Latest vet to be struck off by the DC!

Re: Latest vet to be struck off by the DC!

Clive Ansell — Tue, 06 Aug 2013 18:24:30 GMT

[quote user="Hannah Wynne Richards"]

Please,please, please NOT ' elf and safety. PLEASE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Wynne

[/quote]

Sorry, I'd forgotten this is the veterinary profession and that we have total carte blanche to break the law and disregard sensible health and safety rules.

It depends very much on your catchment area I suppose, but when I worked in OOH clinics they covered most of the Birmingham area, some of which are really not nice places to be with gang, drug and gun violence; the police go round in fours with dogs and armed back up on stand by - would you do an OOH visit there? I sure as hell wouldn't.

There have been cases of violence against staff in 2 of the OOH clinics that I know of, hence the rule that there has to be 2 staff members present before MOP are allowed in. No exceptions, and to disregard it is sacking offence.

Re: Latest vet to be struck off by the DC!

Hannah Wynne Richards — Tue, 06 Aug 2013 18:09:00 GMT

Please,please, please NOT ' elf and safety. PLEASE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Wynne

Re: Latest vet to be struck off by the DC!

Malcolm Ness — Tue, 06 Aug 2013 18:06:06 GMT

[/quote][quote user="Anthony Todd"]If the dog had been put on a blanket, into the Landrover and whizzed to the surgery:[/quote]

[quote user="Anthony Todd"]Think of "Mash"!

They could have got a magic carpet and got the dog there even quicker!! Think of the Arabian Nights

Re: Latest vet to be struck off by the DC!

Clive Ansell — Tue, 06 Aug 2013 18:05:49 GMT

[quote user="Bob Russell"]

In fact a Boxer with suspected bloat arrived at the clinic at the same time Mr Chikosi left to visit the dog. What would have happened had this been a true GDV?

[/quote]

Then surely that must vindicate Mr Chikosi in every way?

What would have happened if a patient with GDV arrived (yes they do turn up without appointments) at the clinic and died whilst waiting for a vet away on a visit, with no back vet up in place (against company protocol)? Would he have been backed by his employer, somehow I doubt it?

Even worse, what would happen if the GDV patient had died on the doorstep, because the only staff member could not allow them into the building until at least 2 members are present (As is strict protocol because of safety and previous incidents of threats and actual violence against staff in 2 of the OOH clinics I have worked in)

These are real life scenarios down on planet real world, not hypothetical ones. I'm amazed anyone still works in OOH clinics to be frank

Re: Latest vet to be struck off by the DC!

Hannah Wynne Richards — Tue, 06 Aug 2013 17:33:03 GMT

At a guess-about the same time as I qualified!!!!!!!!!!!!!!!!!!!!!!!

Wynne

Re: Latest vet to be struck off by the DC!

Gillian Mostyn — Tue, 06 Aug 2013 17:09:24 GMT

[quote user="Anthony Todd"]Of course visits were needed. There were no after hours clinics, no staff on standby, no cannulae, a lot of clinics had no xrays and the vets usually, when they did visit, left from home, and met the client at the clinic on his or her own and used the client as the nurse.[/quote]

Bloody hell - how long ago did you retire??

Re: Latest vet to be struck off by the DC!

Anthony Todd — Tue, 06 Aug 2013 15:36:58 GMT

[quote user="Gillian Mostyn"]I don't understand your answer. [/quote]

Of course visits were needed. There were no after hours clinics, no staff on standby, no cannulae, a lot of clinics had no xrays and the vets usually, when they did visit, left from home, and met the client at the clinic on his or her own and used the client as the nurse.

If not we visited and did the best we could with what we'd got. [trying to remember when drips and giving sets came in]

No other options so we went or some just refused citing all sorts of spurious reasons

But as I tried to explain, NOW when there are dedicated OOHclinics with all the aids and staff it is better for the animal to get to the emergency centre ASAP.

That's the difference, it's MASH without the helicopters but Hawkeye is now waiting.

Re: Latest vet to be struck off by the DC!

Glen McIntosh — Tue, 06 Aug 2013 15:15:39 GMT

[quote user="Gillian Mostyn"]I know you are simply being flippant here...How could you enjoy that coffee?[/quote]

No, I am not being flippant.

