Empathy is different from sympathy, which entails concern from outside the client's position. The practitioner must be able to identify what the client is feeling, or what emotions they are displaying (sadness, worry, anger, shock, denial). An empathic statement could sound like: “I can see that you are worried about the prospect of Willy having his teeth extracted” (Figure 2.7). You may want to explore exactly what the client is concerned about – perhaps they are worried their pet may not be able to eat properly. This message can be strengthened when combined with nonverbal signals, including facial expression, tone of voice, and even touch. This display of empathy is integral to building rapport with the client and enabling true relationship‐centered care because the client feels completely understood and has their concerns validated. In addition, it can help to build a trusting relationship. Trust is also integral to relationship‐centered care, and is a vital tool in being persuasive. It appears, however, that veterinarians may miss vital opportunities to display empathy (Shaw et al. 2004). The clinician should therefore try to identify these opportunities and practice displaying empathy.
Figure 2.7 A centralized position of the patient is necessary to display empathy and accept the unusual bond between owner and animal.
Table 2.1 Verbal behaviors significantly associated with positive or negative outcomes during consultation.
Source: Adapted from Beck et al. (2002).
| Positive Outcome | Negative Outcome |
|---|---|
| Empathy | Formal behavior |
| Reassurance | High level of biomedical questioning |
| Support | Interruptions |
| Encouragement of questions | Irritation |
| Friendliness | One‐way flow of information to patient |
| Courtesy | |
| Positive reinforcement of patient actions | |
| Psychosocial talk | |
| Increased encounter length | |
| Listening | |
| Orientation during physical examination | |
| Summarization |
In 2002, a systematic review of the existing primary‐care research was conducted in order to study the impact of the verbal and nonverbal behaviors of physicians on patient outcomes, including intention to comply, actual compliance, trust, quality of life, health status, and satisfaction (Beck et al. 2002). The findings are summarized in Tables 2.1 and 2.2.
Table 2.2 Nonverbal behaviors significantly associated with positive or negative outcomes during consultation.
Source: Adpated from Beck et al. (2002).
| Positive Outcome | Negative Outcome |
|---|---|
| Forward lean | Backward lean |
| Head nodding | Indirect body orientation |
| Direct body orientation | Crossed arms |
| Uncrsossed arms | Frequent touch |
| Uncrossed legs | |
| Less mutual gaze |
2.6 Marketing Dental Services
Clients have a choice about which veterinary practice to attend with their beloved pet and will often perform Internet searches when looking for a new one. This choice is not necessarily based solely on cost (Lue et al. 2008). Clients will often seek out practitioners with a special interest or particular qualifications in dentistry. It is therefore worthwhile advertising the full extent of your dental services: does your practice offer dental radiography, dental charting, surgical extractions, local anesthetic nerve blocks, or multiparameter anesthetic monitoring? The local clinic offering “budget dentistry” may well forego these vital items, but the client may not realize this unless you advertise it on your website or in a newsletter.
Consider having a waiting‐room display of the dental services you offer or the “dental pet of the month,” including a client testimonial of how treatment has improved their pet's well‐being. Client testimonials can be very motivating for others to read. If they can see their peers have had the same concerns as them but were ultimately pleased with the treatment outcome under your care, it can help to strengthen your message.
We are used to receiving dental check‐up reminders from our own dentists every 6–12 months, and this can easily become part of your practice reminder system. It is vital that clients understand that periodontal disease is managed and not cured by one professional cleaning. Regular check‐ups are vital, and veterinary nurses/technicians can play an important role in the ongoing preventative healthcare regimen. The efficacy of home care efforts can be monitored, advice can be given regarding adjunctive methods such as dental diets or chews, and clients' motivation for toothbrushing can be enhanced or renewed. This can also lead to increased overall practice‐bonding. Once individual treatment plans are agreed upon, reminders about dental checks and professional prophylaxis treatments can be sent.
2.7 Conclusion
Veterinary dental services are offered by nearly all small‐animal practices. When performed to current gold standards (WSAVA 2018), they provide a unique opportunity for improving small‐animal health and welfare, alleviating pain, increasing client bonding to the practice, enhancing practice profitability, and augmenting practitioners' own professional satisfaction. Communication skills are an integral part of this service, and can be learned and practiced just like any other clinical skill. You should challenge yourself to actively display empathy in every consultation. It can be a useful exercise to film a series of consultations with clients (obviously, with their explicit permission) and constructively appraise your own consulting communication skills. How did you come across (bored/angry/rushed/approachable)? Did you display empathy? Did you interrupt the client? By developing our communication skills, we can ensure that pets receive the correct dental treatment. After all, it does not matter how good our surgical extraction skills are if we are not given permission to anesthetize the patient.