Why is the veterinary profession scared of the Internet?
By Christie Keith
December 19, 2008
Someday I’m going to write a book, “Translating from English to Veterinarian: A pet owner’s dictionary.”
I’m not saying we need a book like that because vets use language that’s too technical, scientific, or medical. Sure, that happens, but we already have dictionaries for that.
No, my dictionary would be about the cultural communication gap. Like the one where veterinarians seems to have the idea that the medium in which information is published or transmitted changes the quality, accuracy and reliability of the information.
Let’s take a recent warning from the veterinary profession, as discussed over on Dolittler by Dr. Patti Khuly:
Two recent papers, one of which appeared in this month’s JAVMA (Journal of the American Veterinary Medical Association) effectively urge vets to steer their clients clear of the Internet. Too many of their clients (you), it would seem, are taking to the Web to have your information needs met—and finding “unconstructive” advice instead of the good stuff your vet should be dosing you with regularly.
[....]
it found that even among veterinarian-authored sites, the information on anesthetic risks was more likely to be “unconstructive” than “constructive.”
“Web sites in which information was written by veterinarians were no more accurate or complete than those in which information was written by nonveterinarians.”
Do you see the problem? You’re supposed to trust your veterinarian and only your veterinarian for accurate medical information, but what veterinarians tell you on the Internet is no more accurate than what non-veterinarians tell you. So either some vets just plain don’t know what they’re talking about, or there’s some magical process that transforms veterinary information from good to bad when it’s transmitted over the Internet.
Wow. I mean, what is that process? And does it happen with other media, too? Is my vet going to be less accurate on the phone than in person? Should I trust the faxed lab reports she sends me, or insist she mail them? What if she sends them via an electronic fax?
Are her words more or less true when she sends me an email than when she blogs? What about her journal articles; when they’re published online, say, in the Journal of the American Veterinary Medical Association’s web archive, do web-gremlins slither in and change a few key words, or draw erroneous conclusions from the data?
Can we stop this stupid demonization of the Internet? People have always talked; we used to do it at dog shows and in the dog park and at the pet supply stores and standing on sidewalks with our leashed dogs. We did it on the phone and in the letters to the editor section of our dog magazines and newsletters. Now we do it in those places and online, too.
It doesn’t change the basic truth: some information is good, some bad, and some a mix thereof. We have to judge information on its merits, and sources on theirs, not on the technological system of delivery.
What the Internet has done is accelerated the process of communication and broadened its scope. We are doing what we always did, just faster and with more people. So bad information flows more readily, but so does good. Incredibly valuable pet health web sites, such as those that help people with cats with kidney disease, or email lists, like the incredible resource that is Tick-L, have helped pet owners with credible, reliable, sometimes lifesaving information that their own veterinarians often simply do not have. This is not a conspiracy, this is not a bad thing, and when the veterinary profession starts circling its wagons against truth and the free flow of information, they just look like they’re trying to preserve their mystique and protect their turf instead of really get the best possible care for our pets.
Does that mean everything you read on the Internet is true? Hell, no. But neither is everything you read in the paper, or hear at the dog park, or — and yes, I’m sorry, but this is the reality — get told by your vet in her office. Veterinarians are human beings, and human beings are fallible. In addition, not every vet can be expert in every area of medical practice. In other words, they simply can’t know everything about everything; no one can.
We have to learn to be discerning about the quality of the information we consume regardless of where we find it. And as part of that process, we need to get out what will one day be Chapter One of my English-to-Veterinarian dictionary. In it, you’ll learn to dig into the source of information and identify it to your veterinarian when asking her about it.
This serves two purposes. First, it will make you more discerning about what you read and believe. If something has no better support than someone you don’t even know on an email list said it with confidence, then the odds are it’s not useful information. If, on the other hand, you read an article posted on a respected pet web site, with citations or references to supporting evidence in the scientific literature or clinical practice, it’s far more likely to be something you should ask about.
Which brings us to the second thing, and some translation help. Do not, under any circumstances, go to your vet and tell her, “I read on the Web last night that you can control your dog’s diarrhea with canned pumpkin.”
No, say this: “Doctor, I read an article called ‘Coping with canine diarrhea,’ and it mentioned a study I wanted to ask you about. It was called, ‘Therapeutic response of 24 dogs to various types of dietary intervention for the control of chronic diarrhea,’ and they conducted it at UC Davis a year or so ago. Is that something you could look into for Sarge?”
