Bedside Manner: Why It’s So Important In Veterinary Medicine

Lots of people talk to animals. Not very many listen, though. That’s the problem.  ~ Benjamin Hoff, The Tao Of Pooh

Bedside manner. It’s one of those terms probably more easily defined by what it isn’t, rather than by what it is. Like charisma, you know it when you see it. And when you don’t.

The Cambridge dictionary defines bedside manner as “the way a doctor behaves towards people being treated to make them feel comfortable, especially showing kind, friendly, and understanding behavior.” Most people would agree that a doctor’s bedside manner is just as important as his or her ability to provide quality medical care.

A few years ago when I started experiencing mysterious and escalating bouts of stomach pain that left me in a fetal position and incapacitated for days at a time, I finally went to see a (supposedly) highly-respected local Gastroenterologist for help. The doctor put me through a battery of tests that included an ultrasound, barium study, and colonoscopy, only to meet with me 2 weeks later to tell me that all my test results were normal, so there was “nothing he could do.”

After bluntly delivering this statement, the doctor began edging towards the exam room door, obviously strategizing his escape. When I asked him what the next steps were, he stated (with his hand already on the doorknob and with a great deal of annoyance) that, quite frankly, there weren’t any. Because they hadn’t found anything obvious, it was probably IBS (Irritable Bowel Syndrome), and since the only known drug on the market for treating IBS had just been recalled by the FDA for causing permanent heart damage in users, “his hands were tied.”

When I politely stated that I was aware IBS wasn’t an actual disease, but a generic term used whenever the medical profession didn’t know what was actually causing a GI problem, and that there had to be other avenues we could try, he looked me straight in the eye and said flatly that I. Was. SOL. Unless I wanted to try another drug with a laundry list of side effects that, by the way, also caused severe abdominal pain and cramping in almost every patient who used it (that’s funny, isn’t that why I was there in the first place?) But hey, he would get me a few samples. As he ran out of the room and down the hallway like he had just been told I had Ebola, he threw over his shoulder that I needed to make a recheck appointment and come back in 2 weeks. A recheck for what, exactly, I never found out, since I left that day and never went back.

All of this would have been humorous if it weren’t so pathetic. As it turned out, I had a food sensitivity to wheat and dairy (which I discovered myself after trying a food-elimination diet for 4 weeks, something the doctor failed to suggest). Once I got rid of those foods in my diet, the painful bouts of gastric distress were completely eliminated and haven’t returned since.

So with regard to bedside manner, I think it’s fair to say that, in my humble opinion, this doctor’s bedside manner was so lacking that if it were possible for me to assign it a negative number, I would. I just can’t fathom looking into the eyes of someone who is in that much pain and literally begging for help, and being so completely unconcerned and apathetic to their suffering.

Bedside Manner, From Your Pet’s Perspective

Now imagine for a moment you’re an animal. You’re sick and in a great deal of pain, not sure if what’s going on with your body will ultimately kill you or just leave you permanently disabled, and to make matters worse, you’re unable to communicate what’s wrong and where it hurts to anyone around you. Being an animal, you’re instinctively stoic, an evolutionary survival mechanism that has served you well when you’ve needed to hide any signs of weakness or illness that could make you more vulnerable to predators, but in this case only serves to mask your illness until it’s all but unbearable.

Your caretaker realizes there’s a problem and takes you to the veterinarian. Once inside the door to the waiting room, you’re immediately overwhelmed by a room full of strange sights, smells, and sounds. People whom you don’t know are touching you, poking and prodding and doing unusual things (some of which make you hurt even more). Then, the ultimate terror – you’re carried “into the back”, away from your guardian and towards heaven only knows what.

How important do you think bedside manner would be to you at that moment?

Why Good Veterinary Bedside Manner Is So Important

When our pets are subjected to poor bedside manner, they don’t get offended, or indignant, or disappointed – they simply get scared. Think how far out of their natural element they are at the veterinary hospital, when they’re already sick and hurting, asked to “be good” when their natural instinct is to immediately revert to self-preservation mode. It must take a herculean amount of effort for them to override their natural impulses and not 1) immediately flip out and attempt to climb the walls of the exam room in a frantic effort to get away, or 2) bite someone’s face off. We really are asking a tremendous amount from them in this situation.

