Client compliance is a cornerstone of effective veterinary medicine. It is the extent to which a pet owner’s behaviour – administering medication, attending follow-up appointments, implementing dietary changes -corresponds with the recommendations agreed upon with the veterinary team. Despite its importance, studies consistently reveal a significant gap between the care veterinarians believe they are providing and the care pets are actually receiving. The 2003 American Animal Hospital Association (AAHA) Compliance Study, though dated, remains a landmark piece of research, highlighting that millions of pets were not receiving optimal care due to non-compliance. More recent data from 2024 and 2025 confirms that this challenge persists, and may be exacerbated by economic pressures on pet owners and distrust of scientific authority.

A wealth of research demonstrates a direct correlation between the quality of communication during a consultation and the likelihood of a client adhering to the care team’s recommendations. The traditional, paternalistic model of veterinary medicine, where the veterinarian acts as the sole expert and the client as a passive recipient of information, is increasingly being replaced by a more collaborative, relationship-centred approach. This approach, which has its roots in human medicine, acknowledges that the client is the expert on their pet’s day-to-day life, and their values, preferences, and circumstances must be taken into account when developing a treatment plan. Shared decision-making is a key component of this model, where the veterinarian provides the client with all the necessary information about their pet’s condition, the available treatment options (including the pros and cons of each), and the associated costs, and then works with the client to co-create a plan that is both medically sound and manageable for the client.

The benefits of this approach are numerous. Studies have shown that clients who are actively involved in the decision-making process are more likely to be satisfied with the care they receive, have a stronger bond with their veterinarian, and are more likely to adhere to the agreed-upon treatment plan.

The Calgary-Cambridge Guide is a widely recognized, evidence-based framework for structuring a medical interview. It provides a clear, step-by-step guide to the consultation, from initiating the session and gathering information to explaining and planning, and closing the session. The guide places a strong emphasis on building a relationship with the client and demonstrating empathy. While originally developed for use in human medicine, it has been widely adopted in veterinary education and practice.

Table 1: The Calgary-Cambridge Consultation Model applied to mobility consultations

Stage	Key objectives & tasks
Initiate the session	Establish a positive rapport with the client. Clarify how they perceive their pet is doing.
Gathering information	Explore the mobility issue from both a clinical and client perspective, using CROMs to support as appropriate. Understand the context and impact of the problem on both the client and patient.
Physical examination	Perform a thorough physical examination including gait analysis. Explain to the client what you are doing and share findings to build their understanding of your perception of how the pet is doing and align expectations for the next steps
Explanation and planning	Provide clear and understandable information about your assessment and the options for the next management stage, including pros, cons and costs. Involve the client in shared decision-making to create an agreed plan.
Closing the session	Summarise the consultation and the agreed plan, including the next touchpoint/review (ideally, arrange this before the client leaves). Provide a “safety net” by explaining what the client should do if they have further concerns or if the patient’s condition changes.

There are a number of practical techniques that can be used in the consultation room to improve client compliance:

• Active Listening: This involves paying close attention to what the client is saying, both verbally and non-verbally, and then reflecting back what you have heard to ensure that you have understood correctly.
• Open-Ended Questions: These are questions that cannot be answered with a simple “yes” or “no,” and they encourage the client to share more information.
• Empathy: This is the ability to understand and share the feelings of another. Demonstrating empathy can help to build rapport with the client and make them feel more comfortable sharing their concerns.
• Signposting: This involves clearly signposting the different stages of the consultation, so that the client knows what to expect.
• Chunk and Check: This involves breaking down complex information into smaller, more manageable chunks, and then checking the client’s understanding before moving on.
• Visual Aids: Using diagrams, models, and videos can help to improve the client’s understanding of their pet’s condition and the recommended treatment.
• Written Materials: Providing clients with written materials, such as handouts and brochures, can help to reinforce the information that has been discussed during the consultation.

