Intercultural communication with clients

The Board has recently considered multiple complaints in which a complicating factor was English not being the client’s primary spoken language. Our investigations indicated that the client may not have understood the options presented by their veterinary practitioner well enough to be able to give informed consent to treatment or understand care instructions.

Victorians speak over 290 languages and dialects -27% of us speak a language other than English at home (VicHealth). The ABS reports up to 3.4% of Australians do not speak English well or at all.

With Australians having one of the highest rates of pet ownership in the world, along with our increasingly diverse backgrounds, it is also likely your clients will have attitudes, beliefs, values and behaviours which differ from yours.

There is a diversity of ‘cultural norms around animals, and animal use, as a source of companionship, food, entertainment and/or religious/cultural significance’.

Professor Jaime Gongora of Sydney University observes, ‘Cultural perspectives on animals and differences in communication, consultation and engagement protocols can influence relationships, impacting animal health [and] welfare…’.

Something that may be obvious to you may not be something your client would think about. Clients have different ways of showing agreement. People express grief and other emotions differently. They may have different perceptions and understandings of care, euthanasia, de-sexing and other veterinary procedures.

Making efforts to consider cultural and linguistic differences can help you to communicate effectively and build trust in your relationships with your clients. Where there is trust, a client may make greater efforts to understand and follow care instructions - enhancing animal health outcomes. While initially taking more time, investing in communicating effectively may reduce complaints to your practice and the Board arising from miscommunication, and ultimately generally enhance the reputation of your practice.

• Think about this particular client and what will help you to communicate information to them: what language do they speak at home and what is their cultural background? Are you going to be discussing complex issues with them or any veterinary procedures that may raise ethical concerns? Can the client bring someone with them who understands English better? Would using a translation technology help, bearing in mind that these may help you to translate words but not technical or cultural concepts? Will you need a longer consultation time?
• Demonstrate sensitivity and empathy and be non-judgemental.
• Avoid making assumptions, but focus on gaining an understanding and then to be understood.
• Be straightforward and clear but cover everything necessary. Consider non-verbal cues and the use of demonstrations to assist in understanding.
• Pause frequently and sense check: allow space for questions and answers and clarification. Get the client to repeat back to you what you said if necessary to check understanding.
• Supplement verbal explanations with written or visual information. Written care instructions, cost estimates for procedures and instructions for multiple medications may all help the owner to understand clearly. Consider getting commonly shared information professionally translated into other languages widely spoken in your area.
• It may help to delay the signing of consent information to give a client plenty of time to read and think about what they are being asked to sign and ask any questions before signing.
• Consider seeking assistance from those who speak languages commonly spoken in your practice’s area and share clients’ cultural backgrounds.
• Encourage your staff to learn about the demographic make-up of their local area, undertake cultural competence training and consider ways to create inclusive experiences for veterinary clients.
• Complete the Workplace Cultural Diversity Tool with your team and get involved with events like Victorian Cultural Diversity Week run by the Victorian Multicultural Commission

In closing, the Board's communication plans include reviewing our website and processes to increase our accessibility to diverse public and veterinary communities.

More information

• AVBC Day 1 Competency 25 - Communicate effectively with clients... using language appropriate to the audience and context.
• Cultural competence is everyone’s business: Embedding cultural competence in curriculum frameworks to advance veterinary education, Gongora et al, Journal of Veterinary Medical Education (JVME), Vol.50 No.1 2022
• Workplace Cultural Diversity Tool - Australian Human Rights Commission
• Cultural Diversity Week

Relevant guidelines

• Board Guideline - Behaviours and principles of professional conduct particularly 3.1 - A veterinary practitioner has due regard for the welfare, beliefs, perceptions, customs and cultural heritage of animal owners, veterinary team members and professional peers.
• Guideline 4: Communication between veterinary practitioner and owner or professional peers particularly 4.4 - A veterinary practitioner takes reasonable steps to ensure communication about the provision of veterinary services is clear, and understood by the owner and other individuals involved in the care of the animal.