How to Talk about Pet Genetic Testing with Clients: Using a Narrative Medical History Framework to Gain Compliance
(click to watch)
Like many veterinary professionals, I like to tell a good story. Even better, our clients love hearing them. Studies confirm consumers prefer relatable stories that inform them over lectures and boring brochures to read.
I’ve used (and written about) narrative nutritional histories for years to educate and convince clients to adhere to my dietary recommendations. Let’s learn how to apply the basic tenets of a narrative medical history to teach our clients about the benefits of genetic testing.
📘 What is a Narrative Medical History?
Narrative medical history is a term used to describe using open-ended medical history gathering to facilitate storytelling by a client or medical practitioner.
These conversations are more natural for clients and allow veterinary team members to identify and investigate subtle client preferences and behaviors in a non-threatening manner.
It’s a friendly conversation, not a dueling debate.
💁 What does it have to do with genetic tests?
When presented with a new or unfamiliar product, service, or concept, clients naturally tend to be skeptical, stall any decision-making, and pause before committing. “Let me ask my spouse.” or “Can you give me some information to review at home?” are common responses.
I don’t blame them for hesitating. This self-preservation tactic has probably saved them money and regret in the past.
Some of the keys to successfully gaining compliance with “something new” is that the person must conclude that it is 1) beneficial (improves or enhances something), 2) has good value (cost is less than perceived benefit), 3) is safe and efficacious (does what it says without harm) and 4) it fulfills a need (solves a problem). There are other factors, but if you cover these essentials, your work is over 90% complete.
🐕🐈 What are the benefits of genetic tests in dogs and cats?
While we could write pages about the importance of genetic testing (and we have), let’s keep it simple for now.
Genetic tests provide you with insights into disease risk before symptoms develop.
A (seemingly) healthy kitten can be screened for diseases such as hypertrophic cardiomyopathy (HCM), polycystic kidney disease (PKD), bleeding disorders such as pyruvate kinase deficiency (PK), and any of the other 64 current genetic disease markers can be discovered with a simple saliva swab.
That bouncing bundle of puppy-ness can be screened for dilated cardiomyopathy (DCM), bladder stones, eye diseases, epilepsy and seizures, multi-drug resistance (MDR1), bleeding disorders such as von Willebrand, and over 200 genetic risk factors.
All before symptoms may occur.
In my opinion, as a veterinarian for over 30 years, genetic testing should be conducted on all dogs and cats as early as possible to identify potential health risks early, pursue mitigation measures to delay, minimize, or prevent disease, and educate clients on what to look for and expect.
So how do we convince clients to have their pets tested? A narrative medical history is one technique I’ve found highly successful.
💬 How does it work?
Obtaining a narrative medical history using a conversational structure only takes a few minutes, and the veterinary team member can get a more accurate assessment of the patient's activities, lifestyle, and family preferences in an inviting and nonjudgmental format. This technique often yields insightful information about the pet’s overall care and health, extending beyond the food bowl.
The general steps of conducting a narrative medical history are as follows:
- Conversation invitation – a broad, open-ended question that encourages a conversation and asks permission to proceed. Try open-ended questions focused on the pet's lifestyle, environment, and physical activities. While many veterinarians worry this type of question will result in time-consuming answers, few clients know how to begin.
Veterinary team member (VTM): “Are there any particular health concerns you have about Ginny? I know she’s young and healthy, but are there any diseases or conditions you worry about in her future?”
Client (C): “Oh, I don't know, I just want her to have a long, happy, and normal dog's life!”
- Pivot and acquiring trust – many clients are accustomed to closed-ended, “yes or no” medical inquiries. They simply don’t know and aren’t used to these sorts of queries. You may need to earn the client's trust by sharing your interest and care for the pet and asking a slightly more specific or tangential question, known as a communication “pivot.”
VTM: “I totally agree! We aim to help you provide the best care, so Ginny can enjoy a long, healthy life with you! Ok, for starters, she looks like she has some poodle in her. Poodles potentially have several genetic diseases, such as a form of blindness called progressive retinal atrophy (PRA) and a bleeding disorder named von Willebrand disease (vWD). Did you know we can test her for over 250 genetic risk factors with just a simple swab of saliva?”
C: “I had no idea. Ginny is the first ‘doodle’ I’ve had.”
VTM: “That’s ok; it’s our job to keep you informed of her health and ways to avoid illness!”
C: “Thank you! That’s why I’m here!”
- Active listening – an essential element of narrative veterinary medicine is attentive listening and allowing the conversation to progress naturally, rather than simply instructing, recording dictation, and not forging a personal connection.
VTM: “Do you have any questions about genetic tests for Ginny? Is that something you’d like to do today?”
C: “Just the usual: How much does it cost? Do you find many dogs are sick on these tests? What do we do if she has something wrong?”
- Elaboration – when needed, as the conversation progresses, you can ask for or offer clarification or elaboration on important points.
VTM: “Those are excellent questions. The cost for all the genetic health tests and breed analysis is only $X. The great news is that most of our patients have no serious hidden medical conditions, giving you peace of mind. For those that do, we do everything possible to delay, minimize, and treat as needed. We can potentially prevent some conditions if we act before symptoms develop.
For example, we recently saw a new patient that was a three-year-old mixed breed. Our doctor recommended genetic testing, and we found it was at risk for severe heart disease! We did additional tests to confirm that the heart was still healthy. Luckily it was, and our vet then started the dog on a special diet and supplements, and we’ll monitor it carefully to see if it needs any medications. The vet said because there weren’t any changes in the heart yet, we may be able to delay symptoms for years! The owners were relieved to know about the risk and happy they could take action and monitor now.”
C: “So happy for that dog! Let’s do it! I want to make sure I know everything possible about Ginny’s health!”
This medical communication technique encourages a more organic, genuine conversation than traditional closed-ended medical history questions. Allowing a client or staff member to tell their stories also yields more detailed, authentic information, allowing you the opportunity to provide more precise, personalized recommendations. It can be applied to a wide variety of clinical topics and helps foster more trust and collaboration between veterinary professionals and pet parents.