Consumer choice is now frequently based on information from the internet. This extends to choices in healthcare providers. In human healthcare, individuals use websites to select dentists (Kim et al, 2012), and in some countries, hospitals (Norum and Moen, 2004; Leister and Stausberg, 2007). Veterinary practices may also use websites, as part of the ‘promotion’ aspect of marketing (Vidic et al, 2013). Vidic et al (2013) explain veterinary promotion as communicating with clients and describing products and services in order to gain new clients, retain current clients and build client relationships. Much of the current literature focuses on the use of Web 2.0 websites, such as Facebook and Twitter (Hamlin, 2013; Kerrigan, 2014; Hamlin, 2014a; Hamlin, 2014b; Knight, 2015). However, research in The Netherlands (Molhoek and Endenburg, 2009) has identified that 13.3% of new clients first find out about a practice through the practice's own website. It is possible that, 8 years later, this figure would be even higher. Results from the survey demonstrated that 84.3% of clients thought the website was important in decision making. This included both those clients who first found out about the practice through their website, and those who visited the site later (Molhoek and Endenburg, 2009).
Websites are therefore a potential way to attract and maintain clients. However, Molhoek and Endenberg's (2009) research focused on clients' choices based on the practice as a whole (e.g. services, cost and location) and veterinary surgeons (VSs) (knowledge and skills). It does not consider if clients' choices would have been affected by information regarding other professions and occupations within the practice team.
The Royal College of Veterinary Surgeons' (RCVS') Survey of the Veterinary Nursing Profession stated that more respect and recognition from the public is one of the most commonly cited areas which would improve the working life of veterinary nurses (VNs) (Williams and Robinson, 2014). Coates (2015) suggested that following from the recent developments in veterinary nursing and the ambition to protect the title, public awareness and recognition will increase. However, Coates also acknowledged that this may only be possible if ‘everyone’ (including practice owners and managers) supports this promotion. Practices must therefore enhance public awareness, and ensure that purposeful or unintended actions do not negatively influence perception through lack of consideration of the professions and occupations in the veterinary team. In addition, failing to enhance public perception may cast doubt on veterinary surgeons' (VS') perceptions of their colleagues, and together this may counteract the high intrinsic motivation of working as a VN and cause a reduction in motivation (Coates, 2015), and an increase in individuals leaving the profession.
This article hypothesises that practice websites are an area that could influence public perception of the veterinary professions (VSs and VNs) and occupations (such as administrators and receptionists) that constitute a practice team. Websites which are unbalanced in their portrayal of the professions/occupations, for example, detailing only the VS in a practice, may cause potential clients to think that other groups are not employed in the practice, or that decisions relating to which practice to attend do not require information on other groups. Such websites may also affect current clients' understanding and appreciation of unrepresented groups.
The project is a preliminary investigation to review ‘Meet the Team’ pages of a range of veterinary practice websites and to record how practices portray the professions and occupations that make up their team. This will allow the exploration of potential differences in how members of the veterinary team are portrayed and enable the identification of areas for improvements to websites based on current literature.
Method
This project was a desk-based study, and used Meet the Team (or ‘Our Staff’) pages on veterinary practice websites as a primary source of data. No follow up data were collected and data were not verified, as the focus was on websites' portrayal of professions.
Meet the Team pages list the practices' staff members and provide biographies about them. It is not possible to tell from the websites if the staff wrote their biographies independently, used a prescribed structure, or if they were written for them.
As websites are freely available to anyone with access to the internet, the project was not deemed to require ethical approval.
The practices
One hundred UK veterinary practices were randomly chosen from the numbered alphabetical list of veterinary practices on the RCVS's website (RCVS, 2017) using the random number generator function in Excel (Windows, 2016). Each practice's website was accessed and the information outlined below was collected.
Collected data
General practice information The range of species treated, first opinion or referral status, and independent company or corporation status were recorded.
The team page Whether or not the website had a Meet the Team page was recorded. The inclusion of different professions and occupations was noted (primarily VSs, VNs — including students and assistants, receptionists, administrators, other), as was the order in which they were presented. Where a Meet the Team page did not include personal biographies for a specific group, the whole of the practice's website was explored to ascertain if the practice employed such groups, and these data were recorded.
Veterinary nurses
The professional status of VNs (no information; qualified; registered — RVN) was recorded.
Photographs
The number of photographs of individuals in each profession/occupation was recorded and the proportion per profession calculated. Photographs were categorised as being focused on: the individual, typically their head and shoulders (person); the individual with a pet/animal (pet); or in a work-related activity, such as receptionists on the phone or VSs using a stethoscope (work).
Quantity of words
The total number of words within each biography was counted.
Content of words — VSs and VNs
A random selection of ten of the 100 practices was identified for this more time consuming and in-depth study of biographies. All information from VSs' and VNs' biographies within these practices was collated. Word clouds were created using wordart.com to identify frequently used words. Through content analysis, the percentage of individuals per profession who used these words was then calculated.
