Ubiquitous. To say the least. I am speaking of the way electronic devices seem to have taken over our lives. Now don’t get me wrong, I love my tech. I even have a drug formulary installed on my cell phone for frequent and ease of use. My concerns are when technology becomes a communication barrier, interfering with the client /patient relationship. As a result of this new normal, I have developed a few personal rules of engagement in dealing with clients and technology.
Dr. Google: Whenever you step into an exam room and the client has a stack of papers in hand, it is a sure bet they have been engaged in on line research and are often prepared with a diagnosis. Such research can be valuable since it is not a bad idea for a client to be an informed consumer of veterinary health care. The issue arises when the client presents the internet derived “definitive diagnosis” and expects you to follow it like a recipe. In most cases, a thorough physical exam and thoughtful conversation regarding the dueling diagnoses results in their seeing the benefit of a hands on experience and expertise vs the generic print out experience.
The telephone versus the physical exam: Since your pet can’t tell me why she is on my exam table, it is of utmost importance that I have your undivided attention for the 15-20
minutes while I take a medical history and perform a physical exam. Unfortunately, some people feel if a phone rings, they have to answer it. In such cases, it is best to fight discourtesy with courtesy. For the people who insist on making and taking phone calls while we are in the exam room, I gently place their pet on the floor and excuse myself from the exam room. I then see the next patient or attend to other duties for a bit and when finished, return to the exam room. In the event the client comments on my departure, I explain,” You were on the phone and I thought you would appreciate the privacy.” That usually takes care of the situation for evermore.
The electronic baby sitter: It is not unusual for small kids and teens to accompany their parents and pet to the vet. They often enter the exam room with their faces buried in a tablet or phone blaring with the sound and fury of a video game, movie or social media site. Enviably, the parent proudly states, “He wants to be a vet when he grows up!” yet they are completely detached from the experience. I approach the kid and state, “I am glad you are here and I need you to make a decision. If you want to stay in the exam room with your pet, you have to turn off your device. I you would rather not, please go out into the waiting room.” In 99% of the cases, the device is deactivated and the kid stays, albeit reluctantly in some cases. The parents are universally thankful and impressed with my ability to free their child from electronic enslavement, at least for the duration of the visit. I tend to think it is more the experience of being confronted by a grumpy, grey bearded, bear of a man, rather than any degree of gravitas.
“Competition for Exam Table Space” I enter the exam room and everything other than the pet is on the exam table. Bedazzled telephones and tablets are in full display and if there is an electrical outlet nearby, the table serves as a convenient charging station. Besides being an electronics oasis, it also serves as a repository for purses, magazines, and even babies. Years of being a mediocre football player have left me with arthritic conditions that prohibit my examining animals on the floor. Besides, if I got down there, who is going to help me up? At this point, I use my formidable skills of non- verbal communication. With a raise of my eye brows, the techs know to get the situation corrected and the patient on the table. Unfortunately, the offenders tend not to get it and the recidivism rate is high.
“Diagnosis by Photo or Video” This occurs most frequently. Someone calls and wants to email or text a picture or video of their pet, whom you haven’t seen in a while or never seen at all, with the expectancy of an accurate diagnosis. In such cases, I politely decline to make the diagnosis and encourage them to bring the patient in for an examination. Sometimes my suggestions are followed and others argue the point and find my refusal to provide a diagnosis irritating, to say the least. This is a practice that does have merit when used correctly. Photographs and video of a pet’s condition or behavior are often of great use for comparative and diagnostic purposes. Today, most diagnostics, such as radiographs, ultrasounds, and MRIs are presented as digital files that can be read on devices ranging from smart phones to full size computer screens. Of course, it is helpful when digital diagnostic files are presented in proper context of the case and time. By proper context of time I mean not on a smart phone in the middle of a dinner or while shopping at a ware house store, both of which I have experienced. An occupational hazard of being publicly known as a veterinarian.
“Filming Your Pet’s Examination” No. Just no. I a veterinarian, not a movie star.
“A Selfie with Your Vet” Sure, why not. Probably as close to hero worship I will ever get.
As our electronic devices become more engrained in our lives, for good or bad, we all will have to adjust our reactions and tolerance to them. Personally, I will be drawing the line at the ever increasing screen sizes. Exam rooms are only so big.
Dr. Pierre Bland is the owner of Dr. Bland’s Vet House Calls. He can be reached at 954-673-8579 or at doctorblandvet.com.