Effective client communications is the key to success in many professions, including the practice of veterinary medicine. While serving on the New Jersey State Board of Veterinary Medicine for nearly a decade, I was continuously surprised by the number of complaints filed against veterinarians for what amounted to a failure to adequately communicate with client. The care provided by the veterinarian usually met or exceeded the required standard of care, so the complaint could have been avoided if the veterinarian had ensured that what they had intended to communicate with the client was the information that was actually received.
Of course, in many cases it is difficult to obtain that goal, particularly when a beloved pet is critically sick or injured.
That is why a recently published study on topic was of interest to me.
Jane R. Shaw, et al. recently published “Outcomes assessment of on-site communication skills education in a companion animal practice” see J. Am. Vet. Med. Assoc. 2016:249:419-432.
The objective of the assessment was
“to evaluate veterinarian-client communication and veterinarian and client satisfaction with veterinary visits before and after veterinarians underwent a 6-month communication skills training program in a practice setting.”
The results as reported were impressive:
“After the intervention, appointments were 5.4 minutes longer and veterinarians asked 60% fewer closed-ended lifestyle-social questions, provided 1.4 times as much biomedically related client education, and used 1.5 and 1.24 times as much facilitative and emotional rapport communication, respectively, compared with before the intervention.”
By altering the quality of the communication, the veterinarians received more medically-relevant information from their clients, and both veterinarians and clients felt that enhanced communications benefited the pet being treated.
Adequate communication between veterinarians and their clients is not only considered a “core clinical skill” by the AVMA Council on Education while evaluating colleges of veterinary medicine for accreditation purposes, it forms the basis of requirements by most States for veterinarians to obtain informed consent from clients before providing veterinary services to their patients.
The AVMA approved a policy on informed consent in 2007.
“Informed consent better protects the public by ensuring that veterinarians provide sufficient information in a manner so that clients may reach appropriate decisions regarding the care of their animals.”
“Veterinarians, to the best of their ability, should inform the client or authorized agent, in a manner that would be understood by a reasonable person, of the diagnostic and treatment options, risk assessment, and prognosis, and should provide the client or authorized agent with an estimate of the charges for veterinary services to be rendered. The client or authorized agent should indicate that the information is understood and consents to the recommended treatment or procedure.”
“Documentation of verbal or written informed consent and the client’s understanding is recommended.”
States, including New York have disciplined veterinarians for failure to obtain informed consent.
Also, cases in several states have discussed the requirements for veterinarians to obtain informed consent from their clients.
In Lawrence v. Big Creek Veterinary Hosp., L.L.C., No. 6-2737, 2007 WL 2579436 (Ohio App. 11 Dist. Sept. 7, 2007), the court stated that the informed consent doctrine required for other medical professionals “is clearly indicative of the veterinarian’s duty of care.”
In Hines v. Alldredge, 783 F.3d 197 (5th Cir. 2015), the court cited Tex. Med. Providers Performing Abortion Servs. v. Lakey, 667 F.3d 570, 584–85 (5th Cir.2012) (Higginbotham, J., concurring) for the conclusion that “[t]he doctor-patient relationship has long been conducted within the constraints of informed consent to the risks of medical procedures, as demanded by the common law, legislation, and professional norms.”
In Emes Stable v. University of Pennsylvania, 1988 WL 33893 (E.D.Pa. April 4, 1988) the court discussed the requirement for veterinarian to obtain informed consent from clients which includes informing their clients of the “alternatives that a reasonable man such as the owner would deem significant in making a decision whether to undergo the recommended treatment.”
Whether to comply with state veterinary practice acts, or to prevent unwarranted complaints, veterinarians (and their clients) are best served when their communication skills remain a priority in their practice.
 As of November 2007, the AVMA discontinued use of the term “informed consent” in matters relating to veterinary medicine replacing it with the term “owner consent”.