Faith in learning and the consult room - Veterinary Practice
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InFocus

Faith in learning and the consult room

Dr PAUL MANNING
reports on a recent meeting
organised by the Veterinary
Christian Fellowship to look at
what the Bible says about work
and other aspects of our lives

THANK God it’s Monday. Why do you go to work? What, how and why do you do your work? What is your work ethic? The Veterinary Christian Fellowship (VCF) is a relatively small organisation in terms of numbers of members in the veterinary profession, but it has relevance to its membership and to the wider veterinary community. The VCF decided to hold the first of a series of CPD meetings built on looking at what the Bible has to say about work, and exploring some topics that practitioners are involved in for a large part of their working lives. The first of these meetings was held in a delightful venue in Milton Keynes at the Cricket Pavilion with beautiful scenery and surroundings, ideal facilities, refreshments and lunch. After we had all arrived and introduced ourselves, Brian Aldridge (VCF president) started off the day with prayer, followed by some interesting study of what the Bible has to say about work. Work is what God has called us to do for His Kingdom. God is a worker who never tires. In our work we should be thinking about what, how and why we do is a reflection of the glory of God because God has created us and given us this responsibility after making us in his image. Brian discussed some of the complexities of the work ethic with reference to the Bible. Issues included the divine mandate of work: God is a worker and man also is a worker, finding creativity, fruitfulness, meeting his and his family needs and the needs of others through work, and finding protection from distractions. The greatest commandment is, “You shall have no other gods before me.” In working out our daily lives, work, ethics and morality, living in the fear of God is a challenge to us as we work in the field of serving our clients and patients. We have a privilege to work in such a noble profession in which we have responsibilities of stewardship for ethics, care, example, leadership, money management and working with real costs, connecting through communicating with the emotional and practical needs of our clients and patients. We have the choice of working purposefully and authentically.

Choices and challenges

So we do have choices to make, clinical decisions to make, and for many practitioners we are communicating with these challenges for at least half of our working lives. I engaged the delegates in a mixture of presentation, video demonstrations of live consultations, and interactive discussion during the day about the skills we use and need in the consulting room. The theme “From death to new life” reflected the various types of consultation, starting with bereavement, through medical and surgical consultations to the excitement of the new-born puppy or kitten and vaccination. Handouts included biblical references from Brian, and the PowerPoint presentation from me, together with a handout on consultation models and some visual aids for use in the consulting room illustrating, for example, the effective dental recommendation. Reflection was encouraged as much more than simply navel gazing, but needs to include a wide-ranging and in-depth review of “What is going on here in the consultation?” The presentations and discussions were designed to provide tools to use together with an evidence base to encourage and stimulate reflection so that the learning outcomes for the delegates could be achieved and transported back home with them. Tools included in practice discussions about consultation skills and communication aided by a flip chart, video recording of live consultations using constructive critique, the use of consultation models and rating tools, use of key performance indicators and developing links from the care in the consulting room to the business and qualitative indicators of performance. This helped to illustrate which are the most important approaches and questions to ask clients in following up cases, from a surgical operation such as cruciate ligament surgery in the dog for an example which does have both short-term and long-term implications for the patient. Being embarrassed about what the practice charges is a feeling that was explored in quite a few discussions, indicating a concern in this area from the delegates, so it was interesting to hear that the discipline of following up a case of cruciate surgery which the vet may have referred for a £4,000 operation was not rigorously followed up afterwards, but may be as a result of the greater understanding and appreciation of these issues from this day. The principles of consultation skills were illustrated with the use of structures in models of consultations so that the value of this professional activity could be appreciated. It is challenging to be faced with the issues of value for money when doing such noble and valuable work, but veterinary practice has always been a business with bills to pay to sustain the business and the service provided.

Relevance of the teaching

The Bible says a great deal about money, and also about care and communication, e.g.: the parable of the talents – use your money and skills wisely; the parable of the widow’s mite – although this lady gave just a tiny coin, she had given of herself because that was all she had; the parable of the shrewd manager – do good things and make friends whilst on earth, because earthly people have great difficulty understanding the ways of a higher purpose. Among other examples: “A good man cares for his animals, but the kindest acts of the wicked are cruel” – Proverbs 12: 10; “A good name is more desirable than great riches: to be esteemed is better than silver or gold” – Proverbs 22: 1; “He who answers before listening, that is his folly and his shame” – Proverbs 18: 13. Modern research has shown that there is a golden minute” of listening at the beginning of a consultation when a great deal can be achieved through proactive listening, taking time to gather the case history and client concerns, and the results are more effective medicine with better time management. The vet-client consultation is a very complex process, and lots of things happen and have to be dealt with in what is usually a 10-minute time scale, or in some cases a 15- minute period allocation. The skills needed are also complex and challenging, but the tools and evidence illustrated in real ways how these can be recognised, learned and improved. There was a great deal in this day of value to Christians and non Christians, vets, practice managers and others involved in delivering care where people interact. Vet students would also find this very helpful as consulting is a major part of most practising vets’ days at work. Acquiring a greater understanding of the complex interactions of ethics, business, people and clinical issues here can be of significant benefit. Indeed, consultation skills are a unique selling point for the clinician, and are a set of skills that cannot be delegated.

Challenges and responses

In Paul’s letter to the Thessalonians (2 Thessalonians 3: 6-15) we are warned against idleness. We are told that some among us are idle busybodies, but we are commanded to set an example and treat these busybodies as brothers and to discipline them whilst we never tire of doing what is right. Our focus should be sharp in our delivery of care through our consultations. All our work is in vain if it is not for the Lord (Ecclesiastes). We have a wonderful mission in our workplaces. Challenges in the workplace include resourcing and explaining and integrating the business with caring through the consultations. Some clients refuse to pay for what are reasonable demands for services provided, and not all practice team members play their part with the same strong motivation and commitment. Veterinary care is what vets uniquely provide, and whether that is in small animal, farm or equine practice, the vet has the important role
and duty to use the clinical and nonclinical skills wisely and effectively. Brian encouraged everyone to reflect on how they could use the learning from the day to practise their faith and work together for the glory of the Lord.

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