Veterinarians overestimate client compliance
Posted May 15, 2003
Millions of U.S. pets aren't receiving the best care and treatment available, according to a nationwide study by the AAHA evaluating pet owners' compliance with veterinarians' health care recommendations.
The findings, announced during the AAHA annual convention in Phoenix, showed that compliance levels were lower than veterinarians expected and that the biggest obstacle to compliance was the veterinarians' own misconceptions about pet owners' willingness to follow their recommendations.
AAHA Executive Director John Albers presented key findings of the study March 24 during the association's general session. "What do we mean by compliance?" he asked. "Simply stated, are the pets that see a veterinarian on a regular basis actually receiving the care that that veterinarian and the veterinary professional believe are best for the pet?"
The AAHA commissioned the study in 2002. Among the participants were more than 350 veterinary practices throughout the country participated through interviews and medical records reviews. The goals were to determine compliance levels, quantify opportunities to provide better health care for more pets through compliance, and understand the barriers to compliance and what to do promote compliance.
"What we found was that compliance in practically every practice that we looked at in the study was lower than the veterinarians in those practices believed it was," Dr. Albers said. Most veterinarians in the study guessed at their compliance level and most guessed wrong, he added.
Compliance is a multifaceted issue, beginning with the veterinary professional's recommendation, follow-through by the practice team, and finally, client acceptance. Not surprisingly, the study showed that compliance rates correlated with the rate of staff involvement.
Nearly every practice in the study would substantially increase the level of compliance simply by having the practice team follow up. Sometimes, it was as simple as asking clients whether they wanted to make an appointment at the time the recommendations had been made.
Compliance is essential to a patient's health and well-being. For instance, the study found that 11 percent of dogs in areas considered heartworm endemic had not received a recommendation for heartworm testing; 23 percent of dogs and cats with grade 2 or higher dental disease had no recommendation for dental prophylaxis; 27 percent of dogs and cats with medical diagnoses that could have been helped by a therapeutic diet did not receive such a recommendation; 53 percent of dogs and cats considered to be of senior age did not have a recommendation for any kind of senior screening or diagnostic testing; and 13 percent of dogs and cats were not in compliance with their veterinarians' recommended vaccine protocols.
Seventy-eight percent of surveyed veterinarians said they were satisfied with compliance. Of those, 63 percent believed their clients' compliance was high—which isn't the case, according to Dr. Albers.
A majority of veterinarians believed cost was the biggest barrier to compliance. As a result, in many cases, they based their recommendations on what they perceived as the client's degree of interest or willingness to pay for those treatments. Another concern was that too many recommendations would cause clients to feel the veterinarian is trying to sell his or her services.
Included in the study is a sampling of responses by pet-owning families, which revealed a marked contrast between veterinarians' perceptions and reality. Seventy-five percent of owners agreed or strongly agreed that veterinarians make recommendations because they feel it is good for their pets. Only 10 percent agreed or strongly agreed that the recommendations are motivated by profit.
For pet owners, the main barrier to compliance was not cost; they simply had not remembered or not known about the recommendation, or it had not been explained well. Cost was a factor among only 7 percent of pet owners concerning dental care, 4 percent for therapeutic diets, and 5 percent for senior diagnostic screening.
"While our perception as a profession is that a lot of the clients' problems are due to their unwillingness to pay, the clients are telling us something directly opposite," Dr. Albers said.
Complete results from the compliance study, along with a guide for improving compliance, are being published by the AAHA. "We believe at AAHA that we have a responsibility to improve compliance," Dr. Albers said. "It's not just the client's responsibility."