The internet has millions of bits of information, and some of it is even true. There are thousands upon thousands of blogs like this one; the only real way you can judge the truth of what I’m telling you, short of checking everything I write, is to either accept (or not) the weight of my credentials. As I wrote here, there are ways you can check on the reliability of what I’m telling you. You can also rely primarily on well-known (and well vetted) sites such as those of the Mayo Clinic.

Here is another extremely helpful site for you to bookmark. Titled the “50 Best Medical Libraries on the Web,” it is nice contribution put together by a nursing education site. What is particularly nice about the list of links is that they are grouped according to user, such as medical professional or general consumer, and by category, such as drug information.

It’s a good site to mark and keep handy. I have.

Here is another post taken from my newest book, How to Talk to Your Child’s Doctor. This one concerns what I call the poor conversationalist. There are several common versions of this, and all of them have corresponding parallels in nonmedical settings. Often the most basic difficulty is one of manner. A good conversationalist is a person who, no matter what he is thinking, outwardly projects an air of interest in what the other person is saying. The doctor who acts distracted, hurried, or even uninterested gets the conversation off very much on the wrong foot, especially if parents have been waiting a long time to see him. This sort of doctor may avoid eye contact with you. He often continually writes while you speak; although most of us take notes during an interview, parents not unreasonably expect us to look up at them now and then.

A poor conversationalist is impatient to get at what he assumes to be the crux of the matter and will interrupt parents, cutting off their explanations. It is true the doctor typically directs the flow of conversation, but he needs to do this in a way that does not stifle it. If he is too heavy-handed, the result is a very one-sided conversational exchange, which can in turn result in suboptimal medical care for the child. Knowing how to guide and direct rambling historians is a delicate skill for physicians. The poor conversationalist, however, often errs on the side of demanding from parents short, even yes or no answers only, to the questions he asks. He does not want all the details. As he sees it, like Officer Friday on “Dragnet,” he wants “just the facts, ma’am.”

Besides being annoying, the doctor who is a poor conversationalist of this sort will miss things, occasionally important things, because there are times when it is the details that really matter. A doctor like this often glances at the child or the chart and makes an early, snap judgment about which way to go with the interview when it has barely begun. Already convinced about what is important, he may then interrupt parents who he perceives as wandering from the key points of the history.

Our innate personal conversational styles can also interfere with the process. These are things which, although causing little problem in other aspects of our lives, can interfere with our roles as physicians. Some of us mumble, others of us gaze at the ceiling when talking, and still others of us use convoluted ways of expressing ourselves. Some of us present ourselves as amiable conversationalists, others of us come across to parents as unduly grumpy. If you find yourself trying to understand what a soft-spoken, mumbling doctor with an irritating facial tic is trying to say to you, remind yourself this person may well be an excellent physician for your child, exasperating as it is for you to understand what they are saying to you.

Parents who find themselves opposite a physician who is a poor conversationalist for any of these or many other reasons often become frustrated, and sometimes angry. After all, you have been waiting to see this person, sometimes for hours, or you may have made this evaluation appointment for your child weeks in advance. Now your concern is to get the most for your child out of an interview that seems to you to be moving in an unsatisfactory direction: how can you do this?

I think the most crucial thing is to remind yourself that you and the doctor truly are partners in the diagnostic and therapeutic enterprise, and most doctors, no matter how harried and frazzled at the moment, realize and understand this if given the chance. If you, as a parent and as a partner with the doctor, feel the interview is going seriously off-track, there are concrete things you can do to restore its direction.

For example, show you know how important it is to present your child’s symptoms in the order they occurred, what they were associated with, and what made them better or worse. Be as precise as possible in your words. Remember to stick to one symptom or complaint at a time. A doctor who is already a marginal conversationalist often becomes an interrupting, controlling interviewer if he perceives a parent aimlessly wandering around with disjointed answers to his questions. Once an interview goes seriously awry in that way it is very difficult to restore the situation.

Hospitals can be dangerous places, and the subject of medical errors has been getting a lot of attention over the past couple of years. The movement really got going with widely-reported study from the Institute of Medicine, which calculated that anywhere from 44,000 to 98,000 people die each year as a result of medical errors. That is a staggering number on the face of it, but you should understand that the definition of a “medical error” is an inexact one (hence the range in the IOM report).

Some errors are clear, the ones which generate headlines, such as giving a patient a drug she is known to be allergic to or performing surgery on the wrong body part. Other errors, though, are much softer. Diagnostic errors, for example, such as failing to make the correct diagnosis, are much more difficult to classify. Doctors have our own term for the old saying that “hindsight is 20/20″: we call it the “retrospectoscope.” Looking through this fanciful instrument makes things crystal-clear, but only in retrospect. We live life forward, not in reverse.

Still, the medical safety movement has made enormous strides over the past decade. It turns out that many patient safety measures are actually quite simple things to implement. For example, simple checklists turn out to be easy and effective ways to make sure things are done correctly.

