Good evening, everybody, and welcome to the latest webinar vet practise management webinar. My name, my name is Andy Mee. I'm from Veterinary Management Consulting, and tonight, it is my pleasure to introduce you to Joe Woodnut.

Tonight's talk is sponsored by Simply Health and MWI Animal Health. So about Joe, then after qualifying from Nottingham University, Joe went on to work in small animal practise in Worcestershire. And she now writes pet-related articles for national magazines and loves to educate.

Over to you, please, Joe. Hi, there. Thank you very much.

So, yeah, I, I'm here today to talk to you about, building rapport with your clients and, and, most importantly, about demonstrating empathy with your clients. And this is actually something that the whole team can be involved in. Although, from my experience as a vet, I'm obviously gonna give it from my point of view.

But there's definitely some tips in there for the receptionists, for the nurses, and for the practise managers among you who might want to pass some of this on. So there's a quick outline of what we're going to go through today. I'm expecting it to take about 45 minutes, so please bear with me.

And I'll see you at the end. Oh, and please do excuse me, I've got a, a little bit of a cold. I will try not to shuffle too much.

So, why is it so important to communicate properly with your clients? And I'm guessing you all know it's important, otherwise, you probably wouldn't be here. But it does allow you to bond your clients to you personally.

And for those vets among you, that's obviously quite important when you're talking about negotiating your job, your salary, your hours. If you've got clients that want to see you and you only, that's quite a good bargaining chip. It also increases compliance and therefore creates a better outcome for the animal, which is what we're all there for really.

And it's a bit of a win-win really. So, Silverman in 2009, he did a survey of 204 clients, and he found that clients actually rate the non-technical skills, such as communication, more highly than the technical competence. Lou Atao, he showed the importance of the VET-client bond, and how important it is for client retention.

And Mia Natal surveyed 205 clients and found that clients really rated their communication skills. He also found that 48% of clients felt that vets need to improve upon their non-technical competencies. So that's your client-centered, pet-centered behaviours.

So, handling, communication, bedside manner. You can see this in this list of reasons why clients didn't want to see a vet again. And it, it probably seems like a bit of a silly list and, and a bit minor to us, sort of, you know, rough with the pet and rushing the consults.

Probably seems a bit, a bit strange, but, it is really important to our clients. And we can improve all of these by teaching. So here's a bunch of studies that show a better outcome for the animal, if you can communicate and build rapport.

So, you've probably come across Louise Cora's work. She's doing some really interesting stuff in this area. She's definitely one to watch if you're interested in rapport, empathy and consult skills.

Kanji showed that clients were 7 times more likely to comply if you combine a relationship centred approach and clear recommendations. So that's what we're gonna come back to later, that relationship centred approach. The final few studies on this list are actually from human medicine.

Obviously, we've got a slight additional hurdle in our communication, thanks to the relationship with the client is a triangle with their pet as well. I think it stands to reason, though, that some of these lessons come across in veteran medicine too. So, I find the one about, asking the patient's expectations, or in our case, the client's expectations, quite interesting.

Certainly, we get taught this, or I've been taught this, and I know a lot of people probably have. And it just goes to show how important it is to ask the, client's expectations, because it's much more likely that you're going to, they're gonna comply if they feel like you've listened and you've understood them and asked them what they intend to get from a consultation. It's actually better for you to invest some time, in communications training.

It impacts on your work-life balance, it impacts on your job. Shore found that vets actually improved their opinion of their clients once they'd taken communications training. And I think this is partly because, you, the clients complain less, possibly partly because the clients are seeing you as an individual and you're seeing them as individuals.

They're, they're seeing you, as a, as a human. I love my clients. I, I've rarely found a client I didn't find something in common with.

I spent a lot of time, communicating and empathising with my clients, and, and, it to me, this completely makes sense what Shaw's found here. This report is from the College of Vets of Ontario. Now, so I get these, again, they might seem a little bit minor, things like failed to ask the pet's name or failed to speak to the pet.

But that's what our clients are looking for. And at the end of the day, if that's what they're looking for, that, and that's the way to win them over, that's what we should be doing. There's also this here, another suggestion that communications training is gonna help reduce the complaints and therefore make your guys' jobs easier.

So essentially the complaints are because the vet appeared to the client to be indifferent, arrogant, offhand or dismissive of the client's observations. And we've all been there when the client's observations are clear rubbish, but it's about what you appear to the client, how, how you appear to the client to be listening to those, or, or even just taking them in hand and saying, oh, actually, you know, that's not relevant. Don't worry if you don't feel like you're not very good at this whole communication thing.

You're not alone, if that's the case. Interestingly, the postgrad training seems to be slightly more effective for communications training. Now, whether that's down to a slightly different method that you're being trained, whether it's because after graduation, you realise that you've actually got space to learn about communication, you realise how important it is to learn about communication.

I'm not sure. But good job on you guys for coming because it is important. So, Vet Futures is the working group of the RCVS and the BVA, and their, research is based, around finding the issues affecting the profession now, and the issues that are gonna affect the profession in the future.

They say it's back to the vet-client relationship. This is the, the relationship, the relationship centred approach that we're aiming for. it's 7 times more likely for clients to listen to you if we can get this partnership, this relationship centred approach.

There's a bit of evidence that girls are better at this. But luckily, for all you guys out there, these skin skills can be learned. So don't worry if you don't feel like it's your thing.