Remember care contextualisation applies to clients as well as their pets and budgets. Health literacy is the degree to which an individual has the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Research has shown that a significant proportion of the adult population has low health literacy, and this can have a major impact on their ability to understand and follow veterinary recommendations. It is therefore crucial that veterinary professionals are aware of this issue and take steps to ensure that their communication is clear, concise, and easy to understand. 

Maintaining motivation

Compliance is highest when a client understands why they are doing something and can see that it’s working. Tangibly demonstrating the value of their effort and financial investment is the most effective way to motivate them to continue. Combining subjective and objective monitoring is the heart of turning a good consultation into a successful long-term treatment plan. Their use creates a powerful, cyclical process that transforms the client into an active partner in their pet’s care. This partnership is the key to improving outcomes, maintaining engagement, and boosting compliance.

Subjective Monitoring is the client’s personal perception and experience of their pet’s condition. It is qualitative, and based on their feelings, interpretations, and observations. 

• Examples: “She seems much brighter today,” “I think his limp is 50% better,” “He’s started wanting to play again,” “His appetite is back to normal,” a client’s rating of their pet’s pain on a 1-10 scale, or their overall assessment of their pet’s Quality of Life (QoL).

Objective Monitoring involves the collection of measurable, quantifiable, and unbiased data by the veterinary team. It is quantitative.

• Examples: Body weight, Body Condition Score (BCS), heart rate, range-of-motion measured in degrees, limb circumference, gait analysis or validated CMIs.

Both monitoring types are needed to create a complete clinical picture, but objective data can be used to challenge subjective assumptions that may be based on caregiver placebo effect, misinterpretation or masking of clinical signs, misidentification of chronic change, or the client’s emotional state and projection. Objective monitoring is important to validate treatment efficacy (particularly significant where progress is slower than hoped, preventing premature abandonment of an effective intervention), and also to enable agile course correction if the clinical situation does not respond or deteriorates. Combining such objective measures with the client’s subjective observations empowers and validates the client, communicating the importance of their role in managing their pet’s condition.

Further, regular requests for subjective feedback allow the team to identify barriers to compliance early. If a client mentions, “I’m really struggling to get the tablets into her,” the veterinary nurse or veterinarian can immediately offer solutions (e.g., different formulations, pill-giving aids) before the client gives up and the treatment fails.

Creating Shared Goals and Accountability establishes a clear target outcome. For example, the goal might be subjectively “for him to be able to get on the sofa again” and objectively “to increase the stifle joint’s range of motion by 10 degrees.” Regular check-ins to assess progress on these goals create a natural and positive form of accountability, encouraging the client to adhere to the home care or medication schedule.

Encourage owner participation through goal tracking, milestone celebration, and regular progress updates.

• Use standardised digital or paper templates to record each visit, capturing pain scores, functional status, interventions, client queries, and next steps.
• Set automated reminders for follow-ups (1 week for ‘control’ stage, monthly for ‘consolidate’, quarterly or as needed for ‘maintain’).
• Encourage owners to report interim changes or setbacks promptly.

When faced with a subjective impression that seems wrong, the professional’s role is crucial:

1. Never Dismiss: Always start by validating the owner’s observation (“Thank you for watching him so closely, that’s really helpful information.”). Dismissing their view will instantly break trust.
2. Ask for Specifics: Move from the general to the specific. Instead of accepting “He’s better,” ask “What specific things is he doing now that he wasn’t doing before?” This can help separate vague feelings from concrete facts.
3. Educate Gently: Explain the clinical reasoning. “I understand completely why you’d think moving around more is a good sign. However, in a patient with painful joints, being unable to settle and get quality rest could actually be a sign of discomfort”
4. Anchor with Objective Data: Use the objective findings as the “ground truth” to guide the conversation. “I hear that you’re not seeing much of a limp at home, which is great. When I feel his knee joint, I can still feel a fair bit of swelling. This tells us the underlying inflammation is still active, which is why it’s so important we continue with the anti-inflammatories for now.”