How Do I Say…?: When clients lie about preventive dosing

Q. Our doctors and technicians struggle with how to respond when we ask history questions and clients say they still have preventives, but our records show they do not. How can we have honest discussions instead of confrontational conversations?

Photo: Natalia/Adobe Stock

A. Although most clients are honest, some may lie or provide incomplete answers for many reasons. They may fear being judged, want to please their veterinarians, have an aversion to being lectured, or desire to be seen as good pet owners. To avoid the embarrassment of not knowing how often they give preventives, clients may invent answers. Embarrassment also is an extension of guilt, causing them to claim they gave doses as instructed.

Don’t call out clients for lying because you may trigger defensive attitudes and shut down communication. Criticizing pet owners will break trust in the veterinary-client-patient relationship. You risk losing clients and opportunities to treat patients.

Here's how to encourage honest discussions:

Prepare for wellness appointments. Review the patient’s medical record and identify gaps in adherence to care plans. You may see that a dental treatment was recommended last year but was never scheduled. When checking product purchase history, you may find the client bought 6 doses of preventives 12 months ago but didn’t refill the remaining 6 doses. Knowing adherence gaps upfront will help technicians and veterinarians fix them during today’s appointment. Sending online wellness appointment forms with confirmations also allows clients to answer history questions in advance. Your medical team can read answers before appointments, letting you zero in on follow-up questions and saving 10 to 15 minutes of history taking.

“Prep work is one of those simple things that often gets lost in the chaos of a busy day,” Ryane E. Englar, DVM, DABVP, associate professor at the University of Arizona College of Veterinary Medicine in Oro Valley, wrote in her book A Guide to Oral Communication in Veterinary Medicine.¹ “We can set ourselves up for success before we even enter the consultation room if we take the time to prepare. You would not sit for a test, cold. You would study first. Each consult is a test that can either make or break a client’s relationship with the practice. ”

Establish trust at the beginning of appointments. Introduce yourself, shake hands, maintain eye contact, make personal connections, and keep notes about clients’ hobbies, careers, and families—details that make you relatable and a valued advisor.

Small talk—even for just one minute—builds rapport and creates a comfortable and trusting environment. This leads to better communication, improved understanding of concerns, and may improve patient care. Casual conversations let you connect with clients on a personal level, whether a shared sports team or hobby.

Relationship-centered interactions let veterinarians engage clients in a partnership of care, improving client adherence to recommendations and increasing positive patient outcomes, advises April A. Kedrowicz, PhD, an associate professor of communication at North Carolina State University College of Veterinary Medicine in Raleigh, advised in an interview with Today’s Veterinary Practice.² She advocates 4 communication skills to promote trust: open-ended inquiry, reflective listening, nonverbal cues, and empathy.

How you ask matters. The close-ended question of, “Do you give your pet heartworm disease preventives?” may provide incomplete answers. Instead, ask, “Which heartworm disease preventive do you give your pet, and when did you give the last dose?”

Pet owners who consistently give doses will immediately tell you: “I use <brand> and give it on the 15th of each month.” If clients hesitate before answering, this may indicate inconsistent dosing, another caregiver administers medications, or they may assume a flea/tick product also protects from heartworm disease. “Tell me more about…” is a nonconfrontational way to get them talking.

Approach the situation with empathy and kindness. Empathy is the ability to understand and share the feelings of others. Gently question inconsistencies while emphasizing the importance of honesty for pets’ well-being. Say, “We both want <pet name> to be protected from heartworm disease and parasites. <Pet name>’s medical record shows that you purchased 12 doses of <brand> 18 months ago, which indicates there may have been six months without protection. We know clients sometimes miss or forget a dose occasionally. It’s easy to forget—I’ve done it myself. Did you buy preventives elsewhere or miss doses?”

If the client explains he is buying preventives from an outside pharmacy, you have an opportunity to win back the business and the client’s loyalty. Share benefits of buying medications from your practice. Say, “Our hospital offers competitive prices and has safe, guaranteed drugs that we buy directly from pharmaceutical companies. <Drug name> has a $__ instant rebate when you buy 12 doses from us. We can refill the medication today, or if you prefer home delivery, we can help you place your first order through our online pharmacy. Which do you prefer?”

