Archive for December, 2009

Everybody’s Gone Surfin’ (Part Two)

December 26, 2009

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.  Who can blame them- they’ve grown weary of spending valuable office visit or telephone time talking their clients out of crazy cyberspace notions and reining them in from online wild goose chases.  How unfortunate this is.  Nowadays, people rapidly and reflexively reach for their keyboards to learn more about their pet’s symptoms or disease diagnosis online.  It’s only natural (and in their pet’s best interest) that they will want to discuss what they’ve learned with their veterinarian.

Is there an effective way to communicate with your vet about your online research that is neither irritating to her nor intimidating for you?  I truly believe it is possible, but it involves some work and planning on your part!  Listed below are some secrets for success- things you can do to converse about your Internet research in a manner that is comfortable for you and your vet and, most importantly, beneficial for your pet’s health.

-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. 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.

-Ask your veterinarian for her Web site recommendations- those that have already been “vetted”.  This is a collaborative approach that lets her know you intend to spend some time learning more, plus a respectful recognition of the fact that she is the one who has spent her career learning about your dog’s health issues. 

-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 Web sites trying to sell their products in favor of credible information provided by veterinary college Web sites and forums that are hosted by well-educated moderators who provide cited research references that support their recommendations.  If you need a little refresher course on how to be a “selective surfer,” I encourage you to read Part One of this article (http://speakingforspot.com/blog/?p=654).

-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. Most veterinarians don’t like being told what to do by their clients, and who can blame them?  After all, we expect veterinarians to provide a collaborative approach- it’s only fair that they expect the same from their clients.  Consider the following conversation starters about Internet research:

Approach one:  “I’m wondering what you think about mixing some canned pumpkin in with Sophie’s food.  I’ve been doing some Internet research about diarrhea and this suggestion seems to comes up frequently.”

Approach two:  “I’ve been doing some online research and learned about the benefits of canned pumpkin.  I want to begin mixing this in with Sophie’s food.”

Approach three:  “I’d like to give Sophie some canned pumpkin for her diarrhea.  A moderator from an online forum suggested I do this.”

Approach four:  “I’ve been following an online forum about canine diarrhea. One of the moderators suggested I consider adding canned pumpkin to Sophie’s diet.  How do you feel about this?”

Which of these approaches sound like invitations for discussion? Which are more likely to be a “turnoff” for your veterinarian? If you’ve selected approaches one and four as successful ways for broaching the topic of Internet research with your vet, well done!  Give your dog a hug and yourself a pat on the back!

In the Internet, we have an extraordinary tool at our fingertips. I encourage you to be critical when choosing which Web sites 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 create a win-win-win situation- for you, your veterinarian and your beloved best buddy! 

Wishing you and your four-legged family members abundant good health,

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller. 

Order  a copy of Speaking for Spot personally signed by Dr. Kay – http://www.speakingforspot.com/purchase.html

Join our email list – http://speakingforspot.com/joinemaillist.html

Look for us on Twitter – http://twitter.com/speakingforspot

Become a Fan of Speaking for Spot on Facebook

Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross

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Everybody’s Gone Surfin’ (Part One)

December 15, 2009

When you or a loved one develops a medical issue, chances are you’ll be inclined to do some Internet research.  While I say, “More power to you!” other medical professionals might roll their eyes at the thought of “wasting” valuable time discussing potentially “whackadoodle” notions gleaned from cyberspace. 

Mac, who resides in Vienna, AustriaPart one of “Everybody’s Gone Surfin” will teach you how to find instructive, accurate, worthwhile Internet information while avoiding “online junk food.”  Part two (coming soon to your home computer) will provide tools to assist you in comfortably discussing what you’ve learned online with your veterinarian, in a way that promotes collaborative discussion. 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 Web site is dishing out information that is worthy of your time? Here are some general guidelines: 

  1. Ask your veterinarian for her Web site recommendations.  She might wish to refer you to a specific site that will supplement or reinforce the information she has provided.
  2. Veterinary college Web sites 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 Web sites 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; how global warming is the cause of hip dysplasia), but view what you are reading as fiction rather than fact.  As fascinating as these National Enquirer type stories may seem, please don’t let them significantly influence the choices you make for your dog.
  7. I really love disease-specific online forums.  Check out those sponsored by Yahoo (http://groups.yahoo.com).  Not only do they 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 K9KidneyDiet (addresses issues pertaining to dogs with kidney failure) has 3,391 members and has been up and running for eight years.  A large group such as this typically has multiple moderators who provide more than one point of view (always a good thing) and 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.