Data analysis
This was largely a descriptive project aimed at identifying potential patterns of veterinary practice websites. However, the following statistical tests were conducted. The p value used to indicate significance for all tests was <0.05.
Kruskall Wallis (Siegel and Castellan, 1988) tests were performed to identify if a difference existed in the proportion of photographs per profession, and in the proportion of photographs that focused on ‘person’, ‘pet’ and ‘work’.
A Kruskall Wallis test was also performed to investigate the difference in total number of words written by individuals of different professions/occupations. A Mann-Whitney U (Siegel and Castellan, 1988) test was conducted to establish if a significant difference existed between the total number of words written by VSs and VNs from all practice websites with Meet the Team pages.
Only descriptive statistics are reported for the content of biographies due to the limited number (10) of practices involved in this part of the study.
Results
General practice information
All 100 practices had a practice website. The practices are summarised in Table 1.
| Practices | Total number of individuals identified from the practice websites | ||||
|---|---|---|---|---|---|
| Species treated | Other information | ||||
| Small animal only | 76 | Independent | 80 | VSs | 475 |
| Mixed (small plus Large) | 16 | Corporate | 20 | VNs | 346 |
| Equine only | 4 | Nursing assistants/students | 182 | ||
| Large only | 3 | First opinion | 90 | Receptionists | 261 |
| Poultry | 1 | Referral | 10 | Administrators | 122 |
| Other | 24 | ||||
The pattern of practice types included in this study is similar to the pattern of work of VSs and VNs; i.e. the majority of practices employing VSs and VNs are small animal first opinion practices (Robinson et al, 2014).
The team page
Meet the Team pages were present on 83 of 100 websites. One webpage was under construction and did not identify staff's professions. This practice was excluded from further analysis, leaving 82 practices with assessable Meet the Team pages. In total, this included 1410 individuals, as indicated in Table 1.
The percentage of Meet the Team pages that did or did not include the two veterinary professions and ‘others’ (including ‘administrators’, ‘receptionists’ and ‘support staff’) is shown in Figure 1. The ‘not included — employed’ category is notable — these are instances where the practice did employ the group (VNs or ‘others’), but did not include them on the Meet the Team page as individual profiles.
Biographies were presented either on one page, or in sub-pages for each group. Almost half of the Meet the Team pages (49%) presented the biographies in the order VS, VN and other groups. Other permutations included a mix (often when a non-veterinary qualified practice manager was included early in the list), a diagram of professions and VNs/other groups before VSs.
Veterinary nurses
Through reading each ‘veterinary nurse’ biography (excluding students and nursing assistants), VN's professional status was identified. The results are shown in Figure 2.
Photographs
Photograph frequency per profession/occupation ranged from 70% to 86%. There was no significant difference between the proportions of individuals with photographs per profession.
Figure 3 demonstrates the proportion of photographs with each focus. As Figure 3 identifies, the majority of photographs from all professional groups had a ‘person’ focus. VNs had more photographs focused on ‘pet’ than VSs and the other group, and the other group had more photographs focused on ‘work’ than VSs or VNs. However, these differences between groups were not statistically significant (proportion of ‘person’ between groups, p=0.234; proportion of ‘pet’ between groups, p=0.074; proportion of ‘work’ between groups, p=0.424).
Quantity of words
There was a significant difference between the number of words within the biographies of the professions/occupations (p=0.000). Specifically, the difference between VSs and VNs was tested; VSs' biographies were significantly longer than VNs' (p=0.003). The median number of biographical words per profession/occupation is shown in Figure 4.
Content of biographies
— VSs and VNs Figure 5 shows word clouds created from the 10 random practices whereby individual biographies of VSs and VNs were downloaded and evaluated.
The biographies of VSs and VNs used similar words, regularly including: ‘work’, ‘practice’, ‘veterinary’ and ‘pets’. Other frequently used words included ‘interest’, ‘love’ and ‘enjoy’. ‘Interest’, ‘love’ and ‘enjoy’ were directed at both work activities and activities outside of work; 65% of VSs used one of these words regarding work, and similarly so did 56% of VNs. Regarding out of work activities, 53% of VSs used one of the three words, and so did 48% of VNs.
Some differences existed between the use of words by the two professions. To describe their education, VSs more regularly used ‘graduate’ (33% compared with 0% of VNs), while VNs more frequently used ‘qualified’ (56% compared with 25% of VSs). VNs more often used the word ‘care’, either towards clients or animals (24% of VNs compared with 13% of VSs).
Discussion
This study aimed to record how veterinary practices portray the professions and occupations that make up their team through their practice website. The VN Futures Report (VN Futures Action Group, 2016) describes an ambition to maximise nurses' potential. This includes increasing public awareness of VNs' work and qualifications, and increasing value and understanding by colleagues. Practices that do not include VNs on their websites, or that do not include comparable information on VNs as VSs, may harm public awareness of VNs' roles as team members. Websites have the ability to influence the public (potential and current clients) in their decisions (Molhoek and Endenburg, 2009) and potentially in perceptions of the value of the professions.
