Communication is more than just words.

I was at a veterinary convention and heard a report from our state licensing board.  They told us that the vast majority of complaints they receive don’t involve actual bad medical care.  The complaints almost always arise from poor communication. 

Sometimes the veterinarian failed to give the client a realistic expectation of what could be done for the pet.  If you’re expecting the miracle cure and don’t get it, you would naturally be unhappy. 

Sometimes the veterinarian just isn’t seeing what the client feels, so she (or he) doesn’t give them what they consider an appropriate response.  This gives the client the impression that the  veterinarian doesn’t care about what is happening.  That is very unlikely to be the case, but if you thought your doctor didn’t care, you would NOT be happy.

I can recall an instance of this a few years ago.  I was out of the office and had a great relief doctor covering for me.  He was great at the medical stuff, but he didn’t really know how to read this one particular client. 

In performing a very thorough physical examination, he noticed a grade 1 (out of a possible 6) heart  murmur.  This is a very tiny noise that you almost can’t hear.  It usually means that one of the heart valves has a tiny leak.  This is certainly not a cause for alarm.  It’s the kind of thing you make a note of and plan to recheck in six months or so.  It doesn’t indicate any loss of function and may never get any worse.   When you know this, it’s no big deal.  It could seem appropriate to just toss off “…and we hear a little heart murmur” as you go through the exam.

The problem is: the client doesn’t know it’s not a big deal.  This particular client didn’t hear “no big deal”.  When the veterinarian said “a little heart murmur”, she heard “my dog has heart trouble and it’s about to die.” When he said this like it wasn’t important, she was livid.  She was thinking, “My dog is about to die, and you don’t even care?!”

When I got back, I found this dog scheduled for a cardiac workup: chest X-rays, electrocardiogram, cardiac ultrasound, the works.  I looked at the chart and found a grade 1 of 6 heart murmur.  I couldn’t believe Dr. Substitute would have recommended such a big workup for such a non-problem.  So, I called the owner to talk about it.

It didn’t take long to hear how upset she was, and how worried she was about her dog’s health.  She was afraid it would die before I got back and handled the situation.  When I explained the significance (or lack of it) of the murmur, she was no longer angry, no longer worried, and she cancelled the appointment for the workup.  “We’ll just check it in six months”, she said.  And we did.  And it didn’t get any worse.

So here we had two people with the same goal in mind: taking the best care of that dog.  Yet, because of their very different frames of reference, we had this major upset.  As Strother Martin said in “Cool Hand Luke”, what we have here is a failure to communicate.  There was nothing to worry about, but that wasn’t communicated to the client.  The client was plenty worried, but the doctor failed to pick up on it and address her fears.

When your veterinarian does or says something that doesn’t seem right to you, tell him (or her) how you feel.  Sometimes it’s something as simple as one misunderstood word.  Sometimes we have seen something so many times that it is commonplace to us, yet it is your one and only experience with your one and only beloved pet.  In a hurried world, we don’t always pay enough attention to how the other person is feeling.  Don’t feel bad about telling your doctor when you are not getting what you need.  Taking care of your needs is our job.

When somebody starts crying, right away I know they are upset. I should see that long before the tears start to flow, but if I don’t it’s okay to tell me about it.

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