Tuesday, January 18, 2011

Reasonable Expectations: The Ability to Discuss Your Internet Research With Your Vet

by Nancy Kay, DVM

This is the sixth part of an ongoing series describing how people are developing new expectations when it comes to veterinary care for their pets. Parts one through five can be found at www.speakingforspot.com/blog.  Please take your time with this one- I realize it is a lengthy post, but there is a great deal to say about this worthwhile topic!

When your beloved pet develops a medical issue, chances are you’ll be inclined to do some Internet research and then talk with your vet about what you’ve learned.

Know that having this discussion with your vet is a perfectly reasonable expectation as long as you are careful to avoid using valuable office visit time discussing “whackadoodle” notions gleaned from cyberspace.

Here are some pointers to help you find instructive, accurate, worthwhile Internet information while avoiding “online junk food”. By the way, although I’m a veterinarian teaching people how to better care for their furry and feathered family members, please know that this information also applies to your own health care.

So, let’s begin.

How can you determine whether or not a website is dishing out information that is worthy of your time? 

Here are some general guidelines:

1. Ask your veterinarian for her website recommendations.  She might wish to refer you to a specific site that will supplement or reinforce the information she has provided.

2. Veterinary college websites invariably provide reliable information.  Search for them by entering “veterinary college” or “veterinary school” after the name of the disease or symptom you are researching.

3. Web addresses ending in “.org,” “.edu,” and “.gov,” represent nonprofit organizations, educational institutions, and governmental agencies, respectively.  They will likely be sources of objective and accurate information.

4. If your dog has a breed-specific disease, pay a visit to the site hosted by that specific breed’s national organization.

5. Avoid business-sponsored websites that stand to make money when you believe and act on what they profess (especially if it involves purchasing something).

6. Be ever so wary of anecdotal information.  It’s perfectly okay to indulge yourself with remarkable tales (how Max’s skin disease was miraculously cured by a single session of aromatherapy), but view what you are reading as fiction rather than fact.

7. I really love disease-specific online forums.  Check out those sponsored by Yahoo (http://groups.yahoo.com).  Not only do many of them provide a wealth of educational information, members can be a wonderful source of emotional support- always a good thing for those of us who share our homes and hearts with an animal.

If you are considering joining an online forum, I encourage you to look for a group that focuses on a specific disease (kidney failure, diabetes, etc), has lots of members, and has been around for several years.

For example, an excellent Yahoo group AddisonsDogs has 3,391 members and has been up and running for eight years.  A large group such as this typically has multiple moderators who screen participants, screen comments to keep things on topic, present more than one point of view (always a good thing), and provide greater round-the-clock availability for advice and support.

Look for presentation of cited references (clinical research that supports what is being recommended). Such groups should have a homepage that explains the focus of the group and provides the number of members and posts per month (the more the better).  They may have public archives of previous posts that can provide a wealth of information.

I happen to enjoy hearing about what my clients are learning online.

I sometimes come away with valuable new information, and I’m invariably amused by some of the extraordinary things they tell me- who knew that hip dysplasia is caused by global warming!

Surf to your heart’s content, but be forewarned, not all veterinarians feel as I do.

Some have a hard time not “rolling their eyes” or quickly interrupting the moment the conversation turns to Internet research. What can you do to realize the expectation of discussing your online research in a way that is neither irritating to your vet nor intimidating for you?  Listed below are some secrets for success:

  • I may be preaching to the choir, but I cannot overemphasize the importance of working with a vet who is happy and willing to participate in two-way, collaborative dialogue with you (please reference my earlier blog about relationship centered care- http://speakingforspot.com/blog/?p=1174). Your opinions, feelings, and questions are held in high regard and enough time is allowed during the office visit to hear them. 
A veterinarian who practices this “relationship centered” style of communication is far more likely to want to hear about your online research than the veterinarian who practices “paternalistic care” (far more interested in telling you what to do than hearing about your thoughts, questions, or concerns).  Remember, when it comes to veterinarian/client communication styles, you have a choice. It’s up to you to make the right choice!
  • Let your vet know that you appreciate her willingness and patience in helping you understand how best to utilize what you’ve learned online.
  • Wait for the appropriate time during the office visit to discuss what you’ve learned on line.  Allow your veterinarian to ask questions of you and examine your precious poopsie rather than “tackling” her with questions and discussion about your Internet research questions the moment she sets foot in the exam room.
  • Be brief and “to the point” with your questions.  Remember, most office visits are scheduled for 15 to 20 minutes, max.
  • Let your veterinarian know that you’ve learned how to be a discriminating surfer!  You know how to differentiate between valuable online resources and “cyber-fluff”. You ignore anecdotal vignettes and websites trying to sell their products in favor of credible information provided by veterinary college sites and forums that are hosted by well-educated moderators who provide cited research references that support their recommendations.
  • When you begin conversation about your Internet research, I encourage you to choose your wording wisely. Communicate in a respectful fashion that invites conversation as opposed to “telling” your vet what you want to do.

