Hesteejerkommunikation med Annelies Decloedt , afsnit 1 – teorier, værktøjer og virkelige eksempler

00:00:12: In this episode, we wanted to talk about different cases and situations that can occur.

00:00:18: And there are obviously going to be different approaches you will need when communicating around different cases so I'll bring them up one by one.

00:00:28: but i want start with asking what the differences in how you approach advice on preventive medicine for example something might happen.

00:00:42: Let's take influenza as an example, why it is a good idea to vaccinate and what can be the consequences if you don't for example versus then when we have actual disease or injury?

00:00:56: You want make sure that the owner following your advice on treatment.

00:01:01: Is one of these situations more difficult than other?

00:01:08: Yeah, so there's actually kind of a continuum of giving people information and what makes it easier and harder.

00:01:16: And I think the easiest situation is when the owner asks you for information and you just provide the information.

00:01:23: So that's gonna be more in case of an acute disease or problem where the owner calls You to have a look at the horse?

00:01:37: Well, you still need specific communication skills.

00:01:40: But you're not going to need your more advanced communication skills.

00:01:43: You can just give the information Make sure that you don't give too much information at once and check whether they actually understood what you said.

00:01:51: but That's gonna be it.

00:01:54: The continuum is then whether it's getting more difficult, well the next point when you want to give some information about something that you see for example.

00:02:05: When you come just a preventive visit like vaccination and you actually detect another problem If it's just information, its probably going to be fine.

00:02:13: It is gonna hard.

00:02:14: or if you are going give advice and really advise which means that the owner has changed what they do at a moment That will more difficult than just information.

00:02:30: The hardest situation when You know, you want to give advice and the other person has not asked for it or even worse.

00:02:38: The other person actually doesn't want to hear your advice because they're doing something else And I think that what they do is good.

00:02:45: So the more you get.

00:02:46: two these situations where you wanna give advise on the other Person doesn't one to here.

00:02:50: if then you gonna need really all of your communication skills.

00:02:58: So when we talk about these different skills or strategies that you will need to talk to owners, let's start with the problems that might arise.

00:03:10: Either the horse is affected by risk factor.

00:03:13: You notice it for example When your out on a routine visit and noticed this horses over weight.

00:03:22: it takes in a few of the risk factor boxes for egos, or there could also be general risks such as infectious diseases.

00:03:35: Maybe this horse wasn't properly vaccinated and you're therefore another reason.

00:03:41: then you realize okay so hasn't been vaccinated now for five years?

00:03:45: How do I explain to the owner that your horse is at risk?

00:03:53: How do you convince them to do something about it?

00:03:56: Yes, so this falls in those difficult situations where the owner did not ask for that specific information or advice.

00:04:05: So what is really helpful technique called the Ask, Tell, Ask sandwich.

00:04:15: I think it's like nice to think of as a sandwich where you sandwich your information or advice that you want give about the vaccination protocol for example in between two questions which is really going help get the owner ready and immediately check at other end how they perceived their advice.

00:04:38: so first question might be probing about their knowledge.

00:04:45: So it might just like, what do you know?

00:04:49: About the new vaccination protocols?

00:04:52: or how do you vaccinate your horses and have them vaccinated?

00:04:56: let's say so that is going to probe about there knowledge of they are normal behaviors if possible.

00:05:04: Or first question may also asking for permission to talk about the subject.

00:05:12: To really just start with a first question like, is it okay if I discuss your vaccination schedule which you today?

00:05:23: And you may think of as... Why should I ask that question?

00:05:29: Because, yeah.

00:05:30: I'm the vet and there you know they expect me to do this.

00:05:33: but it's also a psychological thing because most people are probably gonna say yes But that small Yes That They Already Gave You Is Gonna Make Their Mind Be More Open To The Information That You're Gonna Give Next Cause They Actually Approved Of You Giving That Information While If You Just Give The Information And You Just Throw It At Them might be more likely to just ignore it or, um... To think that's not what I called you for today.

