Conversation Analysis of Clients' Active Resistance to Veterinarians' Proposals for Long-Term Dietary Change in Companion Animal Practice in Ontario, Canada

Simple Summary Research suggests that half of all veterinary clients fail to adhere to veterinarians' dietary recommendations, which can lead to serious consequences for pet health. However, little is known about what clients' resistance to such recommendations looks like in actual talk in veterinary consultations and how veterinarians respond. The present study aimed to fill this gap by using conversation analysis to investigate clients' active resistance to veterinarians' proposals for long-term changes to cats' and dogs' diets in 23 segments from 21 videotaped appointments in Ontario, Canada. Clients responded by suggesting that the proposals themselves or the nutritional modifications were potentially unnecessary, inappropriate, or unfeasible. Justifications were most frequently based on their pets' food preferences, multi-pet feeding issues, their current use of equivalent health strategies, or their current enactment of the proposed changes. Thus, client resistance occurred when veterinarians did not first gather relevant diet- and patient-related information, solicit clients' perspectives, or educate them about the benefits of the recommended changes before proposing them. Veterinarians subsequently accommodated clients' resistance more often when barriers to adherence involved patient- or client-related issues rather than clients' lack of medical knowledge. Findings provide valuable evidence for developing effective veterinary communication training and practice guidelines in nutritional assessment and shared decision-making. The impact of nutrition on animal health requires effective diet-related treatment recommendations in veterinary medicine. Despite low reported rates of veterinary clients' adherence with dietary recommendations, little is known about how clients' resistance to nutritional proposals is managed in the talk of veterinary consultations. This conversation-analytic study investigated clients' active resistance to veterinarians' proposals for long-term changes to cats' and dogs' diets in 23 segments from 21 videotaped appointments in Ontario, Canada. Clients' accounts suggested the proposals themselves or nutritional modifications were unnecessary, inappropriate, or unfeasible, most often based on patients' food preferences, multi-pet feeding issues, current use of equivalent strategies, or current enactment of the proposed changes. Resistance arose when veterinarians constructed proposals without first gathering relevant diet- and patient-related information, soliciting clients' perspectives, or educating them about the benefits of recommended changes. Veterinarians subsequently accommodated clients' concerns more often when resistance involved patient- or client-related issues rather than clients' lack of medical knowledge. The design of subsequent proposals accepted by clients frequently replaced dietary changes in the initial proposals with nutritional or non-nutritional alternatives and oriented to uncertainty about adherence. This study provides evidence-based findings for developing effective communication training and practice guidelines in nutritional assessment and shared decision-making.