In the Internet, we have an extraordinary tool at our fingertips. I encourage you to be selective when choosing which websites you intend to take seriously and which ones you wish to visit for a good chuckle.

Approach conversations with your vet about your Internet research thoughtfully and tactfully.  These strategies are bound to facilitate constructive conversation and create a win-win-win situation- for you, your veterinarian and your beloved best buddy!

Have you had conversation with your vet about your Internet research?  If so, how did it go?

Now here’s wishing you and your four-legged family members abundant good health. 

***

DR. NANCY KAY wanted to become a veterinarian for just about as long as she can remember. Her veterinary degree is from Cornell College of Veterinary Medicine, and she completed her residency training in small animal internal medicine at the University of California—Davis Veterinary School.

Dr. Kay is a board certified specialist in the American College of Veterinary Internal Medicine and published in several professional journals and textbooks. She lectures professionally to regional and national audiences, and one of her favorite lecture topics is communication between veterinarians and their clients.   Since the release of her book,
Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life, Dr. Kay has lectured extensively and written numerous magazine articles on the topic of medical advocacy.  She was a featured guest on the popular National Public Radio show, Fresh Air with Terry Gross.

Dr. Kay is a staff internist at VCA Animal Care Center, a 24-hour emergency/specialty care center in Rohnert Park, California. As a way of providing emotional support for people with sick four-legged family members, Dr. Kay founded and helps facilitate the VCA Animal Care Center Client Support Group.  She also facilitates client communication rounds for VCA Animal Care Center employees.

Dr. Kay was selected by the American Animal Hospital Association to receive the 2009 Hill’s Animal Welfare and Humane Ethics Award.  This award is given annually to a veterinarian or nonveterinarian who has advanced animal welfare through extraordinary service or by furthering humane principles, education, and understanding.  The Dog Writers Association of America selected Dr. Kay for two awards.  The first was the 2009 Eukanuba Canine Health Award recognizing
Speaking for Spot as the publication that best promotes the health and well being of dogs. The second award was for the Best Blog of 2009 (www.speakingforspot.com/blog).

Dr. Kay’s personal life revolves around her husband (also a veterinarian), her three children (none of whom aspire to be veterinarians) and their menagerie of four-legged family members. When she’s not writing, she spends her spare moments in the garden or riding along the beach atop her favorite horse. Dr. Kay and her family reside in Sebastopol, California.

17 comments

  1. I've always felt guilty bringing up Internet or book research, not to mention anecdotal stuff, with my lovely vet. I imagine, though he's too polite to roll his eyes in front of me, that he might be doing it in his head. Thanks for the vet's perspective.

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  2. Hi Georgia.

    You know what? I think that a good vet appreciates the owner's investment if nothing else. And sometimes we are not completely dumb. I had a vet who was treating me that way and he was wrong and I was right.

    Not many things, if any, in medicine are written in stone. Open dialog is an important part of the process.

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  3. I definitely do research before I talk to my dog's vet or my own doctor. Doctors do not know everything, even if they think they do!

    My dog Ace had what is called polymyositis where his eyes swelled up due to an allergic reaction. Ace's vet had never heard of this, and most vets have not heard of it, I'm finding. But his vet recommended us to an eye specialist who identified the polymyositis right away. I wrote a few posts about the condition on my blog and now people always email me thanking me for the good information because their vets had never heard of it. Many of them tell me they print out the post and bring it along to their appointments.

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  4. Lindsay, yes, good thing to do, I research before and after, I really feel for our vet, even though I don't come up with ideas such as hip dysplasia being caused by global warming ;-)

    In fact, we found our new vet because of my research. Left the one we had before because he was not up to date and was not willing to learn either when I started talking stem cells then.