All 100 practices randomly selected had a practice website. Despite some research on patients selecting hospitals in Germany suggesting that website quality is ‘less’ important (Leister and Stausberg, 2007), veterinary specific research has demonstrated that websites and their quality are important for clients choosing a new practice (Molhoek and Endenburg, 2009).
The author finds the results of this analysis reassuring because the majority of practices (83%) have Meet the Team pages on their websites which is a promotional marketing strategy. Of these, most include all professions and occupations that make up their practice team. Through comparisons with Meet the Team pages and the content of the rest of the practice's website, six webpages were identified where the practice employed VNs, but did not included them as individual profiles on the Meet the Team page, and similarly, four practices were identified regarding the other group (primarily receptionists and administrators). For the majority of practices, therefore, an appearance of acknowledging each professional group has been made.
Proportions of groups with photographs and types of photographs per profession was similar, indicating no special treatment for one group over the others. A potential client viewing a picture of a person with a pet could lead them to believe that person is caring and/or has the ability to handle animals. While a picture of a person at work may imply a dedication to their work as well as identifying the types of tasks they undertake. The similarities of photographs between the professions leads to the perception that members of all groups are caring, able and dedicated. However, despite VSs' biographies being significantly longer than VNs', VSs' biographies included the word ‘care’ less often than VNs. This mirrors research suggesting VNs have a greater focus on care than VSs (Kinnison et al, 2016), however this is not to suggest that VSs are unmotivated by animal care and this care could be made more explicit through their biographies.
Radha et al (2012) have suggested in human healthcare that sufficient information, for example regarding specialisms, should be provided to allow clients to make an informed choice about which practice to join. To attract clients, veterinary practice websites should therefore include Meet the Team pages with enough information to demonstrate to clients the team's capability in looking after their pet.
Molhoek and Endenberg (2009) suggest that veterinary clients want personnel who can handle animals. Therefore, pictures with pets and information about team members' own pets may be useful to include on the website. Clients also look for quality of treatment, so including information on individuals' further qualifications may be important; for VNs as well as VSs. Regarding veterinary nursing qualifications, this study demonstrated that 13% of VNs could only be identified as qualified while 76% included that they were registered. The content analysis suggested that nurses often described their education as allowing them to become qualified. These two terms may add a layer of confusion to clients regarding VN status, roles and legalities.
Client perspectives on desirable attributes and skills of veterinary technologists in Australia have been used to identify areas for curriculum development (Clarke et al, 2015). The same attributes and skills can also be used to guide the content of Meet the Team biographies so that they match the type of information desired by clients and can help clients to understand the VN's role. For example, Clarke et al (2015) demonstrated that clients perceive several emotional intelligence items to be important for veterinary technicians; such as self control, emotionality and self motivation. Professional skills (teamwork and reflection) were also frequently rated as being important, as were eight of ten technical skills (including take blood samples), while two technical skills (conducting obesity clinics and puppy pre-schools) received a number (30%) of unsure responses. Clarity of VNs' roles is therefore important, and was observed by the author to be lacking on some websites where RVNs and assistants were employed, but the presented order of the ‘veterinary nursing team’ was mixed.
The nature of this study means that the results must be interpreted in light of the study's aims. For example, this study focused largely on VSs and VNs, and in some cases has a lack of depth regarding other occupations. Further research should focus on receptionists and administrators and their portrayed role within the practice team. The study also focused on people's inferences from websites, and it is not claimed that those practices that do not include some professions on the Meet the Team pages do not show respect and trust towards these groups. Nor does it prove that those practices that do include all professions provide an ideal working environment. The study also has not sought to confirm claims made in biographies. For clients, it is the inferences that they make from the website, and not the truth of the interprofessional attitudes at the workplace, which may make a difference to their choice of practice and their perception of the professions.
The biographies of staff members may have been prescribed (or written) by the practice, or may be completely up to the individual. Either way, a key area for future research would be to ask clients what they would like to be included on the Meet the Team pages and use this as a guide. However, enforcing all staff to join the Meet the Team page may have ethical issues for individuals who do not wish for personal information or photographs of themselves to be made available on the internet. Further research would be helpful in identifying how frequent this occurrence may be, and how to manage it to suit all parties.
Conclusion
In conclusion, the majority of veterinary practices make use of Meet the Team pages on practice websites, and include information on all members of their team. Some, however, do not. Previous literature suggests that providing enough information about the practice and its staff, on which clients can make informed decisions, is important. Certain traits are desirable in VSs and VNs and highlighting these abilities in biographies may be useful. This paper promotes the concept of a veterinary team where professional equality is ensured in all promotional strategies and where all team members are given the opportunity to be valued and understood by colleagues and clients.