Vet petitions RCVS to remove house visits from CoPC

RE: Vet petitions RCVS to remove house visits from CoPC

Adam Bell — Mon, 17 Feb 2014 21:59:44 GMT

These are excellent responses and considered comments. I have 21 - no, damn, 22 this summer!- years experience and I have done a lot of house calls in that time, and it is absolutely true that they are rarely essential if the animal is genuinely unwell and more effective and timely intervention is possible if the animal is brought in. Euthanasias are an obvious and very specific exception, and I have seen a handful of animals for elderly or infirm clients, or for spouses left without a car but with a 70kg collapsed Great dane, and essentially been the pet taxi for them. Most owners, however,could have brought the animal in with a bit of effort and some situations were, with hindsight - most were when I was an enthusiastic young gun and saw them all as new challenges - potentially dangerous.The changing demographic of the profession and the reliance on OOH clinics to provide care for a number of smaller practices mean that there will be more and more circumstances where it is either inappropriate for the vet to risk the visit or impossible to leave multiple other animals inadequately attended in a hospital.In my experience a sympathetic but honest discussion by telephone makes people realise that they both can and should attend the surgery and the advent of Pet taxi services is a real boon. However, the more I read and consider this, the more I agree the wording itself is less of a problem than the DCs willingness to interpret it unnecessarily harshly. the debate has to be had though and I doubt the RCVS will recognise that the rulings and interpretations are out of kilter with the times without being lobbied intensively, so I will sign it in any case and hope they are forced to consult more effectively.

RE: Vet petitions RCVS to remove house visits from CoPC

Emily Binning — Wed, 05 Feb 2014 14:19:51 GMT

I was among many who were shocked and saddened by the DC's ruling the Chikosi case. I will stand and be counted in saying that I think the expectations of the DC were unrealistic and the ruling harsh. However I am cautious about making a change to the current code. I have done my share of visits which were for client convenience rather than animal welfare. I agree that in most cases, with the exception of euthanasia, that the animals needs are almost always better met at the surgery. I also agree that there are situations in which our personal safety may be compromised and have on one occasion refused a visit out of hours because I felt that it wasn't safe (there were several drunk people on the other end of the phone using less than pleasant language)and I didn't feel that a visit was required or appropriate (the dog had got its lead stuck on it's foot).

I have also had to attend (out of hours) a GSD impaled on a gate, a collapsed Newfoundland owned by an elderly couple to name a few. These cases required attendance away from the surgery.

My worry with saying that the responsibility lies entirely with the client to get their animal to the surgery does not take into account the circumstances whereby it is genuinely very difficult if not impossible.

I am cautious about there being no requirement for a vet to attend away from the surgery where it is appropriate and it being left entirely to the conscience of the vet. I know we are for the most part a conscientious bunch who do this job because we do care about animal welfare.

I think this is a thorny issue and if the DC would just admit that they got it wrong in the Chikosi case and take a more realistic view of what it is like to be in the front line, then a change to the code would not be necessary.

RE: Vet petitions RCVS to remove house visits from CoPC

Mark Gordon — Sat, 01 Feb 2014 19:16:09 GMT

If that part of the code is being poorly interpreted, why not remove it and leave that negotiation between the vet and their client to proceed without fear of censure. I believe that many a vet would rather do an unnecessary visit than go through the stressful process of defending their decision to the DC.

RE: Vet petitions RCVS to remove house visits from CoPC

Chris Milligan — Tue, 28 Jan 2014 19:29:25 GMT

perhaps better clarification of the circumstances necessitatnig a visit rather than outright removal - true many visits are totally unnecessary and are usually for the owner's convenience, coupled with the fact that beyond euthanasing a patient or transporting it back to the practice you are extremely limited in the clinical service you can provide. However, refusing to attend what sounds like or could be an emergency is pretty poor behaviour for a vet irrespective of their level of experience or how long they've been practicing (which are not the same thing!)

RE: Vet petitions RCVS to remove house visits from CoPC

Bas Hardy — Tue, 28 Jan 2014 19:28:34 GMT

Trust an "Oldie" to wish to provoke discussion about Jo's rationale, but here goes:

The existing Clause is fine as it is. Jo is wrong in para 2,line 1,which should read "whilst it is not mandatory to accede to most requests.." And Line 2 "thereby implying, if there is an adverse outcome, that the vet will..." In other words, for a case which ends up at the DC, it is not unreasonable for the vet who refused a visit to explain why.

If Jo believes the DC doesn't currently "take on board the harsh realities of life in practice", then the better option would be to make changes to the DC.

Such a DC would then recognise as spurious her remark about "leaving the premises unattended". The vet had made the judgement to visit in line with the Code's requirement, and so could not possibly be held to be at fault if a contemporaneous welfare case arrived.