00:06:03: So the first question is either probing their knowledge and asking permission then give your information Then end sandwich with another question And also depending on situation something like What do you think of?

00:06:19: Or maybe even depending on the situation, it could already be like would it be okay for you to do this?

00:06:29: For example, depending what your information or advice was.

00:06:34: But just having that second question and then really important part of it as a vet now is actually also listen to the answer from their owner.

00:06:48: As you are giving unsolicited advice, the chances are pretty high that they might not be super enthusiastic at first.

00:06:59: So let me think about it or maybe I should change but he looks very healthy and his coat is really shiny whatever That may come up with.

00:07:14: And then try to resist your own yes, but because if you start to say Yes.

00:07:20: But really have to do something now?

00:07:24: You're gonna get into the sustain talk again cause they are going just stress why it's not their concern right now or what I don't want to change cuz.

00:07:33: so If you hear some sustained talk try to ask a question Again.

00:07:37: tried to use some reflective listening like okay You can try and make it positive too, so you might be considering to do this in a couple of months but not right now.

00:07:52: Just really trying to do some reflective listening and resist the urge immediately fix

00:07:59: that.

00:08:02: Do you think there is difference when talking about risk factors which apply to these specific individuals?

00:08:11: compared to risk factors that are general, such as an influenza outbreak.

00:08:17: Is there a different mindset or... Because I can imagine for the horse owner it might be less sort of a little bit more abstract maybe?

00:08:29: That this is something that may happen in all my horses and depends on external factors which I cannot really influence in comparison to when you have one specific individual, it is obese or it's at very high risk for developing laminitis.

00:08:54: Yeah I think the more abstract something seems or you know the more distant it seems, harder this for owners.

00:09:04: Well if we talk about an individual might be easier that you can actually demonstrate and show them how to feel their ribs of that horse which makes easier for them to really understand it.

00:09:23: So that's, I think also very helpful in any situation.

00:09:27: so just whether if you can show something or have them do something make them feel it and see the problem.

00:09:35: That is more difficult when we are talking about infectious diseases and risk of an outbreak on a stable which seems probably like its not going happen with me something called the health belief model which is actually used to predict exactly this like whether people will vaccinate or not because they talk about Yeah, what?

00:10:03: To make that decision you have to first be aware of the risk and then you also have to Think that.

00:10:10: You know That might happen to you cuz he might be aware Of the risk yes but you might say well it's not gonna happen to me for this and whatever reasons.

00:10:21: So yes, it's probably going to be more difficult if something is abstract and you cannot really show.

00:10:30: Then again, you will need more of your communication skills.

00:10:33: And asking the questions like why?

00:10:38: Well not why?

00:10:39: maybe because I said... What's a reason that!

00:10:46: As mentioned in episode one we shouldn't ask why but what is the reason it won't happen to

00:10:53: us?

00:10:53: or

00:10:55: and then trying to find out how they see that risk.

00:11:01: And in the end, it's gonna be the owner's decision probably so you can give them the information.

00:11:09: but if they were totally unaware of their risks at start of a consultation You're probably not going decide to vaccinate their horses within that thirty minutes consultation which might have been there You know, be happy with small steps forward that you made.

00:11:26: That even if they're maybe aware of the risk but still don't think it applies to them well might one step forward.

00:11:38: And then we have problems already occurred and those as mentioned can sometimes a little bit easier because its very tangible.

00:11:47: It's where you see something happened.

00:11:50: We need fix things about it.

00:11:56: But then we can also divide those into problems that require persistent changes, because you want to avoid the problem of coming back.

00:12:07: For example, egos or when you have a horse that's insulin dysregulated and wants to avoid laminitic episodes.

00:12:16: Asthma is probably not going one hundred percent healed, but you're always gonna have to sort of manage the environment with a horse.

00:12:25: And or it could also apply to lifelong medical treatments such as in case of PPID for example.

00:12:34: and then You have other issues that do require some very difficult or advanced rehabilitation.

00:12:45: but where there is a distinct end point, you see sort of light in the tunnel.

