Client Communication: My Responsibility

We all have strong emotional ties to our horses. At the same time, we know that the cost of veterinary care can be a limiting factor in our decisions for our equine partners. When our horses are sick or injured their welfare is our first priority, but worry about associated costs also is a painful reality.

My job as your veterinarian is to communicate with you using compassionate yet straightforward language. By clearly explaining your horse’s problem, the treatment options and their costs, and the prognosis for recovery, I should help you balance your emotional response, and equip you to make informed decisions that are in your horse's best interest while also financially responsible.

Let’s consider Flash and Mary. Flash lives in a show barn. Mary is a very involved, experienced owner who juggles a heavy schedule, and often is unavailable for my visits with Flash. She values a complete and prompt report from me to keep her on top of developments and allow her to make appropriate decisions for Flash’s welfare. I appreciate these qualities because they reflect her concern for her horse and allow us to have an open, productive relationship.

Fulfilling Mary’s expectations was simple after suturing a facial laceration Flash sustained last year. I left clear, written instructions with Flash’s trainer followed by a phone call to Mary as I departed the barn, assuring her that Flash should recover uneventfully. More recently, Flash developed a lameness that is proving difficult to diagnose. Now client communication is a critical part of my obligation to Mary.

After my initial exam I explained the possible causes of Flash's lameness to Mary without overwhelming or confusing her, and then focused on laying out a specific, structured plan explaining how I would use diagnostic nerve blocks and imaging to narrow down these possibilities. This included a time line, and it addressed Flash's care during that time. I told Mary that should the diagnosis not become clear once this plan was completed, then we should consider a referral setting where more advanced diagnostics such as MRI, and a board certified lameness expert, would take the evaluation to the next level. We reviewed the cost of my work-up, and the costs associated with referral and advanced diagnostics, and discussed the risk-benefit of early referral vs following an initial diagnostic plan at home.

At this point, I asked Mary if she had any questions, and how she wanted to proceed. Mary expressed her confidence that her horse was safe and that with our well defined time line she was comfortable moving forward with the diagnostic plan at home. Currently we still have no specific diagnosis for Flash. I am consulting with a colleague who is an American College of Veterinary Surgery diplomate while Mary continues to balance the value of more advanced diagnostics against the cost, and Flash patiently waits as Mary and I navigate the course of his care together.