I can enjoy the coffee because I am honest and realistic. After 18 years in small animal practice, for my own sanity, I have tried to develop (for the most part at least) a strong sense of where my professional responsibilities begin and end. I will start worrying about the injured dog when it is in my presence. Until then I have no idea what the condition of the animal is. It is not uncommon that an owners description of a massive bleed turns out to be cut nail. Occasionally an owners description of a mild laceration over the telephone turns out to be a fly blown and almost completely severed limb. Either way, me becoming agitated or upset does not help the situation. Sometimes you have to sit down and make yourself enjoy that cup of coffee.

It is not my dog. I didn't run over the dog. I have done everything I can to help the owner to transport the dog to the clinic without success. I have determined that the greater good requires that the clinic remains staffed and I have arranged for another vet to attend. I have done everything I can within the circumstances. If I have nothing else to do then I am going to have a cup of coffee.

Please don't accuse me of not putting animal welfare first, of lacking compassion or empathy for the dog etc. I am perfectly at ease with my level of compassion and empathy for the suffering of animals, which has only increased with the time I have been doing this job. But the world is full of suffering and for your own peace of mind you must set boundaries. We all do, including you.

Re: Latest vet to be struck off by the DC!

Evelyn Barbour-Hill — Tue, 06 Aug 2013 15:03:38 GMT

[quote user="Gillian Mostyn"]

In my experience, requests for home visits in the UK are sometimes made (although I would say not commonly) but those incidences where welfare is best served by doing so are very rare.

In my own opinion I think animal welfare is best served by the UK system.

[quote user="glen mcintosh"]Oh, and I would have sat down and had a nice cup of coffee while waiting for the covering vet to arrive if i wasn't otherwise occupied.[/quote]

I know you are simply being flippant here - but I can't understand this at all. If you wasn't otherwise occupied, why wouldn't you just go and put the dog out of its misery? How could you enjoy that coffee?

[/quote]

The professional obligations we have in the UK are fine. What's done elsewhere is interesting, but that's all.

So, here's the rule if you want to keep your nose clean: while delayed, waiting for a covering vet or any other reason, on no account drink any coffee, tea or orange juice (nervous sips of water are acceptable); and don't sit down (hopping from one foot to the other is recommended). Smoke by all means (outside the front door of course) but quick drags with the fag held like that (the thumb-and-two-fingers claw pinch hold) are the only permitted method, preferably on a Woodbine or previously-made rollup.

Re: Latest vet to be struck off by the DC!

Gillian Mostyn — Tue, 06 Aug 2013 14:24:17 GMT

[quote user="Anthony Todd"]

Probably as many as any other vet in London at the time, judging by the wide area I visited and the number of OOH calls I did.

Remember one of the neighbouring vets used to consult in a pinstriped suit and it wasn't too unusual for phones not to be answered after hours, let alone visits!

But was it the best service judged on today's standards?

Would the animals have been better served if they had been stretchered into a landrover by two farmers and one other, supported quicker and diagnosed quickly and accurately or, as I often did late at night and in the gloom of a 40W bulb, put down, as being the best thing under the circumstances and standards of the time?

[/quote]

I don't understand your answer. You obviously did some visits when requested - so presumably you felt they were needed at the time? Why would things be any different now? Afterall, then, as now, there was always the option of making the pet comfortable enough to travel in yours or the owners vehicle - PTS isn't your only option.

Re: Latest vet to be struck off by the DC!

Gillian Mostyn — Tue, 06 Aug 2013 14:21:59 GMT

In my experience, requests for home visits in the UK are sometimes made (although I would say not commonly) but those incidences where welfare is best served by doing so are very rare.

In my own opinion I think animal welfare is best served by the UK system.

[quote user="glen mcintosh"]Oh, and I would have sat down and had a nice cup of coffee while waiting for the covering vet to arrive if i wasn't otherwise occupied.[/quote]

Re: Latest vet to be struck off by the DC!

Anthony Todd — Tue, 06 Aug 2013 14:18:58 GMT

[quote user="Gillian Mostyn"]I know you are now retired - but when you worked, did you ever need to attend an emergency visit?[/quote]

Probably as many as any other vet in London at the time, judging by the wide area I visited and the number of OOH calls I did.

