Is it time to put more responsibility on the owners’ shoulders?

Re: Is it time to put more responsibility on the owners’ shoulders?

Hannah Wynne Richards — Tue, 09 Jul 2013 13:09:01 GMT

In this area we're just coming out of a nasty outbreak of human disease (measles) caused by (guess what?)-Vaccine paranoia

Wynne

Re: Is it time to put more responsibility on the owners’ shoulders?

Mark Hedberg — Tue, 09 Jul 2013 13:06:08 GMT

[quote user="Lucy Fleming"]

I think the best one I ever saw was a tale of woe on a website claiming their great dane suffered from pica due to 'hereditary vaccinosis' - as a result of its parents being vaccinated!!

[/quote]

That's amazing, must remember that for my next difficult consult!

Re: Is it time to put more responsibility on the owners’ shoulders?

Lucy Fleming — Tue, 09 Jul 2013 12:50:51 GMT

[quote user="Evelyn Barbour-Hill"]

Doesn't matter, Canine Health Concern reckons that anything happening within three months of a vaccination is a vaccine reaction.

[/quote]

Canine Health Concern thinks anything that happens at any point after a vaccination has ever been administered to an animal is a vaccine reaction I think the best one I ever saw was a tale of woe on a website claiming their great dane suffered from pica due to 'hereditary vaccinosis' - as a result of its parents being vaccinated!!

Re: Is it time to put more responsibility on the owners’ shoulders?

Stephen Courtney — Sun, 07 Jul 2013 22:16:28 GMT

[quote user="Richard Stephenson"][quote user="Malcolm Ness"]

[quote user="Stephen Courtney"]I have noticed that our fantastic OOH vets accrue an unfair number of complaints ( always money) and our foreign vets ( speak with accents) also have a similar unfair number of whinge letters ( I believe this is a charming manifestation of xenophobia) [/quote]

You hit the nail on the head there. If you are male, white, Anglo-Saxon and aged as a vet you can talk the most unutterable sh*te to the average client who will end up thinking you are wonderful. On the other hand if you are a bright young female with a hint of foreign-ness, you can be the best vet and the most articulate communicator in the world but a measurable proportion of the clientele will doubt your word.

[/quote] Malcolm, Just to point out that in terms of RCVS complaints data the group complained about most that is at a greater level than their proportion on the register are middle aged Anglo Saxon white males! In fact European graduates are complained about in the proportion you would expect from their numbers on the register. Young female vets are under represented in the statistics. Obviously complex factors involved as it is still the case that middle aged men tend to be practice owners. Also depends at what stage of the process you look at. Yours, Richard s

[/quote]

I meant whining letters to the practice rather than official RCVS complaints. But i am surprised at your comment - it wasn't that long ago in the Vet times that there was an article stating that foreign vets were far more likely to suffer complaints ( again, perhaps at practice level?), and something about a course newly registered foreign vets could go on to help them understand the crazy British folk.

Perhaps it's all about perceptions?

Re: Is it time to put more responsibility on the owners’ shoulders?

J G Wray — Sun, 07 Jul 2013 12:07:09 GMT

[quote user="Francisco Gomez"]At the end of the day, it is the well-being of the pet what we are pushed (and I agree) to improve! We won't be able to do so if the pet owner is not asked to do enough.[/quote]

Or if our Regulator punishes vets harder and harder without regard to consequence or pretending there is no consequence or precedent and therefore nothing to be discussed.

JGW

Re: Is it time to put more responsibility on the owners’ shoulders?

Francisco Gomez — Sun, 07 Jul 2013 11:14:45 GMT

I am a foreigner and I do OOH. (and therefore a slightly biased post?)

[- funny thing: My very experienced colleague Anthony is black and Polish. And I am very pale to be a Spaniard. While we were practising together in Norwich, some clients (who didn't remember our names) would ask the receptionist to see the foreign vet again. The receptionist wouldn't dare to ask: Who? The black one or the white one? So very often we had the wrong patient assigned to our consults...-]

I have suffered the

- Book me a consultation but I don't want a foreign vet (when OOH sometimes you don't have the choice, so let's complaint about another thing)

- I don't want to speak to that Indian girl again (about one of my female colleagues who, by the way, wasn't Indian)

- Why are you here? Aren't there any English vets in this country? (During a routine vaccination)

...

However, I find it slightly off topic. I agree that these unfounded complaints may arise from people who may be xenophobic and they don't have other legal ways to express their discontent. I don't think this is the main issue. (or at least not the one I want to discuss)

In my first post I make clear that I have dealt with complaints on behalf of nurses (who are on their majority British nationals). Some vets that had been in practice for 20+ years have agreed in this thread that they find it inconceivable when a client is 'willing to ignore a condition of their pet' with no sanction; but you may get a complaint if you fail to tell them about the almost non-existent side effect of a drug (like if you hoped for that side effect to happen).