Sorry Jo, but there will always be some cases not just RTAs but other traumas, collapse and a variety other cases where distressed owners, especially the old & infirm will be physically unable (because of pet's condition,or owner's

condition) to move the pet to the surgery. And how, from a phone call, would a vet be "unambiguously" able to ascertain all of the factors in such circumstances?

Of course there are a number of owners who attempt to exploit the profession's goodwill, and the vet has to make best endeavours not to accede to their unreasonable demands. Conversely, not everyone out there is uneducated, some (often unknown to the vet), are even qualified in healthcare professions. Also, on TV, there's lots of "stuff" (maybe too much!) about not moving human patients, so many owners really do understand that moving on animal without a professional diagnosis could not only be harmful, but be fatal.

Finally, whenever personal safety is an issue the existing clause is clear in its guidance to the vet & the DC.

So, in summary, I believe the existing text is appropriate and Jo's changes are not necessary, better the RCVS makes improvements to the interpretations of the existing Code.

RE: Vet petitions RCVS to remove house visits from CoPC

Craig Connolly — Tue, 28 Jan 2014 19:26:01 GMT

I agree with Caitlinwitch that the only really useful small animal visit is for euthanasia. In the majority of genuine emergency cases we often need further diagnostics which will never be portable, or the animal will need to be hospitalised eg on a drip, so what's the point in the visit.

Many of the demands for out of hours calls are usually because the owner cannot drive, either they've been drinking (unsafe for us) or they've no transport (no money so potentially bad debt). If there's little money then surely what little they have is not wasted on an almost certainly pointless visit.

RE: Vet petitions RCVS to remove house visits from CoPC

Caitlinwitch — Tue, 28 Jan 2014 17:36:05 GMT

with the exception of euthanasia i have always felt that house visits just add a delay to the animals treatment. I also think most clients understand this when explained. I am also not happy leaving critical patients alone in the wards whilst driving out to a house visit. I have had calls late on a saturday night from owners who are not clients, live in rough areas and start the conversation that they cannot drive as they have been drinking…what female vet on their own is going to rush out to that nature of call? After all…doctors usually have a driver with them when they attend houses.

RE: Vet petitions RCVS to remove house visits from CoPC

sarah merrell — Tue, 28 Jan 2014 16:06:04 GMT

We had a case on Saturday morning displaying this issue perfectly. A client who portrayed they were desperate and that a visit was the only way to deal with their animal dragging the vet away as reception could only agree. Two able bodied owners with a mode of transport and an animal that could have been taken to us with no welfare implications. The implication that a visit is essential is rarely the case but difficult to refuse given recent events.

RE: Vet petitions RCVS to remove house visits from CoPC

Christopher Burch — Tue, 28 Jan 2014 14:45:39 GMT

It would indeed be a very sad day for the animals if a perfectly competent and caring vet was struck off because of antiquated ideals imposed by a disassociated ruling body (which are incidentally made up of a lot of caring individuals trying to do the right thing in a committee setting, and getting a hopelessly out of date result)

RE: Vet petitions RCVS to remove house visits from CoPC

Carla — Sat, 25 Jan 2014 23:21:16 GMT

I agree with Jo. There's nothing sad for animals and owners to be provided with the best possible care at 24hour premises and make vets working properly and in a safe environment. Let's not forget please that the very majority of small animal vets are girls nowadays, so the nurses!

RE: Vet petitions RCVS to remove house visits from CoPC

Martin Whiting — Fri, 24 Jan 2014 13:00:16 GMT

What do we think the public would want? That is a key question for a code provided by a regulator.

RE: Vet petitions RCVS to remove house visits from CoPC

Clive Ansell — Thu, 23 Jan 2014 09:18:23 GMT

I don't think it would be a sad day for animals. In almost every case I have ever dealt with, the quickest way of administering emergency care is to get the animal to the surgery as quickly as possible. I can think of only 3 cases in 17 years where a home visit as been essential on the grounds of welfare, 2 of which were entrapments.

RE: Vet petitions RCVS to remove house visits from CoPC

Arlo Guthrie — Thu, 23 Jan 2014 08:21:39 GMT

It would be a very good day for veterinary surgeons, though, removing a source of anxiety in a profession characterised by a high suicide rate.

Equally, it could be a very good day for animals, who can benefit from better facilities at the practice than at the owner's home, and owners taking greater responsibility.

RE: Vet petitions RCVS to remove house visits from CoPC

Hannah Wynne Richards — Wed, 22 Jan 2014 11:04:24 GMT

It will be a very sad day for animals if this requirement is removed.

Wynne