Hypothesising and drifting off at a tangent...!

Re: Hypothesising and drifting off at a tangent...!

Braden Collins — Thu, 27 Jun 2013 06:15:31 GMT

I experienced a similar thing when doing a locum in Wales. Two vets in town, with one referring to an OOH provider in Cardiff. We used to get a lot of their OOH calls from people not wanting to head into Cardiff.

From a business point of view, I would always see these in the clinic as it is a great way to gain new clients and word of mouth is such a good source of new clients, as long as they sounded reasonable and I had a promise to pay in full at the time. Personally, I would not have done a house call for them as I believe it is beyond reasonable to expect someone in general practice trying to balance work, life and their own OOH calls to do a house call for someone who has chosen to use another vet. the responsibility lays with their regular vet and their OOH provider in such a case.

No transport would definitely not qualify for a house call in my opinion. That is very different to not being able to move the animal to bring it in.

I recently had a client of another practice ring me (I was the third clinic they had called OOH) for a cat with a fish hook in its mouth. Their regular vet had refused to see it as they had no money at all (not even $10 to cover some of the costs of the drugs). They didn't even live in the same town as I work. I refused to see them but talked them through their regular vets obligations for analgesia, etc and advised them to call their regular vet back and point out their obligations, then call me back if they had no luck. They didn't call back so must have got the message through. So far as I am concerned, it was not my responsibility to see another vets clients who would not pay the bill. Had they been my client though, I would have seen them.

Re: Hypothesising and drifting off at a tangent...!

sam aldridge — Wed, 26 Jun 2013 23:21:16 GMT

I wouldnt neccesarily believe the clients in this.... I work for Vets-Now and I have never heard it said that we dont do house visits. In fact the total opposite, it is stressed to us to never say that and that overall animal welfare comes first. The art is of course to get that balance with a hospital full of inpatients....anecdotally, a vet from one of the clinics went out last night to a collapsed St Bernard that was in status epilepticus in a dubious area, a house full of 'interesting' characters, vague threats about the last 'vitinary' who didnt bring enough drugs etc etc. She went with a nurse, left the practice with just an RVN as it was 1.30am and something of an urgent case (it had of course been fitting for some time before they called...). The taxi alone cost £140, paid for by VN. The client? paid £10, apparently all they had in the world (but all were chain smoking...). Chances of getting paid - 0. Nobody has or will suggest that she shouldnt have gone, except maybe on H and S grounds without police escort. I know of many more stories the same, so I find the suggestion that they said 'we dont do them' hard to believe. Or an older tale and lessons have been learnt since then?

Re: Hypothesising and drifting off at a tangent...!

Miriam Lodewyks — Wed, 26 Jun 2013 19:26:49 GMT

Although I'm all for providing a caring and professional service to the public (yesterday, after work, I dropped off a little commemorative tree and card for a client who lost his beloved dog), I do fail to see why the RCVS feels that certain clients' lifestyle choices (be it a Newfie, or an obese border collie) has to become our responsibility....

Re: Hypothesising and drifting off at a tangent...!

Jo Cobbett — Wed, 26 Jun 2013 16:44:03 GMT

[quote user="Virginia Campbell"]

After all, it is statistically more likely that my nurse and I will be paid rather than assaulted.

[/quote]

Didn't get assaulted, but didn't ever get paid either. Still wouldn't have done anything different though - at least one of the dogs need to be seen ASAP.

[quote user="Bob Russell"]

Not sure I would fancy a trip to 'Staffmageddon' out of hours or otherwise!

[/quote]

It was pretty grim. And happened in the owner's mother in law's house. After I had dispatched the dogs and loaded them into my car, the owner just locked up the house (well, caravan...) and walked off to their own house. Not sure mother-in-law would have been very happy to get back to a house liberally covered with blood stains.

And I was terrified I'd get stopped on the way home (although there was no reason I should be) with a boot full of dead dogs...

My original question really was, if Vets Now couldn't/wouldn't (I don't know their side of the story) see it, does that alter my responsibilities given the GtoPC remarks about OOH for other people's clients?

Re: Hypothesising and drifting off at a tangent...!

Martin Atkinson — Fri, 21 Jun 2013 14:56:09 GMT

[quote user="Stephen Courtney"]It seems to me that the difference between Vets Now's official position regarding visits and what actually happens in practice, is poles apart.[/quote] I've already posed this conundrum to Richard Dixon on the original thread following his response on there. It would be interesting to hear his reply if he's brave enough to come back again.

