How To Avoid "Judgment" in Veterinary Care
By Pet Pro Supply Co. Featured Veterinarian,
Dr. Shadi Ireifej DVM DACVS
Co-founder and Chief Medical Officer at VetTriage
Veterinarians ought to offer their clients all options, including the very best and most expensive - and let clients decide for themselves.
Those who sell a product or a service will likely judge their clients or customers, regardless of whether they do this consciously or subconsciously (likely both). Let’s explore this seemingly surprisingly complex issue and its impact on veterinary care.
What we mean by “judging”
Being a veterinarian myself, I will focus this discussion towards and about veterinarians. Like it or not, veterinarians are salespeople. We sell products and we sell services. Our success comes from our clients purchasing such products and services. This is as true for the veterinary field as it is for any type of business.
We judge clients based on their appearance, mannerisms, words spoken and so on. We may do this consciously or subconsciously, innocently or maliciously, appropriately or inappropriately. Our pre-emptive judgment on clients then affects our actions and thoughts as doctors. For instance, doctors will hold off on offering certain products and services and push for other products and services based on this judgement. Since the majority of pet owners are not medically trained, most clients are unaware of what they are not being offered, or why they are being pushed towards other options. Further, because the pet owner is unaware, the doctor does not receive constructive feedback on their behavior; in this way, this cycle continues.
When we judge a client we make assumptions about whether they can or cannot afford products or services, and whether they want or don’t want these products or services. So when we judge the client, we not only have limited what their options may be for their pet, but we implicitly have already have made the decision for them, to a certain extent. We feel this is justified because our judgement of them is rarely, if ever, questioned; nobody calls out the veterinarian on the behavior. Additionally, there are typically no long-term consequences of this judgement so there is no reason to change the behavior.
Judging often comes in the form of assuming a client cannot afford available options. Judging also may come in the form of assuming a client will not or should not pursue a specific option for their pet because the medical provider wouldn’t perform such a procedure on their pet or utilize such a product on their own pet. I am confident there are other categories of judgement relevant in veterinary care, but these two are by far the most common types, in my experience.
The inherent problems with judging
Ignoring the obvious social implications of preemptive judgement on consumers, medically speaking, we eliminate the options from the pet owner when not all the options are being discussed. Meaning: pet owners will not be able to make a completely informed decision if all the options are not laid out in front of them as being equally plausible. We are making the decision for the pet owner, to a potentially significant degree, by withholding all fair options for them to consider regarding their pet.
Consequently, if the pet owner realizes at a later time that other options were possible, then mistrust, annoyance, anger and so forth may ensue towards the veterinarian or the clinic. Ethically and medically speaking it is also inappropriate to not make every plausible option available to the pet owner. These repercussions hurt the reputation of the veterinary clinic, the doctor and the staff involved. This also can hurt the veterinary profession as a whole, whereby the community will mistrust the lot of us.
Lastly, if the same consumer presents to the doctor some time later with another pet with similar concerns, and different options are presented to this particular pet than what were presented to the consumer previously to their other pet with similar concerns, they may question as to why this discrepancy exists. Since our level and type of judgements likely differ day-to-day or week-to-week depending on our mindset that day and other psychological factors, it is possible that you may offer the same consumer different options for the same medical concern at different time periods, and not be able to recall why. This is important because as doctors we are trained to act in a structured or even “algorithmic” manner. We are trained to proceed with an action the same way every time to minimize mistakes and maximize consistency and thoroughness. Judgement taints this ability because on any given day, your actions as a doctor will be influenced by it and therefore subject to inconsistency.
Not being a psychologist or even remotely trained in how the human mind operates, especially in the context of judgement and other similar “imperfections,” I can only expand on this from my own experiences as a veterinarian of over 15 years. So, although the solution being presented in this article may seem appropriate, the concept of judgement is a larger topic that would require a much deeper understanding of the human psyche and society as a whole.
With that being said, the solution to the problem of judgement in veterinary is straight forward: give all plausible options that are currently available for the pet owner regarding their pet, all the time, for every pet owner. The reason why this is straightforward is because of how doctors are conditioned, as touched upon above. If we, as medical professionals, are acting in structured or patterned manner every time to minimize error and maximize success, then offering pet owners all the fair options in every instance, despite the inherent judgments that will occur, is the solution to this problem.
In fact, had this train of thought been stressed in the training of veterinarians in veterinary universities, the issue of personal judgment would not be problem at all (or would at least occur with less frequency). If this training occurred to the same degree and intensity as training a doctor how to read x-rays, for example, then certainly judgment would be less of an issue.
Veterinary colleges and universities should take heed, and train veterinarians to avoid such biases or judgments that influence their medical decisions as well as the decisions of their clients.
The medical case is analyzed by the veterinarian and all options should be made available, specific to that case. No option is to be eliminated until the consumer eliminates an option or options themselves, for whatever reason or reasons they elect. Once the client is given all viable options specific to that case, they then choose what they agree to and what they do not agree to, with their own reasons. In this way, you, the doctor, will remain consistent, transparent and fair in all cases for all pet owners.
In my opinion, doctors’ judgments pertaining to clients are largely not malicious. I do believe that veterinarians judge because they are trying to save the client money or are trying to spare them from having to reluctantly decline an unaffordable option – and the guilt that may be associated with that. Or, perhaps the veterinarian feels it’s more time-efficient to not go through options they feel the client will not have an interest in pursuing.
Sometimes judging is performed with negative intent, however. Perhaps the veterinarian is tired or lazy and does not feel like going through all options because of the required time and energy. Or perhaps the veterinarian honestly does not know that other options exist for a particular case, and their actions lean more towards ignorance than malice.
Regardless of the known or unknown intent of judging a client, it should be eliminated from our thought process, as it not only affects the doctor’s decision-making but it also affects the decision-making of the client, and ultimately hurts the pet and potentially the reputation of your clinic as well as veterinary medicine as a whole.
Offer all fair and available options specific to that medical case, without judging the client and without entering your own opinion as a pet lover into the equation. Let the client make their own informed decision, and let’s keep our “judgy paws” off their decision-making!
About Dr. Shadi Ireifej:
Dr. Shadi Ireifej DVM DACVS is the Chief Medical Officer at VetTriage. He holds degrees from SUNY Binghamton and Cornell University and has practiced as a veterinary surgeon all across the United States. Follow him on Instagram @dr.shadi.ireifej and subscribe to his YouTube channel (Dr. Shadi Ireifej).
VetTriage is the world’s foremost provider of veterinary telehealth services. With VetTriage, pet owners have immediate access to triage advice from licensed veterinarians. Follow them on Instagram @vettriage and Facebook (facebook.com/televeterinarian).
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