Lots of studies have showed a benefit to formal communication training, and it's now being covered in all 4 vet schools, sorry, in all vet schools. But there's still some work to be done. None of these models here are perfect.

So the Calgary, Cambridge model is taught quite a lot, but it's adapted from human medicine. This means that there's actually no space in there for the pet. And although we've adapted it to make it a little bit more relevant, there's actually some, some major differences we'll go into later.

There's also the 4 habits model, which, as far as I'm, I know, isn't taught in any of the vet schools. This is also adapt adapted from human medicine, and doesn't really have any evidence behind it because it's not really studied like the Calgary Cambridge one is. However, I, I came across it when I was talking about, how I communicate.

I was, I was helping a new grad out. And, actually, this is closest to what I do, so I thought I'd put it down there. OK, so, I break a consultation into 4 major steps, hence the 4 habits model, sort of.

First one is preparation. So this is super important. There's 5 key things to remember when you prepare.

Who, what, room, you, and time. Not everything's relevant to every situation. Just take it, you know, 30 seconds or so to prepare properly, and it gives a really good impression to your clients.

So who, who is the client? Most of you will be doing this without thinking, but it is really important. If you know someone's medical professional, you can alter your approach.

If the last vet's left a terse note about a discussion on raw feeding, then you can know whether to pick your battles or not. Now's the time to check if the last time you saw them you put their dog to sleep, or if there's any ongoing conditions that you feel like you should ask after. So just a little bit of time to flick through the notes and just check who is the client.

And that's not necessarily the dog that you're seeing, that is the client as a human. What are they there for? So if it's a booster, fantastic.

You're probably gonna have 15 minutes to, to build rapport with them. In fact, especially, say, if you've got like an L4, 4 weeks after sort of thing, that's a really good time because they've recently had a workup, they've been looked over, so you've got 15 minutes or, or 10 for some of you to, to really get that client communication and rapport built in. We all know the feeling of dread when the receptionist's written there's a list of things as the problem or not well.

But this is a time to have a quick check, and whether that's what you're gonna, you know, gonna be preparing yourself for. Also, if it's a follow up or an op, just double check, you know, the location of it, even if it's not clear in the notes, just go back till you find out where the lump was that was being removed. Otherwise, it's a bit embarrassing when you get in there and you're trying to take the pet shirt off and find the wound.

The room, just very quickly, you might be able to move your tables around if you've got a large dog. Consider your positioning for communication. So, you know, are you gonna be behind the table?

Is this, are you gonna be in front of the computer? Is there somewhere more neutral and less sort of, aggressive that you can stand? We'll go into that a little bit anyway, so.

And you, and this is one that's really important to me. We know you don't always have time to do these things, but as I'm gonna, I've alluded to already, and I'm gonna go into detail, your clients really need to know you're human. If you need to go to the toilet, you need to go to the toilet.

Your clients don't mind. Trust me, I've tried it. If you stop, if you go through reception, just say, I'll be with you in a second.

I just need to go get a glass of water. They don't mind. If you have a bite to eat, if you literally just pop out the back and stuff some cake in your mouth, your clients need to know that you're not late because you couldn't be bothered.

You're late because you probably hadn't eaten all day. And teaching your clients that you're a human too is a really important part of what we're doing. With this presentation today.

And for me, it's a really important part of, of our mental health as vets. It's an important part of how our clients treat us, because sometimes we've all been on the receiving end of some pretty nasty clients. But if they know that we're human beings, they're, they're more likely to remember that when they, when they treat, think about how they're treating us.

Take a second before the consultation just to turn inwards to assess your own needs. Cora, Louise Cora, back, going back to her again. She found that a vet's job satisfaction, their mental health and their well-being all influence our agenda and therefore, the direction of our consultation.

So take care of yourself because it will impact upon the pet. And last but not least, the time. Are you running late?

Now, apologise, even if you're only 5 minutes late, even if you've got no idea why anyone would think a Friday evening was a good time to book for a nail clip, it's easier just to apologise. It does absolutely no harm. It, it shows the client that you value their time, and, and if we treat them like humans, they're gonna treat us like humans.

It gets things off on the right foot. And remember that today's nail clip is tomorrow's complicated workup and you want them to trust you as a vet, and that you listen to them and that you understand their concerns. So just, I'm so sorry we're running late this evening.

We had an emergency come in. Or if you want to make your point about the Friday evenings, I'm so sorry about your wait. Friday evenings are mad here.

You know, that's kind of saying, oh, you know, I'm sorry you've waited so long, but it wasn't the best time to book really. It can make the world a difference, apologising, you know, especially if a client's upset. I do like to add on something like, Oh, it can't be nice for Millie to be in that noisy waiting room.

I do apologise for that. This goes to just remind them that no matter how bored they got, it's their pet that they're, they're about, it refocuses things back onto the pet rather than their emotions. Just as a side note, it goes without saying that cats should be, removed from a waiting room if it's noisy, wherever possible.

And have a think about the other way your receptionist can help, because they are the absolute masters at building rapport with their clients. And they can be lifesavers when it comes to having that, that client who's getting over in the waiting cause they've been waiting too long. Another little point here, although it might be tempting when you're running late to speed through and try and catch up, your clients will realise that's what you're doing.

