BLOGGING ANSWERS TO MOST COMMON CLIENT QUESTIONS

• Veterinaries should blog to educate clients by answering common questions of pet owners. Such content should be posted on social media to increase the reach of their blog.
• The Animal Emergency and referral center of Minnesota is an example of a regular blog that provides information on common pet issues that their owners may face.
• AAHA lists popular pet owner questions that veterinaries can build upon this information when developing their blog.

DIRECTING CLIENTS TO CREDIBLE SOURCES

• Health care professionals should laud clients for seeking more medical information. However, clients may not receive credible or complete information given their lack of medical expertise.
• As such, health care professionals should step in and recommend credible sources of medical information that can provide insight into medical concerns.
• Importantly, veterinaries should teach their clients on how to avoid business-sponsored websites or anecdotal information. 
• The Billings Animal Family Hospital recommends that clients can use the Pet First Aid App from the American Red Cross for first aid information for their pet.
• In this regard, veterinaries should encourage their clients to seek additional information while assuring them that it will not hurt their current relationship.

TELEHEALTH: PHONE AND EMAIL CONSULTATIONS

• Veterinaries should develop their own telehealth services that involves providing veterinary assistance over online or phone channels. Such assistance can bridge the information gap that Google serves.
• Veterinaries can engage clients over phone and email consultations to provide pet owners with answers to pertinent questions on the health of their pet.

EMPATHETIC EXPERT ADVICE

• When pet owners visit veterinaries with ludicrous demands on what their pet needs after undertaking online research, should respond with empathy rather than frustration.
• Veterinaries should tackle each matter with factual information while handling clients with the utmost respect and care.

SOCIAL MEDIA FORUMS

• Veterinaries can set up social media forums for constant engagement with their clients. As such, the veterinary can provide instant insight on medical concerns.
• Social media forums will result in sharing of experiences among pet owners that educates members on the social media forum despite not having similar afflictions. Optionally, veterinaries can poll community members building their engagement and sense of community.
• Clients of veterinaries also received behind the scenes' footage of surgeries from social media as well as information on pets going home. Such success stories inspire confidence of pet owners to reach out to veterinaries for information.

RESEARCH STRATEGY

Ways to Incorporate Online Medical Research

• According to Dr. Shelton, online medical research helps doctors explain information to patients regarding their medical condition.
• While searching for medical information online, Dr. Shelton firstly focuses on the publication dates so as not to share outdated details. The ideal publication date should be 1 or 2 years prior.
• Further, Dr. Shelton checks the credibility of the author and confirms whether the information is just an opinion or authored by an expert in the field.
• He further encourages patients to seek information through their own online medical research.
• Dr. Shelton’s favorite website for online medical research is UpToDate.com which features physician-written content.

• According to Dr. Mishori, physicians' use online medical research, since they are strapped for time with office visits, should be kept to as short as 15 minutes.
• Dr. Mishori believes that online medical research enables her to give patients extra information they can further pursue at home.
• Also, sharing online medical research with patients enables them to understand complex medical issues and engage in an informed dialogue with health care professionals.
• She recommends the following sources for online medical research: the Centers for Diseas Control and Prevention, National Institutes of Health, the Mayo Clinic, Family Doctor, and WebMD.

• Initially, Dr. Colucci, (who received her Ph.D. in medical engineering and medical physics through the Harvard-MIT Health Sciences and Technology Program) used to use websites such as WebMD, the Mayo Clinic, MerckManuals, and MedlinePlus.gov. However, she found that most of such websites only provide the same basic information which she found unsatisfying.
• Later, Dr. Colucci came across other websites such as UpToDate, DynaMed and Current, among others, that doctors used instead of some of the more popular sites that are often delivered via Google results.
• These evidence-based databases provide doctors with all information for treating just about any patient according to the most up-to-date guidelines.
• Dr. Colucci’s favorite site is UpToDate which features a “Provider Information” section that provides detailed information to healthcare professionals.