Remember one of the neighbouring vets used to consult in a pinstriped suit and it wasn't too unusual for phones not to be answered after hours, let alone visits!

But was it the best service judged on today's standards?

Re: Latest vet to be struck off by the DC!

Glen McIntosh — Tue, 06 Aug 2013 14:13:52 GMT

[quote user="Gillian Mostyn"]f you had been the vet in the clinic that night, what, honestly, would you have done?[/quote]

In Australia, in the circumstances of this case, I would have informed the owner, unequivocally, that I was unable to leave the clinic as I needed to be onsite for other emergencies. I would have given the owner firm advice on how to transport the animal to the clinic, and the animal would have attended the clinic.

Except in Australia, these circumstances are very likely not to have arisen. Requests for house visits for emergency conditions are rare and usually limited to those cases that TRULY cannot be transported - eg the cat impaled on the fence. Clients seem to be aware that emergency vets are unable to leave the clinic to attend house visits (except in truly exceptional circumstances). The circumstances of the Chikosi case were not truly exceptional.

In the UK I would have done much the same thing ie: I would have informed the owner, unequivocally, that I was unable to leave the clinic as I needed to be onsite for other emergencies. I would have given the owner firm advice on how to transport the animal to the clinic, and the animal would have attended the clinic (in 99% of cases with circumstances similar to the Chikosi case).

The only difference in the Uk is that because of the Code requirement to attend house visits, in that 1% (or less) cases where the owner adamantly refused to follow my advice on how to transport the animal to the clinic, then I would have made arrangements to perform a house visit. I would have done the house visit not because I thought it was clinically necessary, but because of my fear of being brought before the DC.

And I would have done exactly what Mr Chikosi did (ie attempt to find a vet to cover my absence and wait for that vet to arrive), not because I was slavishly following my employer's protocols. I would have followed the protocol because in my professional opinion the protocol provided the best way for me to meet both of my professional obligations under the Code: ie 1) to attend house visits under certain circumstances and 2) provide continuous 24 hour emergency care for the clients of the 10 - 15 veterinary practices that have entrusted the care of their clients animals to me when they are not working.

Sometimes following a protocol is the right thing to do, and following a protocol does not mean, necessarily, that you have abrogated your professional responsibilities, (despite what Mr Chikosi might have written in an unsigned email to his employer that has since become the only evidence of what his thought processes were at the time and upon which the DC has founded its completely unjustifiable decision).

Oh, and I would have sat down and had a nice cup of coffee while waiting for the covering vet to arrive if i wasn't otherwise occupied.

The difference between Australia/US (indeed the rest of the world) and the UK is that in the former, requests for emergency OOH house visits are actually very rare and unless there are truly exceptional circumstances (like impalement) then the client will, almost invariably with advice, bring the animal to the clinic. In the UK requests for emergency ooh house visits are common. Like anywhere else in the world those truly exceptional cases that do require attendance off site are vanishingly rare. The problem is that in the UK vets have a sword of Damocles hanging over there head regard to house visits (which has been further exaggerated by the Chikosi decision) and clients sense this and this promotes clients to feel entitled to house visits and this perception of entitlement is reinforced by the DC decisions in Albring and Chikosi.

The Chikosi case was not one of those truly exceptional situations.

In Australia and the US it is absolutely clear that the vet's responsibility for an animal's suffering begins and ends at the threshold of the clinic. The RCVS policy in the UK suggests the opposite, and that cannot be right. It certainly does not improve animal welfare.

Re: Latest vet to be struck off by the DC!

Gillian Mostyn — Tue, 06 Aug 2013 14:02:51 GMT

[quote user="Anthony Todd"]

[quote user="Gillian Mostyn"]

Anthony:

If you had been the vet in the clinic that night, what, honestly, would you have done?

[/quote]

If I was somewhat inexperienced and insecure [he was a colonial like me] I probably would have thought as I do now but done what Mr C did.

And been struck off and stigmatised forever for being caught in an almost impossible situation.

[/quote]

I know you are now retired - but when you worked, did you ever need to attend an emergency visit?

Re: Latest vet to be struck off by the DC!

Bob Russell — Tue, 06 Aug 2013 13:33:40 GMT

I genuinely feel he could have attended sooner. As my own boss I would have done.

