Otitis externa: How to partner with veterinary clients for a successful outcome

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Client education is essential for success in veterinary practice. “Clients need (and usually want) to understand why we are managing their pet the way we do,” says James Noxon, DVM, DACVIM.

When it comes to ear infections, this couldn’t be more true. According to Dr. Noxon, the educational process starts on Day 1, the first time you see a client with a pet who is suffering from itchy, uncomfortable ears.

Here are his top five non-negotiables to include in that first exam:

1. Some basic information about the pathophysiology of otitis. This is crucial. It underscores the importance of following the therapy you are about to discuss. There are predisposing factors, primary causes (underlying factors), and perpetuating factors (secondary causes). Failure to address all the pathogenic factors will result in long-term failure and recurring disease.

2. Information about your plan for their pet. For example, you’ll identify secondary issues, treat those, then look for the underlying cause.

3. Diagnostic findings on their pet at the first visit.

4. Why the recheck exam is important and what will happen at that appointment. Explain that you’ll be repeating diagnostics, switching from a treatment plan to a maintenance plan and performing additional testing for primary factors.

5. The long-term picture of otitis.

It is helpful to use analogies when speaking to clients. Use an example like the building block concept to describe the pathogenesis of otitis, or an analogy of archeology to describe the layers of problems that are present with dermatological and otological diseases. These seem to really help clients understand the nature of otitis.

Use ear models for client education. Several companies have provided these to veterinarians in the past, so ask your reps for one! These help to demonstrate the L-shaped ear canal and help with discussions of procedures to administer medication. Another great tool to facilitate client education and communication is the video-otoscope. These instruments allow clients to see the changes in the ear canals and will definitely help to convince them that cleaning and medications are warranted. They also encourage client compliance when you show them positive results after cleaning or after treatment. The clinical effects of client education include better client compliance, more cooperative clients and better success. Everybody wins.