I mean, why mention the Internet at all? It’s like saying, “I heard on the phone…” Information is information. Sources are sources. The Internet is neither; it’s just a technological publishing platform.
Of course, this really has nothing to do with the Internet. What’s really being objected to here is the free and untrammeled flow of information. No gatekeepers. No censors. No nannies, mommies, or daddies. Everyone decries that — the government, the armed forces, the church. But the truth is, you’ll never put the genie back in the bottle.
Instead, we have to deal with the world as it really is. And accept, too, that the Internet, like the world, is both a wonderful and scary place. Gullible people are everywhere, and they’ll fall for nonsense when they encounter it. Smart people will make better use of the information they obtain, no matter where or how they find it. That’s just human nature.
If vets want people to stop believing fairy stories about animal health, their efforts would be better directed to educating their clients in how to evaluate medical information, no matter its source, rather than suggesting that they are the only reliable place to get that information. That might be what our vets believe, but that ship has sailed and it’s not coming back. People will hit Google the minute they get home from your office. That’s just how it is. You can’t change it, not with all the hand-wringing and Dire Warnings(TM) in the world.
My proposal is simple: we should stop believing everything we hear, and our vets should stop telling us everything we hear from anyone but them anywhere but in their office is wrong. We should instead judge all information on its merits, and realize that no one knows everything or is always right — neither your favorite Internet guru, nor your beloved veterinarian.
That is, after all, why we have brains. Let’s use them.
Yes, I know I’m a curmudgeon dreamer.
What a great post! Hilarious and accurate at the same time.
Comment by Selma — December 19, 2008 @ 3:42 pm
Nice piece Christie.
I feel that many veterinarians are threatened by the knowledge their clients bring because there is a vulnerable underside to their practices. They are dispensing potent medicine with sometimes dangerous side effects without getting “informed consent” from pet owners.
When I chided one veterinarian for using Rimadryl without telling me of the potential danger beforehand, I became a “less than desirable” client.
This attitude taught me to research everything before I agree to anything.
I currently have a wonderful vet. She’s communicative, receptive and cooperative. She encourages me to “do my homework” which she knows I will anyway, and get back to her with questions. It’s taken several failures with less than forthcoming professionals to find her.
Comment by Pamela Picard — December 19, 2008 @ 3:47 pm
“My proposal is simple: we should stop believing everything we hear, and our vets should stop telling us everything we hear from anyone but them anywhere but in their office is wrong. We should instead judge all information on its merits, and realize that no one knows everything or is always right — neither your favorite Internet guru, nor your beloved veterinarian.”
That’s a really great summation and I agree. The problem comes about when people who have little to no scientific understanding of their pets’ healthcare try to judge the information. If you don’t understand the scientific merits of one treatment option versus another, how are you supposed to choose between them? You basically have to rely on how much you trust each source. If it’s a new vet telling you treatment A is better and an old friend telling you B works, you’ll probably pick B. If the person advocating A is nicer or more well-spoken than B, you’ll pick A.
It’s not as easy as you make it sound, is all I’m saying. My mom, for example, doesn’t usually understand her pets’ medical problems. She relies on me to help “translate” for her, and if I contradict her vet or whatever article she’s been reading, she’ll believe me automatically - even if my opinions are completely baseless.
What I think is necessary here is a better understanding of medical research and science in general by pet owners (and all consumers.) Unfortunately, that would take things like better science education and better health education. To sum up this super long comment, I agree with your article, but wish that more people were better equipped to actually use this advice.
Comment by Tara — December 19, 2008 @ 3:55 pm
“This is not a conspiracy, this is not a bad thing, and when the veterinary profession starts circling its wagons against truth and the free flow of information, they just look like they’re trying to preserve their mystique and protect their turf instead of really get the best possible care for our pets.”
This.
I am lucky that my vet is open to my needs when it comes to the care of my pets. When my cat developed fibrosarcoma, she was willing to try Acemannan at my request even though she had no experience with it and it was still experimental at the time. I learned about it on the internet and did my research before even pursuing it with her.
And yes, there are some wacky things out there and I can see why vets don’t want to have to dispel the wackiness time and time again. But there are also bad vets out there being exposed via their treatment choices or lack thereof - like someone I know who had a cat diagnosed in renal failure. The vet never discussed treatment options, never offered fluid therapy, nothing. Essentially sent the cat home to die.