 Listed below are three Web sites that discuss Addison’s disease (an illness that can affect dogs and people- John F. Kennedy was diagnosed with Addison’s disease).  Now that you are an expert on evaluating Web sites, here is a little test of your skills.  Which one of these three sites is worthy of your time and attention? Have a look and let me know what you think! 

  1. http://addisonsdiseasebreakthroughs.com
  2. www.addisondogs.com
  3. http://www.natural-dog-health-remedies.com/addisons-disease-in-dogs.html 

Keep an eye out for Part Two of “Everybody’s Gone Surfin” in which I will give you some tools for comfortably and effectively broaching the subject of your Internet research with your veterinarian! 

Wishing you and your four-legged family members abundant good health,

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine 

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller. 

Order  a copy of Speaking for Spot personally signed by Dr. Kay – http://www.speakingforspot.com/purchase.html

Join our email list – http://speakingforspot.com/joinemaillist.html

Look for us on Twitter – http://twitter.com/speakingforspot

Become a Fan of Speaking for Spot on Facebook

Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross

Frankly Speaking

December 6, 2009

In 2001, the Journal of the American Veterinary Medical Association stated, “Veterinarians’ responsibilities have expanded to include the mental health and well-being of their clients as well as their clients’ pets.”  For me, this came as no great surprise.  Having graduated from veterinary school in 1982, I’d already learned that if I wasn’t taking good care of my clients’ emotional needs, it was far more difficult to take good care of my patients’ health needs.  Admittedly, it took me a few years to catch on to this notion.  During my formative years, I recall thinking that good client communication would be a “slam dunk”.  After all, I fancied myself to be a good teacher and a nice person.  It didn’t take long for me to realize that the “medicine part” was becoming a whole lot easier than the “client part.”

Thus began my avid interest in the art and science of client communication.  I read whatever I could get my hands on (not much in the veterinary literature at that time) and attended communication workshops. I began studying my clients, trying new tactics and techniques, and asking questions of them not necessarily directly related to their dog or cat (Kleenex consumption increased exponentially).  I founded and continue to facilitate a community Client Support Group (talk about a front row seat in terms of understanding what is going on in our clients’ minds) and have enjoyed teaching client communication skills to local and national audiences.

The unfortunate fact of the matter is that few veterinary colleges provide any formal client communication training to their students- doesn’t make much sense does it?  One of the schools that doesn’t overlook this important subject is Colorado State University.  Here veterinary students receive fabulous communication training via the Argus Institute (www.argusinstitute.colostate.edu).  This organization’s stated mission is “to strengthen veterinarian-client-patient communication and support relationships between people and their companion animals.” In addition to providing formal client communication training to CSU veterinary students, the Argus Institute also makes communication training available to veterinarians.  These workshops are called FRANK (based on the notion of “frank” communication), and the emphasis is on relationship-centered care, an approach that emphasizes collaboration and shared decision-making between veterinarian and client.  Pfizer Animal Health was involved in the creation of FRANK in 2007 and continues to generously fund this program.

I just completed my first FRANK training workshop- what a fabulous experience.  I left the program feeling invigorated, renewed, and eager to apply what I had learned. The majority of the workshop time was spent in small groups within simulated exam rooms.  Professional actors played “the client,” each getting in character with their assigned emotional agendas (they were awesome and totally believable).  Everyone took turns as “the veterinarian” during these mock office visits.   The interactions were videotaped after which respectful, constructive critique was offered within the small group setting. We worked on several communication skills including delivery of empathetic statements, maintaining focus on the “common ground” (the well being of the patient), reflective listening, facilitating silent pauses (time for clients to gather their thoughts), disclosure (sharing stories of our own that might parallel what the client is emotionally experiencing), and asking open-ended questions (allows the client greater opportunity to share their stories).

A veterinarian can be a sensational surgeon or a dandy diagnostician, but such skills may wither on the vine if he or she is not a successful communicator.  More than ever before, people are becoming savvy consumers of veterinary medicine and better effective medical advocates for their pets.   My sense is that these wonderful trends will drive the awareness that client communication training for veterinarians is profoundly important.   Frankly speaking, I think it’s about time!

Wishing you and your four-legged family members a joyful and healthy holidays season.

Dr. Nancy Kay
Specialist, American College of Veterinary Internal Medicine

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot. There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot is available at Amazon.com, local bookstores, or your favorite online book seller.

Order  a copy of Speaking for Spot personally signed by Dr. Kay – http://www.speakingforspot.com/purchase.html

Join our email list – http://speakingforspot.com/joinemaillist.html

Look for us on Twitter – http://twitter.com/speakingforspot

Become a Fan of Speaking for Spot on Facebook

Listen to Dr. Kay’s interview – A Veterinarian Advises “How to Speak for Spot” on NPR’s Fresh Air with Terry Gross