I agree that the public should be expecting more from us than from a lay person. But the RESPECT we deserve had been lost somewhere in the way. You, as a vet, should be entitled to hope for a higher level of trust from your pet owner. Instead the pet owner seems to be trying to find if you forgot to put the yellow sign after you mopped the waiting room...

At the end of the day, it is the well-being of the pet what we are pushed (and I agree) to improve! We won't be able to do so if the pet owner is not asked to do enough. Will eventually our regulators expect us to phone each one of our clients, every day, to ask them if they had fed their pets today? So it can be our fault if they haven't done it because we didn't ask?

Re: Is it time to put more responsibility on the owners’ shoulders?

Malcolm Ness — Sun, 07 Jul 2013 08:02:59 GMT

Hi Richard,

I was aware of that but it does contrast with my day to day experience in a practice. I think the explanation is that rather than being well-founded complaints, most of these incidents are expressions of small-minded prejudice or nasty bullying.

Re: Is it time to put more responsibility on the owners’ shoulders?

Richard Stephenson — Sun, 07 Jul 2013 07:45:36 GMT

[quote user="Malcolm Ness"]

Re: Is it time to put more responsibility on the owners’ shoulders?

Miriam Lodewyks — Sat, 06 Jul 2013 22:49:11 GMT

Back to the OP. I'm with Francisco. I too get frustrated with this culture where everything is the vets responsibility and their fault when anything goes wrong. Whatever happened to good old fashioned "s*** happens!"? Most vets I know work hard and always try to find a balance between doing the best for the patient and the client (not always alligned), and work to the highest ethical code. The latter appears to apply only to a very small handfull of the clients I've ever met. It seems to be acceptable for a pet owner to wilfully neglect to treat that chronic ear infection or terrible gingivitis, but heaven help me if I neglect to mention that 1 in 1000 possible side-effect of a drug which I use once a year, or that you need to invert the Metacam bottle to get it into the syringe! The other day my head nurse decided it was preferable for her staff to get mauled whilst trying to obtain a BP measurement, than to "risk" clipping kitty's claws. Her reasoning being this: if we clip claws, kitty could try to scramble up a fence/wall/tree in fright, find that it's nails were no longer gripping, fall... and break it's pelvis. WTF? Seriously? It boggles the mind. But the really sad thing is that I didn't have the will to argue (or even laugh) , because this is the culture that I am surrounded by.

Re: Is it time to put more responsibility on the owners’ shoulders?

Evelyn Barbour-Hill — Sat, 06 Jul 2013 13:54:52 GMT

[quote user="John Flynn"]

[quote user="Hannah Wynne Richards"]In a perfect world(all dog's vaccines up to date) then 1/365 prolapses will occur within 24 hours of vaccination[/quote]

Off topic, perhaps, but I'm not sure that the majority opinion considers perfection to be a dog vaccine every 365 days...

http://www.wsava.org/sites/default/files/New%20Puppy%20Owner%20Vaccination%20Guidelines%20May%202013_0.pdf

[/quote]

Doesn't matter, Canine Health Concern reckons that anything happening within three months of a vaccination is a vaccine reaction.

Re: Is it time to put more responsibility on the owners’ shoulders?

John Flynn — Sat, 06 Jul 2013 13:48:54 GMT

[quote user="Hannah Wynne Richards"]In a perfect world(all dog's vaccines up to date) then 1/365 prolapses will occur within 24 hours of vaccination[/quote]

Off topic, perhaps, but I'm not sure that the majority opinion considers perfection to be a dog vaccine every 365 days...

http://www.wsava.org/sites/default/files/New%20Puppy%20Owner%20Vaccination%20Guidelines%20May%202013_0.pdf

Re: Is it time to put more responsibility on the owners’ shoulders?

Hannah Wynne Richards — Sat, 06 Jul 2013 11:28:47 GMT

In a perfect world(all dog's vaccines up to date) then 1/365 prolapses will occur within 24 hours of vaccination, therefore vaccination carries a 1/365 risk of causing prolapse. Obvious, isn't it? Or at least that's how owners think!!!!!!!!!!!!!!!!!!!!!!

Wynne

Re: Is it time to put more responsibility on the owners’ shoulders?