The whole point of my concern about this case is that Mr C became a punch bag for perceived VetsNow inadequacy. This has been clarified in no uncertain terms by VetsNow.

This event happened in 2011 and I am sure VetsNow make sure that all vets are not left in any doubt about their requirements.

Hopefully the RCVS have now worked out that you can send stuff by signed for international delivery and there is a 'read receipt' box to tick when sending out emails.

At no stage did the DC get a straight answer as to whether the bundle of correspondence had been received. It was noted that the acknowledgement form was not returned.

The Legal Assessor: Q: Can we be clear as to what precisely the respondent has had? A copy of the documentary evidence?

Mrs Curtis: A: Yes. A copy of the inquiry bundle was sent to him (my italics).

The Chairman: Q: With all the documentary evidence?

Mrs Curtis: A: Yes, the bundle itself. I turn now to the .............

Sir Humphrey would be proud of that non-answer!

To proceed in the absence of the respondent the committee must be satisfied that the notice of inquiry was properly served, and that it was in the interests of justice properly to do so!!

Re: Latest vet to be struck off by the DC!

Anthony Todd — Tue, 06 Aug 2013 13:13:02 GMT

[quote user="Gillian Mostyn"]

Anthony:

If you had been the vet in the clinic that night, what, honestly, would you have done?

[/quote]

If I was somewhat inexperienced and insecure [he was a colonial like me] I probably would have thought as I do now but done what Mr C did.

And been struck off and stigmatised forever for being caught in an almost impossible situation.

Re: Latest vet to be struck off by the DC!

Anthony Todd — Tue, 06 Aug 2013 13:05:29 GMT

[quote user="Robin Grimmer"]But the GtoPC states that there are times when a visit may be necessary, and this was one of those occasions[/quote]

I realise that and that's why the "Guide" [which isn't; it's a "law" 'cos if you breach it you'll be struck off!!!] must be changed!

Once again, how do the Americans and Aussies and probably others, get away with a "no visits" policy?

[quote user="Robin Grimmer"] That's the difference between lay people and us vets. [/quote]

But it isn't the difference between three people, two of whom are farmers, with a Landrover!

Which also should have been considered by the DC

Re: Latest vet to be struck off by the DC!

Robin Grimmer — Tue, 06 Aug 2013 12:57:26 GMT

[quote user="Anthony Todd"]

[quote user="Robin Grimmer"]The fact that the farm was only 3.5 miles away puts a whole different spin on this case. We know that the vet wasn't tied up with an emergency at the time, and that there were not many inpatients in the clinic that evening. If he'd gone out straight away he would have fulfilled his RCVS obligations and ended the dog's suffering more quickly.[/quote]

If the dog had been put on a blanket, into the Landrover and whizzed to the surgery:

1. Would suffering and distress time have been reduced considerably, even assuming a Vet had attended "ASAP"?

2. Would the chances of survival increase, bearing in mind that crucial treatment and diagnosis would have been improved considerably?

In all but a very few cases, which, no doubt, some will quote, the answer to both questions, will be "yes".

If this policy was implemented in the "guide" suffering will be reduced and survival will be increased.

Think of "Mash"!

[/quote]

I don't doubt any of those points. But the GtoPC states that there are times when a visit may be necessary, and this was one of those occasions. The owners tried but were unable to get the dog in. Maybe they didn't try hard enough? That's the difference between lay people and us vets. We can muzzle a dog, sedate it if needed and move it.

Re: Latest vet to be struck off by the DC!

Anthony Todd — Tue, 06 Aug 2013 12:50:29 GMT

[quote user="Gillian Mostyn"]

Anthony:

If you had been the vet in the clinic that night, what, honestly, would you have done?

[/quote]

See my previous post, but to reinforce my answer I would have stayed on the line and guided them through the transport procedure, from sheet to surgery.

If you want me to do a script I will....

Why can't we assume that Mr C realised the advantages of a surgery attendance [but didn't say so] and realised how much stick he could get if he left the premises and a valued client turned up with a serious emergency and the patient died with the place unattended by a vet?

As I said, how do the Americans or the Aussie vets manage to avoid the accusations that are flung at the MRCVSs that they "Caused or allowed Mitzi to remain in pain and/or suffering for longer than was reasonably necessary" by not attending?

