Investigation of the effects of a practice-level communication training program on veterinary health-care team members' communication confidence, client satisfaction, and practice financial metrics.

OBJECTIVE: To investigate effects of an intensive 2-day practice-level communication skills training program (CSTP) with a 3-month follow-up communication in practice program (CIPP) on veterinary health-care team members' communication confidence, client satisfaction, and practice financial metrics. SAMPLE: 5 US companion animal veterinary practices. PROCEDURES: Following pilot testing at 1 veterinary practice, communication skills training was performed on-site at 4 practices. The 2-day CSTP focused on veterinary communication-specific content. The CIPP included in-practice training sessions every other week to reinforce and build upon communication skills. Team members' communication skills confidence (before and after the CSTP and after the CIPP) and client satisfaction with veterinary visits (2 months before and 3 months after the CSTP) were assessed with surveys. Practice-level financial metrics were collected for 18 months. Variables of interest were compared among time points. RESULTS: Measures of team member communication skills confidence and initiation of client conversations regarding the value of goods and services were significantly greater after the CIPP than before the CSTP. Composite communication skills confidence scores 3 months after the CSTP were positively correlated with the mean practice transaction charge and percentage change in the number of heartworm tests performed in the 3 months after the CSTP, compared with results for the same 3 months in the previous year. Measurements of client satisfaction were high before and after the CSTP. There was no significant change in financial metrics in the 3 months after CSTP, compared with the same 3 months in the previous year. CONCLUSIONS AND CLINICAL RELEVANCE: This study highlighted opportunities to increase veterinary health-care team members' communication confidence and identified future considerations for communication training in veterinary workplaces.

LGBT healthcare disparities: What progress have we made?

Nearly fifteen years have passed since this author's publication which examined the depth of education and training for medical students and practicing physicians specific to clinical competence in the care of lesbian and gay patients in the United States. Since then, there has been an explosion of research gains which have shed a steady light on the needs and disparities of lesbian and gay healthcare. This rich literature base has expanded to include bisexual and transgender (LGBT) healthcare in peer-reviewed journals. Despite these research gains underscoring a call for action, there continues to be a dearth of cultural competency education and training for healthcare professionals focused on clinical assessment and treatment of LGBT patients. This article will focus exclusively on the current status of medical and nursing education and training specific to clinical competence for LGBT healthcare. We are long overdue in closing the clinical competency gap in medical and nursing education to reduce the healthcare disparities within the LGBT community.

Disclosing medical errors: restoring client trust.

Discussing medical errors with affected clients can ultimately benefit your practice. This article provides tips on creating a protocol for resolving medical errors.

Impact of communication training on physician expression of empathy in patient encounters.

OBJECTIVE: To examine whether an educational intervention that focused on physician communication training influenced physician empathic expression during patient interactions. METHODS: This study used a quantitative research method to investigate the influence of communication training on physician-expressed empathy using two measures (global and hierarchical) of physician empathic behavior. RESULTS: The differences in global empathy scores in the physician training group from baseline to follow-up improved by 37%, and hierarchical scores of physician empathic expression improved by up to 51% from baseline scores for the same group. CONCLUSIONS: The results strongly supported the hypotheses that training made a significant difference in physician empathic expression during patient interactions demonstrated by both outside observer measures of global ratings and hierarchical ratings of physician empathic behavior. PRACTICE IMPLICATIONS: These findings have significant implications for program design and development in medical education and professional training with the potential to improve patient outcomes.

Are clients truly informed? Communiation tools and risk reduction.

Experience in human medicine has shown that clear doctor-patient communication can improve treatment success and lower malpractice risk. The authors apply the lessons learned from human medicine to veterinary practice and present communication techniques to help veterinarians and clients understand each other.

Addressing disappointment in veterinary practice.

Disappointing experiences are not uncommon in the increasingly complex setting of veterinary practice. Managing these situations requires that health care teams be sensitive to client disappointments; accept responsibility for engaging with clients to resolve them; and act ethically, sensitively, and flexibly to reach the best resolutions possible while learning from the experience to reduce the potential for recurrence. The reward for their efforts is an enhanced capability to rebuild rapport, trust, credibility, and loyalty after disappointments and adverse outcomes. Success should translate into a more satisfying practice that builds and maintains its client base and minimizes its liability risks.

The same but different: clinician-patient communication with gay and lesbian patients.

Surveys estimate that 3-6% of the patients seen by physicians are gay or lesbian. There are unique health risks of gays and lesbians that are important to the clinician in determining an accurate diagnosis, providing patient education, and arriving at an appropriate treatment plan. One of the most significant medical risks of these populations includes avoidance of routine health care and dissatisfaction with healthcare. Many of these healthcare risks are not addressed because of lack of communication based on a number of common assumptions including the assumption that the patient is heterosexual. This article includes a summary of the medical literature through computerized searches to March 2002 in MEDLINE, PsychInfo, HEALTHSTAR, and bibliographies in articles on health care with gay and lesbian patients. The search strategy included health care of gays and lesbians and clinician-patient communication, partner and family issues. Secondly, it will examine common communication barriers and provide strategies for enhancing communication with patients in a gender-neutral, non-judgmental manner including suggestions for enlisting the inclusion of patients' families.