Anthony Todd — Sat, 06 Jul 2013 10:29:22 GMT

Totally agree with Elisa but [or and]

[quote user="Elisa Best"]off licence consent[/quote]

This has nothing to do with efficiency or safety but totally to do with an economic decision by the manufacturer to make sure that any generic, widely used, safe and effective drug goes through the "licensing " process which has nothing to do with safety or efficiency but everything to do with packaging, warning of the myriads of conceivable side effects and the certainty that the drug will cost sometimes at least 10 times the price of the human generic which has been fine in humans and our animals for years. I mention phenobarbitone and prednisolone as typical examples.

[quote user="Elisa Best"]'defensive medicine' [/quote]

Don't the powers that be realise that when we prescribe any drug we used to weigh up the benefit/side-effects/cost ratio automatically but now have to confuse the owner with the myriad possible side effects. [and use exactly the same drug but one that is licensed and costs 10 times as much

Should we warn owners every time we spay a cat of the possible side effects of isoflurane, let alone of NaCl by injection.....?

Of course the owner only hears these and wonders why we are trying to kill their pet rather than cure it........

The irony is that it's the public that suffers because the vet has to use a much more expensive drug.

Don't worry there'll be a plethora of examples of new drugs which have never been in human use etc. etc.

Re: Is it time to put more responsibility on the owners’ shoulders?

Elisa Best — Sat, 06 Jul 2013 10:03:21 GMT

I completely agree with Francisco. I have been in practice for 20 years and have always tried to work to the highest possible standards. I agree that more and more we are having to practice 'defensive medicine' at every turn which is not always in the best interests of our patients or their owners. I fully agree that owners should be warned about side effects and possible complications of procedues, but when half your consult time is spent filling out off licence consent forms, is this really the best use of our time? I have had to answer one RCVS complaint in my time which related to an animal experincing a known side effect from a licenced drug. Although it was thrown out after my reply, it took a considerable amount of my time and caused a significant amount of unnecessary stress. During the process I felt that I was entirely having to defend myself when I had done nothing wrong. I do feel that complaints like this should be dealt with by our governing body, instead I received a letter saying I had prescribed an unlicenced drug so the person handling the complaint clearly had no veterinary knowledge. I also believe that clients do need to take some responsibilty for their own actions but I guess this is partly down to the 'blame' culture we all live in now, where if we trip over in the supermarket, instead of just feeling slightly embarressed, we immeditely look for someone to blame or sue. This is a stressful enough job as it is and I dont think any of us need the threat of being sued or struck off hanging over our heads. And yes we do have a high suicide rate; 2 colleagues in the past 18 months one attempt and one successful. Sad but true. I do believe that most vets do try and do the best for thier patients. Sure people make mistakes but true cases of negligence or fraud are quite rare and in my experience they are not the ones who get suedor struck off!

Re: Is it time to put more responsibility on the owners’ shoulders?

Mark Hedberg — Fri, 05 Jul 2013 22:33:14 GMT

[quote user="Malcolm Ness"]

[/quote]

I agree fully, having more than a hint of foreignness about me. I'm lucky; it happened rarely and when it was, it was usually patronizing rather than overtly aggressive. (Being six foot six tends to take the aggression out of most folks.)

Re: Is it time to put more responsibility on the owners’ shoulders?

Malcolm Ness — Fri, 05 Jul 2013 22:17:20 GMT

Re: Is it time to put more responsibility on the owners’ shoulders?

Stephen Courtney — Fri, 05 Jul 2013 22:02:56 GMT

i think it is important to remember a few things -

Firstly that most clients are nice people with nice animals - and that these are the ones you definitely WON'T remember.

Secondly while not all pet owners are mad, ALL mad people have pets.

Thirdly, i do believe that complaints derive from 2 main areas - distress over costs, and poor communication - but there is also a third category and that is people who don't like (me) the vet. I have (Touch wood) never had serious complaints, but a fair few over many years that have upset me terribly, made me quite ill and even now can provoke a night of sleepless tooth grinding.

I have noticed that our fantastic OOH vets accrue an unfair number of complaints ( always money) and our foreign vets ( speak with accents) also have a similar unfair number of whinge letters ( I believe this is a charming manifestation of xenophobia) .

I was one told by a vet i saw practice with, the secrets of success in this business are the 'three A's' - Affability, Availability - and finally, Ability. i think he was right.

Re: Is it time to put more responsibility on the owners’ shoulders?

Martin Atkinson — Fri, 05 Jul 2013 16:57:59 GMT

[quote user="Gillian Mostyn"]How often has a pet you've treated died solely due to using metacam? [/quote]Erm....3 out of the first 6 cats I treated with Metacam Cat when it first came out, all died of renal failure, all had their kidneys tested before treatment for one reason or another and renal function was normal, all were eating and properly hydrated. I have only just started gaining confidence in meloxicam again but now Onsior is my NSAID of choice in cats. Sorry for the slight hijack of the thread but it hit a nerve. As for complaints I get so few it isn't worth worrying about and they were all unreasonable or nut-jobs, 3 have gone to the RCVS in 38 years all summarily dismissed.

