Petconsent December 2020 blog - Do vets and pet owners want to share decision-making?

Posted on: 18 December 2020 by Dr Carol Gray, ESRC Postdoctoral Fellow in the School of Law and Social Justice. in Blog

Carol Gray's workshop powerpoint slide asking 'Do vets and clients want to share decision-making?'
Title slide from Carol Gray's workshop, 8 December 2020.

This month, Carol Gray's Petconsent project looks at shared or collaborative decision-making. Our final blog of 2020 looks back at the end-of-project workshop that took place on 8th December 2020. Thirteen participants, including vets, vet nurses and animal owners, spent an afternoon on-line discussing shared decision-making in the vet clinic.

We started with a short presentation on the differences between consent (simple and informed) and shared decision-making. We then analysed the type of decision-making that was shown in a video (a clip from a TV programme) of a consultation, arriving at the conclusion that we hadn’t seen enough to judge whether the decision was truly shared between vet and dog owner. This raised some excellent discussion points regarding the use of new treatments, and the fact that shared decision-making does not mean handing full responsibility to the owner, with no support. In fact, some of the group preferred the term ‘supported decision-making’ rather than ‘shared decision-making.’ However, as the former term is used when talking about those who have lost capacity to make their own decisions, it was felt that we should stick with ‘shared’ – although a further discussion on social media has produced ‘collaborative’ as an alternative, still to be decided!

'Purr-tual workshop' - photo by Chris Barbalis on Unsplash.

A chance to discover what the participants viewed as the biggest barrier to shared decision-making in vet practices revealed ‘time’ as the most popular culprit. We’ll come back to that later. Other suggestions included the vet’s values or ethics, the vet feeling that their professional opinion was most important, or the vet failing to find out the client’s concerns or failing to pick up on cues. Also mentioned were ‘client factors’ – the client not having enough knowledge to take part in decision-making, and the power imbalance between vet and client preventing sharing.

Our second presentation looked at a review of human medical research on shared decision-making to try to clarify what prevents and what encourages the sharing of decisions between doctors and patients. The group discussions that followed this focused on which of these factors also apply to vet practice. Time, again, was a popular factor in both limiting and allowing shared decision-making. Also popular were continuity of care, getting shared decision-making into vet education more generally than just in communications training, moving away from the idea that there is one right decision for each condition, and supporting newly graduated vets to be confident enough to share decisions with clients.

Post-It notes on a white board

Photo by Daria Nepriakhina on Unsplash.

Finally, we asked participants to think of one thing that they would change to enable more shared decision-making in practice. This revealed some interesting suggestions. Of course, there were a few related to time – for example, 20-minute consultations as standard; other suggestions included more effective use of the vet nursing team to get to know clients, perhaps having vet nurses conduct part of the consultation, changing the culture in vet practices to allow authentic partnership between vets and clients and removing the judgmental approach to colleagues and clients.

We have decided to take the group forward to carry out further work on this type of decision-making and its potential for changing the whole approach to the vet-client and vet nurse-client relationship (or perhaps more neatly, the vet practice-client relationship).

If anyone is interested in joining the group, please contact me.

 

Carol Gray

Dr Carol Gray is an ESRC Postdoctoral Fellow in the School of Law and Social Justice. After qualifying as a veterinary surgeon from the University of Glasgow, Carol spent 15 years in clinical practice. A career change to veterinary education included 13 years in the veterinary school at the University of Liverpool. Completion of a Masters in Medical Ethics and Law from Keele University laid the foundations for an obsession with informed consent in general, but particularly in the veterinary context. Carol was awarded her PhD from the University of Birmingham in 2019 and now holds an ESRC Postdoctoral Fellowship here in the School of Law and Social Justice, where she is developing the ideas from her thesis and bringing together consent and shared decision-making in the veterinary clinic.

As part of her ESRC Fellowship, Dr Carol Gray has been researching and writing monthly Petconsent blogs since December 2019.

Find out more about Carol's Petconsent research, which also includes a resource list of health information for pet owners

Email Carol at: carol.gray@liverpool.ac.uk