Managing expectations: a vastly underutilised skill

In this article our Professional Conduct Department gives advice on how members of the profession can manage their clients' expectations from the very outset and how effective communication can prevent concerns being raised with the College.

Clinical prognosis is based on evidence, literature and personal experience and should evolve during a clinician’s career. It is often prompted by the client’s enquiry “Will s/he get better”.

In many cases it will not be possible to offer a definitive answer and managing the client’s inevitably optimistic expectations will be a prerequisite.

There are, though, a gamut of other expectations of a more mundane nature that also need to be managed, examples of which include likely on-going costs, out-of-hours arrangements, the need for and timing of follow-up examinations or telephone reports, other staff members that may have to take over the case, arrangements for euthanasia and for the disposal of a pet’s remains.

Veterinary surgeons who know how to manage expectations are able to more seamlessly navigate the sometimes choppy waters of the vet/client relationship.  Why? Because they anticipate their client’s needs and know how to communicate, organise, and direct conversations in a way that is easily understood by the client.

Client concerns raised with the College can arise when the veterinary surgeon assumes that a client knows what to expect or even what they're talking about. Assuming clients have understood the treatment options, plan, costs, prognosis or wider arrangements for their animal is dangerous territory.

You can avoid concerns being raised by having a conversation in which you openly discuss, in non-technical language, what is expected and how it might be accomplished.

Veterinary professionals should remember to encourage, and leave plenty of opportunity for, client questions. This is also the time to agree and explain what will be delivered by you or your team (the basic ingredients for informed consent).

The most common threads for the majority of concerns brought to the College’s attention are miscommunication or misunderstanding. Managing expectations at an early stage can ultimately avoid the stress and worry of a College investigation.

One of the best ways to manage expectations is to make sure you communicate with your clients on a frequent basis. The frequency will vary from case to case and from client to client. You may want to even over-communicate, so there is no misunderstanding.

In the early stages of a consultation the client may not have developed a level of trust in your ability to deliver, so better safe than sorry. 

Providing frequent updates for the client throughout the course of the treatment will give you the chance to provide real-time updates (clinical, prognostic and financial).

When you are proactively honest and transparent in your communication, you will have room to put a Plan B in place, if needed, or the flexibility to take new decisions, offer new treatment options or modify prognosis as the case evolves. 

A huge part of managing expectations is whether the actual expectation is realistic and achievable.  If not, you should reconsider the options and what is best for the animal (and the client).

The key here is to continuously assess and re-assess cases in a way that balances the animal’s welfare needs, the client’s wishes and resources, and also your ability to deliver these. Being open about what can be delivered and what the plan is can go a long way in instilling client confidence and co-operation. 

There is a gulf between being heard - and being understood.  Communication is not simply about the transmission of information, it’s about the reception and understanding of it too.