00:12:50: In five months the horse will be back on track.

00:12:55: What are the differences here and what do we need to be mindful about when talking these conditions?

00:13:03: It's probably going to be easier if it has an endpoint as you mentioned, the light at the end of tunnel.

00:13:14: While lifelong changes that's just something which is really hard especially if it requires some adaptations.

00:13:26: they require more work and financial efforts.

00:13:32: It's really important to be very transparent, I think with the owners from the start.

00:13:37: To just be clear about what they can expect and also manage their expectations so that people will always be disappointed if there are high expectations but not met when you have lower expectations which is ideal for client satisfaction.

00:14:03: I don't want to say that you have set the expectations too low, of course.

00:14:09: You just have to be realistic and not too optimistic To try and convince the owner but just very transparent open about things.

00:14:22: That's also what clients really appreciate.

00:14:26: And then there is this risk for relapse into old behavior and that they cannot manage the changes, that had to make on a long term.

00:14:42: And it's really important to be aware of this as a vet but maybe also an owner.

00:14:47: There is some research about that especially with younger people.

00:14:51: when you tell them in advance like This will probably hard for your to keep doing these things.

00:15:01: This might actually cause a little bit of... resistance and they want to show that.

00:15:06: They can do it on the long term, so actually this kind of be helpful.

00:15:09: I think a lot of FETs might recognize because there's quite a number of FED students who have been told like its gonna really hard for you to do the veterinary studies And your probably not going make it.

00:15:21: Actually that motivated them to stick through all those years To show yes i can't do this So that could help.

00:15:33: You don't want to say it the other way, you will not be able do.

00:15:35: but just warn them that might hard and transparent about.

00:15:42: And also use affirmations again even after maybe many months or years to just keep on reinforcing them, positive reinforcements like wow you're taking good care of your horses and it's great that you managed to keep this table dust-free.

00:16:03: It is fantastic that you are feeding so much forage.

00:16:07: I know its really hard but still doing it.

00:16:18: People don't really tend to think about this when you have a plan or your planning lifestyle changes, for example.

00:16:29: And then you don't have the expected outcome.

00:16:32: If we're talking about losing weight For example You have an obese pet that you want to lose weight and Then everything is right.

00:16:41: It's not happening in a pace where it happens.

00:16:44: Or if something doesn't happen What would've been the case?

00:16:54: good to sort of think when, someone is very pessimistic and like nothing's working.

00:16:59: It's not.

00:17:00: I'm doing everything that can.

00:17:02: it's not working.

00:17:04: The situation if you wouldn't have been doing all these things could've been much worse.

00:17:09: so something is just happening in the pace that your wish or... Not as a result but there are progress that actually did.

00:17:21: that is not meaningless just because you didn't get the exact results.

00:17:25: Yeah,

00:17:26: and I think again those positive reinforcements of like wow it's great that you made all these changes.

00:17:32: It hasn't got any worse than this good thing And managing expectations from start as a bad thing.

00:17:45: the horse might not be cured, like for a hundred percent that you're also from start very open and transparent about it as well so they know what to expect.

00:17:58: Then if the disease does cure totally then they are just going to happy because their expectations have been exceeded.

00:18:08: That's really important.

00:18:11: It's not easy, of course.

00:18:14: Especially those long-term things because it takes a long time before you see the results and then even if you do see the result pretty quickly... ...it might be hard to keep change going as the owner may think that my horse is better!

00:18:33: So, you know I don't need to make all these adaptations because it worked.

00:18:37: and now i can go back to my usual habits which require less work.

00:18:43: Less money...

00:18:50: Then we have another situation as well where You might have the horse owner completely on your side.

00:19:00: everything that you said got through but actions of the horse owner, and what is possible to do was actually dependent on someone else.

00:19:12: A stable owner or somebody who's financially responsible if that isn't a person you're talking to for example... You can also have situations where the whole premise or stable need will be affected in the event of an infectious disease outbreak.

00:19:34: or in the case of where you have your horse boarded and someone else is managing to feed.

