Being a GP vet

RE: Being a GP vet

mariette asselbergs — Fri, 06 May 2016 23:38:28 GMT

Ha, thank you, good point, I always resented this phrase!

Mariette

RE: Being a GP vet

Stuart Jackson — Fri, 06 May 2016 16:04:55 GMT

At LAST. This has been bugging me for years.

On another note - who instigated the idea of calling me a "first opinion practitioner"? Has it come from the US or London? I really object to it. Would you be so kind as to stop it?

Thank you

RE: Being a GP vet

Stuart Jackson — Fri, 06 May 2016 16:02:53 GMT

RE: Being a GP vet

J G Wray — Fri, 06 May 2016 13:19:23 GMT

[quote user="Chris Barker"] have spent four years on Standards trying to ensure demands made of practitioners are justified, fair and deliverable.[/quote]

Thank you

[quote user="Chris Barker"]As for the rest of your concerns...the RCVS is a supertanker with momentum.....[/quote]

Steady, you've signed up to a Code of behaviour and you know what they're like. Don't get yourself into trouble.

The supertanker analogy is amusing, given RCVS is sponsoring Vet Futures where one of the underlying tenets is that practice is not a nimble, agile and responsive exercise and needs to be steered somewhere over fifteen years, just like a supertanker.

RE: Being a GP vet

Chris Barker — Fri, 06 May 2016 13:09:23 GMT

[quote user="J G Wray"]Are you going native? [/quote]

Hopefully not - have spent four years on Standards trying to ensure demands made of practitioners are justified, fair and deliverable. As for the rest of your concerns...the RCVS is a supertanker with momentum.....

The proposal for shrinking the size of Council and doing away with the Operations Board will mean than individual Councillors will have far more influence over policy decisions. The time frame for these changes is some 3-5 years; if those in practice truly want to influence the direction of the RCVS then by then we need to have more active, interested practitioners standing for Council election.

RE: Being a GP vet

J G Wray — Fri, 06 May 2016 13:06:43 GMT

[quote user="Chris Barker"]any of you read it?[/quote]

Yeah and he got it nearly right. He summarised the work of a GPVet as triage for process in consultation. It's quite a lot more than that, so he/RCVS is still off the mark. I could go on in detail, but....

[quote user="Chris Barker"] The value of the generalist is well recognised within the walls of the RCVS [/quote]

Really? When are RCVS going to demonstrate this? I ask because Queen's medals, Fellowships and Advanced Practitioner badges only mean something within the profession. The RCVS is there to look after the public interest and since most GPs will never be Advanced Practitioners, Queens medal recipients or even F'sRCVS, there's a need for RCVS to back this claim of valuing generalists to build on the trust and confidence GPVets have already earned for themselves, by themselves.

Are you going native?

RE: Being a GP vet

Chris Barker — Fri, 06 May 2016 12:34:24 GMT

[quote user="sajackson"]My point is that there is no recognition of general practice as an option for AP[/quote]

Then watch this space.... The value of the generalist is well recognised within the walls of the RCVS and a Certificate/Advanced Practitioner option for the generalist in first opinion practice is being discussed at the moment. And the new President-elect Stephen May published a paper in the Vet Record quite recently recognising and praising both the skills and the value of the first opinion practitioner...any of you read it?

RE: Being a GP vet

David Mills — Fri, 06 May 2016 10:31:55 GMT

[quote user="Michael Woodhouse"]I'd say that was slightly unfair. If you didn't do any emergency work for 20 years, do you think you'd still be any good at it?[/quote]

I do have sympathy for GPs.

I think many of them would want to do 'more' (whatever 'more' is), but they're hamstrung by two factors: the threat of litigation if a patient perceives suboptimal outcome; the fact referral doesn't cost the patient anything. If you were a human GP, would you risk your livelihood doing something in your practice that there is someone more experienced and better qualified to do at the hospital down the road, to whom your patient could go to for free (to them at least)? I wouldn't. Human patients are far more likely to be litigious, and with the profusion of no-win no-fee, and NHS Trusts' willingness to settle out of court, it creates the NHS we've got at the moment where GPs simply refer most things upwards.

