The biggest advance in what we do?

Re: The biggest advance in what we do?

Wren — Wed, 25 Jul 2012 12:04:35 GMT

The mobile phone. When I graduated (2000) most farmers or horse clients didn't have them and the only time to contact them was dinner-time (that's Yorkshire dinner - 12 o'clock on the dot!) or after hours. Consequently most of my lunch-breaks and evenings were spent trying to get hold of people and sometimes it would take several missed calls in both directions before a TB test could be arranged. Now I can speak to them whether they're on the tractor silaging or out mucking-out their horses.

The same goes for the office being able to contact me. Where I saw practice there were car radios but when I started in practice it was a pager and 20p for the phone box. Inevitably you had to drive 5 miles off route to get to a phonebox (having tried 3 that weren't working first) only to pick up a non-urgent message like 'Mrs Sleightholme wonders whether you could come at 3pm instead of 3.30'. Now they can just text me the information and it doesn't disturb my day at all.

Re: The biggest advance in what we do?

patrick murphy — Wed, 25 Jul 2012 11:07:46 GMT

if being philisophical about this, there is a great book The Rise and Fall of Modern Medicine that explores these issues.

Re: The biggest advance in what we do?

Hannah Wynne Richards — Tue, 24 Jul 2012 10:57:34 GMT

David The over-dependance on modern antibiotics in production animal practice is I think the result of ARTIFICIAL disease consequent on over-crowding and the stresses of high production Cross reference to current farmer blockades of milk processors I did some maths-converted from shillings and pence per gallon to pence per litre and factored in for inflation-and calculated that in order to restore farm gate prices to those of 50 years ago,farmers would need to be paid 60p /l for their milk If we could restore thise prices, farmers could make good livings without pushing their animals so hard,so there would be less need for so many antibiotics tobe used so I feel this is a backward not forward step

Food prices would go up, and the consumer would grumble,but quite frankly I couldn't care as long as animalwelfare improved

Wynne

Re: The biggest advance in what we do?

J G Wray — Tue, 24 Jul 2012 07:30:06 GMT

In 2005 someone developed this theme and wrote what follows

"..

SIR, – In her letter to The Veterinary Record (December 3, 2005, vol 157, p 751) Mrs Lynne Hill, the current RCVS President, writes: ‘Following recent recommendations made by the RCVS Education Strategy Steering Group (ESSG), RCVS Council decided at its November meeting that continuing professional development (CPD) should now be promoted as a mandatory requirement of veterinary surgeons.’

I heartily endorse this, but I am not at all clear what counts as useful CPD. I hope that the basis of this is an opportunity for me to develop my professionalism through my practising career. To define CPD as being based on ‘professional knowledge and skills’ alone seems rather limited.

In companion animal general practice over the past 20 years, there has been change, and if I were to reflect on a top 10 most significant changes for me they would be, in no particular order: the development of effective and safe ectoparasiticides; the recognition of and treatment for feline hyperthyroidism; the development of computerised practice management systems; the need to comply with new legislation in respect of health and safety and employment law and medicines; a rise in client expectation; year-on-year change in client and pet numbers with the knock-on effect on the business plan; the development of new fixation systems for fractures seen in everyday practice; the development of safe and potent non-steroidal antiinflammatory drugs; the development of nutritional support for clinical disease; and the development of formal management systems.

Others in general practice will have their own top 10, but I believe that their lists will also not be related exclusively to veterinary knowledge and skills.

Although we have seen change over the past 20 years, by the time those changes reach general practice, the changes actually happen in quanta (this is the correct use of the term) rather than by leaps. To believe otherwise is an intellectual snobbery. Compared with the legal profession, where law changes year on year, or doctors working for the National Health Service monolith, veterinary science changes are [sic] quanta.

Thus, there are few clinical changes that have actually had an impact on my clinical life, and when they do happen, they do so in small amounts.

It is a shame that the RCVS message is not ‘promoting and sustaining public confidence in [the provision of] veterinary medicine’, because this would permit a career view of CPD where the other, non-clinical, top 10 aspects of general practice could be developed. The public, our patients, our employees and ourselves would all gain from this strategic and catholic view. To have CPD narrowly defined with annual requirements for this and that clinical entity is disappointing. To fail to recognise these aspects of general practice and incorporate them in the definition of CPD, in my view, actually represents an abrogation of the RCVS’s responsibilities to the public.

It is perfectly clear from the constitution of the RCVS Council and the level of influence of academic, research and DEFRA appointees that this view from general practice will be difficult to comprehend and accept. However, it does not mean that it is wrong. It is a pity that the efforts of those who promote this more general view, for instance, from the SPVS Masters group, have been delayed by RCVS, when in fact they are just as relevant to a general practice career as attending yet another course on say, pruritus in the dog or fracture fixation.