00:19:40: Do you have any good tips there on how to approach these situations as a vet?

00:19:45: When the horse owner is on your side, do you convince them and now they need to sort of expand.

00:19:51: And then make the horse owners advocate for their advice also with the rest of the stable or manager.

00:19:59: Yeah I think this can be really difficult situation and it's quite common in equine medicine because so many people surrounding that horse might be a rider or trainer stable, maybe another therapist.

00:20:12: There's a lot of people that need to be on board there.

00:20:17: I think well.

00:20:18: actually if i go back to the Calgary Cambridge model for consultation one important thing is they really stress The opening the consultation and so setting the agenda, you know what client wants.

00:20:32: What do want but also making sure that who are talking to from beginning of conversation is going be really important.

00:20:42: So don't have this whole conversation at end.

00:20:47: Actually, you figure out that the owner is not over.

00:20:49: The one that you have been talking to it's not the one making decisions or Not one.

00:20:53: making the financial decisions are not the ones doing the actual You know changes That you were talking about.

00:21:01: so I am.

00:21:02: So i think It's really important to try and start from the beginning of a conversation To Try And get A grasp Of who Am I Talking To Here?

00:21:12: if you don't know or are not sure to just really ask them about, what is your role?

00:21:22: Or again use reflective listening and just ask them.

00:21:29: Before we start explaining all the changes that need be made regarding housing... Are making decisions here regarding the housing at this table?

00:21:41: Well, maybe try and get the person who is making decisions to get that person into the conversation so you can get them on board.

00:21:48: So I think that's one thing.

00:21:53: And then of course yet too if You cannot talk to actually the person Who Is Making Decisions or has To do The Work?

00:22:01: I mean ideally Just Talked to That Person.

00:22:03: i would say If You Cannot It might be good to really check that the owner exactly knows what your recommendations are.

00:22:19: Ideally have them repeat the recommendations.

00:22:21: You might also use that as a Kind of trigger, you know The fact there are other people involved to check whether the owner actually understood your recommendations like say something Like okay I yeah.

00:22:33: so i understand That you Have To Also Communicate This Two Other People You Know.

00:22:39: So Just To Make Sure That I Explained Everything Correctly Can You Just Repeat What Recommendation Tell them and then so that at least you know for sure.

00:22:50: That, there's not gonna Get things lost in translation when they.

00:22:55: well There might be things loss but that You try to minimize as much as possible.

00:23:00: Maybe even have some of your things that you recommend in written So that the owner can use that to talk to others Aswell And again Try to follow up maybe with people who are actually going To do change or make decisions.

00:23:20: If we talk then about the difficult talks or the breaking of bad news, for example when a horse has long recovery head and you know this is going to be different.

00:23:32: We talked a lot about motivation and relapses and so on.

00:23:38: Do you have anything that you want add there?

00:23:41: Any specific advice when having really serious situation?

00:23:47: It's going to be life or death for this horse if you're able to stick with it.

00:23:57: How can you as a vet keep the horse owner motivated and engaged in this treatment plan when there is one?

00:24:07: For bad news, there are specific communication strategies that we use.

00:24:13: Important thing there.

00:24:14: Well, first of all bad news can mean a lot of different things.

00:24:17: like.

00:24:18: it doesn't have to be life or death.

00:24:19: It can also be just like you cannot Do that competition next week might also Be really bad news for the owner.

00:24:27: so it might be sometimes difficult To know what is going to be bad news and what is not?

00:24:34: But then for bad news, there's also some guidelines as to how to communicate those.

00:24:40: In human medicine they have the spikes model where it spikes like an acronym The S is setting.

00:24:47: so making sure that you... That there is time For breaking the bad news and preferably in a quiet environment.

00:24:56: You're not just... The owner isn't walking the horse while you are breaking the Bad News.

00:25:03: And then the P in spikes is about the client's perception.

00:25:07: So again, it starts with where?

00:25:09: Where does that client at?

00:25:10: do they already know this bad news or not?

00:25:13: are they aware of the situation?