Re: Hypothesising and drifting off at a tangent...!

Bob Russell — Fri, 21 Jun 2013 14:24:07 GMT

The reality of life comes down to how much will the pet owning public pay?

If it is a lot more, then we get a fleet of ambulances, ready to fly off to every emergency. Paramedic on-board. A helicopter or two with a trauma vet ready to speed things along.

In practice it is pretty good to have a vet on call. Not been on duty all day. A nurse, possibly a receptionist in support. Private ambulance services have been tried around here but are pretty uneconomical businesses.

What does the owner have to do to get this? A car and a credit/debit card.

We should not be hammering vets for an hours delay to visit but educating owners that if they have pets they must be willing to look after them. They must have insurance or a budget available at least to the cost of an out of hours visit and euthanasia. Beyond that is a choice they have to make for themselves.

Not sure I would fancy a trip to 'Staffmageddon' out of hours or otherwise!

Owners have to take responsibility for their pets and have realistic expectations for what they can get for their money.

Re: Hypothesising and drifting off at a tangent...!

James Laidlaw — Fri, 21 Jun 2013 14:04:09 GMT

Staffmageddon. Excellent.

Re: Hypothesising and drifting off at a tangent...!

Virginia Campbell — Fri, 21 Jun 2013 13:27:01 GMT

[quote user="Jo Jones"]The owners had rung Vets Now and apparently been told that they didn't do home visits[/quote]

How exactly did that conversation go?

"Hi I'd like a home visit for my 3 Staffies that have tried to kill each other"

"No we don't do home visits ever ever ever"

"hmm...sure you have no way of bringing them in..right...hmm...I will see if i can organise a couple of staff members to come with me (if your dogs are capable of killing each other I'm a tiny bit concerned for my own safety). There'll be a bit of a delay as I would also like another vet at the clinic to deal with other clients as I don't expect I can pop to your Staffmageddon callout and back in ten minutes. By the way, the charge for a home visit, euth of one and patching up till morning of possibly near-fatal fight injuries on the other two will be £quitealotofpounds"

"I don't have £quitealotofpounds, I spent it all on buying Staffies and dog food. I will find somewhere cheaper"

We use Vets Now, but we consult+phones are open till 8.30pm. Between 7pm and 8.30 we quite often get calls from clients of various other practices which also use VetsNow.

"My own vet - X vets- isn't open"

"X vets have OOH provision. The phone number will have been on their anasphone message. It's VetsNow- would you like us to tell you the number?"

"*shamefaced mumbling*"...cos they've already phoned and think it's too expensive

We usually do see these clients if they will come in, as we have a nurse on site to look after our inpatients anyway so can admit if necessary.

If one of our own tusted clients asked for a callout for a Staffmageddon, we'd put the phones over to VetsNow early and go.

If a non client wee old lady wanted a collapsed old lab put down, we'd probably finish consults then go (DC delay, anyone?) if nobody else would

If the unknown owner of Staffmageddon wanted a callout...um, don't know? We might, after finishing consults, locking up and phoning the boss to say where we were going. After all, it is statistically more likely that my nurse and I will be paid rather than assaulted. In reality if I went I would be just slightly tense that my car's windows would be done in in Dodgyville, and annoyed that I wasn't going to get home to my boyfriend's nicely cooked dinner cos I was going to a non client callout, and hoping they bothered to come up with some cash when I'd helped out rather than promising to pay tomorrow. Oh, and there would be just that tiny, tiny remote wee voice of fear keeping me on my toes on the way out speaking of the statistically highly unlikely possibility of the front door closing us in with a murderous rapist or two.

Re: Hypothesising and drifting off at a tangent...!

Stephen Courtney — Thu, 20 Jun 2013 13:47:47 GMT

It seems to me that the difference between Vets Now's official position regarding visits and what actually happens in practice, is poles apart.

Jo, the situation you outline is exactly such a situation that could have ended up in front of the DC.

If you had been too busy to visit, what then? I think you would only be in trouble if you refused a visit because you couldn't be bothered, but the scenario you describe is exactly the sort of home visit that raises serious safety issues - i would be very uneasy about going on such a visit without someone with me.

Re: Hypothesising and drifting off at a tangent...!

Hannah Wynne Richards — Thu, 20 Jun 2013 13:41:05 GMT

One of my reasons for stopping using Vets Now was their refusal to do a home visit to a 30 kg recumbent dog,owned by an elderly widow,who lived alone

Wynne