On a more sinister note, the letter from the RCVS President goes on to say ‘Currently, formal documentation of CPD is required … It is also taken into account by the Preliminary Investigation and Disciplinary Committees in the event of a complaint being made against a veterinary surgeon.’

This looks like a threat to me. The relevance of formal documentation of CPD to a particular complaint would seem to me to be idiosyncratic rather than general. Perhaps the RCVS means this but, as written, the President is implying that just by having a complaint made a vet will have other aspects of their professional life brought under scrutiny. Perhaps I should complain about every member of the Council to test this ambiguity..."

Re: The biggest advance in what we do?

Rajat — Mon, 23 Jul 2012 23:04:25 GMT

I agree with Mark R - analgesia and the internet!

Re: The biggest advance in what we do?

Mark Rowland — Mon, 23 Jul 2012 22:59:59 GMT

A vote also for the Internet since while it can sometimes be annoying with clients over googling, serves as a massive source of easily accessible information for us ofer a huge range of disciplines.

Re: The biggest advance in what we do?

David Mills — Mon, 23 Jul 2012 22:51:02 GMT

Increase in range and efficacy of antibiotics in production animals has to be the utilitarian answer. Overused, but at a price of saving millions upon millions of animals from death and abject welfare.

Re: The biggest advance in what we do?

Mark Rowland — Mon, 23 Jul 2012 22:47:28 GMT

Oh well someone doesn't agree with me but does with everyone else ? Or is my saddo red star person still grubbing around? Le sigh ;-( 0 )

Re: The biggest advance in what we do?

Utlendigur — Mon, 23 Jul 2012 21:37:13 GMT

I'd also like to vote for analgesia - I can still remember the bad old days when I had to fight to be allowed to give vetergesic alongside acp as a premed. Now we have vetergesic, methadone, morphine, plus licensed nsaids for cats. I suppose another advance would be the availability of in-house blood tests - I used to dread the collapsed dog on a Friday evening when you knew it would be Mon/Tues before you had an idea of what was going on with it, or whether it was safe to GA - if it lived that long...

Re: The biggest advance in what we do?

Luke Edwards — Mon, 23 Jul 2012 20:14:04 GMT

There is a story- can't remember where I read it - that when this very question was asked to an old time equine practioner, he thought for a while before replying "the car heater".

Re: The biggest advance in what we do?

Michael Woodhouse — Mon, 23 Jul 2012 19:03:29 GMT

[quote user="Julian Earl"]but as a fairly recent graduate of 1981, I am not directing the the question solely at the older members...[/quote]

You qualified before I was born......

Re: The biggest advance in what we do?

Tim Cheyne — Mon, 23 Jul 2012 18:26:42 GMT

Surely one of the biggest advances in veterinary practice is the support derived from working with other professionals, adequately trained and qualified in their own particular fields; veterinary nurses, radiographers, farriers, pharmacists. and practice managers? A far cry from the single vet with a kennelman, and his wife answering the telephone and keeping the accounts.

Tim. (Cannot find a fogey smiley).

Re: The biggest advance in what we do?

Tim Cheyne — Mon, 23 Jul 2012 14:24:39 GMT

As one of the old fogeys with much to reflect on I would agree the considerable improvement in managed anaesthesia and analgesia across the board in the common domestic species; the ability to do safely many LA procedures in the standing position rather than the hassle of 'throwing' or casting (in short, LA surgery has become much less 'heroic' and physically demanding); and less reluctance to undertake abdominal surgery in the horse (this came years after cattle and sheep). When it comes to therapeutics the list could be endless; I would single out the availability of a vast range of diagnostic tests although sometimes I feel that the piece of paper from the lab is allowed to dominate, rather than guide, clinical acumen and experience.

Tim.

Re: The biggest advance in what we do?

Alex Gough — Mon, 23 Jul 2012 13:38:19 GMT

Pain relief is probably the biggest advance in my career. Parvo prior to vaccination was before my time but I understand was pretty horrendous, and distemper is a nasty disease too, so it may actually be that vaccination has relieved the most suffering. I'm sure it's saved more lives than anything else we do, regardless of what certain lobbies claim.

Alex

Re: The biggest advance in what we do?

Hannah Wynne Richards — Mon, 23 Jul 2012 12:07:56 GMT

I'm torn in 2 between analgesia and the ability to treat imature stages of redworm before they cause damage to gut wall I was lucky enough when newly qualified to work with and also be friendly with Leslie Hall so analgesia was always something I was concious of-but had an uphill task convincing bosses Where horses are concerned I'm sure the avoidance of gut damage is the biggest single factor in the huge increase in equine longevity

Wynne

Re: The biggest advance in what we do?

Mark Rowland — Mon, 23 Jul 2012 11:36:41 GMT

Yep I agree that analgesia has dramatically improved things. I wish that now it seems to be the norm (or even a science in itself) for dogs and cats that it is given more consideration for other species, e.g. sheep as well as for exotics.

Another plug for my free Exotic Animal Analgesia chart on my cpd website.