Being a private profession, and charging for services means vets get to do more because the number of people able to afford referral is quite small. Along with the tightening of the insurance belts in response to asset stripping at centres over the years, I can envisage fewer upwards referrals in the future, more in-house or within-group. Referral centres will continue to service the surface cream as before, with ever-more complex interventions, but their slice of the pie will become smaller and probably more exclusive.

RE: Being a GP vet

J G Wray — Wed, 04 May 2016 16:45:17 GMT

[quote user="Bob Russell"]Sorry I am not convinced that most owners are that interested in getting a trusted GP vet. They are easily drawn in by plush premises, clever websites and the promise of cheap treatment.[/quote]

There are two types of clients, existing and new. The new must at least match the departing existing clients or a practice will wither. If new clients have an expectation then unless you meet or exceed that expectation then the practice will wither.

Vets are notoriously poor at understanding what clients want, see Mellanby's paper and all following - I have no idea how many times this bears repetition. I'm pretty sure plush premises aren't on that list. Clean ones are. Websites ain't but they're one of the first points of contact, so why not have one and as for price, why not use price to select a clientele and deliver value - as clients' perceive value, not as vets see value? It's something GPVets are particularly good at after all.

RE: Being a GP vet

Stuart Jackson — Wed, 04 May 2016 10:21:13 GMT

[quote user="Michael Woodhouse"]Tell you what (assuming you meet the CPD requirements) I challenge you to apply for AP status and if they turn you down with your CertAVP I will donate the £80 to a charity of your choice![/quote]

Thanks Michael. I'll give it a go and match your offer. My point is that there is no recognition of general practice as an option for AP (I concede that VetGP is an option in the application - but it does not lead to AP-General Practice). I could apply for AP-Small Animal Practice (using CPD & GPCert(Endos)) (although the RCVS doesn't recognise this), but that's not the point.

RE: Being a GP vet

Eilidh Corr — Wed, 04 May 2016 09:18:37 GMT

[quote user="Bob Russell"] They are easily drawn in by plush premises, clever websites and the promise of cheap treatment.[/quote]

It's a marketplace though - to survive you have to offer what people want. You can look modern and shiny but the question is whether the vets are practising modern shiny veterinary medicine! I still think you need to bond with clients on a personal level to retain them in this context. People are everything, and more powerful than any logo or promotion.

Unfortunately it often takes something going wrong for the client to realise your true value and to test that trust out.

RE: Being a GP vet

Bob Russell — Wed, 04 May 2016 09:11:12 GMT

[quote user="Eilidh Corr"]

[quote user="Michael Woodhouse"]That's a rather bold statement when about 2.5% of the profession is on the specialist register compared to about 55% of doctors.....

[/quote]

I suppose the question is whether greater specialism is to the benefit of the animal population of this country, and their owners.

If 55% of vets were specialised, would that correlate with improved welfare? I have my doubts.

Most pet owners want a trusted GP and access to specialism as an option if required. I'd say that's what I want from my healthcare too. I think with pet ownership the element of decision-making responsibility makes a good relationship with a GP essential. Being that person who an owner trusts to help them make decisions is a big part of what gives me job satisfaction.

[/quote]

Sorry I am not convinced that most owners are that interested in getting a trusted GP vet. They are easily drawn in by plush premises, clever websites and the promise of cheap treatment.

The vet and standard of care seem to be an afterthought! Too many see a vet as a vet.

We do, however, see quite a few that like the cheap vets until something goes badly wrong. Then they make appointments here but still expect treatment to be cheap!

RE: Being a GP vet

J G Wray — Wed, 04 May 2016 07:30:13 GMT

There is a temptation to look at the profession from the point of view of minorities. I count in this "Specialists" as a slice and I also count mixed and LA practice as a slice.

The profession is largely neither.

Instead I look at the profession as largely GPs, mainly in SA practice. I qualify this view with the gender demographic. All of these are the truth.

The public has indicated how they feel about the profession. They meet the profession mainly through the SA part of the profession. They meet the profession mainly through the GPs and they are gender blind.

The profession's standing is a reflection of the efforts of all of those delivering most of the care. What baffles me is why RCVS and to some extent BVA try to undermine this, largely through lack of understanding and engagement. It looks to me like their path is the unproven one.