Additional Information on Clinicians' Use of Online Medical Research

• Internet search engine usage is common among healthcare professionals for finding answers to point-of-care clinical questions.
• A study of internal medicine residents in the United States estimated that 63% used an internet search engine to identify evidence at least daily.
• One of the most common sources of online health information is Wikipedia, with over 70% of physicians using it for health care information.
•  91% of physicians consider the internet to be an indispensable professional resource.
• Top information sources for physicians include professional journals, general web browsers, colleagues and online free services.
• Physicians now spend twice as much time using online resources as paper resources to make clinical decisions.

Research Strategy

SELF-DIAGNOSING AND ITS IMPACT ON VETERINARY

•  Pet websites have evolved in recent years, providing some reliable sources to find pet-health tips, nutrition tips, preventive wellness, exercises, and at-home care for pets, like AVMA and AAHA.
• However, not every site is reliable, and with the easiness of access to veterinary sites, a lot of pet owners choose to do online medical research and to self-diagnose their pet's before taking them to the doctor.
• What most pet owners don't realize is that doing so is a gamble on their pet's health.
•  Veterinarians use external and internal examination to determine a pet's condition and identify illnesses, while pet owners rely only on external symptoms due to the lack of experience.
• Self-diagnosing and doing online medical research is commonly known in the medical field as relying on "Dr. Google."
• One of the reasons people self-diagnose their pets is to save the expense and time of visiting a doctor.

• More than 75% of pet owners do online medical research to answer doubts about their pet's health instead of making an appointment with a veterinary.
• According to the results of a medical survey in the US, 35% of pet owners confirmed that the first thing they do when their pet is sick or ill is researching online.
•  15% of pet owners say that, because of the information found online, they don't rely on their veterinary as much as they should.
• According to the Veterinary Hospital Managers Association, 40% of pet owners have created a mental diagnosis of their pet's health before they visit a clinic.
• In some cases, they have already administered their pets with some medication or a "natural" treatment" they found online by the time they reach a veterinary, worsening their condition and in some cases intoxicating the animal.
•  Self-diagnosing can potentially delay the proper treatment and lead to further health issues causing harm and distress for the pet.
• Some other times, they follow their self-made diagnosis treatment and, if they notice it didn't work because their pet is suffering, they reach a doctor for the right diagnosis. They come with elevated and often unreal expectations of the situation, and in some cases arrive too late to treat the animal.
•  Self-diagnosis through online medical research is changing how the clients treat and diagnose their pets, and interfering with the veterinarian-patient relationship that guarantees a better patient care.

• Trusting in their self-diagnosis makes many customers second-guess a trained pet health professional's treatment plan and doubt their expertise.
• A study was conducted in 2017 by Frontiers in Veterinary Science about the relation between the client's internet use and the veterinarian-client relation in the UK and the US, where they identified that the results and statistics between both countries were very similar.
• Based on this study, 82% of the veterinarians have had a patient who has challenged their diagnosis, professional opinion, or recommendation because of the information they found during their medical research.
• "Dr. Google" gives customers false security that they understand and know how to interpret correctly the medical information they found online, even better than a professional.
• This false security reduces the value that customers give to a medical appointment, regarding the cost of the visit and the doctor's opinion.

•  Self-diagnostic is also impacting the perception of veterinary medical care and the field's profitability.
• This situation impacts veterinarians economically, forcing them to search for new ways to compete with the resources online.
• It also makes them unable to develop a proper veterinarian-client-patient relationship or give the advice to treat their customers' pets effectively.
• As veterinarians have accepted that they can't change this behavior, they are modifying the way they connect with their clients to become more approachable and ensure their patients receive the proper diagnosis, creating websites, blogs, and ways to address their questions online.
• A study by Pew Internet & American Life Project determined that 35% of US adults research medical sources to figure out a medical condition they or another person has before visiting a doctor.
• The same study indicated that 72% of the people who use the internet have searched for health information in the past year.
•  73.3% of veterinarians say they have changed their approach and give time to answer the questions their client have from their online searches.
•  22.2% of veterinarians stated that self-diagnosis has negatively impacted their relationship with their patients.
• Veterinarians are creating websites to help their clients and recommending reliable sites they can read when they have doubts.

