Addressing Communication Challenges With Clients

Julie Churchill
DVM, PhD, DACVIM (Nutrition)
University of Minnesota
St. Paul, Minnesota, USA

Q. Why are nutrition conversations important?

A. Pets depend on their guardians for proper nutrition, and providing the right food and amounts is essential for supporting long and healthy lives. Given the implication nutrition has on pet health and well-being, client communication about nutritional management is a professional responsibility for the veterinary health care team (VHCT). Educating pet owners about nutrition, however, often presents challenges. Veterinary health care team members frequently report a lack of confidence in addressing nutrition topics, concerns about time constraints, or apprehension about potential controversy.

Q. How can veterinary health care team members use core communication skills to build client-centered nutrition conversations?

A. Building trusting relationships with clients enhances patient care, client satisfaction, and veterinary team success. The bond between the veterinary team and pet owner significantly influences client compliance. Shaw¹ outlined four key communication skills to strengthen veterinarian-client-patient relationships: 1) open-ended questions, 2) reflective listening, 3) nonverbal communication, and 4) empathy.

Open-ended questions, like “Walk me through the day including everything your pet eats,” gather crucial details efficiently while fostering trust. Nonjudgmental phrases such as “Tell me about,” “Describe for me,” or “What type of treats do they enjoy?” elicit the owner’s perspective and inform nutritional plans. Reflective listening, which involves clarifying responses, reassures clients they are heard and helps redirect focus if needed.

Nonverbal communication, including body language, facial expressions, and tone, is critical, especially during discussions on sensitive topics like nutrition. For example, positive words paired with closed-off gestures (e.g., crossed arms or frowning) may send mixed signals. Regularly checking for client understanding ensures clarity and alignment.

Lastly, showing empathy while focusing on education, rather than judgment of past decisions, builds trust. Using these communication strategies strengthens client relationships, fosters trust, and improves outcomes for pets and their owners.

Q. What framework can be used for nutrition conversations?

A. Just as the use of treatment protocols can help deliver the best practice of care, developing a nutrition framework will provide high-quality nutrition recommendations that are consistent between team members and become expected at every visit.

When every member of the team uses a framework to approach conversations about nutritional care of patients at each visit, this helps the process of creating a nutrition-focused culture in the practice as well as proactively creates the expectation that a pet’s nutritional needs will change throughout life stages and health conditions. It establishes the VHCT as the expert in their pet. Every visit should include a) a nutritional assessment to evaluate for risk factors as well as identify what is going well; b) a specific nutritional recommendation that includes specific food(s) and treats, amounts, and feeding directions; and c) a follow-up plan to evaluate and record outcomes. How the VHCT engages with clients impacts the outcome. Compassionate curiosity during the history provides a key understanding about more than the diet or food intake but also the environment, the client’s goals, motives, and abilities to carry out recommendations. 

Q. How to cultivate collaborative care and decision-making?

A. Benefits of shared decision-making, the approach where clinicians and clients (or patients) partner to discuss goals and options and make care plan decisions together have been well established in human health care. Recent studies have confirmed veterinary clients prefer collaborative decision-making regardless of type of appointment.^2,3 Elwyn describes an easy three-talk model to incorporate shared decision-making with clients.⁴ Implementing this communication model while using the core skills can optimize care and reduce communication challenges.

1. Team Talk—Start by using partnership-focused language, such as “we” or “let’s,” to engage the client in a collaborative conversation about their goals. Use team talk to provide support, present options, and foster a sense of shared decision-making. Always ask for the client’s permission before discussing options to ensure everyone feels comfortable and included.
2. Option talk—Checking a client’s understanding of their pet’s condition provides valuable opportunities to clarify information, discuss diagnostic and treatment options, and outline the pros and cons. Research in veterinary medicine shows that clients appreciate benefit-focused communication, especially regarding preventive care.⁵ The impact on their pet’s health and life expectancy was deemed the most important feature in deciding to act on treatment recommendations.^6,7 When discussing topics like a nutritional plan, emphasize the benefits it provides. Additionally, include a discussion of costs, present available options, and offer support for decisions made collaboratively. Always offer follow-up if the results are unexpected and the client wants to revisit choices.
3. Decision Talk—After discussing the options, elicit the client’s preferences and ask what matters most to them in the decision-making process. This approach helps them make informed, preference-based decisions. Support their choices and encourage them to revisit aspects of the options or decisions as needed, based on their pet’s response.

Effective communication about pet nutrition is essential for improving patient outcomes, building client trust, and fostering collaboration between pet owners and veterinary health care teams. By integrating core communication skills, adopting a structured framework for nutrition discussions, and employing shared decision-making models, veterinary professionals can address communication challenges, provide tailored nutritional care, and support pets’ lifelong health. This approach not only enhances client satisfaction but also reinforces the veterinary team’s role as trusted experts in pet care.

1. Shaw, J. R. (2006). Four core communication skills of highly effective practitioners. Veterinary Clinics of North America: Small Animal Practice, 36(2), 385-396.
2. Groves, C. N. H., Coe, J. B., Sutherland, K. A., et al. (2024). Clients prefer collaborative decision-making with veterinarians regardless of appointment type. Journal of the American Veterinary Medical Association. Advance online publication. doi: 10.2460/javma.24.06.0421
3. Janke, N., Shaw, J. R., & Coe, J. B. (2022). Veterinary technicians contribute to shared decision-making during companion animal veterinary appointments. Journal of the American Veterinary Medical Association, 260(15), 1993-2000. doi: 10.2460/javma.22.08.0380 
4. Elwyn, G., Durand, M. A., Song, J., et al. (2017). A three-talk model for shared decision making: Multistage consultation process. BMJ, 359, j4891. doi: 10.1136/bmj.j4891
5. Sutherland, K. A., Coe, J. B., Blais-Vaillancourt, K., et al. (2025). Veterinary clients prefer benefit-focused online communication while clinic websites uncommonly communicate benefits of preventive care services. Journal of the American Veterinary Medical Association, 263(1), 113-121. doi: 10.2460/javma.24.09.0568 
6. Davies, A. R., Sutherland, K. A., Groves, C. N. H., et al. (2024). Impact on life expectancy was the most important information to clients when considering whether to take action for an overweight or obese dog. Journal of the American Veterinary Medical Association, 262(6), 808-817. doi: 10.2460/javma.23.12.0697
7. Sutherland, K. A., Coe, J. B., Groves, C. N. H., et al. (2024). Information about life expectancy related to obesity is most important to cat owners when deciding whether to act on a veterinarian’s weight loss recommendation. Journal of the American Veterinary Medical Association, 262(6), 798-807. doi: 10.2460/javma.23.12.0703