"Specialism" leads to narrowness of experience and vision. Mixed and LA practice are burdened with their history of undervaluing services and are a minority of practice, with no one pretending there is expansion in prospect. The gender issue is I believe more complex than currently portrayed, because it also has a generational dimension - the values of 30 somethings are not those of 50 somethings.

There are practices out there, independent and corporate, whatever that means, who know what the public want, trust and value. For most it is not what the RCVS or, for that matter the BVA and its legacy mixed and LA practice think or espouse. They [RCVS/BVA] are the ones with the problem.

RE: Being a GP vet

Eilidh Corr — Wed, 04 May 2016 06:38:33 GMT

I understand.

But going back to the original question of "are we good enough and how do we know?", I think there's possibly a mismatch between what vets want to do with their lives and what clients want from vets. Clearly the profession is failing to keep graduates, and while some of that is a natural effect of having a primarily female workforce, there's also a sense of discontent which leads to losses too.

Leaving the politics of the RCVS aside and speaking as a member of a dying breed (a non-certificate holding mixed practice vet), I know that my clients wouldn't value me more if I was to gain another qualification. Personally I would love to do it and would probably value myself more, but the inference that I might not be good enough without it is unhelpful and I don't suppose it's shared by my clients.

Yes, ten or fifteen years down the line, with the corporates trying to meet the needs of an ambitious workforce, there will inevitably be increasing numbers of vets specialising in generalism and I'm not saying that's a bad thing. I'm just saying that there is more than one way to be good enough - something that many disheartened and poorly supported young vets don't always realise when floundering in the early years of their career. Sometimes a certificate isn't the answer to a crisis of confidence, although I agree that it has potential as a preventative measure

RE: Being a GP vet

Michael Woodhouse — Tue, 03 May 2016 23:52:53 GMT

[quote user="Eilidh Corr"]

I suppose the question is whether greater specialism is to the benefit of the animal population of this country, and their owners.

If 55% of vets were specialised, would that correlate with improved welfare? I have my doubts.

[/quote]

I think you seem to be mixing up the concept of the veterinary general practitioner being a specialist in its own right and the concept of vets specialising in increasingly narrow subject areas. I agree that if half the profession went off and studied their own little area then animals may be no better off. That said I do think that excellent 'general practitioners' probably should be recognised in veterinary medicine as a specialist grade as they are in human medicine.

I think it is inevitable that there will be greater structure brought into veterinary medicine - that vast majority going through life as 'just a vet' is likely to change. The younger end of the profession seems to be embracing the CertAVP route (many of my peers from university either have gone through or are going through it). I've yet to find a vet who undertook further study and regretted it. We have conversations in the practice now that we would never have had 5 years ago.

In that regard then increased 'specialisation' of general practitioners can only be a good think for animal welfare. Increasing numbers of more traditional specialists would also mean greater opportunities for animals to receive better care.

RE: Being a GP vet

Michael Woodhouse — Tue, 03 May 2016 23:32:53 GMT

[quote user="sajackson"]The guidance does indeed state this....but (VetGP) is not on that list..![/quote]

Tell you what (assuming you meet the CPD requirements) I challenge you to apply for AP status and if they turn you down with your CertAVP I will donate the £80 to a charity of your choice!

RE: Being a GP vet

Eilidh Corr — Tue, 03 May 2016 19:57:52 GMT

[quote user="Michael Woodhouse"]That's a rather bold statement when about 2.5% of the profession is on the specialist register compared to about 55% of doctors.....

[/quote]

I suppose the question is whether greater specialism is to the benefit of the animal population of this country, and their owners.

If 55% of vets were specialised, would that correlate with improved welfare? I have my doubts.

RE: Being a GP vet

J G Wray — Tue, 03 May 2016 18:15:17 GMT

[quote user="sajackson"]

[quote user="Michael Woodhouse"]The guidance clearly states that an RCVS Certificate in Advanced Veterinary Practice, with designation will be accepted with no further requirements.[/quote]

The guidance does indeed state this....but (VetGP) is not on that list..!