• The healthcare profession is becoming consumer-driven and changing what customers expect from their doctors.
•  83% of patients in the US said that they felt more comfortable after their doctor agreed to hear and discuss the doubts and concerns they had from their medical research.
• Also, it is changing the way healthcare institutions and professionals communicate with their patients, forcing them to create websites and communication channels with their patients to ensure they have access to accurate information, instead of data that could be potentially harmful.
• As self-diagnostic and online medial research is becoming a common practice from patients, the healthcare industry is looking for new ways to use the technology to provide self-diagnosing tools that give correct diagnoses.
•  Self-diagnosing tools that are approved by professionals can benefit the patient and assist the doctor.

Apps

• There are several apps aimed at pet owners that, among other features, provide health and medical-related insights and tips.
•  PetCoach is an app that connects veterinarians and other professionals to pet owners, allowing them to ask these professionals questions regarding their pet’s health for free. Besides asking a veterinarian a question, users also can access vet-authored articles and review previously asked questions.
•  ExpertoAnimal is another app for pet owners that works as a social network, where people share information about pet’s health and medical insights, among other issues. The app also provides information written by professionals.

Emergency Lines

•  Pets Best, a pet health insurer, offers 24/7 Pet Helpline with their policy, a service that provides pet owners with access to veterinarians 24/7 by phone, live chat and email.
• The American Society for the Prevention of Cruelty to Animals (ASPCA) offers an app that connects users to Animal Poison Control Center and provides information about household hazards from expert toxicologists.
• ASPCA also has an emergency line for animal poison-related emergencies, available 24 hours a day.

Ask-A-Vet Websites

•  Vet Live lets customers ask veterinarians questions for $59.95, get a nutritional consultation for $59.95, or get a second opinion for $79.95.
•  Ask a Veterinarian online also allows users to get real live answers from veterinarians. The user first goes through a screening process, where they are asked about the issue, the animal type and other information relating to the animal’s health, they are then directed the Just Answer Veterinarians page for payment information.
• Users can post questions for veterinarians at Vet Babble, and are able to read previously answered questions and articles.

Online Consultation

• Besides their in-home vet care for those in the New York City or SF Bay Area, Fuzzy offers live consultations about health, lifestyle and activities.
•  VetChat provides both online chat and video consultations with Australian veterinarians.
•  Best Friends Vet Access connects users to certified vets to do preliminary diagnosis, the app offers several options regarding prices, from 1-day access for $3.99 to one-year access for $107.40.

YouTube

• YouTube could also be a viable alternative to Google, with some channels gathering relevant followings, such as Dr. Andrew Jones, with over 240,000 subscribers.
•  Dr. Jones is an advocate for natural pet health and former veterinarian, his videos are focused on natural solutions for medical or wellness issues pets may have. He talks about several conditions, ranging from fleas to cancer and heart failure.
•  Bondi Vet claims to provide vet advice for different health issues related to pets and the channel, that counts with over 40,000 subscribers, has a variety of videos, from cute animal collections to how to identify if the pet has skin abscess.
• Created by Dr. Karen Becker, Mercola Healthy Pets has over 89,000 subscribers and focuses mainly on health and medical conditions, such as ear hematomas, lick granuloma, and other conditions.

Websites

• The Pet Health Center from WebMD offers a great variety of articles, news, symptoms checkers and other features relating to pet’s health, wellness and medical conditions.
•  Healthcare for Pets has articles, videos, Q&As from topics ranging from behavior to vaccination and medical conditions.
•  Vets4Pets has a tool that allows owners to check their pet’s symptoms to see how serious the condition may be, what to do next, first aid advice, what the problem could be, and travel advice.