Monday, March 5, 2012


Warning: this is not a strictly veterinary post

My mom and my dad both graduated from college. My dad and uncle were the first people in their family to do this while my mom and her siblings followed my maternal grandfather in getting a college education. My dad died suddenly when I was a teenager, so my mom raised my sister and me once it got to the pretty complicated stage (13 and 16, respectively). Education beyond high school, and even beyond college, was expected in our family.

When my mom, a very medically savvy and medically educated woman, married into a family of people with a pretty low educational background, it created a new job for her. I am in no way discounting intelligence: my step father does not have a college education but I consider him to be someone that is a genius in his own right. However, her in laws (my step grandparents) have an education that tops out at 8th grade. I think they had to drop step dad's mom because she had to take care of the other kids in the family and my step dad's father because he had to go to work to help with his family's bills. I don't think that the initial education was any great shakes either: think of a place where "You gotta a pretty mouth, boy" might be uttered. That is the kind of place I am talking about. My step grandmother can create a meal that will make you cry with joy. And Papaw is the kind of guy that can take parts from 20 different cars and build a vehicle that would make most people clap their hands with delight.

However, my step grandparents have a distinct lack of understanding of biology. And a lack of ability to read with comprehension much better than my 6 year old daughter. So, my mother has become the person that reads everything from warranties for appliances to information about health. Which is fine with her...that is part of being a family.

A couple of days ago, Mamaw told my mom that her doctor told her she had "Flea-bite-us" but she had no idea how this could happen: she couldn't find any fleas. The answer was of course she doesn't have fleas...she has phlebitis. Now, since neither my mother nor I was there, I have no idea if the doctor explained what he meant. I don't know if he gave handouts (though my mom usually interprets this for the inlaws). However, I do think that it illustrates things that we can all take home.

As a vet, I always make sure that my clients have oral and written information on disease processes. I give actual handouts, I give internet addresses where clients can find "vetted" information. I have given out my phone number to some clients if I know we are going into a weekend and the patient has a serious problem. And other vets that follow this site, likely do similar things. If you are a vet and you are reading this and you don't do this, start. It is not very hard to link a diagnosis in your computer system to a blurb on something....hell, take it straight from Veterinary (please cite it). The Homeless Parrot in our side bar also has great information on diseases and terms.

If you are a non-vet reader, please ASK for an explanation from your MD/DO or DVM. Please ask for the spelling of the problem. And while you can google the information, please take all information with a grain of salt. The initial exam can often feel rushed...but if you approach your health care provider with real questions....real interest without agenda, you should be welcomed...even if they tell you they will need to look into it (NOT a sign of weakness...a sign of strength). If you are not taken seriously, find a new doctor/NP/DVM. As a doctor, I want to CURE my patients. I assume my clients will research something online. Fine... I will evaluate this and I might find it FOS or I might take it seriously...and some will be a combination of the two.

Don't be a passive doctor or nurse/tech: every question is a chance to critically evaluate why you believe and advise the things that you do. And others, don't be a passive consumer of your health. The only way for a health system to work is to be honest about the things that you don't understand. The health care providers will do a better job if you tell them what you don't understand.

As much as I initially wanted to snicker at the word "flea-bite-us," it really just makes me mad. Someone failed. And I don't think it was the woman with an 8th grade education.


  1. I love!! In ER, I often don't have the time to explain things beyond the basics as I need to get to the back and start working on your pet. Even if it is not a critical case, I often don't have time to spend explaining every little thing to a client, though I wish I did as I really want them to be educated about their pet's condition so that they can make the best decisions regarding care. I will often print the handouts from the website and highlight the areas that I really want the client to understand and that I think are important. It also keeps me from forgetting to say something because I have a gazillion things going on in my head at once. If it's a slow night, I will take all the time in the world to answer questions to ensure the client understands the condition, how we diagnose it, treatment options, prognosis, and expectations. I have taken it upon myself to just print out the information regardless even if they choose not to treat right at that moment.

  2. This is a wonderful point. I recently read an article about research at Johns Hopkins that had something to do with elderly patients being accompanied by someone (usually a son/daughter or other family member) to doctor's appointments, and it seemed to improve the doctor-patient communication by having an extra person present who is actively engaged in the dialogue. And I would imagine the younger generation is more likely to utilize the internet for research and be ready to ask good questions. Like you said I think it's important in any appointment, for four-legged or 2-legged family members, for both the doctors and patients/clients to find ways to improve the dialogue.

    1. When my dad was being treated for lymphoma, my mom went to every appointment with a notebook and a tape recorder.

      He still died, but they were informed to the end.

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