Re: Latest vet to be struck off by the DC!

Anthony Todd — Tue, 06 Aug 2013 12:38:44 GMT

If the dog had been put on a blanket, into the Landrover and whizzed to the surgery:

1. Would suffering and distress time have been reduced considerably, even assuming a Vet had attended "ASAP"?

2. Would the chances of survival increase, bearing in mind that crucial treatment and diagnosis would have been improved considerably?

In all but a very few cases, which, no doubt, some will quote, the answer to both questions, will be "yes".

If this policy was implemented in the "guide" suffering will be reduced and survival will be increased.

Think of "Mash"!

Re: Latest vet to be struck off by the DC!

Gillian Mostyn — Tue, 06 Aug 2013 12:29:35 GMT

Anthony:

If you had been the vet in the clinic that night, what, honestly, would you have done?

Re: Latest vet to be struck off by the DC!

Bob Russell — Tue, 06 Aug 2013 12:28:14 GMT

[quote user="Malcolm Ness"]

[quote user="Bob Russell"]I don't agree with the DC at all! I also feel they need to justify their behaviour and decision making but without an appeal it is not likely to happen. [/quote]

Had DC done other than find against Chikosi in this case, the precedent they would have set is that the professional responsibilities of a veterinary surgeon could be set aside at the behest of a corporation or other employer. In effect we would cease to be professionals.

[/quote]

I cannot see this setting a precedent (the RCVS insist it does not!). The vet made efforts to get cover, he probably should have gone out more rapidly but he stated that he was unhappy leaving the premises without a vet present. The rights and wrongs of this can be argued and will go round in circles.

Does this really constitute a striking off offence?

Re: Latest vet to be struck off by the DC!

Robin Grimmer — Tue, 06 Aug 2013 12:25:37 GMT

[quote user="Evelyn Barbour-Hill"]

[quote user="Robin Grimmer"]

If the visit was only 3.5 miles away then why didn't he save himself a lot of bother and just go out? If an emergency came in to the surgery in that time then he could have been back in 5 minutes.

[/quote]

Hardly. The time to the farm has been variously suggested as 10, 10-15, and 15-20 minutes. Not 5. Even if he were not struggling singlehanded in bad light with a greasy overweight Labrador skin vein at the time the phone call came "get back here – now!" Anyway, we know why he didn't "just go out": he thought he ought to get the cover vet in first.

[/quote]

Normal 0 MicrosoftInternetExplorer4

You're splitting hairs here. 15-20 minutes was the time the dog owners would have thought was reasonable to allow attending their dog, giving the vet time to get some drugs, find out where he was going etc. If he had to get back to the surgery in a hurry he could have easily done so within 5-10 minutes. Bear in mind this was 9pm on a Friday evening, it's a rural area, I know - I have worked at this OOH clinic before it was VN.

As for "greasy overweight Labrador skin vein" that may or may not have been the case. But that's irrelevant, if he had gone to the farm, he could established a/ whether euthanasia was appropriate and done it on site. He could have given i/m sedation drugs first if the veins were difficult to find. or b/ if treatment was appropriate he could have given pain relief/sedation and got the dog back to the surgery - with a blanket if necessary!

The fact that the farm was only 3.5 miles away puts a whole different spin on this case. We know that the vet wasn't tied up with an emergency at the time, and that there were not many inpatients in the clinic that evening. If he'd gone out straight away he would have fulfilled his RCVS obligations and ended the dog's suffering more quickly.

Re: Latest vet to be struck off by the DC!

Anthony Todd — Tue, 06 Aug 2013 12:14:24 GMT

[quote user="Malcolm Ness"]Had DC done other than find against Chikosi in this case, the precedent they would have set is that the professional responsibilities of a veterinary surgeon could be set aside at the behest of a corporation or other employer. In effect we would cease to be professionals. [/quote]

That's why the "guide" must be changed, or is this a suggestion that American and Australian vets have ceased to be professional?

Re: Latest vet to be struck off by the DC!

Malcolm Ness — Tue, 06 Aug 2013 12:06:24 GMT

[quote user="Bob Russell"]I don't agree with the DC at all! I also feel they need to justify their behaviour and decision making but without an appeal it is not likely to happen. [/quote]