When she found out through the internet that there were *things* she could be doing with diet, phos binders, fluids, etc., she was horrified. Then she switched to a new vet and got the treatment that the cat deserved. And you can bet that if anyone asks her about the first vet, she’ll have something to say. But without the internet, I doubt she would have considered a second opinion.
The health support lists are a huge boon to the average pet owner. Helping to translate blood work, investigating new treatments, finding what works for some and what doesn’t and just general hand holding support. They’re a tool and like any tool, they can be used properly or improperly. Used well, they can even help the vet.
Comment by mikken — December 19, 2008 @ 4:39 pm
“What’s really being objected to here is the free and untrammeled flow of information.”
YOU SAID IT!
It’s kind of, um, “interesting” that there has been a whole spate of these kinds of “don’t get medical information from the Internet” articles, about human medicine too.
Personally I don’t think it’s a coincidence. I’m pretty sure the medical/vet world is passing on some internal information about how to scare/intimidate patients from trying to become independently knowledgeable.
Let’s all remember how many more pets would be dead from tainted food if not for the Internet…
Comment by EmilyS — December 19, 2008 @ 7:44 pm
You are right. The internet is here to stay. Anyone telling you not to research medicial human or animal problems on the internet is a dinosaur,out of touch with the world.In fact I assure you these professionals are searching for information on all types of other subject using the internet. However, that said it does pose some problems.The use of Acemannan for fibrosacroma has been around close to twenty years and the use of diet, phos binders,and fluids has been part of the treatment for kidney failure for thirty years. I am glad the internet helped these individuals received what should have been considered standard vterinarian care. However for everyone case of this nature, medical professionals deal with twenty problems created by the internet. They fall in two types. The first one is incorrect diagnosis by reading on the internet. Everyday people go to there doctors and veterinarians demanding what medicine they need based on an incorrect diagnosis they made on the internet. The second group are prople with seriously sick animals or terminal diseases themselves wanting off the wall treatments that have absolutely no value and may even cause harm. Many professionals spend hours researching these crazy treatments to be sure there is not something new available they are not aware of. This is major source of frustration. This is a waste of time they could be using to treat patients. This will be a continual problem. The internet is here to stay. Somewhere in the middle of all this we have to learn not accept everything becuase it is on the internet as the truth even if it is posted 100 times (much of the information is recycled by different individuals)and professionals have to realize the internet is not an evil enemy trying to create them a headache. Oh, by the way these are not new problems,professionals have dealt with them from dog breeders,pet shops and host of other people for years, it simply was not as commonplace as it has become with the internet. The hope is all groups can find a common ground so that our pets receive the best medical care to maintain a high quality of life.
Comment by Owen Fisk — December 19, 2008 @ 8:05 pm
:-) Funny how some professionals want only sanctioned and edited sources to disseminate information.
The wonderful thing about the internet is that there is freedom of speech which is disappearing from the mainstream “traditional” sources.
Yes, there is good and bad and discernment is needed. However, bucking traditions and the status quo usually only means forward movement despite any hurdles tossed out.
Just look back in time and you can see this repeated over and over again.
Comment by Ark Lady — December 19, 2008 @ 10:14 pm
For me the issue is, as one of my post’s commenters said, a damned-if-you-do-damned-if-you-don’t proposition.
Should you try to inform yourself by any means necessary (i.e., the Internet) you’re told you’re as likely to be getting crappy information as not—whether a vet is the author or not. So why should you bother trusting *any* veterinarian? Why are vets online any more or less wrong than those found anywhere else?
If you happen to be a veterinarian who uses the Internet to communicate with pet owners (as I do) you’re likely to take a little offense at the singling out of us Web types..as if somehow the magic of the medium implies an inherent distortion of the message.
Comment by Dr Patty Khuly — December 20, 2008 @ 7:02 am
Some of the worst animal-health misinformation I’ve ever heard disbursed has been from the vet’s office.
Not from the vet — it was the receptionist answering questions over the phone, while I sat waiting for my appointment.
In one five-minute period on a particularly memorable day, I heard Ms. Phone Twinky tell someone who had scooped up what he or she was sure was an “orphan” litter of cottontails that “bunnies like lettuce,” that no, the litter of puppies could *not* have two daddies, and then the cherry on top, “have you tried rubbing her nose in it?”
AAAARRRGHHH!!!!!
Of course I spoke to the vet as soon as I saw her — more or less immediately forgetting whatever it was I’d brought my dog in for — but it was all I could do in the meantime not to grab the receiver and stuff it down the twinky’s throat.
