Apples & Oranges: Significant Differences Between Fear Free^TM and 'Fearful' Veterinary Practices

There are three things I can pretty much predict someone will say every time these situations arise:

1.  Cute baby in sight. I've always loved children and, like everyone else who sees a baby, I always say in a syrupy sweet voice, "Ahhh....she's so cute!" The baby could be wrinkled, bald, and spewing pablum, and we still say the same thing.

2.  Pets lower blood pressure. Since veterinary school I've been privy and partner to the human-animal health connection and wrote an award-winning book on the subject called The Healing Power of Pets. When doing the initial book tour in 2001 and every time since then, when the book's subject title comes up, 7 out of 10 people say, "I hear pets lower blood pressure." It's like that's the only benefit of pet companionship anyone has ever heard of.

3.  Fear Free veterinary practice. I've yet to speak on this subject without at least several members of the audience assuring me, "We've been doing Fear Free for years." In some ways, yes, they have; but in most of them, no, they haven't - and here's why.

Starting in the late 1980s, working with famed veterinary behaviorist and inventor (Gentle Leader) Dr. R.K. Anderson, we tried to become "All Treat Veterinary Hospital" vs. "All Pain Veterinary Hospital" by deploying treats at every moment of truth in a veterinary exam or procedure. Yes, this helped reduce anxiety and stress for pets, and is a component of a less-stress visit, but it wasn't Fear Free.

Fear Free is a multimodal approach to removing or reducing anxiety/stress/fear triggers, mitigating these same factors when they arise, and always having the pet's emotional wellbeing in our hands (along with physical wellbeing).

Let me contrast a Fear Free (FF) practice with one that remains fearful for pets, pet owners, and the hospital team:

1.  Primary focus. The North Star for a FF practice is the emotional wellbeing of all stakeholders (pet, pet owner, practitioner, practice team). In a fearful practice, the focus can be medicine, money, or both.

2.  Hiring. FF practices hire for attitude and genuine care and compassion for pets and people. They're looking for that special 1 out of 10. Fearful practices hire for performance above all, and pay little or no attention to attitudes of compassion in their team members.

3.  Harmony. Fearful practices care more about getting the job done than the emotional environment of the business, out front and in back. Fear Free practices know both pets and people can easily detect, and are put off or made anxious by, stressful interactions among members of the hospital team.

4.  Design. In the fearful hospital, design is all about curb appeal, efficiency, durability, safety and cost. The FF practice has colors that please pets and people, use high coefficient of friction floor coverings, use a lot of soundproofing, have species-specific exam rooms (some have species-specific treatment areas), and have the ability to isolate pets who are hospitalized for procedures or treatment from pets who are currently being treated or examined to minimize the viral spread of fear.

5.  Where pets are parked. In the fearful hospital, appointments are booked without thought, and in doing so aggressive pets can be side-by-side with fearful ones, dogs with cats, or new puppies with hyperkinetic, emotionally damaged pets. Fearful hospitals pack the schedule and the waiting area with nervous pets and people. Fear Free practices utilize the exam rooms (with enough rooms and the technology) for checking pets in and out, bypassing that stewpot of stress called reception. If there aren't enough rooms or the technology, FF practices have pet owners check in (leaving the pet in the vehicle) and then go back outside and wait with their pet in the vehicle or outdoor area until it's their turn to be seen.

6.  Pace. Fearful hospitals are all about auguring the pets through the system to help as many animals medically as possible. More pets = more money. FF facilities are all about smart scheduling (looking how to minimize stress for individual pets and people), being more relaxed, working to remove or reduce excessive noise, and not being afraid to delay or stop a procedure if fear flares.

7.  Exam. In a fearful facility, almost every pet is put up on the exam room table for exams and procedures. In a FF facility, the pet is given the choice of where to be examined and treated (on the table, floor, or lap).

8.  Hold still. To examine ears, eyes, wounds, or to draw blood or give vaccinations, fearful practices use restraint, which is designed to protect the healthcare provider. FF practices use Gentle Control or Stress Less handling, which is designed to protect both the pet and the person.

9.  Sedation. In fearful practices, sedation is rarely used and is thought of as a last resort. Sedation is a resort reached for early and often in a Fear Free practice. FF practices have a saying, "If you can't abate (as in anxiety/stress/fear)...then you must abate (with sedation)."

10.  Records. It's all about the medical record in a fearful practice, whereas in the FF practice, there's a great medical record but its bookend is a great emotional record. It includes things like the anxiety/stress/fear triggers for this unique pet and pet owner; where the pet likes to be examined; what Gentle Control method works best; what treat the pet likes best, what tricks the pet knows, with cue words; what products (compression garments, chill pills, pheromones, sedatives) work best with this pet.

So just as not every baby really is the cutest one ever born, and pets do so much more than lower blood pressure, Fear Free is not about adding treats and a warm bedside manner to your "get 'er done" veterinary strategy. And you can take that to the bank, fearlessly - guaranteed!