In another scenario, the client shares that he is giving preventives left over from a deceased pet. Express empathy for the loss of the pet and then ask about the medication. Say, “We were honored to have cared for <deceased pet’s name> and know you loved and cared for him/her. Let me check the medical record to confirm the dose is the correct size for <current pet name> and the expiration date of the medication. We both want <current pet name> to be protected from heartworm disease.”

Don’t trust “guilty” body language. Clients may avoid eye contact, fidget, and nod dutifully in agreement. Nonverbal clues are unreliable, Jeffrey Knuppel, MD, a psychiatrist in Lancaster, Wisconsin, said in an interview with Physicians Practice, a dvm360 sister publication.³ “Lying comes naturally for some people. The truth may cause them more anxiety.”

It's easier to read clients if you’ve treated their pets for years. It may be harder to interpret expressions or tone of voice in conversations with new clients or those who you’ve only seen a few times.

Run lab tests for revealing answers. If your standard of care is to perform an annual heartworm/tick test, you can assess patients’ health and reinforce the medical necessity of testing and preventatives. Say, “It’s OK to share if you are unsure whether you missed a monthly dose. We will perform a heartworm/tick test today. If the test is negative for heartworm disease, we will renew the prescription so you can safely restart medication. We also will help you remember to give the dose every month with a text/email reminder. We want to be your partner in protecting <pet name>."

Fix compliance breaks with proactive reminders and callbacks. Relying on clients to remember to refill medications is unreliable. Just as your practice sends vaccine reminders, send refill reminders.

Set up dosing reminders in your practice information management software or third-party reminder service. Include action buttons, which increase click-through rates by 15 percent over hyperlinks.⁴ (Table) Lead clients’ actions with positive choices of dose given, remind me later, and change reminder date. If clients choose “remind me later,” set up an automation so another text is sent the next day.

If clients fail to refill preventives, call them. As part of morning tasks, client service representatives will run a report of patients whose preventives were empty or expired as of today. Because the daily callback report is short, it will be manageable and easy to consistently complete.

In this scenario, the client bought 6 doses of preventives and is eligible for a refill of the remaining 6 doses. If you talk to the client, say, “Dr. <Name> asked me to call you because <pet name>’s prescription for <brand> for flea/tick, heartworm, and intestinal parasite prevention is now overdue. We don’t want <pet name> to be at risk for parasites. Dr. <Name> has approved your refill. Do you want us to refill the medication for pickup at our hospital, or shall I text you a link to order through our online pharmacy with home delivery?”

Use the veterinarian’s name to bring credibility and authority to the conversation. Reinforce the medical necessity of parasite protection. Rather than ask, “Do you want a refill?” lead pet owners with the yes-or-yes technique, asking if they want to get medications at your hospital or through your online pharmacy.

If you get voicemail, leave this message: “Dr. <Name> asked me to call you because <pet name>’s prescription for <brand> for flea/tick, heartworm, and intestinal parasite prevention is now overdue. We don’t want <pet name> to be at risk for parasites. Dr. <Name> has approved your refill. I am sending you a text now. Let us know if we should refill the medication, and you will pick it up at our hospital. The text will include a link to our online pharmacy if you prefer home delivery. If you have questions, text or call us at 555-555-5555.”

When your team talks with clients about use of parasite preventives, remember that you both want the same result—the best medical care for their pets. Honest discussions will help you achieve that goal together.

Need a script for a client conversation? Submit your scenario to info@csvets.com for consideration in future columns.

Wendy S. Myers, CVJ is best known as the “Queen of Scripts.” She knows the right words will lead clients to accept your medical advice, driving patient and practice health. As founder of Communication Solutions for Veterinarians, she teaches practical skills through online courses, conferences, and onsite consulting. Wendy’s experience as a partner in a specialty and emergency hospital helped her understand issues that owners and managers face. Learn how Myers can train your team at csvetscourses.com.

REFERENCES

1. Englar R. A Guide to Oral Communication in Veterinary Medicine. 5m Publishing; 2020.
2. Kedrowicz A. Enhancing veterinarian-client relationships with competent communication. Today’s Veterinary Practice. December 8, 2023. Accessed April 1, 2025. https://todaysveterinarypractice.com/personal-professional-development/enhancing-veterinarian-client-relationships-with-competent-communication/#.
3. Schwartz S. When patients lie to you. Physicians Practice. August 23, 2010. Accessed April 1, 2025. https://www.physicianspractice.com/view/when-patients-lie-you
4. Data on file. Otto. Accessed April 1, 2025. https://otto.vet