The barrier of “the back”

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The obvious role of veterinary professionals might inherently be to give patients the highest quality of care. However, by purely focusing on this notion, the quality of attention we offer our human clients might subsequently be overlooked. The idea of veterinary medicine, although not unfamiliar, is still a fairly foreign concept to many. As a result, the fundamental conceptions of veterinary professionals, financial responsibilities, and humane decisions could be difficult to grasp, ultimately leading to controversial or even inaccurate perceptions of this field.

The development of the veterinarian-client-patient relationship needs a strong level of communication and is crucial to cultivate trust, but it can be rushed into a brief appointment window. The standard practice, especially after the COVID-19 pandemic, has drifted to bringing pets to “the back” to complete procedures in a quick and uninterrupted manner. While this may be the easiest process to attain some quick lab work or X-rays, is it the most beneficial process for the visit as a whole? While it productively handles the patient, does it leave clients out of the loop and consequently heighten tough discussions?

Erik Zager, DVM, DACVECC, co-department head at Philadelphia Animal Specialty and Emergency, elaborated that the concept of bringing animals to the back stems from “the feeling that people won’t understand what we’re doing – it can look distressful or even be distressful, but is necessary.” Pet owners’ sole purpose is to provide their pets with the highest level of comfort, which means providing the best type of bedding, the tastiest looking treats, or the most prestigious collection of toys. As veterinary staffs, our sole purpose is also to provide pets with the highest level of comfort. However, this now means giving multiple boosters of vaccines, holding them safely for IV injections, or soothing their cries while they get their blood drawn. Although our intent is identical, the general perception of this purpose drastically differs as our positions change.

While Zager initially thought that protection against hospital liabilities meant shielding clients from tougher situations, his stance began to change as he practiced in an emergency hospital in Hong Kong that allowed visitors 24/7. He realized that practicing under the public’s gaze, although daunting at first, helped the clients better visualize the entire medical process. Zager learned that this mixture of detailed diagnostic demonstrations and the team’s attentive care better justified the cost of treatment and the quality of care than any verbal reassurance could.

Tannetje Crocker, DVM, a practice owner and an emergency veterinarian at the Veterinary Emergency Group echoes this sentiment with a memorable experience. Two human specialist clients watched in awe as she explained the labs and ultrasounds, performed a belly tap, identified the intracellular bacteria on the microscope, and walked them through the diagnosis.

“In our world, there isn’t one person that would do everything that you just did,” Crocker recalled the owners saying, and further explained that “the way we have to be versatile is really different.” Because she works in an open-concept hospital, Crocker highlights the efficiency of the workflow, where “owners see what you’re talking about before you say it, and process things as you’re doing them.”

In her experience, “clients watch many shows like Grey’s Anatomy, and understand the idea of interns, residents, and senior doctors.” When it comes to training new graduates or staffs in public, Crocker explained that making it “intentional” allows the “clients to see it as being collaborative, building a community of support rather than distrust.”

Erica Brandt, CVT, VTS (ECC), from WestVet 24/7 Animal Emergency & Specialty Center, acknowledges that “the defensiveness about [keeping clients out of] the back can create a barrier or wall in the relationship between us and clients. Clients think we’re hiding something when we really should be embracing and showing off our skills.” While Brandt advocates for this method of increased transparency, she also poses a few crucial factors that should be accounted for.

“Most humans are not equipped to handle that type of trauma,” Brandt explained, “so clients must have abundant opportunities to realize and opt out [of this experience],” For example, Brandt would consider secure areas for clients to exhibit private emotions, make personal decisions, and say goodbye. Although most pre-existing hospitals are not built to demonstrate this level of transparency, perhaps the effort of continuously aiming for it is enough to show clients our dedication.

Brandt, like many veterinary professionals, still struggles with financial conversations, saying “it’s hard to come across as compassionate and talk about money all the time.” Even if Brandt is foreign to the open-hospital concept, the value of transparency and being upfront is something Brandt aims for daily. While some hospitals are not built to show off every step of the diagnostic process, Brandt does believe that celebrating achievements publicly and providing ample support for staffs to perform confidently sets the culture of the staff’s working environment and the tone of the client’s trust.“ We are already professionals that have a big heart and want to do a great job. If we can provide the basic need and support to get them excited to come to work… the majority of veterinary professionals are great people that just want to do great things.”

While our purpose as veterinary professionals are still to nurture and protect animals, it is equally as important to nurture and protect the connection with our clients as well. Transparency not only increases the exposure of clients to the veterinary field, but also defends the hard work, care, and love each member of this community has for our patients. Whether it is being more verbal with walking clients through the entire process or explicitly showing the collaborative efforts of doctors and technicians behind the scenes, it seems the idea of shielding clients in fear of public misconception might end up being counterproductive as clients are implementing veterinary care into their daily lives.