And if we go back to that previous list, one of the things that they absolutely really hate is when we're rushing consults. As far as they're concerned, they've paid for 10 or 15 minutes of your time, and they're gonna be pretty upset if it takes 30 seconds. It's much better to provide value.

To them, but maybe just try and shave a couple of minutes off each concert rather than trying to catch up all in one go and upsetting somebody. Who is introductions and reading the room, and this one I think is quite important. The first bits especially for the locums amongst you, if you've not met the clients, introduce yourself.

Don't shake hands if you don't like shaking hands and you feel uncomfortable. Owners are gonna pick up on that and they're gonna wonder what's going on. So a confident smile works just as well, or what works really well if you're feeling a bit awkward is to introduce yourself to the animal.

So although it's a bit rude, most clients see it as kind of a cute eccentricity. I mean, you can even like shake their paw or whatever. Don't forget to give them your name, just a little side note, I once met a vet who refused to give a client his name.

That obviously didn't get things off to the right foot, and the client was suspicious as to why he didn't want to give up his name, and, you know, she was then starting to wonder what he was hiding. It was all very awkward and uncomfortable. Don't forget to greet the animal.

So this is where it comes in that these Calgary, Cambridge models and things don't quite work, for us necessarily. So all of our studies and our adaptive models of consultations don't consider this animal in the room, the elephant in the room. Just show them some love.

The, that animal is the centre of your client's world, and if you can show the animal you care, show the client you care, they're gonna warm to you. Treats obviously help, especially if you've got a nervous animal, but do just check that they haven't got allergies or intolerances. Try and let them come to you.

But you can always just cuckoo them at the basket, talk about how gorgeous they are. If you forget their name, don't worry, just call them a young man, handsome boy, cutie pie, gorgeous girl, sweetie pie. Most clients will love it.

Those that find it a bit weird, generally just accept that we're all animal mad, and that's fine. So these are all just little things you can do in the beginning of a consult, the 1st 30 seconds of the consult to make the client believe that you're there for them and for their pet. So you don't have to stick to your initial impressions of people.

They can surprise you. I think we've all been there when the, the family comes in that clearly have very little money for themselves, and then you find out the pet's completely insured. However, it can help you to get a little feel for the consult.

So, you know, you get that one that's down as health check, and then everyone comes in crying. You know, that should be ringing some alarm bells. And that's where your preparation comes in handy, but also don't stick to every impression you make.

Interesting here about, reading the room, how bonded they are. So if they are touching their pet, if they're reassuring their pet and willing to let their pet go, they're probably more highly bonded. These are your best clients.

They invest a lot in care. They're also the clients that need you to recognise and acknowledge how bonded they are. They need you to say, you know, to basically treat them like their, their dog is their baby.

Just some interesting, things here from Lou in 2008. So this is how bonded people are. What I find interesting is the crazy cat lady really does win out.

So you've got your, your single female living in a flat. You've got, interesting that the lower income families tend to be more bonded with their pet. And the busier families, so more people or a single family household with children generally have a slightly weaker bond with their pets.

Males and are generally weaker than female, which I think we all see every day. It's always, always the, the women that bring the dog in. And if it isn't, it's the men bringing the dog in, not necessarily knowing why they're there.

They've just been asked to come. So you can use this to help you make some impressions of your clients when they come in, but obviously don't stick to the script, you need to look at what's going on in the room. So, how experienced are your clients?

Obviously, some have, people have never been to a vets before. They don't know what to do. They don't know where the animal should go on the table.

They're gonna need different handling to someone who's reared dogs all her life and at least thinks she knows what's going on. People with a dog for, with, like recurrent ear disease, they're really tricky cases. You might want to introduce a new idea for APP.

They might have seen. 5 different vets being given 5 different ear meds and not once had A0P suggested to them. But bear in mind that the owner's gonna feel like she knows what's going on.

And that's where you need to be very careful about how you approach her. You don't want to patronise her. You don't want to let her know that you think she's wrong.

And we're gonna talk a little bit more about how we can do that later. Cota interviewed lots of clients and found that a client's perception of the problem, their knowledge, their life experience, their information sources, Dr. Google, their personal beliefs, their relationship with the animal, those things all influence their agenda.

And that's what you're trying to assess when they walk into that room. What's their agenda? If they're highly bonded, they're a human nurse and they've had a Google, they're gonna have a very different idea as to what's going on, and therefore a very different agenda to the experienced owner who's got 10 cats and doesn't believe in drugs.

And, and that's where these initial impressions can really help you just work out how to pitch what you're talking about today. Have a quick look at their mood as well. If they are in a hurry, if they've been waiting half an hour and they've got to get somewhere, now's not the time to try and bond them, with anything except being as quick and as effective as possible.

But if they're relaxed and you've got the time, it's definitely a good time to try and get to know them a little bit. So listening to the client, most people call this history taking, but actually what it is is listening to the client and most importantly responding to the client. So history taking, in my opinion, should be a conversation.

It's not asking the client a load of questions and then answering a load of single word answers. It's about opening, opening questions as best as you can. I know we all get told that, and I'm sure you all feel like we're repeating ourselves with this sort of information.

But sure, in 2006 found that only 7% of the vet's time was asking open questions. Now, given that that's been linked to greater rapport and greater outcomes, we kind of need to get better at that. I'm just as guilty of this as anyone sometimes, especially when it's been a long day or I've got a full waiting room.