00:25:15: so to asking them trying to ask an open-quendant question you understand your horses condition and something like When we're actually getting too well, this is bad news and I want to make sure that the owner knows it.

00:25:34: Usually starts with some invitation which in that spikes model, they call it invitation and say well not all clients might want to know the details.

00:25:46: So you wanna ask them about what do you want to now?

00:25:50: I don't know if thats always so easy to do.

00:25:54: but when bring bad news start with some warning shots like this is bad news or Some fats might say this is not so good news, but that's a little bit you might.

00:26:08: You can be really clear about us And just make sure that they know what is coming and then actually give the bad news?

00:26:16: Then most important thing when we're talking about Bad News and how to keep clients Engaged Is that When your bringing bad news you probably get an emotional response.

00:26:29: That's like definition of bad news.

00:26:31: it changes the client's perspective of the future in a negative way and they're going to be affected by that emotionally.

00:26:37: So when you see or feel like there are emotional about it, then might all kinds of emotions... even if they were angry at YOU because of bringing bad news?

00:26:51: It may have been sad but maybe they don't believe you!

00:26:55: But when you know those emotions this is not time for them other information regarding treatment plans, rehabilitation because they're not going to be ready for that.

00:27:07: When you are highly emotional... You aren't ready to process rationally information.

00:27:15: so at this point we really need to show empathy and try understand what they're going through before you go on about, You know?

00:27:29: What's the plan and how are we gonna make you stick to the plan because That's yeah even your emotion.

00:27:37: It's really hard to process information.

00:27:39: Yeah I can imagine that it's difficult To deliver it and sort of be The one that has to bring these bad news but it could also And you could also turn into Being sort of the hero, you know that your I'm there.

00:28:00: The person who's gonna help you Get out if this is a way out?

00:28:05: There could also be situations where they're sexually the prognosis so poor That you can't really do anything but in those cases You would probably deliver it.

00:28:18: the owner still has some sort of good feelings at least about you.

00:28:23: Yeah, I think these are the moments where that can make or break your relationship with a client because for this bad news might be something that you deliver weekly but They usually, these are things that happen a few times in their life.

00:28:46: That they get really bad news about the horse.

00:28:50: so it's really make or break situation and I think what you mentioned being there for them is important.

00:29:00: yes.

00:29:01: So as i said when your owner is emotional like trying to convey your understanding of, I know this is really hard for you or came as a shock.

00:29:14: But also part of that supporting them and letting them know they're not alone in it.

00:29:19: Yes we are going together.

00:29:23: try figure out what's the best for our horse at this time?

00:29:27: And do whatever takes... You're not there alone in that decision also, but we're going to decide together.

00:29:37: So that's indeed really important

00:29:42: when it comes to them the decision making.

00:29:45: how do you involve the horse owners?

00:29:47: In the best way?

00:29:47: because I mean at The end if were talking for example an emergency situation or we are talking about a situation That could potentially and the life of the horse If the horse doesn't sort of die by itself, it's always going to be the owner's choice whether this is done or not.

00:30:06: So in these complex and very emotional cases for that matter what's best way to involve them with decision-making?

00:30:16: And how do we move forward?

00:30:18: because you might have a specific opinion as a vet about which thing would work best on your case.

00:30:24: It may also be the other way around.

00:30:28: you feel that there is a way to fix this horse and we can do it if we put in lots of effort into it, but the owner has already given up.

00:30:40: How do you navigate this so that the owners still feels like its their decision?

00:30:46: But maybe you can nudge them or... Yeah

00:30:51: I think it's important that it has to be shared decision.

00:30:54: So we don't want... I think for a long time, probably the communication between veterinarian and client have been more in a paternalistic way with where the veterinarians had authority.

00:31:06: they just say this is what were going to do And the clients followed that and then with some clients that might still work, but as society is changing most clients actually want to have collaborative decision-making.

00:31:21: So they also wants be heard a decision.

00:31:24: I think it's really important because you don't know all the circumstances of those clients so its hard for them what is best especially since veterinary medicine has evolved much.