The practice owner was an *excellent* vet. But like most around here, she did not get or keep good help. I assume they don’t pay well enough, or their working environments are not up to retaining employees.
When I moved about 30 miles, I found a practice quite near with superb technicians. I’m still with them 14 years later — and so are those original technicians, plus more as they’ve expanded. I’ve never heard one of them give horrible advice to a client, and I’ve spent plenty time in the waiting room.
Comment by H. Houlahan — December 20, 2008 @ 7:04 am
I’ve written before about my “don’t ask, don’t tell” relationship with my vet. I’ve known him for over 20 years and he’s totally been there for my pets, but he completely has this bugaboo about the Internet.
He flipped when I first started quoteing articles (no matter what articles) and gave me the lecture that Christie writes above. Since I do have a few critical thinking skills, I’ve read through all sorts of vet journal/conference presentations for my pets, but we now have this weird “he doesn’t ask where I got the information and I don’t tell him” where I discuss findings from vet journals (without quoting them, because how the heck am I reading Canadian Vet Conference papers without the Internet?) and ask them as questions about treating my pets and he gives me answers based on his reading. IT’S BIZZARE but at least my pets get good care.
I really like this guy and wish that we could be honest about where we are getting our information. It just kills me that I can’t be honest with my vet and have real, unedited discussions. But he’s there for me when I need it (if I call and say, Pet is in bad shape, bother the appointment in an hour, we’re coming NOW, he drops everything for me and that’s what saved Lindsey’s life in the pet food recall). We trust each other’s judgement — I just wish we could share what informs eachs other’s judgement.
Comment by Dorene — December 20, 2008 @ 7:13 am
I’ve been writing about pets for newspapers for almost a quarter-century (I was 10 when I started … not!).
Getting feedback and “dissent” takes getting used to! Both were relatively rare in the pre-Internet days, but that’s not true now. I can’t even answer but a fraction of my e-mail. But I read it all, and always consider it, and have seen my views on many things evolve as a result of online discussion with thousands and thousands of readers.
Frankly, being able to accept challenges and have respectful discussion with your readers (clients in the case of veterinarians) makes you better at your work.
It’s not always easy: Sometimes I get my feelings hurt, and sometimes I get angry. But no one knows it all, and on balance the Internet has made me much, much better at what I do. And that should be the same for professional, open-minded and progressive veterinarians.
Change or die.
Comment by Gina Spadafori — December 20, 2008 @ 7:59 am
Excellent, Excellent ! I think you should write the book or more articles on how to research and present valid information to your pets health care provider!
Comment by Lisa C — December 20, 2008 @ 8:08 am
Surely it was simpler in the pre-internet days when the overwhelming majority of pet owners took answers from their Vet as gospel. Now we have an easier way to network among owners, trainers, breeders, etc and access to opinions from all over the world (wide web). I can understand how that’s a bitter pill to swallow for some Vets who wanted to stay with the ‘gospel’ scenario. But to throw the virtual baby out with the html bathwater strikes me as stubborn and close-minded.
btw, my last TWO Vets dismiss any study from UC Davis, no matter where it’s published. Cos those people in CA are all crazy, doncha know?
Comment by slt — December 20, 2008 @ 8:09 am
I once had a vet go postal on me about a drug combination I inquired about for a sick rat who wasn’t responding to her prescribed treatment. The reason she got so upset? Because I read about it on the internet. Thankfully, she got over herself and went and looked it up in her own literature, and decided it was a good idea after all. But geez.
OTOH, the neurologist I took my old seizure dog to gave me two online epilepsy websites, both with communities, to check out.
Comment by katie — December 20, 2008 @ 9:42 am
IMO there are two sides to the story. There is a lot of crazy, crappy information on the net and, unfortunately there is also a depressingly large number of people who are simply not capable of differentiating between crap and fertilizer. There are also a number of well-known dog magazines who publish crap as science; and a lot of their junk science gets spread around the web (and vet clinics) as gospel.
That said, I’ve also experienced the cross-eyed look from my own vet when I showed up with peer-reviewed articles on issues I wanted to discuss. She’s also convinced that I’m going to kill my dogs with that wacky raw diet. I put up with her eye rolls and sighs because she does listen when I push politely and I like every other thing about their clinic.