But MacArthur actually found that vets didn't ask open questions in 10% of appointments, like, at all, at, at no point in that appointment was it an open question, asked, which is completely bizarre to me, because I, you would have thought, at least there was an open question at the beginning, something like, how can I help you today? Or what can I do for your pet? Or, so 10% of appointments that animals going in there and, and leaving again without a single open question being asked.

It's embarrassing really. Part of listening is responding correctly. So if they say they're worried because their dog fell in the pond, now he's got diarrhoea, it's OK to laugh that the dog fell in the pond if they find it funny too.

You need to respond to what they're saying because you're both human and this is a conversation. It, it's not, you know, if, if we stand above them, taking information from them and then spewing out possible diag diagnoses, we're, we're removing this whole partnership that we're supposed to be in together. Active listening's really important, so it's little interjections of things, body language, it's also, most of us here either are or work with Brits.

And it's a bit of a joke, but we don't say what we mean, do we? You need to not listen just to the message they're actually verbalising, but also the feeling behind it. So what are they trying to say?

And the classic one, especially for me, is, oh, the other older vet said this. They're they're saying that the other vet said this. What they mean is that they're really nervous that you're approaching this differently, and they're nervous that you look young.

Let them know that you understand the message behind their concerns. So, for instance, oh yeah, in my final year at vet school, I studied with so and so. She's a leading dermatologist.

We saw a few cases like this. I've got experience. And she explained to me the latest evidence shows that this method will clear the problem up more quickly.

So you're not dropping the other vet in it, you're saying it's the latest evidence, and you're showing that you have experience of the situation. So, most importantly, you're responding to her actual concern, not what she said out loud. One way you're showing that you're listening, especially if your body language or situation have made it at all unclear, is to rephrase and feedback.

So you're saying the diarrhoea started a couple of days ago, but the blood only started after you gave him chicken and rice. It's also a really good way to get yourself out of a situation where your concentration wavered for just a second and you're not 100% sure what they said. So it can just give them a chance to correct you and say, Oh, no, no, the blood, actually it was the day before that, I think.

It's very easy, especially for new grads out there, to feel nervous. So you've been told not to cross your arms. So then you try and stand behind the console table, you look really rigid.

If you can't find a way to stand that isn't awkward, fuss the animal. It, it goes down really well. And sit on the floor, I know that sounds completely bizarre, but I can't tell you.

I do this in pretty much every consultation. The dogs relax immediately. And, and I can speak to the clients, and the dog comes over to me and has a cuddle.

And the older vets walk in and they look really shocked that I'm sat on the floor and I'm being casual with my clients. But holding yourself above a client isn't gonna help them and help this relationship that we're trying to build. So just kind of put yourself down on the, on the floor with, with them and, and your pet, put them, put yourself physically below them.

It just takes away that whole hierarchical, you know, I'm a vet, you have to listen to what I say, and puts in the mindset that you're gonna work together on this. Just be careful if you do sit on the floor that you then have to show extra hard that you're listening. So keep looking up at the owner and talking to them.

I find about 50% of clients will sit on the floor with me, or at least crouch. Some will just stand there looking a little bit confused, at which point you can always stand back up again after you've fuss the animal. It's absolutely fine.

Excuse me. One other little thing to say, if you do need to make a note, like a temperature or a weight, just make sure you tell the client what you're doing, otherwise they generally think it's a little bit rude. So you could say, oh, I'll just put this down so I've got all the facts, I, I'll just be a minute, or I'll just put this on his records and then you can tell me more.

So just let the client know that it's not that you've got bored. This is a really interesting excerpt from an article from the point of view of a doctor. This is one example that I found, but there are several examples in there of how important it is to remember that you're talking to a human.

I'd fully recommend reading the whole thing, but I'll just give you a second to read that. So for me, the most important bit of this is, is right there at the end. The transformation.

There's an actual person behind that hospital issued gown. And, and that's exactly what, what I'm trying to get at here is there's an actual person behind that worried face clutching their dog, and, and trying to understand and appreciate that person as a human being is gonna make our clients trust us and, and get the job done. Step 4 is saying goodbye.

Not so much to the pet as just to the client at the end of the consultation. It can be really hard, and as a new grad, I often found myself saying, good luck, which didn't really help the clients have confidence in my suggestions. You can try by then, see you soon.

We'll see you next week. Have you got any questions? You know where you are if you need me.

Even have a great holiday if they've mentioned that they are going on holiday. It doesn't have to just be the clinical, aspect. I also like to joke, the whole, see you soon.

Well, not too soon, hopefully. Touch wood, ha ha ha. No offence.

Which clients really enjoy. They love having a little joke with you. And take care of yourself if there's been a euthanasia is, is sensible.

So, on to some dos and don'ts. So do try to make jokes with your clients and laugh if appropriate. I do think it really helps them see us as people, as humans, and it increases that bond.

Do try to find something in common with your clients, so. Well parallels to your pets. If you don't have a pet, make one up, borrow friends.

I used to always use my mom's dog, Jazz, who's in the background of these images. She's, she's gone now, bless her. But I, and I have a puppy, so I don't need to use her anymore.

But I used her all the time. And it, it's nice for clients to feel like you've got firsthand experience in their issues as well, as medical, medical knowledge, you know. Do try and be sincere, obviously, don't, don't just completely make it up.