00:31:36: we can do more.

00:31:42: Yeah, it doesn't necessarily mean that because we can do something... ...that is the best option for that horse and client.

00:31:50: You really need to know their perspective as well,... ..because they are aware of the situation or the horse.

00:31:58: How should I do this?

00:31:59: First off you have a shared decision so you want to present your clients with options... And if you think that something is not an option, like for example no treatment.

00:32:13: Well it's always an option right?

00:32:14: The client can say I don't want to treat the horse but If he thinks this isn't a good choice because the horse will be in pain.

00:32:21: then we have really clear what are other options.

00:32:26: If euthanasia as an option its best veterinarian to bring this up, because it can be really difficult for the client to bring these themselves.

00:32:36: Because they already probably feel quite guilty about making a decision and if also have themselfs ask whether is an option that's going to be even harder on their own.

00:32:49: so you definitely bring your options as well.

00:32:52: And then there are actually three steps in that.

00:32:57: So its pretty simple Model and first is to just start them.

00:33:01: make sure that the owners know That there is a choice.

00:33:04: so they take all this choice talk.

00:33:06: So you just Start with saying well, there are a few options It's okay for you to look into those or what do You think?

00:33:14: maybe already?

00:33:15: They'll tell you Well, I've thought about it And the horse is pretty old He also has some other problems a lot of treatment.

00:33:28: Okay, then you already know that.

00:33:30: so just figure it out from the start to say there's a choice to make You have decision here as well.

00:33:38: and Then when you go into the option?

00:33:40: The second part is options talk.

00:33:41: So you're going through the options the pros the cons off all the options again asking the owner what do think or Do you have any questions?

00:33:49: What concerns we have?

00:33:52: And finally if the last part isn't the decisions talked where are actually make the decision.

00:33:57: And maybe there is some you need sometime in between, because maybe they need sometimes also to discuss this with someone else.

00:34:05: or and but then again it's up to you as a veterinarian to really tell them how much time do they have if its an emergency?

00:34:13: Maybe they have fifteen minutes to decide.

00:34:17: If his more chronic problem may be that he had a week to decided.

00:34:21: so just made sure.

00:34:23: Then,

00:34:30: in the situations where... ...the owner's wishes then collides with your wish.

00:34:38: It could be welfare issues like you said when not treating is not an option and owners decide to go ahead and not treat anyway.

00:34:49: I mean obviously we'll have really severe cases that are actually illegal obligation for you to report, to authorities and so on.

00:34:57: But there could also be a great scale where it's not enough for you sort of to report but still your very concerned about the welfare or horse best interest in this case how to approach those situations or navigate that because I can imagine different reasons why owners will just say And I'm guessing that finding out those reasons could be part of the way to approach it?

00:35:32: Yes, yeah.

00:35:34: We're coming back to a shared goal we talked about in episode two as well.

00:35:38: like they probably also have their goals.

00:35:46: and then there concerns about the horse.

00:35:47: so The reason is that they're making this choice, so maybe it's just unaware of the fact that a horse is in pain or don't really see.

00:35:59: Maybe you can convince them to try medication for one week and if they see behavioural change on their horses... They might actually see that the horse does have pain when you give it pain medication and its behaviour changes be an option, or maybe it's other reasons.

00:36:20: Maybe its other things that are withholding them from doing the treatment.

00:36:28: they just cannot cope with this new problem.

00:36:33: because there is a very nice picture actually, a schematic drawing.

00:36:39: It's like very big circle and then you have this very small tiny circle in the middle of that big circle And it says there is everything going on with the life of the horizoner.

00:36:52: The small circles are what we see So you never know where else they go.

00:36:57: so asking about them might be important.

00:37:01: What I usually tell students not to do in the process of shared decision-making, because it is kind of when you talk about nudging or... It's actually a little bit emotional blackmailing.

00:37:12: Is telling them if I was my horse then that would be enough for me!

00:37:17: So i wouldn't do this.

