Shared decision making with animal owners
Shared veterinary decisions are made with the animal's owner, combining veterinary expertise with the owner's knowledge of the animal and ability to carry out care. Animal welfare remains the veterinarian's responsibility throughout that conversation.
Roles and autonomy
An animal cannot participate in treatment decisions as a human patient can, so shared veterinary decision making centres on communication with the owner. Veterinarians interpret animals' signs and behaviour and act as their advocates, with animal welfare a paramount professional obligation whether decisions are shared or not. Shared decisions and motivational interviewing may improve that advocacy, but their practical aim is better client communication; sometimes maintaining welfare is the best achievable outcome.
Owners contribute expertise about their animals, living and working environments and themselves, while veterinarians contribute medical expertise. Recognising client autonomy is particularly important when owners or farmers must perform treatment or preventive measures themselves. Dairy farmers should be recognised as professionals who understand their livestock. Owners’ financial, physical or emotional circumstances can rule out otherwise available choices.
In herd health, information alone may not lead to action: a cattle-health researcher found that some advice, including colostrum-feeding recommendations, was difficult to put across and turned to motivational interviewing to encourage practical change. In small-animal practice, a veterinarian found engagement with clients satisfying even when it meant making euthanasia less distressing for owners, and observed that older colleagues who enjoyed client relationships often seemed more resistant to burnout.
Communication models
The veterinary client relationship has been compared with the paediatrician–parent relationship, and some human medical interviewing models have been adapted for it. The Calgary Cambridge model, a 71-point framework adapted for veterinary teaching, has been used in communication-skills classes and recognised by the UK's National Unit for the Advancement of Veterinary Communication Skills. Veterinary client-communication models may draw more from psychology than from human medicine. The psychology of behavioural change is also relevant: many techniques evaluated for cattle veterinarians were originally developed to help people recovering from alcohol or drug addiction.
Options and practical concerns
Hypothetical consultation examples show how exploring an owner's circumstances can change the conversation.
- A diabetic cat and an owner with arthritic hands: if injections are impractical for the owner, vet and client may need to identify other options.
- A cat needing dental work: explaining why and how a procedure is performed, and asking about anaesthetic worries or difficulty returning to the clinic, may work better than simply instructing the owner to return.
- A herd with displaced abomasum: naming the problem, presenting options and asking what options the farmer sees can be better than demanding a change to recommended rations.
- An animal-welfare violation: asking whether the farmer knows the situation is unlawful and offering to discuss consequences may achieve more than demanding that it stop. If conversation cannot resolve such a situation, the vet may need to consider communication failure as one contributing factor.
Assessing outcomes
Client satisfaction may not distinguish shared decisions from other consultations: two veterinary communication researchers found high satisfaction irrespective of a client-centred approach, and veterinarians were also found to be highly trusted.
In preliminary herd-health research reported in 2023, farmers were 1.5 times more likely to talk about changes after consultations with veterinarians at least moderately skilled in motivational interviewing. Discussion is not implementation, although intent can sometimes correlate well with action, making the findings promising for possible improvements in animal health. Shared decisions may also improve adherence because owners are more likely to follow a regimen they helped choose.
An informal assessment of some veterinarians using the human-medicine Option5 tool produced mean and median scores around 50%–60%. A medical writer interpreted these scores as probably reflecting difficulty in scoring consultations, while suggesting that even some vets familiar with shared decisions might communicate more paternalistically than they realised.
Adoption, training and written communication
In 2023, veterinary communication researchers identified lack of time as a severe constraint on wider adoption, and questioned whether the profession's post-pandemic pressures made it a suitable moment for major changes. Telling professionals to abandon paternalism can itself sound paternalistic. Recent graduates had received training in shared decision making and motivational interviewing and could help spread it, but motivational interviewing might still require years of practice to master. Many older graduates probably had little formal client-communication training, and established paternalistic habits could be difficult to change.
Several veterinary practices had produced literature preparing clients for shared decisions by 2023, but this was not standard. Digital access to information may mean that owners already expect participation and recognition of their autonomy, reducing the need to introduce the approach as a new methodology. Farmers may not welcome an announcement that their paid consultation will use a new psychological technique.
Medical writers can communicate these approaches beyond the limited audiences of research publications. Two veterinary teaching programmes used actors as clients opposite vets or students, with professional actors able to portray dairy farmers convincingly at short notice. A medical writer proposed that writers might also act as simulated clients, while acknowledging practical difficulties.
Much veterinary interaction involves advice rather than a distinct treatment decision, and experienced veterinarians may already practise collaborative consultation without using the shared-decision-making label.