The clients will find out. I did, once managed to. Well, a client decided that my dog had diabetes, and tried to bring me a load of her insulin after the dog died, and I, I can only think that at some point I'd referred to Jazz as having had diabetes in order to get her inside.

So I try not to fall into that trap. So a few things I've done in consults. That just to go and show the range of things you could discuss with clients, in order to, to be yourself, to, to show that you're a human being.

So I've commented on someone's shoes. Actually, there were two separate people with the shoes by the same, brand, and, I love them. Excuse me.

One client clearly thought I was absolutely mad, but she thought I was nice. The other client was known to be difficult and she instantly warmed me, and now she won't let anyone else examine her animal, which is not great, but hey ho. If you're not sure, gardening's always a very safe hobby to discuss.

Curtain's not so much. I can't quite remember how I ended up doing that. But the point is here is that it's all about building rapport by responding to your client as a human being.

If they mention a film that you like, tell them you like it. So, as I said, it's all about being yourself, allowing your individuality to interact with your client's individuality. And, and that's, that's the essence of it, really.

Also empathy, empathy is the other main thing, so you've done the rapport and and now you're onto the empathy. We're rubbish at this. So Morse EA 2008, human medicine.

In 20 recorded interviews they identified 384 opportunities for empathy and only 39 were actually responded to. Sure, in 2006, in 300 small animal consultations, empathy was expressed in only 7% of them. It's a bit embarrassing.

And MacArthur out in 2013. Statements that were intended to reassure clients were expressed frequently, but in 59% of appointments, empathy statements were not expressed towards either the client or the patient. So this goes back to what we're saying.

If the client mentions having a bad cold, say, oh you poor thing. If the client says they've taken on the family pet because their parent died, say, I'm sorry to hear that. And you can express empathy towards the patient as well, obviously for the client's benefit.

So, ouch, you poor thing that looks really sore, or I know your skin is itchy, sweetheart, but you really can't lick it like that. You're gonna make it worse. Slightly eccentric, but clients do like it.

So we're gonna go through some examples of, statements, have a little think about the situation and some of the emotions the clients likely to be feeling. Then have some think about some ways that you might respond. I've come up with some responses and then we can have a little think about which category the empathy statements fall into, .

So, the first one, you've got a dog going deaf, he's otherwise well. He's an old dog, a little bit of arthritis, maybe, but he's bright and well and happy in himself. He, but he's going deaf and the client just wants to come and check that there wasn't anything to worry about.

Chances are she's gonna be worried, perhaps. She's gonna be a little bit embarrassed, perhaps. So why not say something like this?

Oh my old girl's just the same, it could be so embarrassing, can't it? You're reflecting the emotion back on them, the empathy statement is reflective. It's also legitimising it.

It's OK to be embarrassed, you know, it's one of those things. Fat pet, that's always an awkward one. What, what's the owner like to be thinking here?

Perhaps defensive, a bit embarrassed again, disbelieving sometimes, especially if it's a family member that's told them the animal's fat and they've come in to get your opinion that it's not, that can be embarrassing. Sometimes a little bit frustrated if they've been having a really hard time with it. So one thing you can do is, partnership, we're all in this together.

You know, we all ate too much this Christmas, but we're gonna get back in shape together. Also, it helps that you're throwing them a little bit of bone. We all know it's not just Christmas, that they're animals, they feel a bit better that way.

Or support and reflect, so, you know, I can see that she's put on some weight and I know you've been trying hard, but I think we'd to have another look. So we're working together, support, . We're reflecting the emotion back on them as well.

I can see you're frustrated. New puppy? What's your client gonna be thinking?

Well, probably very excited. A little bit nervous, perhaps. And a slightly weird one is they, they're embarrassed.

They're embarrassed to ask questions. They often, because of this hierarchical thing where the vets have been this untouchable animal guard above them, they're, they're unable to talk to us and ask questions as well as they might. So, gosh, I mean, really, that's all you can do, isn't it?

It's gushing, finding something in common with them here. More gushing. There's always room for humour here.

There's, it's a puppy. It's not a dying dog. You don't even have to be going to a consult for this bonding moment, actually.

You can just be walking through the waiting room and you can see the cute puppy. Yeah, you know, you don't have to, with these bonding points, you don't necessarily have to be seeing the client, taking time to stop when you're walking through the waiting room and, and talk to them about their holiday, really makes them feel like you care. As a side note, I always legitimise my clients' feelings of fear and being overwhelmed when they've got a new puppy, and I reflect that back on them.

So I know there's so much information in this new console, and I apologise for that. I'll make it as clear as I can, but please stop me if you've got any questions, and we'll see you in a couple of weeks, so you'll have time to ask again. Please ask any questions you've got, da, da da, da, da.

Nurses are really handy for this. Clients, again, this untouchable vet guard at the top of the, the pile there, and they, they don't feel they can ask silly questions, but the nurses are much more on their level and they do feel they can ask. So, booking a nurse consult for a couple of days' time allows them to ask any of those questions they've suddenly got highly remembered.

So, the dog coming in for a last minute kennel cough vaccination, you've got a 15 minute slot and assuming the dog is young and healthy, you're unlikely to be taxed with diagnosing anything complex, so why are they coming in for a last minute kennel cough back? We go on holiday. What are they gonna be feeling, they're excited, they're nervous.