    I love vets who realize they don't know everything. That is a good start.

    My blog is also in a way result of my research and also it is to help people realize that educating themselves can make a major difference for their dogs.

    It is good to research and it is good to learn from each other's experiences.

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  5. Really informative post! It really provides some good guidelines regarding where to look and how to bring it up at the vet's office. Honestly, a lot of these tips would probably be useful when dealing with a human doctor about human ailments too!

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  6. Hi Pup Fan. Yes, great stuff. If you haven't yet, do get the Speaking for Spot book, trust me, you'll be glad you did. It is loaded with great information and at the back it features list of symptoms and a list of conditions with explanations and other useful notes.

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  7. hi jana - my vet is lovely, really! in case i gave you the wrong idea!

    he's been looking after rufus for years, is thorough, very patient, and generous with his time. he gives better advice than the 2 other mainstream vets, 1 holistic vet, and best orthoepaedic surgeon in australia that rufus used to see. remember that one? :p

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  8. I usually compile my research into bulleted format and print--and give a quick spiel of "This is what I read..." and rattle off some points and then I see what the vet thinks. I usually let her read over the sheets after we talk for a moment. I typically only bring info from yahoo groups and/or peer reviewed articles I've found. I wish my vet would join a yahoo group or two and see what a tremendous wealth of information they can be, but you can't always have *everything*...

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  9. Hi Georgia,

    nope I didn't get the wrong idea, dealt with enough vets by now. I often wonder what nightmares our vet has about me too!

    And we feel the same way about him, so far he did more and knew better than a whole lot of others. That's why he remains in charge even when we bring other modalities on board.

    Here is to wonderful vets.

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  10. Hi Serissime

    yeah, I break these things down to him in emails also, so he has time to mull it over :-) We have constant email conversations about things

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  11. Jana,
    How generally acceptable is it to email with your vet? My vet has an online presence, but I haven't contacted her via email because I wasn't sure how it would be regarded. I corresponded with one of my doctors once via email and it felt awkward, like we weren't supposed to be doing it. Hah! You don't think it would be like asking her to work off the clock or something, do you? (As for email at work, I know she doesn't check it but for once a week or so...)

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  12. Well, I imagine that depends on the vet. Our vet and I exchanged probably 500 letter sizes pages of emails by now.

    Our vet has a system where he has everything web based (I can access any medical files there) and we exchange messages there. If the vet wants to charge for it that would be fair. Ours doesn't, so we always come up with some way of compensating him.

    Dr. Kay also wrote on the subject
    http://speakingforspot.com/blog/?p=1363

    Using email works for our vet and us, the advantages are that one can do that when they have time (unlike phone calls), I can research his answers and so on.

    Our TCVM vet is happy to respond to emails also.

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  13. Thank you Jana and Dr. Kay for this great post! I appreciate clients being proactive about their pets' health. They let me steer them away from misinformation and toward great medical information, and in turn I have learned quite a bit, for example, about exotic pet husbandry, especially of species I have not had as pets.

    I think if your vet is comfortable discussing internet information, and both parties are humble enough to admit they can learn from each other, it can be a very healthy dynamic!

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  14. Shawn, our vet is great this way.

    He used to have a introduction video on his website in which he said, "We encourage the public to be as involved as they wish with their pet health information ..."

    For some reason the video isn't there any more ... LOL

    That just comes to prove you gotta be careful what you wish for! LOL

    But he takes it in strides and was able to put up with me till this day. Keeps him on his toes and I think that in a way he likes that.

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  15. I am a big fan of "knowing my stuff" so that I can have an intelligent conversation with our vet about what is going on. #3 & #7 are especially important I think, you should always be looking for a reputable information source. Our old vet would refuse to discuss anything with me, and I tell ya, we got rid of him pretty fast! Great advice :)

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  16. Glad you have a vet you can talk to; it is very important! Of course it is also important not to buy in any nonsense that is out there :-)

    I agree with you, I wouldn't have a vet who's not willing to discuss things.

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  17. I loved my pets. I am always concern about their health. Because they are also a part of family. They give us many many happiness. If they are in sick then I will go pet hospital san diego immediately.

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