Our ability to communicate with clients determines our success as clinicians and caregivers. This is because client adherence
to our recommendations depends in part on the relationship we share. In medicine, as in life, improved interpersonal interactions
between caregiver and patient lead to increased commitment and satisfaction for all concerned. Since we cannot not communicate,
every aspect of our communication affects our relationship with clients. The importance of the quality of our interactions
contains elements of both verbal and nonverbal interactions between the caregiver and patient (Figure 1). Verbal elements
include what we say and how we say it. What we say needs to be calibrated to the ability of the client to understand our
language. The use of technical jargon, while a useful shorthand between colleagues, can lead to misunderstanding and confusion
for clients. How we say what we say also is important. Our cadence, tone of voice and volume all communicate our empathy
and concern for the client.
Effective nutritional advice depends on obtaining an accurate diet history and successful compliance with recommendations
by the pet owner. Effective communication requires us to:
• Determine the emotional state of the owner;
• Evaluate the owner's knowledge and understanding of the situation;
• Ask open-ended questions;
• Actively listen to client responses;
• Accurately interpret verbal cues such as silence;
• Accurately interpret non-verbal cues from the client's body language;
• Provide clear, unambiguous instructions.
We try to determine the emotional state of the owner first because it determines their ability to provide information and
understand instructions. Clients who are frightened, worried, or angry may not be able to think clearly, and first may need
to be calmed and comforted. This often happens when the owner brings an animal in on an emergency basis, or with a chronic
problem that hasn't been resolved.
We need to learn who we are talking to because the person who actually feeds the pet can provide the most accurate information
on exactly what is being fed, how much and how often. We can only obtain partial or incomplete information when the primary
caretaker of the pet is not present; when this happens we recommend sending home a comprehensive diet history form that the
primary caretaker can complete and telephone, mail or FAX it back as soon as possible.
Once we decide the client is ready and able to provide a history, one should try to ask open-ended questions. Open-ended
questions are those that do not result in a yes or no answer. They invite the client to describe what happens to their individual
pet in their unique environment. Although using open-ended questions may require more time, it allows the client to provide
information by "painting a picture" we might not otherwise be able to see. Asking open-ended questions also avoids the temptation
for the client to provide answers they think we may want to hear.
What should we do when our clients remain silent in the examination room? How do we interpret silence as a [verbal] clue?
In an effort to prevent long periods of silence, some of us continue talking, thinking that the client hasn't quite grasped
our explanation or intention, while others of us abruptly cut the interview short and make a hasty exit. Silence on the part
of the client could mean one of three things: they understand what we are saying and they are waiting for us to continue;
they do not understand what we've said (and are hesitant to ask any questions); they [simply] require a bit of time to process
the information we've just shared and/or formulate their question. It's imperative that we allow clients the necessary time
to think before reacting to information their next decision will be based on. Along the same line, how should we interpret
one- and two-word responses, such as "okay", "I see", or "I get it"? These types of verbal cues may or may not indicate that
the client is following what we're saying and is in agreement with us. For some clients, these phrases represent a non-commitment,
and are said just to keep up their end of the interview, while many clinicians and technicians interpret these responses to
mean the client understands and will comply.