Most of you have probably heard the saying “the death of expertise.”

And if you haven’t heard about it, you’ve witnessed it every day in practice.  Clients come in with a diagnosis from Dr. Google long before they even step into the hospital.  They bring paper work from their breeders telling them under no circumstances to let their vet “sell” them on lepto vaccination because it will kill their pet. They tell us what medications they want before their animal has even been examined.

This isn’t just a veterinary problem, it’s happening everywhere.

Big Pharma is poisoning us to make a buck

Climate scientists are in it for the money

Lawyers are crooks (okay so that one’s not really new)

People today don’t trust “experts.”  They don’t trust us.  There are a lot of reasons for this, most of which I’ll leave to the sociologists.  But there is one reason in particular that I think resonates in veterinary medicine.


We’ve always been relatively powerless to the whims of biology.  People and animals get sick.  No matter how many advances there have been in modern medicine, we still keep getting sick.

This isn’t new; but add in all the new ways we feel powerless in our lives—powerless to the politicians who govern our society, powerless to the big corporations that rule our economy, powerless to Mother Nature and the ever-worsening natural disasters that cripple our cities; and people are grasping for any little bit of control they can get.

Sickness is scary.  And when the health of you or someone you love is at the whim of someone else, it’s even scarier.  I experienced this first hand last fall when I got sick.  I had stomach pain and nausea.  I could barely eat.  I lived off matzo ball soup and sherbet for two months.  I had ultrasounds, CTs, MRIs, and endoscopies.  I got no answers. And it took an awfully long time to get those non-answers.  I had to wait for insurance clearance.  The first available endoscopy appointment wasn’t for over a month.  Eventually I just got better, but for those two months I was miserable, not just physically but emotionally too.

I felt feelings I never want my clients to feel. I can’t protect them from biology.  Their pets are going to get sick sometimes.  But hopefully I can make them feel like they are more than just passive observers, waiting and hoping for me to give them all the answers. I want my clients to trust me, and to feel like we are a team, taking care of their pets together.

So what can we do to make out clients feel a little less powerless?

Create a repour:

Don’t be a stranger to clients.  Let them know who you are.  Of course, any of us who have been in general practice long enough have those favorite clients who come in on a regular basis, take great care of their pets and with whom we have established a relationship even above and beyond the medicine.  But that’s not the majority of the people we see every day.  Many of our clients are strangers to us, and we are to them.  The great news is that we have ways to let our clients know us, even before they’ve ever met us.  Social Media is our friend.  People can develop a relationship with the faces they see on Facebook and Instragram every day.  So let it be your face they’re seeing.  Let them get a glimpse into who you are as a person and a veterinary professional.

Get on their level:

No one likes being talked down to. Literally or figuratively.  The first thing I do when I enter an exam room is squat down and let the dog come up to me while I talk to the client.  Now this is good for the patient who gets to feel you out a little but that’s not all it does.  First, clients love it when you get down on the ground because it makes them feel like you care about their pet and aren’t afraid to get a little dirty.  But is also literally puts you down below them when you talk.  And at the end of the visit, when it’s time to talk about what’s going on, take a seat.  This makes it a conversation, one where the client feels included and not lorded over or condescended to.

Give them choices:

I know there’s some debate about this topic. And I’m not here to advocate for giving a client eight different treatment plans and letting them pick and choose, or even making certain diagnostics optional from the get go.  I’m talking about giving them a bigger choice—what are their goals for their pet.  When I have a really sick patient, that usually comes down to three things; we can go the whole nine yards; do a full work up, hospitalize, refer to a specialist.  We can treat palliatively and try to make the patient comfortable, or we can euthanize.  Giving a client these options before you come out with the $3000 treatment plan, lets them know that you’re not judging them and that you want to do what’s best for not only their pet, but their whole family.

We need to change the dynamics in our exam rooms to make clients feel more empowered and less defensive.

We need to break through the skepticism that’s holding them back from really trusting us. As long as clients feel like we hold all the power, they’re going to keep pushing back because skepticism and doubt is powerful. It lets them feel like they’re still in control. So maybe we should let them have that control because if we spend too much time getting caught up in this power struggle, no one is going to win—least of all, our patients.


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