[/quote]

You can allus tell uh Yawkshuman, but yuh cant tell 'em motch

RE: Being a GP vet

Julie Turner — Tue, 03 May 2016 18:14:28 GMT

If you read Medical GP forums, they are so tied up with what they can refer and what they have to do first for you to 'qualify' (in the NHS) for referral etc etc

I have a very good GP, who is a senior partner- she tries to work the system, but all to often I pay for rapid private referral just in case I die in the NHS before my notification of being on a list arrives.

I think as vet GPs, we mostly offer a better and efficient basic service and I would happily be treated by the likes of Davies or the AHT rather than my local general hospital.

So, GrumpyOM, I mostly agree!

RE: Being a GP vet

Stuart Jackson — Tue, 03 May 2016 16:46:06 GMT

[quote user="Michael Woodhouse"]The guidance clearly states that an RCVS Certificate in Advanced Veterinary Practice, with designation will be accepted with no further requirements.[/quote]

The guidance does indeed state this....but (VetGP) is not on that list..!

RE: Being a GP vet

Michael Woodhouse — Tue, 03 May 2016 15:39:06 GMT

[quote user="sajackson"]The College doesn't accept the post nominal CertAVP(VetGP) as a "pathway" to AP (it is not on their list of accepted qualifications), despite what the AP list appears to state - those with this post-nominal have not been granted AP status primarily through this certification. The RCVS would reject an application for AP if the application was on the basis of this certificate.[/quote]

The guidance clearly states that an RCVS Certificate in Advanced Veterinary Practice, with designation will be accepted with no further requirements.

If you have a level 7 qualification worth a minimum of 60 points then they will also allow it - but may make you jump through some extra hoops.

RE: Being a GP vet

Stuart Jackson — Tue, 03 May 2016 13:50:54 GMT

[quote user="Michael Woodhouse"]Untrue. There are 6 advanced practitioners in small animal practice - half of them with the CertAVP(VetGP)![/quote]

The College doesn't accept the post nominal CertAVP(VetGP) as a "pathway" to AP (it is not on their list of accepted qualifications), despite what the AP list appears to state - those with this post-nominal have not been granted AP status primarily through this certification. The RCVS would reject an application for AP if the application was on the basis of this certificate.

There is no RCVS acknowledgement of the status of GPs. The College has reverted to type regarding certification, despite the current President being the major instigator and driving force behind the CertAVP(VetGP). He and others have effectively abandoned the GP in preference to their reversion to type - to recognise speciality (which is fine!). I also have another specialty which the RCVS won't recognise, but that's another issue!).

RE: Being a GP vet

Michael Woodhouse — Tue, 03 May 2016 12:59:21 GMT

[quote user="sajackson"]This is based, primarily, on my CertAVP(VetGP). The RCVS has abandoned the GP in its policy of awarding AP status, despite the VetGP importance and ground breaking process we went through to initiate the CertAVP in the first place.[/quote]

Untrue. There are 6 advanced practitioners in small animal practice - half of them with the CertAVP(VetGP)!

RE: Being a GP vet

grumpyoldman — Tue, 03 May 2016 12:24:00 GMT

[quote user="Michael Woodhouse"]Not very professional behaviour from a professional person. I'd be rather cross if one of the referral centres accepted one of our clients who had decided to refer themselves directly. They wouldn't be getting any more business from me.[/quote]

If they, GP doctors were any good I would not need to, time is money, waiting is a nuisance.

RE: Being a GP vet

J G Wray — Tue, 03 May 2016 11:17:13 GMT

[quote user="sajackson"]As a minor but important display of rebellion, as of last week, my LinkedIn page and practice web site now indicate my status as an Avanced General Practitioner (self appointed). [/quote]

Ya wee Scots rebel

[quote user="sajackson"]The RCVS has abandoned the GP in its policy of awarding AP status, despite the VetGP importance and ground breaking process we went through to initiate the CertAVP in the first place.[/quote]

The RCVS, where it has to have contact with GPVets, can only interpret them within their [RCVS]own frames of reference. Thus, they have created systems which match what they know and understand and, baffled by the knock back they got on post nominal registration have pressed on with their language for their post graduate qualifications.

You will get some form of disapproval from RCVS for your temerity because it doesn't fit with their thinking. They will use some form of words around striving for clarity for the public, but it's nothing of the sort. It's baffling for them and therefore bad.