I’ve been asked on several occasions to lend my veterinary skills to the cause of pet wellness in an online Q&A format. I’ve also seen numerous announcements looking for vets to fill this function on several “ask the expert” websites.
In these cases I invariably ask myself, “Why would anyone like me do this?”
So you know, it doesn’t pay dividends in bucks-per-words. The biggest return is in new clientele, I’d imagine. Yet even then, how could most professionals ever hope to enhance a local clientele through online Q&As? I don’t get it.
Some of you might think me two-faced for bringing this up. Isn’t Dolittler a Q&A at times? After all, the Virtual Vet Hospital (look to the right of this post), while designed as a mode of support, encouragement and learning, has kind of manifested as a friendly advice area, instead. (Not that I’m complaining—though I’m redesigning it to thwart strict advice-seekers, I still think it’s fun.)
Online advice is a tricky thing. I’ve written about it before as being potentially illegal, often unethically administered and usually kinda cheesy.
Yet it’s clear that sometimes it can be beneficial, as when someone Googles “veterinary pathology wait times” and sees themselves in the words of a post. Or when their sick dog receives a vaccine (as in tomorrow’s post and a recent Virtual Vet Hospital entry) and they question the safety of its administration.
Individualized advice is even trickier, what with the moral, legal and ethical demands of something we call the VCPR (Veterinary Client Patient Relationship). Cultivating a valid VCPR is the cornerstone of companion animal medicine and the Internet is no medium through which to perform a physical exam (a basic requirement of the VCPR).
The arena for middle-ground advice is vast, though. And yes, I think advice of a sort can be properly administered. Problem is, there are no professional standards for meeting the needs of those who might easily be duped by less-than-scrupulous online advice providers.
To whom do you turn when the advice you received resulted in the death of your pet?
And that brings me back to the question I asked myself earlier: Why would anyone join in these reindeer games when they have a safe, legal means of practicing their craft in the physical world?
And what does this mean for those who seek responsible advice as an adjunct to their real world care?
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I was one of those vets answering questions in a now gone forum called Animal Health Channel. It was NOT my idea, but rather something my boss did. Then he had a stroke and this fell to me.
I was not identified by name, and there was no payment associated with the system, so I had no benefit doing it. It turned out to be something that would require a lot of my time (and I never dealt with it on MY time--I figured it was a Work Thing) to research some of the questions and answer them. The best questions were of the "My pet was just diagnosed with X and these are the options I was told about, does it sound right?" variety. I liked doing those because they were more teaching than giving specific advice to an owner. I prefaced a lot of posts with "I can't know what is going on because I don't have the benefit of seeing your pet" too, though.
There were always posts that were examples of a person who would have been better off going to a vet than noodling about the internet--I came in after a 3 day weekend to find a post from someone who had a puppy that had been seizuring for 4 hours when he wrote the post Friday night. And once I had a fellow with 3 daschunds that were all very sick and when he posted one had already died...and when I urged him to seek care NOW, he took the time to reply back THREE times about how angry he was that I refused to tell him how he could save his dogs and how I was part of the Money Grubbing Veterinary Conspiracy.
I do have one funny story from it though--as I said, I never knew who I was dealing with since everyone had aliases and my tag online was "veterinarian3" One day I answered a question that included a rather long and weird story. Later that day, a client came in and I suddenly realized she was spinning the EXACT same tale--I forget the details now. We had a good laugh about that and she stopped posting to that site and started just calling in with questions instead (which we preferred!)
I was glad when that task got taken away--it was not something I enjoyed. People wanted immediate answers (boy did I get taken to task over weekends! Or even an hour!) but did not want to pay to support sucha service either. It did go to pay per question (I think it was $25) eventually, and all questions immediately stopped.
DrSteggy July 30th, 2008 01:06:00 PM
If I'm not under stress or in a pinch for time, I research possible avenues for pet care in several ways: experienced and long-time breeders of the specific breed, online articles both written by people experienced with their own pet and articles written by experts or medical people. There is a wealth of legitimate information to be had. A friend of mine found "Dodger's List" with members in various states of pet recovery dealing with IVDD. It was through this list that we owner's of afflicted Sealyhams are participating along with Dacshund club to find a genetic link (U of CA, Davis).
I've offered more than once, to post my elderly Sealyham Dottie's treatment of secondary glaucoma, in the virtual hospital, either with or without the doctor or clinic name. I thought it a great and successful alternative for a pet in lieu of sugery to remove the eye. I most likely would have chose an alternative , had she been younger and healthy---but this afforded many more months of quality life for a dog with multiple health issues. No need to solicit advice in this instance, the purpose would be to share with others a reasonable alternative for their own pets.