00:37:18: in case you are really trying to come up with your own share decisions.

00:37:24: When doing so you're pushing your opinion forward but worried about welfare, perhaps you could use this phrasing because it is quite strong and convincing for most owners.

00:37:44: And also helps them.

00:37:45: Also empathy might help Because instead of pushing on like no You have to decide to utenize the source or treat it.

00:37:54: Just empathy.

00:37:56: I understand that it's really hard for you to make the decision because, y'know.

00:38:01: You see him walking around and still seeing what he is eating And just showing that your understanding might also change their opinion a little bit.

00:38:15: So...and we can do this together with being very clear about.

00:38:19: as a veterinarian my advice would be to use this horse or treat but also showing empathy and as I understand it, an owner is really hard to make the decision.

00:38:32: So that can be helpful... just the veterinarian, let's say you're not the police.

00:38:43: You are not animal welfare inspector.

00:38:45: so in case there is really a problem then you have to go to the authorities and... ...you cannot be as a veterinarian the judge or the police and an animal welfare inspector

00:38:59: etc.,

00:39:01: you can give your owner information and advice but if you worry about animal welfare than other people more appropriate roles to do something about it.

00:39:15: How would you recommend people to answer if the owners were the ones asking, what would you do?

00:39:22: If was your own animal?

00:39:23: because that's always one that comes up and I think It's...I don't know What The Appropriate Way To Handle This Would Be.

00:39:30: What's Your Opinion On This?

00:39:33: Yeah, so two things.

00:39:34: First you can like try to revert that question back to them and just say well it is not my animal I don't know your situation.

00:39:46: So its really hard for me to answer the questions And then just like revert a question Back To Them Like what's important For You or What Are Your Concerns?

00:39:56: Just Try To Get That Out Of Them clear that you really want their opinion here, and it's in there.

00:40:05: Opinion is important.

00:40:08: second because of course You are the veterinarian And your.

00:40:11: they want Your advice?

00:40:13: And when They're asking for your Advice You have to.

00:40:17: well It's Important That You Give Them Enough Information and Advice.

00:40:21: so How You can then Help them Is You Can give Your Opinions as Well but Based like on the objective facts.

00:40:32: So you can also use whatever you know about their situation for that, so like say okay I know that you have this competition coming up and i know that it's really difficult because your horses are out on pasture to give medication twice a day.

00:40:54: And if we choose this option, then you only have to give the medication once a day.

00:40:58: So I think that might work best.

00:41:00: for what do you thing?

00:41:02: That way are not just saying well... If i was owner of this horse and would do it but trying help them based on more objective facts You can say which is your best option But also give arguments why.

00:41:19: So

00:41:24: we're closing in on the end of our conversation, but as a finish off We would like to ask you Because you do a lot of teaching and new.

00:41:36: You meet a lot young veterinarians and veterinarians to be And what's the most important advice?

00:41:46: You would give two new vets about navigating these emotionally challenging client conversations.

00:41:54: Yes, I've been thinking about that question.

00:41:58: You told me in advance you were going to ask it and... ...I have a lot of things i would want to tell them.

00:42:03: but actually if its really about practical tip for managing those conversations.. ..i had this meme on my slides when im teaching which states like go to school learn communication skills and then constantly get taught don't talk.

00:42:24: And I think this is really important, listen first speak second.

00:42:33: so the listening is going to be more important than how you frame your information.

00:42:39: and there's also this afro-american writer Maya Angelou.

00:42:43: maybe you've heard her quote.

00:42:46: So her quote is i've learned that people will forget what you said but they will not forget how you made them feel.

00:42:56: And I think that's really important piece of advice, especially in UVETs might be very insecure about making a mistake or saying something giving information which is not one hundred percent correct.

00:43:11: But well anyway what i've learned from the communication part of it people only remember twenty percent.

00:43:20: That's not going to be the most important.

00:43:22: It is also important of course, but it will really be important that people felt listened too and understood And they felt you wanted help them in their animal.

00:43:35: Then its okay if don't know something immediately.

