Trust and transparency in the veterinary profession

I bring to your attention the following article by the Australian Veterinary Association (AVA). It’s a worthy reminder to review it, as ongoing trust and transparency in the veterinary profession is essential for all our clients and the profession in general.

You might remember recently receiving an AVA member alert about a story that was broadcast on ABC TV’s 7.30 program. It cast suspicion on how pharmaceutical and pet food companies ‘influence’ the decisions made by vets and the AVA. Our members posted in the AVA’s online discussion forum in response.

We deal with the media a lot in the public affairs team, but this experience was unusual for a number of reasons. For starters, we tracked the development of this story over several weeks. Any one media story rarely takes up a few days, let alone a few weeks. It was also the first time that perceived conflicts of interest between veterinarians and industry suppliers were raised in national mainstream media in Australia.

This unusual experience unfolded against the backdrop of numerous ongoing challenges to the high levels of trust that veterinarians have traditionally enjoyed. These have included controversies around the Hendra virus vaccine, the ‘right’ intervals for dog and cat vaccinations, vet fees, pet insurance, and the greyhound racing industry among others.

Some of these issues have been around for many years, while others are relatively new to the public consciousness. Whatever you think about the story and whether its points are valid, it seems to me that the veterinary profession has travelled somewhere slightly new in the trust/transparency landscape in the last year.

Conflicts or confluence?

Disclosures of interest are a common approach to managing potential or perceived conflicts of interest. Within the AVA, various types of disclosures of interest are required of Board or committee members, and in relation to journal publication and conference presentations.

In the human medical world, there is a line of research that questions the effectiveness of disclosures and in fact whether they may have “perverse effects” by preventing productive communication and relationships between physicians and supplier companies. [1] [2]

An editorial in a recent issue of the Journal of the American Medical Association suggests that instead of “conflicts”, we should understand a “confluence” of interests around medical research in particular. [3]

The themes in these papers revolve around both the benefits of close connections between researchers, clinicians and companies, and the need to avoid bias. How those interests are balanced can be understood as “a complex ecosystem”.

Transparency

Surely if we’re straightforward, open and transparent about our relationships, this should knock suspicion and reputational risk on the head, especially when these relationships are completely above board.

97 research organisations in the UK have signed the Concordat on Openness in Animal Research in an attempt to combat extremist opposition to the use of animals in research. In September 2015 the first Concordat on Openness Annual Report was published, which details how signatories have fulfilled their commitments to improve openness and transparency.

The European Federation of Pharmaceutical Industries and Associations has launched several initiatives to increase public trust. These include a voluntary annual disclosure by all member companies of all payments in kind or cash to health professionals.

In my experience, true transparency for an organisation is often a lot harder than it seems. Being open helps to build trust in others, but it’s no more a panacea than disclosures of interest.

Philosopher and consultant in building trust, Brennan Jacoby, points out that being transparent is not the same as being trustworthy. The trust equation is very dependent on the mindset of the trust-er: “… distrust and scepticism that citizens hold can be self-reinforcing, causing citizens to interpret disclosed information more negatively than is, perhaps, justifiable.” [4]

Community perceptions of the Australian veterinary profession

So what’s in the mind of Australian pet owners, former pet owners and non-pet owners when they think about veterinarians? In 2014, we commissioned independent research to find out. [5]

 

We found that vets are generally considered very trustworthy, on a par with general practitioners, nurses and pharmacists for trustworthiness. These views didn’t change significantly across our respondent groups, indicating that the feeling is a general one across the community.

There was also an interesting finding in that those pet owners who visit a favourite vet or vet practice were significantly more likely (49%) to trust their vet’s recommendations than other pet owners (25%). This was especially the case in relation to services the owner had not intended to use when seeking the consultation.

The conclusion we drew from this was that a solid ongoing relationship is the basis for positive interactions – and trust – between vets and clients.

Relationships and trust

We trust people we know well more than those we know less well, and a lot more than we trust strangers. So it’s not the least bit surprising that mainstream and social media can challenge trust in the veterinary profession.

In mainstream media, relationships between speakers and audiences are not possible and judgements about trustworthiness are made on whether a person ‘seems’ trustworthy. How a person looks, sounds, and ‘comes across’ will be the basis for a person’s judgement about trustworthiness. This is why the AVA invests a decent amount of money each year in training our expert media spokespeople. You can be the most knowledgeable vet on earth, but if a reader or listener doesn’t think you’re trustworthy, they’re not going to listen to or respect what you say.

In social media, it’s tempting to think that being in the same virtual space at the same time as someone automatically creates some kind of relationship. Sometimes it does work a bit this way if you have a common close friendship with someone or find you’re passionate about the same things.

But if you look at social media interactions about controversial issues, the dynamic at work is usually the same as mainstream media. Unless you have a relationship in ‘real life’, you are strangers. So you’ll most likely be judged by how trustworthy you seem in relation to a controversial issue, not so much by whether you have a veterinary degree, or expertise in a particular subject.

A few hundred years BCE, Aristotle set out his three proofs of rhetorical argument – ethos, pathos and logos. The ‘ethos’ component relates to the character or credibility of the speaker, without which, the emotional (pathos) and rational (logos) arguments are much less persuasive. In fact, he went so far as to assert “there is no proof so effective as that of the character”.

How can we as a profession and individual veterinarians demonstrate our character or credibility when people challenge our trustworthiness? We could probably do a lot worse than Aristotle’s tried and tested three proofs as a starting point.

© 2016 ava.com.au | This article was written by Marcia Balzer and first appeared on ava.com.au.

 


Dr Sue Samuelsson is a caring and dynamic vet in the Northern Territory, Australia who has had a profound effect on many remote communities around East Arnhem Land. She is the creator of i-Vet, an innovate online service designed for pet owners. Away from her busy schedule she enjoys catching barramundi in the Daly River.