You do occasionally get it they're doing that last minute vaccination because they've actually got a funeral, so you do just be aware of that. But you know what, that's another opportunity for empathy and any empathy is good empathy. So, oh, are you going anywhere nice?

Oh, I've always wanted to go there. You're finding something in common with them and responding to them on an individual level. What about when you've got a an ill dog with an extremely worried client, a highly bonded client, maybe clutching the dog to her, crying her eyes out.

Obviously she's gonna be worried, and reflecting that back on her makes her feel like you understand her concerns a little bit. So. You can do that and that you can support them by offering one to help.

Is it a good idea to jump the gun. Not often, but I have used it once or twice when the clients are so worried they can't actually focus enough to listen to you and understand what you're trying to say. The classic example is something like an idiopathic vestibular, and you've got the client coming in and crying her eyes out, thinking her dog's had a stroke and you're gonna put the dog to sleep there and then.

And sometimes you just need them to calm down and, and take a second to think about it. If you've got an old dog, and you've put the dog to sleep and, you know, it's not too traumatic, it's just a, a sad old time. Some clients want to be with their thoughts, but the majority want to talk about their dog.

So I tend to try to recognise that. I try to try to recognise the emotions and reflect them on them. And I try to support them as well, you know, you've done your best, we, we've done this together.

Thing is like, have you had her since a puppy? It's the hardest thing to do, isn't it? Again, that you're, you're supporting, and reflecting those emotions back on her.

You're also opening up the channel for them to communicate what they're feeling. And the vast majority of clients will go away sad, but also sort of happy that they've had a good life with their pets, which is much more what we want to foster the idea in their head. If they're not sure whether to PTS, then they're gonna be having some really difficult thoughts and I think we need to have a lot of empathy for this situation.

We always get that question, Oh, what would you do? But really what they're asking is, is, are they, am I, am I jumping the gun? Is it the right time?

They're asking, what is my vet thinking? Is my vet scornful or judgmental of my decision here? And they're worried, am I, how am I gonna do this?

How am I gonna make this decision? So do you recognise the difficulty that they're having. Do respect and reflect how hard it can be to make that decision.

And give them time if you have to, if the decision doesn't have to be made today, let them sleep on it. We all know, we all dread making that decision, it's it's a really good thing to say is we all dread having to make the decision, but it's the important part of being a pet owner. If the client asks what you do, the best thing I normally find to do is to honestly answer.

The majority of us can honestly answer that you've never been in that exact situation before. So we don't know for sure, but that you'd hope that we'd make the right decision together. Something like that.

So just reflect it back at them and let them know that you're there to help make the decision. What about a dog attack? So you've got a, a client bringing in their dog.

They've probably phoned ahead to say, Oh, my dog's been a bit of money on the dog. I'm gonna bring him straight down. What are they gonna be feeling?

Shock and fear? Definitely. Is my dog OK?

Sometimes it's a little bit of embarrassment, especially if their dog started it. Is the other dog OK? Oh my God.

Sometimes anger as well, if it was the other dog, and especially if they felt like they were doing, you know, the right thing. So, reflect that it might be scary, and partnership. You've got him here now, and I'll do my part.

So these are all empathy statements. You know, you're showing empathy with the fact that she might be scared, that she's been in a, you know, in a situation that none of us would want to be in. Again, reflecting, you, you look a bit shocked, you've done a great job getting him here, support, I'll check him over, partnership.

All of these ways are ways to show an owner that you understand their emotions and give them a chance to calm down. Dog with behavioural issues, the owner's likely to be a little bit embarrassed, perhaps a little bit worried that, you might say that the dog's got to be put to sleep. So, recognise the emotion of embarrassment.

And you can also legitimise it by saying that you would have felt the same. A little bit of support there as well, we can get it sorted out. Don't worry, we're gonna do, we're gonna get it sorted out.

Or reflecting the frustration, especially if you know that this is a client who did everything they possibly could have thought thought of as a puppy. A few don'ts, and most of these are very simple. It can be really hard not to interrupt a client when they're on a tangent, especially if you're running late, but there are some better ways of doing it.

So use sort of body language to indicate that you're not interested. So, start taking the clinical exam, or, direct them back to the history, you know, Oh, yes, you clearly care what he eats. So, is he actually on that food now?

It's quite a good way to bring them back from, you know, the 15 years' worth of dietary history they start launching into. I have, as far as jargon goes, heard through the door of a new grad consult. We'll have to induce some ESI.

He did get complaints, not from that client in particular, but from clients in general, that he was offhandish, that he is arrogant, that he used to reach jargon, which were all things that were, we identified early on as things clients really don't like. It can be hard to strike the right balance between jargon and being patronising. And it can appear that these two things are mutually exclusive.

There's no easy way to get away from it. What I generally recommend doing is trying to use your rereading your preparation to work out how much knowledge a client has. You can also check whether there's a client note, which is something like client's a retired nurse or something like that, that might just give you a little bit of information about how much they know.

If it doesn't work, just ask, say, have you got any experience of hyperthyroidism? OK, well, I'll just cover the essentials to make sure nothing's changed since last time. Or, have you got any experience of hyperthyroidism?

Oh, well, you know, it, it's, it's a, it's a very common disease, but there's a lot that we need to go through, so we're gonna go through it step by step. Just as a, a funny story, I know a doctor. She was one of my, my vet friends's mum.

