Culturally Competent Care

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It is important for veterinarians to deliver care without judgment and incorporate inclusive language throughout their practice. This extends to a communication style that meets the needs of every client, regardless of their background and knowledge. Adam Christman, DVM, MBA, of dvm360® Live, spoke with Marie E. Kerl, DVM, MPH, MBA, about ways to encourage community and inclusivity in the veterinary community.

Adam Christman, DVM, MBA: What does cultural competency mean to us?
Marie E. Kerl, DVM, MPH, MBA: In its broadest sense, cultural competency means we need to provide consistent, excellent veterinary care to all clients and pet owners, no matter where they’re from, what they look like, or their sexual orientation. We need to provide the same level of care for every pet. We also recognize in veterinary medicine that our profession does not reflect society in general right now and we’re working hard to try to correct that.

Christman: What is your team and network doing in the hospitals to help promote inclusive behavior?

Kerl: There is space for everyone to belong and show up as their authentic selves, which is the environment we are working toward across our 1000 locations. The first way we are doing so is associate resource groups. These are helping to build community, provide learning opportunities, and raise awareness around several issues impacting our associates. We currently have 5 of these groups: Pride for the LGBTQIA+ (lesbian, gay, bisexual, transgender, queer or questioning, asexual or allied, intersex community; the WISE (Women’s Initiative for Self-Empowerment) group for women; AAmbition, which represents Black and African American people; Latinx, which is for the Latino/Latina/Hispanic community; and Asian Community Empowerment, which includes (the Asian American and Pacific Islander populations).

These are led by associates, which is what makes them special. They have executive sponsors that focus on making sure the groups are moving forward. It’s also not just about being a member of that community; rather, we always welcome allies into these groups to support their colleagues and our associates. The associates in our hospitals continue to drive this change.

Christman: Do you feel it is important for pet owners to see that representation matters?

Kerl: It is important for clients, but even more so for our associates. Veterinary medicine is a team sport. You can’t be a full member of the team if you don’t feel like you are seen and heard as your authentic self, and your contributions are those that you can come in and provide.

Christman: What is inclusive language, and how do we incorporate it into our day-to-day activities and interactions?

Kerl: Inclusive language is very important. A small example is using pronouns, having pronouns displayed on name badges, and asking when someone comes in, “What do they want to use?” I think of inclusive language as aiming to provide the best care for our patients, including the clients in that conversation about what’s best for them, and providing the same care to every client. This means the same recommendations, no matter what that person across from you or next to you looks like or your perception of them. You must approach everyone as an individual.

Christman: Share some examples of microaggressions you have seen or heard about in veterinary medicine.

Kerl: These have been around for as long as society has existed and can be divided into different types: verbal, behavioral, and environmental. If I think about a verbal microaggression, an example might be, “Oh, you’re so smart for a woman.”

Behavioral microaggressions can occur if somebody is behaving in a way that is discriminatory or hurtful to a certain group of people. That might be a customer service representative who, if they have 2 clients in front of them, may always serve the client who is the cisgender person instead of the transgender person. Another example is them serving someone who looks like me as a boomer, as opposed to somebody who’s heavily tattooed or has piercings. It is an individual’s behavior, and they may not necessarily even know they do that. Rather, it is a pattern of what they do.

Environmental microaggressions are discriminations within society. One is a failure to provide language interpretation services or American Sign Language services. I think also about wheelchair users not being able to enter a facility easily to take care of their pet. Finally, there are several deserts across the United States where people don’t even have access to care.

Christman: Can you recommend additional resources to better educate our profession?

Kerl: All of us should seek out educational opportunities throughout our careers. The Journey for Teams resources from the American Veterinary Medical Association (offer) accessible inclusion training free of charge. Within the VCA, we have equity, inclusion, and diversity training included in all new associate onboarding modules, as well as for current associates. When I’ve gone through training for things like microaggressions, it points out errors I may not know I’m making. Having accessible, good-quality education is a great way to do that.

Just talking to one another is also crucial. While working in a practice, you can ask different people how they feel about things and what you can do to better support them. When I’ve had people reach out to me specifically with those asks, it’s been a bit surprising because I grew up in an era where that wouldn’t happen, but it is very touching that somebody cares enough that they want to know what my experience has been and if things are OK.