When do the questions get tough? Well, I plan on posing a difficult question in the future re: piroxicam treatment for adenomacarcinoma (as per DVM360 article). The question would be: is the risks worth taking for the benefit for an elderly dog?
Barbara A. Albright/New Hampshire July 30th, 2008 01:19:00 PM
In the above example of Dottie: I had never heard nor researched the treatment prior to her receiving it. It was one of 3 options presented by her wonderful ophthamologist/surgeon and time was of the essence.
Barbara A. Albright/New Hampshire July 30th, 2008 01:49:00 PM
DrSteggy: Sounds like a nightmare. Good thing you never left your day job, right?
Dr. Patty Khuly July 30th, 2008 04:30:00 PM
Well, you'll be glad to know that some of us use the internet to look up the phone number for the emergency vet rather than trying to find a forum on the problem. : )
There's not an online replacement for taking the pet into a clinic where a vet can examine her and determine how to treat the problem. As a pet owner, I'm appalled by DrSteggy's daschund story (appalled at the pet owner, not the vet).
Posey July 30th, 2008 11:50:00 PM
I answer question on various animal at allexperts.com and you wouldn't believe the number of questions I get where the animal is clearly very sick or dying and the owner stil takes the chance of me not replying for hours or days. Apart from that I clearly state that I don't give advice on health questions - I'm not a vet - and give websites where vets can be found in my profile and the people still ask me.
Jennifer July 31st, 2008 03:04:00 AM
Jennifer: What kind of questions are a "good" use of your skills? I'm just curious. I agree with DrSteggy that helping someone sort out the advice they already have in hand is an excellent example of where online consulting can be helpful. Do you have another example?
Dr. Patty Khuly July 31st, 2008 07:57:00 AM
Veterinary websites have been invaluable to me in the form of "supplementary information." We have an excellent vet, but I like to do my homework too so I can ask intelligent questions about medications, side effects, the role of nutrition, etc.
When we first met our now adopted cat at her shelter, she had conjunctivitis in her eye. I went right home and researched everything I could find on legitimate veterinary sites about eyes, infections, etc. The next day I called the shelter and requested they give her eye medicine on top of the regular clavamox, to make sure she didn't get an ulcer. She is fine now, but I am thankful the information was out there, so I could ask the vet on Monday morning what risks there were to my other cats in taking this one home.
Unfortunately, there are always going to be ignorant people who try to get free advice on the web, and put off the vet visit they know they should be making for their pet. But please don't let that stop you from educating the rest of us so we're prepared in advance for whatever comes up.
Debby July 31st, 2008 03:24:00 PM
You're right, Dr. Khuly--people who dispense advice on the internet do walk a very fine line. I write a cat advice column myself, where I answer letters from readers about various feline issues. My constant refrain is that I'm not a veterinarian, the advice I give is absolutely no substitute for veterinary care, and if you're in even the least doubt that your cat requires veterinary attention, go to the vet! I also tell my readers that if anything I tell you conflicts with what your vet says, take your vet's word because he/she is the professional, not me.
I see my job as entertaining readers and hopefully offering some wisdom that people can use to be better caretakers. I've also made sure to set boundaries: I answer one letter a week, and I work on answering that question one day a week. I receive e-mail questions every day, but I don't act on the question unless it's obviously a matter of life and death for the cat. ("Help, my cat can't pee" or "my cat's lost a lot of weight in the last couple of weeks, what do you think it could be?", for example. I respond to these letters as soon as I get them with a comment along the lines of VET! NOW!)
I've seen some REALLY HORRIBLE animal health answers in places like Yahoo!Answers, though, and I think it's exceedingly foolish to take advice from people in that sort of forum--there's really no responsibility or accountability in a forum where everyone is anonymous.
I view myself as an advice columnist as more along the lines of Dear Abby or Click and Clack. I can give you a general idea of what might be going on and probably some pretty good advice--but I'd never dare to make a diagnosis because I don't have the proper credentials to do so, and even if I did, I'd never do such a thing sight unseen. Ethics and all that.
JaneA July 31st, 2008 04:24:00 PM
Debby wrote: "Unfortunately, there are always going to be ignorant people who try to get free advice on the web, and put off the vet visit they know they should be making for their pet."
Or, they aren't ignorant at all. Some are caught in unemployment or another situation where they can't take their pet to a vet. And let's not start with "Then they shouldn't own pets" because if they try to find another home for a beloved pet, someone will come back with "How irresponsible to not keep the pet for its entire life."
Life is complicated, and reducing eveything to name calling does not help.
I'm with Posey about calling the emergency vet.
Mary August 2nd, 2008 05:48:00 PM
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