00:43:38: If I am looking this up for you They are actually probably gonna happy.

00:43:44: You're gonna spend some time looking up something for them and trying to help them.

00:43:52: And don't talk is a very good advice in that matter, I think i already mentioned the power of the pause but really sometimes just actually listening and not being afraid of having a pause every now, then.

00:44:08: And just hearing what people need... What their questions are is going to be more important than preparing your own... ...what they call like your own spiel.

00:44:17: this my monologue advice that I'm gonna give because it's gonna different for everyone.

00:44:25: Good Thank you.

00:44:26: so keep silent once in awhile Don't talk.

00:44:34: And

00:44:34: then about

00:44:35: the students, before they come into vet practice.

00:44:40: What is the most important thing that you would like to send them along on their journey?

00:44:47: Because there's a lot of things That are new.

00:44:49: obviously when your a veterinary student and new veterinarian I mentioned it shortly that your confidence and self-esteem, how secure you are about what you say or do can be not very high.

00:45:12: They could be insecure... What's the most important thing?

00:45:15: That students really got from school before they started in practice?

00:45:22: about client relationships in general and about client communication?

00:45:28: I actually have two things, if that's okay.

00:45:31: Of course!

00:45:33: The first thing is it something... It's an ad from a bank which opened my eyes to this about client satisfaction and clients' relationship because Belgium banks had this publicity, which stated we go a hundred percent for ninety five percent satisfied customers and as you know people pleasing veterinarian.

00:46:02: Which I think a lot of veterinarians are more or maybe the What?

00:46:08: We're not going for a hundred percent satisfied customers.

00:46:11: I mean, that's what we want right?

00:46:14: Everybody to be happy.

00:46:15: and actually so when i looked into that client satisfaction rate of ninety five percent is exceptionally high.

00:46:23: it's excellent you cannot do better.

00:46:27: And When You Think Of It as A Vet As A Young Vet When You'Re Going To Graduate Your Gonna See More Than Twenty Clients A Week Probably So That Means At Least.

00:46:36: Every week you'll have a client who is not satisfied no matter what.

00:46:40: You might do a backwards flip-flop, whatever for them.

00:46:45: they will not be satisfied because That's just the way it is.

00:46:50: You know, ninety-five percent client satisfaction is exceptionally high.

00:46:53: so one in twenty clients are going to be unhappy no matter what and I think realizing that probably already quite important.

00:47:00: So its actually one of first things i show students when we're talking about difficult situations you not gonna make everybody happy anyway.

00:47:10: Good advice

00:47:12: Yeah.

00:47:12: then second thing And that's just about communication skills.

00:47:17: It is when you have in mind the spirit, let us say of client-centered communication or relationship centered communications it better worded than clients relationships centered then everything will probably follow on.

00:47:37: and basic idea A relationship-centered conversation is a meeting between experts.

00:47:44: And on the one hand, I really want to tell those young vests you are an expert in animal health.

00:47:50: You studied for many years and took all of these courses... ...you know your thing so that they can be confident about it.

00:48:01: but you have to realize that the owner is also an expert.

00:48:04: They're experts in their own situation and about their animal, they can tell whether it has lost weight or gained weight.

00:48:11: You will not know if you don't talk with your owners.

00:48:14: so... ...you really need to see the owner as an expert.

00:48:19: not as an expert in animal health, because that's you.

00:48:21: But as a expert on their own financial situation.

00:48:26: they know the housing and diet what care will be able to give them for their horse.

00:48:32: So seeing it as meeting between two experts I think instead of having you giving information to your owner in one directional way is really important.

00:48:47: That has a lot to think about but very good advice And I hope that the listeners have been getting some aha moments because I certainly did.

00:48:58: So thank you so much, Annalies for joining us in this podcast.

00:49:01: it's really valuable.

00:49:03: thanks a lot For joining us.

00:49:05: It was pleasure to join and also like the examples of questions You had Because we had an interesting conversation.

00:49:13: Probably could've gone on for hours.

00:49:18: Thankyou.