Most practitioners I know have a love-hate relationship when asked, “What would you do if this were your pet?”
Some of us proudly boast that we answer this question honestly whereas others carefully sidestep and move the conversation in a different direction. Why is it that we feel compelled to dodge this question in the clinic, yet behind the scenes we’ll quickly offer our opinion off the record?
Perhaps, it is because we don’t want to skew an owner’s decision away from gold standard medical recommendations. Perhaps, it is because this question goes against the textbook way to approach a case. Or, perhaps, it is because we don’t actually know what we would do without truly being in their shoes.
As doctors, we are taught an algorithmic approach to diagnosis and treatment of disease. Whereas this approach provides gold standard care for our patients, it leaves out numerous factors that can drastically change what practically needs to be done.
As an emergency veterinarian, I am commonly asked this question by owners in high-anxiety situations, and for the most part, I will readily answer it — although my response is usually more of a non-answer answer.
How to answer the “What would you do?” question honestly
I am often faced with owners that bring their relatively healthy pet into the ER; maybe their pet only vomited once or it was limping after playing at the dog park.
After discussing the gold standard recommendation of radiographs, bloodwork, or other appropriate measures, the owner will usually ask something along the lines of “Look, I understand what you’re saying, but if this was your pet, would you really do all those things?”
Situations like this usually get a response from me of “Well, to be honest, if this was my pet, I wouldn’t be that concerned or wouldn’t have even brought them in.”
This is met with an exasperated sigh and an unspoken tone of “I knew it, you’re just in it for the money.”
Hold on, let me explain.
“If this was my pet, I wouldn’t even be worried or be at the ER because I can do a physical assessment at home. I can take into account recent history and other variables that normal owners may not have considered. This knowledge allows me to decide whether I am worried or not worried.
I can also monitor my pets for worsening signs, understand symptoms that may merit further diagnostics, and have the ability to medicate my pet as necessary with safe over-the-counter medications or with a quick trip to the clinic. These factors allow me to understand my situation very differently than you and are why I’m trying to now place you in my shoes.”
Even with the knowledge and access we have as veterinarians, I’m sure we have all been guilty of bringing our pets into the clinic for diagnostics “just to check” or “just to take a peek under the hood.”
I’ll be honest, one time I came home after a rough shift and my dog just seemed off. Even though my physical exam was unremarkable and I should have “known better” that he was fine, he went to work with me the next day for bloodwork and an ultrasound to be sure. The drive for peace of mind is at times irrational, yet, it is incessant and persistent.
Client communication in difficult situations
Often we will avoid answering the question as to not skew the owner’s decision because we all know too well that emotions are part of the equation and it’s ok for “irrational” decisions to be made if it indulges their need for peace of mind.
And that’s ok. I often tell owner’s this story to help them feel more comfortable with decisions as they debate the “what ifs” before running more diagnostics.
The harder response to this question is when we are faced with end of life situations, to which I respond with the following. First, I offer them the story of when I had to euthanize my heart dog. And second, I tell them that “whatever decision you make today, trust me when I tell you it is the right decision, and that I will support you through it.”
Building trust through honesty
I think if more veterinarians would answer this question honestly, it would highlight the importance of our physical exam, history taking, advice, and knowledge that owners are paying for!
Even if owners elect for “just” the consultation and leave without diagnostics/treatments/etc, they are likely to feel more comfortable having paid for a piece of mind and an algorithm of what to do next if XYZ occurs.
So while I may answer the question in not so certain terms, I also give them the knowledge and tools to answer that question themselves. I’ve found that owners are very receptive to understanding you have truly put yourself in their position and are giving an honest opinion. Sometimes we treat the pet and sometimes we have to treat the owner.
At the end of the day as long as I have a stable, happy animal and a content, educated client, I go home smiling knowing that I provided the best possible care for each individual pet.
Michelle Clancy, DVM, MPA is an Associate IndeVet practicing in Virginia.