And she had a foreign gentleman come into her consult room with a child with an itchy bottom. And having done her clinical examination, discussed it with them, she said, Do you know what a worm is with these great big movements of her arm, to which the gentleman replied, I'm a consultant parasitologist. And that just goes to show why sometimes you rereading and your preparation, aren't always to be trusted.

Don't ever make a client feel like they've done the wrong thing. One thing to remember is whatever they've done, they've almost always chosen to do it for love, for reasons of love. And alienating them isn't gonna help them understand.

So I had a, a client the other day who was booked in for possible pancreatitis. So I thought, Oh, that's funny. I wonder, has the dog had pancreatitis before?

No. Looking back through the notes, it hasn't. OK.

Well, maybe she's had another dog with it before. I can't see that she's ever had another dog. Fair enough.

Let's work out what's going on. In she comes. They dumped the dog on the table and said, the royal cannon is killing dogs, so we, we don't feed the dog of that anymore.

And also, dogs are dying from pancreatitis, and I think my dog might have it. He didn't have any symptoms of pancreatitis, but it's more about working out why she was saying that, what she was doing. And I have to say, her husband, has said some very, frankly, inflammatory things to me.

But, you know, the usual, being paid by Royal Cannon or Doctor Google said, that sort of thing. But at the end of the day, what you take away from the situation is that she wants the best thing for her dog, and alienating her isn't gonna help her do that. She doesn't want to, to do something just because.

She read it online, she does it because she's scared that she's being lied to. She's scared that she's doing the wrong thing. And unfortunately it turns out she was just feeding the dog chicken and peas, and that was definitely the wrong thing.

But telling her that wasn't gonna help. So, a couple of learning points I took away from the situation, obviously keeping calm. I actually had to put my stethoscope in my ears and and listen to the dog's chest for a few seconds just to shut them up long enough to take a deep breath.

That worked quite well. Remember that they only do it out of love, and it's not their fault that they don't have a way to evaluate a source. None of these guys will have done a medical degree.

The majority didn't even do biology, GCSE. They don't have much information about what's a good source, what's a bad source, and how to tell one from the other. So it's really hard for them to Identify that Karen from HR doesn't know anything about animals.

and they're all really, really scared that they're doing something wrong for their pet. And it just as an example, the amount of people who've, I've had talked to me about grain-free food since the DCM thing, they all just want to do what's best, and That's all there is to it, really. So this one's obvious, but it happens.

I've literally heard this exact thing happen again, same new grad. So the other thing I would add to this is that. Clients are able to learn, and a lot of them are willing to learn.

So, although you need to start off at the very simple level, actually going in and talking about the Year and the crackatine allows you to then talk about it more quickly with them next time, and they will appreciate you giving them that extra little bit of information. This is a, this is an interesting one. I've, I've had quite a similar situation to this.

I didn't hear someone say this, thankfully, but I could have done. It's all about getting them on side and not alienating them, and I think I hope that you're very clear that that's not what we should be doing. So the bottom line, we need to be asking more open questions.

We need to be understanding and responding to our clients' concerns. Both the verbal ones and the nonverbal ones. Remember that you're both human.

So treat them like one and allow them to make mistakes. And also allow yourself to make mistakes and allow yourself to go to the toilet and everything else that you don't do in a day, because you're both human and you need to do that. Take every opportunity for empathy.

7% of consultations is not enough. We will need to try and understand their point of view in order to effectively respond and get their clients on the side. And be yourself.

Allow your individual individuality to interact with their individuality. It's the only way that we're going to, get down off our, our veterinary godlike high horse and become someone that our clients can talk to, someone that they can share everything with, and therefore, you get a better history, you get a better, outcome for the animal. They trust you to, you know, they trust you.

If they, yeah, medication's not working, they're gonna come back and say it to you rather than be embarrassed to, to tell you that they can't get into their pet. So, treat them like a human and allow your individuality to shine through. Thank you very much.

Wow, 48 minutes. Right, thank you very much for that, Joe. Just to remind everybody, there's either the Q&A box at the bottom or the chat that you can use if you've got any questions for Joe.

I think it was a bit of a tour de force. I've got a couple just to, to throw at you, Joe. Yeah, sure.

You talked initially about clients placing more importance on the non-technical skills, and, and I get that. But obviously, the Royal College wants us to have good technical skills and Kind of where do you get the balance, how do you get the balance right then I think particularly for young, you know, new grads coming in, they're going to be wary of. Making a mistake, that type of thing.

Yeah, definitely. I mean, I think it's really important to remember that the vet school does a very good job of preparing us for the, the technical skills. But actually, less, less so on the non-technical skills, and coming out and being able to explain to a client, that perhaps you don't know, what's going on, but you're gonna ask another vet.

Having the confidence and the communication skills to build rapport with your clients by saying that, rather than depending on excellent technical skills, which we know take time to build. I think that's really important to remember, is that your, your communication skills will always get you out of a tricky situation. Your technical skills won't.

Your technical skills are always gonna come second to someone else's, you know, unless you, you end up being the top surgeon in the country, realistically, there's always gonna be someone that knows a little bit more than you. But your communication skills, what gets you out of, out of a hole, what allows you to be able to say to the client, actually, you know what, I'm going to go away and look that up. Or, as a new grad, I often found I was really, really nervous about missing a foreign body.

