The Art of Private Veterinary Practice

Considering all the years of education required to become a veterinary practitioner, it is understandable that Dr. Scharf considers himself a reasonable man, capable of objectively analyzing any situation and coming to logical conclusions based on the evidence.

“After all,” notes the veterinarian, “In addition to all that coursework, I also worked as a research assistant and know all about the proper collection and analysis of data.”

Dr. Scharf ’s associate, Dr. Costello, possesses similar credentials and also a similar view of her objectivity, as does their client, Dr. Plant, a well-respected musicologist. However, just hearing the musicologist’s name makes both veterinarians bristle.

“If he thinks he’s objective, he’s totally deluded,” declares Dr. Scharf with a bitter laugh. “I’ve never known anyone who spends so much time in la-la land.”

“You can’t convince him or his wife of anything they don’t want to be convinced of, even if the scientific data is right in front of them,” adds Dr. Costello.

It does not require a crystal ball to divine that the veterinarians have difficulty communicating with these particular clients. Nor does it come as any surprise that these clients consider communicating in what they consider an objective manner with the veterinarians equally unrewarding.

“Those two vets are nice enough, but some of the things they want to do to the dog make no sense to me at all.” Dr. Plant tells his wife.

“I know, Dear,” replies his wife. “But most of the time, I think they have Spotty’s best interests at heart. Just tune them out like I do.”

So who is to blame? For those who desire to assign blame, it rests with neither the practitioners nor their clients. It rests with the way our brains process data. Even though we may claim to process information with the cool objectivity of Star Trek’s Dr. Spock, this does not represent the way the normal brain works. Quite the contrary, incoming data get processed by emotional and memory centers before we make any conscious response.

From an evolutionary perspective, the survival advantage this gave early humans is clear. When danger arose, those who instantly responded to fear and any memories of predators had an advantage over those who paused to consciously consider whether the predator actually existed, what kind of predator it was, and/or how best to respond to it. Only after sufficient humans survived and created societies in which people had the opportunity for more time-consuming conscious analysis did such analysis play a role. Even so, great thinkers throughout history have acknowledged that what passed — and passes — for conscious reasoning is actually a process of rationalizing our emotion-based biases. The creators of the scientific method hoped to eliminate this bias, but while the method theoretically may do this, it in no way guarantees that the interpretation of any results will not be biased.

Because veterinary medicine is not the only profession whose members are likely to be plagued by communication breakdowns with their clients or others, researchers in multiple disciplines explore this phenomenon referred to as “motivated reasoning.” A sampling of scholarly articles on the subject may be found at: http://scholar.google.com/scholar?q=motivated+reasoning&hl=en&btnG=Search&as_sdt=1%2C30&as_sdtp=on

Not surprisingly, those who want or need others to support their views have the most to gain by recognizing the role motivated reasoning plays. While images of political or religious proselytizers immediately come to mind, Dr. Scharf’s desire that the Plants get the excess weight off their dog or Dr. Costello’s push for biannual dental prophylaxis may strike their clients as bordering on messianic zeal. Meanwhile, the Plants’ resistance to their recommendations may strike the practitioners as completely irrational.

“I’ve showed them the data on the relationship between obesity and disease every time they bring the dog in and they refuse to see it!” fumes Dr. Scharf.

“If I suggest dental prophylaxis to Dr. Plant, I can practically feel him tense up. Then he gives me all kinds of lame reasons why he doesn’t want it done,” adds Dr. Costello. “His wife is much more pleasant, but in her own way she’s as resistant as he is. I just don’t get it because they’re both well-educated.”

Dr. Costello’s comment brings us to another characteristic of motivated reasoning revealed by studies of the subject: education has little to do with reason. This occurs because the more educated people are, the more studies they can seek out to support their particular views. As a result, their education can entrench them even more deeply in their emotionally biased beliefs. On the other hand, someone who lacks this educational exposure may view those same studies and their results with less bias.

“I don’t believe it,” says Dr. Scharf only half-jokingly. “It doesn’t make any sense.”

To understand how this works, let us consider a non- veterinary example often used by those who study motivated reasoning — climate change — about which the more conservative Dr. Scharf and the more liberal Dr. Costello disagree. Regardless which studies each practitioner cites to prove the validity of his or her position, the other counters these by citing studies that prove the opposite view. Put another way, and in spite of the fact that both of these individuals consider themselves well-educated, trained objective scientific thinkers, when it comes to this particular subject they see and hear only what they want to see and hear.

“Does this mean we should just throw in the towel when it comes to clients whose bias makes it impossible for them to understand our point of view?” asks Dr. Costello.

Not necessarily. As neuroscientists have learned more about the way the brain processes data, they also have explored ways to get around embedded emotion-based bias, some of which may be beneficial to veterinary practitioners.

Step one is to admit that, seemingly New Age philosophy or not, we do create our own emotion-bias views of reality which serve as the lens through which we perceive the world around us. Just recognizing this enables Drs. Scharf and Costello to eliminate much of the negative emotion that currently suffuses their interactions with clients like the Plants. This is important because otherwise the existence of those negative emotions will color their interpretation of everything their clients communicate to them. In such a way, motivated reasoning becomes linked to the self-fulfilling prophecy. The veterinarians expect the Plants to resist their dietary and dental recommendations and, as a result, become so wedded to this perception of reality that they miss signals that this may no longer be the case.

The second step is to present the desired material in a manner that complements rather than antagonizes the clients’ belief structure. If clients believe that practitioners are deeply entrenched in a particular view, this also may mean using a different source to present the same material.

Consider this alternate scenario: Dr. Costello knows that Ms. Plant is actively involved in community projects involving young children and the elderly. The veterinarian calls Ms. Plant and asks if she would be willing to critique proposed programs that combine walks and appropriate exercises for overweight kids or senior citizens overseen by volunteers and their dogs.

In such a way, the veterinarian reframes her relationship with the client. At worst, Ms. Plant will see Dr. Costello as someone with whom she shares a common interest — the welfare of young children and senior citizens in their community — as well as someone who values her opinion. At best, Ms. Plant will volunteer her own and her dog’s services to this worthy cause and the former canine couch potato will get more exercise. Any positive emotions that result from these activities may then cause her to view dental prophylaxis more favorably, too.

“Seems like an awful lot of work to me,” says Dr. Scharf.

But that is his interpretation based on his emotional bias. Unlike his associate, he has little interest in the kind of human-animal bond activities that she enjoys. As a result, what she sees as a fun project whether the Plants and their dog participate or not, he sees as not worth the effort — until Dr. Costello reframes it for him.

“What’s more important? That the Plants do what we tell them to do when and how we tell them to do it? Or that they get the excess weight off Spotty and pay more attention to his dental hygiene?”

Here again, how another responds to reframing remains a function of their own emotions and beliefs. It may be that Dr. Scharf would resist the above remarks if they came from the much younger Dr. Costello. On the other hand, were his wife or his fishing pal to make the same observation, he immediately might see the “logic” in the argument.

But regardless which way practitioners choose to view these and other client interactions, just recognizing that this is, indeed, a choice will do much to improve communication, because it is that recognition that keeps the door open to greater understanding.