrettably that is not what I found as a recent client. The latest encounter serves as an example. Though the staff and employed veterinarian were courteous and friendly, their focus was only upon what I viewed as their clinic protocols. Only a cursory exam was conducted focused predominantly on the entering complaint. They then immediately turned to requesting a battery of diagnostic procedures (blood work, x-rays) to aid them in diagnosis. When asked, only a rough estimate of costs was given but they reemphasized their need for them. Little if any additional significant information was gained from the tests so the diagnosis remained solely as the entering complaint. 

Follow-up treatment was conducted at a later date. Even more diagnostic procedures and subsequent treatment were invoked during the course of said treatment that went well beyond that requested by the owner with associated escalating costs. Needless to say, effective communication failed, particularly in regard to listening to the owner, their wishes in regard to treatment and ability to pay anticipated costs. Definitely not a good ending.

In this case there was a lack of compassion for the owner’s feelings, level of treatment chosen and concerns over cost. In other words, they failed the listening part of communication and only cared to enhance their level of treatment and subsequent income.

I’m sure others would counter my assessment of the situation stating current standards of practice rather mandate these added procedures and their associated costs. I will counter that argument in a forthcoming article discussing appropriate but differing levels of veterinary service.