Re: Is it time to put more responsibility on the owners’ shoulders?

Clive Ansell — Fri, 05 Jul 2013 16:01:36 GMT

[quote user="Robin Grimmer"]

Another reason I no longer do ooh work is you are much more likely to get a complaint. A combination of not being their usual vet, often distressed or upset owners, not having sufficient time etc. Not to mention the increased ooh charges.

[/quote]

100% with you on that.

I must say, I don't miss it one little bit

Re: Is it time to put more responsibility on the owners’ shoulders?

Robin Grimmer — Fri, 05 Jul 2013 15:38:15 GMT

Re: Is it time to put more responsibility on the owners’ shoulders?

Clive Ansell — Fri, 05 Jul 2013 15:32:10 GMT

[quote user="Francisco Gomez"]

[quote user="Clive Ansell"]

[quote user="Francisco Gomez"]

And about your last post: Yes! I thought that was the whole point of booking a second scan. (By the way, I didn't miss it, it wasn't there)

[/quote]

Never say never!

I would use phrases like "I can't see it" , or "as far as I can tell there is no puppy", or "I'm 95% sure she is not pregnant" I am not a good enough ultrasonographer to say hand on heart I am 100% sure.

At what stage was the pregnancy?

[/quote]

That's what I said!!!!!!!!!!!!!!!!!!!

I said something on the lines of:

'Mrs. X. I am afraid that I can't see a live puppy in (let's call her 'Tia') Tia's tommy. There may be several reasons why this has happened... Also let me remind you that no test is 100% accurate and it is possible to miss a puppy in a ultrasound scan. However as far as I can tell, I cannot see one.'

[/quote]

No basis for a complaint then.

Re: Is it time to put more responsibility on the owners’ shoulders?

Francisco Gomez — Fri, 05 Jul 2013 15:01:18 GMT

[quote user="Bob Russell"]

The big but is the owner blames the vaccine!

More likely that it was triggered by some sort of 'trauma' associated with transport/lifting to or from the vet (or pure coincidence of course) rather than the vet giving the vaccination.

Owners are blaming a needle rather than the more likely cause which is day to day life!

We all know that it would have ruptured at some point so vet (and owners) are really blameless!

[/quote]

I agree. My problem with it is that increasingly more people tend to blame the vet for their own failures (and in some cases for no-one failures) and this is partly because of the media, internet, etc... I believe (I may be wrong here) that if something of the shape of a document (Not the Animal Welfare Act., I am not accusing anyone of cruelty) could be published to remind the clients of their responsibilities and if more of those should be shifted to them. (like the availability of transporting an animal, I still can't believe that you are at fault for this!).

Re: Is it time to put more responsibility on the owners’ shoulders?

Clive Ansell — Fri, 05 Jul 2013 14:58:14 GMT

[quote user="Bob Russell"]

The big but is the owner blames the vaccine!

More likely that it was triggered by some sort of 'trauma' associated with transport/lifting to or from the vet (or pure coincidence of course) rather than the vet giving the vaccination.

Owners are blaming a needle rather than the more likely cause which is day to day life!

We all know that it would have ruptured at some point so vet (and owners) are really blameless!

[/quote]

Impossible to say exactly whether it was caused by trauma (not to my knowledge while in the surgery) or was a coincidence (opinion of RCVS specialist who did the spinal op)

Very unpleasant abusive owners, who threatened the staff with violence, and promised to go to the papers, the RCVS, court, the Pope etc etc etc over the telephone.

If they wanted to point blame, they would need to come up with some form of proof or evidence.

Re: Is it time to put more responsibility on the owners’ shoulders?

Francisco Gomez — Fri, 05 Jul 2013 14:52:04 GMT

[quote user="Clive Ansell"]

[quote user="Francisco Gomez"]

And about your last post: Yes! I thought that was the whole point of booking a second scan. (By the way, I didn't miss it, it wasn't there)

[/quote]

Never say never!

At what stage was the pregnancy?

[/quote]

That's what I said!!!!!!!!!!!!!!!!!!!

I said something on the lines of:

Re: Is it time to put more responsibility on the owners’ shoulders?

Bob Russell — Fri, 05 Jul 2013 14:48:10 GMT

The big but is the owner blames the vaccine!

More likely that it was triggered by some sort of 'trauma' associated with transport/lifting to or from the vet (or pure coincidence of course) rather than the vet giving the vaccination.

Owners are blaming a needle rather than the more likely cause which is day to day life!

We all know that it would have ruptured at some point so vet (and owners) are really blameless!