That’s why it’s so important for veterinarians and veterinary technicians to have the ability to communicate compassion and impart a sense of calm, protection, and trustworthiness to their patients. Veterinary professionals must be able to forge, in the span of mere minutes, a bond that enables them to gain if not their patient’s entire trust, then just enough to allow them to accomplish what needs to be done without bloodshed or permanent emotional trauma (for both parties). And they have to be able to do all of this without the use of verbal language.

What Does “Good” Bedside Manner Look Like?

All good veterinary bedside manner starts with empathy, the ability to understand and share the feelings of another creature. In order to possess empathy, a person must be able to read and observe nonverbal cues: actions, gestures, and facial expressions (all of which apply to animal patients as well as human ones). Although a large portion of empathy is innate, new studies show that it can also be learned – which human medicine is now taking advantage of with innovative empathy training for doctors.

Veterinary professionals who are deeply empathetic are able to tap into a level of communication with animals on a whole different level than those who are unable to relate empathetically with their patients.

Good bedside manner also involves a confident but extremely gentle touch. This includes using a soft and caring vocal tone, slow and deliberate movements, and the knowledge of when to back off. Using forcible restraint on a pet patient who is not cooperating is certainly easier, because it’s faster – you don’t have to wait for the pet to calm down. But when a veterinary professional takes the time up front to make sure the patient is feeling secure and less threatened, it not only avoids trauma and negative associations for the pet, but also makes it easier for them to be treated in the future.

Bedside manner extends beyond the patient to the pet parent as well. All veterinary professionals know that an informed and knowledgeable pet parent is much better equipped to provide the best care possible for their pet. Therefore, your veterinary team should always take the time to explain what they are doing during an examination, fully answer all of your questions, and provide education on preventive healthcare as well as on any medical conditions your pet may have.

How Veterinary Medicine Is Working To Improve The Patient Experience

Fortunately, veterinarians are now taking bedside manner even further and studying how they can continue to improve the experience of pets during vet visits, from the patient’s point of view. The Fear-Free^TM initiative, led by Dr. Marty Becker, is an innovative program that teaches veterinarians how to create low-stress environments and techniques to treat not just the physical well-being of their patients, but their emotional state as well.

Some of these groundbreaking techniques include:

• Spending as little time as possible in the waiting room. Since the waiting room is often one of the more stressful parts of a visit to the vet, check-ins can be conducted directly in an exam room, or in a separate holding room away from other pets. If this isn’t possible due to space constraints, waiting rooms can be made more pleasant by including natural barriers such as plants, or shelves that can be used to place cat carriers on so they’re not directly on the floor.

• Having separate exam rooms for dogs and cats. Exam rooms can be customized specifically for either dogs or cats to reduce the amount of strange smells in the environment. Each room can incorporate calming music, colors, and pheromones specific for that species. Even the temperature in the rooms can be carefully controlled (since cats prefer warmer temperatures than dogs).

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  Creating a sense of calm in the exam room. Ideally, this can be done by having veterinarians and technicians already in the room before the pet enters, avoiding direct eye contact with the pet, using a soft and soothing voice, having a nonslip surface on exam tables, and providing treats to pets during the exam.

• Being flexible on where, and how, patients are examined. Instead of just hoisting a dog or cat up onto an exam table, whenever possible pets can be examined on the floor with a yoga mat or blanket, on the owner’s lap, or for cats, directly in the carrier with the top removed.

• Treating emotional well-being as equally important to physical well-being. It may take a little more time, but examining a pet only after he or she is calm (a mild sedative can even be used if the patient is particularly stressed) will ensure a less traumatic vet visit and a pet who may be much less anxious the next time around.

Seeing Life From The Patient’s Point Of View

Perhaps the most important aspect of good bedside manner is simply seeing life from the patient’s point of view. Doctors often get so caught up in the science of practicing medicine, sometimes they unintentionally neglect the art of it.

When it comes to your pet, make sure that your veterinarian’s bedside manner is a good one. This will make your pet’s life easier and less stressful, communication between you and the doctor more effective, and will greatly improve the overall quality of your pet’s health care.

To quote the author Harper Lee in the classic novel To Kill A Mockingbird, “You never really understand another person until you consider things from his point of view – until you climb inside his skin and walk around in it.”

Our pets deserve nothing less.

How important is bedside manner to you when it comes to your pet’s veterinary care? Have you had any experiences that are particularly good…or not so much? Please share your stories with us in the comments below!