Win-Win-Win: How Shared Decision-Making Benefits Pets, Clients, and Veterinarians
There’s a common notion that we need clients because pets can’t drive themselves to the veterinary hospital or pay their bills. And while this is often said in jest, it’s important to remember that clients are an asset—not an adversary.
Our livelihood is built on the human-animal bond and humans’ interest in and willingness to provide the best possible care for their pet companions. Shared decision-making (SDM) is a revolutionary step for veterinary medicine that combines veterinary knowledge with pet owner preferences to create a collaborative and mutually beneficial outcome for all.
What is shared decision-making?
SDM is a collaborative process that emerged from human medicine, in which “two participants—typically doctor and client—exchange information and preferences to reach an agreement on how to proceed.” In this scenario, “[a]greement is understood as a readiness to proceed with a certain decision, not necessarily as agreement that this decision was the best option.”
In SDM, decisions are guided not only by evidence-based information but also by the patient’s—or in our case, the client’s—informed preferences (i.e., their personal values and perspective about their pet).
A quick look at SDM data on the human side reveals impressive benefits, such as:
- Increased physician-patient trust
- Improved health outcomes
- Reduced malpractice claims
Shared decision-making benefits in veterinary medicine
When we apply shared decision-making to veterinary medicine, we are effectively inviting the client into an active role in their pet’s care conversation, and in doing so, we establish deeper relationships, prioritize the patient—not the outcome—and eliminate conflict and potential pressure by redefining what it means to make the “right” or “best” decision for the pet.
When we extrapolate the data from human medicine and combine it with the limited veterinary literature on SDM, the results suggest shared benefits for all involved:
- Clients feel seen, heard, and valued.
- Pets receive appropriate care and better outcomes.
- Veterinarians enjoy increased client compliance and less frustration. When more clients agree to recommendations, vets experience less burnout and compassion fatigue.
Redefining the gold standard—what’s “best” for every pet
In veterinary medicine, traditional decision-making involves the authority figure (i.e., the veterinarian) providing a list of treatment options—typically in order of prognosis or preference—and making a recommendation. In this model, clients may feel excluded from the conversation or, worse, pressured to consent or guilty for declining what is “best.” Veterinarians, in turn, may take rejection to heart, feeling that they are failing to provide gold standard care for their patients, or suffer from negative emotional backlash from clients (e.g., complaints, poor reviews, speculation about motives).
In SDM, the concepts of “best” or “right” become more fluid and less pressurized. By combining perspectives, the veterinarian and client uncover many valid options for every circumstance and can more easily reach an agreement.
Meeting in the middle—a shared decision-making roadmap
One common concern about applying SDM to practice is time—when veterinary teams hear the word “collaboration” they tend to picture laborious back-and-forth deliberations. But once you’re familiar with the process, SDM takes only a few extra minutes, especially when you use the three-talk model to guide the conversation.
- Team talk — This step lays the groundwork for SDM by conveying a team approach (e.g., “Let’s work together”) and your intention to help the client make an informed decision. During team talk, ask your client to describe their goals for their pet and then outline your goals (e.g., “Let’s consider all the options so that you can make a decision that suits you and Mr. Jingles”). Convey support and empathy as you outline their possible choices.
- Option talk — During this phase, you’ll outline any possible alternatives for the options you provided during team talk. This step may be informed by your client’s goals (e.g., “No heroic measures,” or “Keeping my pet comfortable”) and helps clients compare different options and weigh the risks, costs, and benefits.
- Decision talk — By this stage, clients are prepared to make informed, preference-based decisions that suit their needs and their pet. Veterinarians can encourage client reflection with open ended questions and prompts such as “Tell me what matters most to you when making this decision.”
Trust-building—create an environment where clients can share
Trust is the cornerstone for effective client communication—especially when you’re asking clients to share their goals, concerns, and opinions about potentially difficult topics like quality of life and prognosis.
Fortunately, you don’t need a long history with the client to establish trust and confidence. Here are some quick methods for conveying honest intentions, empathy, and support:
- Get curious — Curiosity can help you seek understanding without seeming intrusive or pushy. Genuine curiosity also conveys a friendliness and warmth which can relieve tension and soften the overall mood. Curiosity-based questions can help you pull out the client’s goals, abilities, and concerns.
- Listen well — When your client speaks, listen with the intent to understand—not respond. Give them your complete focus and use positive nonverbal body language. This will encourage them to express themselves without feeling rushed or ignored, and they will be more likely to answer thoroughly and honestly.
- Express empathy — Having empathy isn’t enough—veterinarians must demonstrate empathy through active concern, acknowledging the situation (e.g., “I know this is difficult”) and using open-ended questions to identify areas where the client may be struggling (e.g., “You seem upset, can you share what’s on your mind?”).
Results may vary—what to do when clients say “No thanks” to sharing
Some clients do not want the responsibility or involvement necessary for shared decision-making and instead prefer a traditional top-down approach—and that’s perfectly acceptable. In these situations, it’s important to communicate clearly to determine the client’s desires.
Ask the client specifically how involved they prefer to be and if they’d like you to weigh in on the decision. Although this approach is not truly a shared one, clearly defined roles can still ensure both parties reach an agreeable decision.
Shared decision-making allows you to assist your client in making the best possible choice for their pet without becoming unhealthily attached to the outcome. By merging the client’s preferences, outlook, and perspective with evidence-based information, you can be assured in knowing that you’ve done your best to shape an informed and thoughtful decision—while preserving your happiness and helping the client reach their goals.
Client communication is a vital veterinary skill, but its lessons are more often learned in the exam room than the classroom—resulting in frustration, decreased confidence, and a lot of trial-and-error.
Ready, Vet, Go Veterinary Mentorship helps new and early career grads hone these critical—but rarely taught—skills with practical tips, techniques, and coaching on key topics such as client communication, time management, practice culture, financial wellness, and preventing burnout. Get in touch with our team to discover how Ready, Vet, Go is more than an online course—it’s veterinary mentorship, elevated.