One of the most problematic aspects of the entire patient safety movement is the sticky issue of blame. The ground-breaking IOM report’s title was “To Err is Human,” and it is. Nothing done by humans will be completely error-free. Yet the way to make things safer for all patients is to devise a way of monitoring and reporting errors without making healthcare personal afraid to report them, either because they will be disciplined or sued. Although I think we still need a way to make individuals accountable for their actions, a systems approach, such as the airline industry has done, is the best way to make the system safer for everybody.

It can work in medicine as well as in air traffic control towers. A well-known example of this is anesthesia. Getting an anesthetic is many times safer for patients these days than it was decades ago because the specialty of anesthesiology took a systems approach to accomplishing that.

The high-tech, high pressure environment of the PICU makes it a place particularly susceptible to errors, and I have seen them happen. The widely-reported incident with Dennis Quaid’s child is an example. I can’t quote you any statistics, but it is my personal impression that the patient safety movement of the past decade have reduced their number and severity.

Speaking of checklists, the American Academy of Pediatrics has an excellent one here, entitled “Twenty Tips to Help Prevent Medical Errors in Children.” It covers medications, surgeries, and hospital stays. I recommend it to you.

Over the next couple of months I’ll be putting up the occasional post taken from my new book. This one is the first in a series about communicating with doctors — in particular, what you as a parent can do about it. This post is about the poor explainer.

A physician, like anyone, can be a poor explainer of things for several reasons, but foremost among these is the tendency to use medical jargon. This is not a problem unique to doctors. When I take my car in for repairs I often must ask the mechanic to explain what is wrong in a way I can understand. I have a rudimentary understanding of what the various parts of the engine do, and I even recognize the terms he uses to describe these parts, but I have little understanding of how the parts relate to each other and what can go wrong with them. Automobile mechanics often wrongly assume most people know more than they actually do about car engines. If you spend all day working with engines and talking with colleagues who are doing the same thing it can be difficult to grasp how confusing the subject can be to nonmechanics.

Physicians find themselves in an analogous situation. Most parents know about their child’s body and many of the ailments that can affect it in the same way I know about my car and what can go wrong with it. But even though we know the words for body or engine parts, someone explaining to us what is wrong with a child or a car should not mistake this passing acquaintance with the vocabulary as true understanding–explanations should be in plain, jargon-free English.

There is another way this situation is analogous to auto mechanics: often the non-mechanically inclined, especially men, believe they ought to know about car engines, even if they do not, and are reluctant to press for clearer explanations from the mechanic. So they nod wisely while the mechanic explains, all the while having little or no idea what he is talking about. Likewise parents sometimes feel as if not being medically knowledgeable makes them somehow poorer parents, and they are reluctant to press the doctor for clearer explanations when they do not understand what she is telling them. You should not let your mechanic do anything to your car you do not understand the need for; do not accept any less from your child’s doctor.

What should parents do if they find themselves with a doctor who is a poor explainer, either from her excessive use of medical jargon or some other reason? I think the best approach is to do as a doctor does when we take a history from parents who are vague and imprecise in their descriptions: we pause frequently and rephrase our questions in different ways, and keep doing that until we understand. Parents can do the same thing by stopping the conversation at intervals, restating in their own words what they think they are hearing, and then asking the doctor if that is correct. Thus a parent can respond to a murky explanation from the doctor with something like: “So, what I hear you saying is . . . . Is that right?”

The worst thing to do for your sick child is to imply to the doctor you understand when you do not. One way or another, make her explain it to you so you understand it. Make her draw pictures if necessary. When you insist on continuing the conversation until you comprehend everything you are not being a pest, you are doing your job of being a good parent.

Medical news is all around us, fed by, among other things, the insatiable needs of the round-the-clock news cycle. Much of the news tends to be either scary or hopefully uplifting. Thus we read of a new cancer threat or a new hazard of daily life, or of some new wonder cure. How good is this news coverage? Can we rely on it for useful information?

Unfortunately, it turns out that much of the news coverage of medical issues is not very good, and some of it is unreliable or misleading. One pernicious difficulty with medical reporting is that medical news, like all news, needs to be news. So, just as dog-bites-man is not newsworthy but man-bites-dog is, medical reporting is skewed toward reporting the scary or the fabulous. What many don’t know is that this tendency is not limited to the popular media; it is also a problem with medical research in general. Scientific journals also exhibit a well-known bias toward publishing positive findings — research that shows something new or some new treatment. A scientist who demonstrates the absence of something, negative findings, has a much more difficult time in getting her work published.

Gary Schwitzer, a journalism professor at the University of Minnesota, maintains an interesting and useful website called Health News Review. There he and his colleagues offer you detailed analyses of how the media reports the medical news. It is in many ways a sobering report card, because much of the reporting is not very good. On the other hand, it shows simple and clear ways the reporting could improve. Reading these critiques is also a good way for you to understand yourself how to read and interpret the medical news.