In our experience, practicing veterinarians tend to develop a “personal style” of consulting with clients that is rarely based on any form of rigorous analysis regarding its efficacy.  The same is true of paraprofessionals working with clients in the exam room (for example, in obtaining an initial history, presenting an estimate, or discharging a patient).   Despite a growing body of communication research in the veterinary field, many recommendations to improve communication are based on the anecdotal advice of “experts,” who are often seasoned practitioners.  While there is certainly value to experience in any endeavor, experience alone may be insufficient training in regard to communication techniques and could even serve to promulgate bad habits. 

Given the significant similarities between the MD-patient and DVM-client relationships, and the large number of empirical studies regarding human medical communication, there is much that we can learn from our human medical colleagues regarding evidence-based recommendations for improving client communication.  In the late 1990s Kurtz and Silverman reviewed the human medical communication literature and developed a detailed summary of specific communication skills validated by research and theoretical evidence called the Calgary-Cambridge Guide (CCG).³  Application of the CCG skills in human medical practice has been shown to improve:  1) client understanding; 2) client satisfaction; 3) doctor satisfaction; 4) accuracy and completeness of the medical history; and 5) medical outcomes.  The CCG has been modified over time and a number of organizations have adopted the guide as the underpinning of their communication skills training programs in the human medical field.

In the course of reviewing the large body of literature (mostly in the human medical field) regarding exam room communication skills, many experienced veterinarians would likely discover that they already utilize a number of evidence-based communication techniques, adopted simply through trial-and-error over years of practice.  There would, however, inevitably be room for growth, which might require “unlearning” some communication habits and adding new approaches.  For those desiring improved communication skills, the most effective approach is via live practice in a safe environment incorporating self-reflection and expert feedback.

Upon assuming leadership of the communications skills training program at the University of California at Davis School of Veterinary Medicine in 2010, Dr. Jim Clark set out to adapt the CCG to veterinary practice and streamline the guide to create a practical tool for both veterinary students and veterinarians. With the assistance and input of numerous

colleagues in both private and university practice, a brief, skills- and evidence-based guide was developed for exam room or field call interaction with clients based on the acronym “WISE COACH^®.” The acronym reflects the veterinarian’s desired role as a “coach” rather than an authoritarian figure, now referred to as “relationship-centered care.” It also recognizes, however, that the veterinarian has significant wisdom regarding what will be in the pet’s best interest.

The WISE COACH^® veterinary consultation guide can help veterinarians meet the challenges of today’s practice, which include heightened client expectations and growing financial, legal, and regulatory concerns.  The model includes important evidence-based communication tools from the CCG while providing a new, veterinary specific schema.  Over the past ten years, the WISE COACH^® model has been taught to veterinary students at UC Davis and veterinarians in practice.  The model has been repeatedly revised and refined, most recently by incorporating reminders related to the Fear Free® initiative, to foster greater patient and client well-being.