So without fail, I took every single animal out the back to get another vet to, to check for, for me. And clients are very understanding of that. And once they had explained to them that I was actually gonna go and get a second opinion just to make sure that nothing got missed, and, and I think.

The effort into those, those non-technical competencies at an at an early stage is really, really important for for getting out of those difficult situations, especially as a new grad, like you say. OK, great. Thank you.

You talked about that vet refusing to give his, his name. I do quite a lot of work in the NHS and of course, I'm sure you're aware, they have the, Kate Granger initiative with the Hello my name is. And certainly my experience in human medicine is most doctors don't introduce themselves, but yeah, just a reminder of that.

Yeah, I, I think that's really important. And I, and I didn't, when I was in, permanent practise, I found myself not doing it as much as I should have done. And then I started to hear clients go out to reception, and go, Oh, who is that vet I saw?

And I wasn't doing it because I was embarrassed to admit, in case I'd seen them before and I'd forgotten. So I wasn't introducing myself cause I didn't want to admit that. But actually, clients would have preferred it if I got it wrong on the other side of the, you know, more often.

Yeah, and in my experience, there, there's an opportunity to work with the reception team as well, that, you know, they can say you'll be seeing Joe today. Yeah, definitely. That kind of thing, you know, all links together.

Yeah. And, and again, your preparation stage just flicking back through your history and just seeing, oh, wait, hang on, I saw them last time or have seen them before, rather than, yeah, embarrassing yourself. Yes.

Couple of personal examples here. You've talked about how to deal with, an obese pet. And without getting non-PC, in my experience, quite often the owners are quite obese.

As well. And how, and have you got any tips on how to be tactful in that respect? I think just generally being, honest with them, you know, you don't, at the end of the day, their, their own health, would benefit.

A lot of people benefit from walking their dogs. That's a proven thing. But you, you don't have to go into that.

That's, that's not our job. And a lot of, vets have actually, had an interesting discussion with a load of vets, and some of them said that the best weight loss initiatives they had. Was where they, the, the vet themselves was overweight, and then they made a deal with the client that, if they could get 1 pound off their dog, the vet would try and get 1 pound off themselves.

So being quite honest in that respect, I think, is quite an interesting way of doing it. But yeah, at the end of the day, the client's obesity is not our problem. And, and, luckily, we look so different from our pets that, we can't, hopefully they won't draw too many conclusions about what we're saying.

But going into the health things, they're all very comparable between, humans and animals. Going into body condition scoring, I think, really helps because, that's something, you know, people often think the weight is important, and it's not about weight at all. And then we had the BMI in humans, and that's often rubbish when you look at all the obese rugby players out there.

And, and going into the body condition score for, for pets is, it's so different from human medicine. I really don't think clients view it as being, being a problem at all. I've actually seen more obese pets, in the last 9 months than I saw in the ever, actually.

There's a really bad obesity problem where I am. And, and the same with people, actually. A lot of, a lot of very well off people who are a little rounder than they should be.

But they really don't seem to mind if you just focus on the pet. OK, yeah, I'm reminded as well, and it links to the communication element. I had one owner, who, and the dog was very obese and we talked about increasing exercise and she said, I'll, I'll, I'll go for a run in the park.

And the dog just wasn't losing weight. Turns out she was leaving the dog at the gate, running around the park and coming back and collecting it. It's like, what?

The dog didn't want to exercise. But there you go. Last one from me then, and nothing else is coming through at the minute.

So, And this is, I, I remember many years ago being a young graduate, you said don't make them feel bad if, you know, as if they've done something wrong. I had what I suspected was, somebody that was, doing dogfighting, and I probably didn't handle it very well, but kind of when it is that they are doing something wrong, I appreciate where you're coming from for those other conditions, but, but how, have you got any tips? Yeah, I mean, that's a really hard one there, and it, it's a situation that luckily, I've not been in too often, but there are situations, definitely, I can think of where you're, you know, you're sure they're doing something wrong and you actually want to make the point that they are, because they might listen to you.

And, and the classic one is the person on Facebook who thinks that they're, you know, the animal's not in pain or it's OK to open up the oral hematoma with a scalpel at home and that sort of thing. And I see quite a lot of that. And I, I'm generally actually now firmer with them.

you know, if they, if they're really truly doing something awful, I think, again, honesty is the best policy. And actually, some of these people just need to be told, from someone that knows what they're talking about, that it's not OK. However, you know, that's where you get into difficult situations.

And like you said, as a, as a new graduate, particularly, you'd find it very difficult to, to, to handle that situation. I'd probably recommend trying to pass the buck a little bit to, to a vet who's been there before. Perhaps pop the dog out the back for, for anything that you could think of in order to, get a second pair of eyes on the dog to back you up.

Because it's not, it's not an easy situation to deal with. and, you know, it's all very well being honest with them, but if it then ends up you being in trouble with the boss because it was all a big misunderstanding, sometimes it is better just to have a backup from your, your fellow professionals. Sure, great.

OK, thank you. All right, well, there are no other questions coming through. So just to say thanks again, a fantastic talk, very thorough, and just to thank again our sponsors, Simply Health and MWI as you have upon the slide there.

So thank you everybody for attending. Thank you again, Joe, and, We'll see you again on next month's webinar. Yes, lovely.

Thank you very much. Bye.