Comment by Janeen — December 20, 2008 @ 1:10 pm
Personally, I’m fascinated by the fact that they didn’t say the internet information was “bad.” Or “incorrect.” Or “inaccurate.” They said unconstructive.
There are possible interpretations for that that would certainly explain why a vet telling you something in the clinic is a Good Thing, while the same vet telling you the same thing on her blog is a Bad Thing.
Comment by Lis — December 20, 2008 @ 5:13 pm
There’s an April, 2008 article in the JAVMA about a survey of veterinarians called the ‘Digital Clinic Study’ which, was conducted during the 2007 Western Veterinary Conference.
“The Digital Clinic Study has given us fascinating new insights into how impactful the digital age is on the veterinary profession,” said Dr. Ron DeHaven, AVMA executive vice president, in response to the survey. “It is exciting to see that, in many ways, veterinarians are ahead of the curve when it comes to using this new technology.”
The study revealed that about 88 percent of veterinarians said “the Internet enhances their access to the latest science and research. About 64 percent said the Internet makes their work and practice more efficient, and 61 percent said the Internet helps them provide better care for animals. The respondents turned to Web sites for information on professional and medical matters ranging from veterinary associations to animal genetics.”
—————-
..but then again, JAVMA published this information on the Internet…..
Comment by Joy — December 20, 2008 @ 5:30 pm
The reason the veterinary profession has been “ahead of the curve” can be spelled out in three words:
Veterinary. Information. Network.
VIN is a completely independent online service by veterinarians and for veterinarians. There’s just nothing else like it. And the reason for its crusty independence and honesty is it’s co-founder, prominent cardiologist Dr. Paul Pion.
Of course, y’all ought to know (in case you don’t already) that both Christie and I have worked for VIN. (We met and became friends WHILE working for VIN, and in fact Christie took over my job there when I left.) Neither of us work for Paul currently, but we’re still members of the extended VIN “family.”
I’m just flat-out in awe of what he has built for the veterinary community.
Comment by Gina Spadafori — December 20, 2008 @ 8:09 pm
Great piece. I will never understand why so many vets look at the internet as something to be feared rather than something to be embraced - yes, pet owners do need to be careful about where they are getting there information, but I think it is great that we are taking the initiative and doing research to protect our pets on our own.
Comment by stylepup — December 21, 2008 @ 1:12 pm
Same comment I posted on Dolittler “very, very sad, indeed” . I would be wary of the veternarians preaching this type of mantra to the clients. The fear is based on dessiminating truthful information, which infortunately is not easily had at every clinic. I feel that the real danger in pet medicine is the information that is “withheld” from the client to make reasonable & informed decisions, and yes, some may just put a “crimp” into the future monies to be derived.
Perfect example is my experience, though extreme: “Pocket’s Story from NH” —-link attached to my name….
Comment by Barbara A. Albright — December 21, 2008 @ 3:23 pm
VIN rocks — but I’ve gone into my vet’s clinic with VIN articles on vaccinations or seizures and gotten the same stink eye that the doofus who brings in a missive on Willard Water from the Whole Dog Journal gets…
(wanders off looking confused and humming “One of These Things is not Like the Other…)
Comment by Janeen — December 21, 2008 @ 9:38 pm
Janeen! You made me spew my Willard Water all over the keyboard. You can laugh now but when I’m still alive and kicking at 147, I’ll show you…
Comment by slt — December 22, 2008 @ 6:20 am
At the risk of tossing my profession under the bus a little…
…on the peer-reviewed papers…could it be that no one likes to think they’re not doing as good a job as they could be?
I know most vets don’t keep up with the more science-y journals…many prefer to read the digested stuff instead. There’s nothing wrong with that but it still irks some to be “outshined” by their clients.
“So you think you’re a vet, now that you read the journals?” I wouldn’t be surprised at that reaction. No, it’s not right…but it’s understandable to some extent.
Comment by Dr Patty Khuly — December 22, 2008 @ 2:28 pm
I believe the Internet scares people who are hooked on the social power. The demon Internet represents people’s ability to research the dictates of doctors, find out that other folks have similar complaints about a corporation’s products, and dig into what a nonprofit is actually doing with donations rather than allowing these entities to hide behind a cloak of authority.
There have always been, and will always be, people who question authorities based on non-credible information. There have always been, and will always be, people who raise legitimate questions. The Internet’s sin is pushing the culture in a democratic direction.
Comment by Barbara Saunders — January 3, 2009 @ 8:20 pm