Snail mail.

RE: Snail mail.

Anthony Dennison — Mon, 21 Sep 2015 09:49:44 GMT

I'm with Michael Woodhouse on this one. My practice does the same, and I fully agree with his arguments.

RE: Snail mail.

Joyce Whitehead — Sat, 19 Sep 2015 20:24:05 GMT

Yes we have, used in context with a court case my husband was attending as a witness. The defending witness was described as Mx, apparently used for transitioning transsexuals. We looked it up as we thought it was a misprint initially. [quote user="robloxley"]

[quote user="J G Wray"]PS we have no probs with the plural of Mr > Messrs but Ms and Miss is different[/quote]

On a tangent, has anyone else come across Mx as a title?

[/quote]

RE: Snail mail.

Rob Loxley — Sat, 19 Sep 2015 16:59:18 GMT

[quote user="J G Wray"]PS we have no probs with the plural of Mr > Messrs but Ms and Miss is different[/quote]

On a tangent, has anyone else come across Mx as a title?

[quote user="Michael Woodhouse"]

[quote user="Martin Atkinson"]If you did this to me I would be reporting you to the RCVS. This cavalier attitude to your responsibility is similar to that you take towards incomplete vaccine records.[/quote]

Good luck with that. Lets hope it backfires and you get the slap on the wrist for not following the code properly...

[/quote]

Remind me what the code says on filling in owner/breeder names in vaccination cards

RE: Snail mail.

Evelyn Barbour-Hill — Sat, 19 Sep 2015 14:18:44 GMT

[quote user="Gillian Mostyn"]

[quote user="Evelyn Barbour-Hill"]f i were seeing a lame dog for a second opinion (which I would not be, I don't believe one should do second opinions on anything one does not have special knowledge and expertise in, but leave that aside)[/quote]

A second opinion is just that, a second opinion. It is not an expert opinion.

In the vast majority of cases I have seen for a second opinion, I have agreed with the first vet and recommended they return there to complete the tests/treatment. Some choose to, some don't, but often a complete medical history gives me so much info I can simply agree with the first vet!

[/quote]

Yes, I partly agree and I wouldn't make a big thing about it. However I feel many clients seeking a "second opinion" are seeing the second opinion as an expert opinion, either consciously ("my friend said you were very good when her Binky-boos hurt her leg" ) or subconsciously (second-opinion syndrome ).

Also. If a second opinion is being sought, usually, it's because a case isn't going quite right or it's because the client doesn't like the serious diagnosis or the gloomy prognosis they have been given. In that case, they don't need an opinion from another ordinary all-rounder, they need an opinion from an expert. And most of us are familiar with the occasional owner who totes the dog around all the practices for a third opinion, a fourth opinion..... until they finally get an opinion they like. And I am happy to explain all this, politely and with no charge for the time it takes (which can be lengthy), to second-opinion seekers.

Of course I'm glad to do second opinions on matters which are within my field of special expertise.

I just feel that the ordinary practitioner should, in the interests of the patient, not be quite so ready to do second opinions on what seems to me like a "have a go" basis.

Now, getting back to the original discussion:

[quote user="Gillian Mostyn"]Histories are more often requested simply because the client wants to move practice, where there isn't an ongoing medical condition. The reason can be financial, location or due to a recommendation but is rarely, in my experience, due to a specific issue with the original vet.[/quote]

Quite so. And in such cases there is no reason why a few days or a week cannot be waited. Anything needed urgently can be passed on over the telephone.

RE: Snail mail.

Emily Rainbow — Sat, 19 Sep 2015 13:30:47 GMT

We had a similar issue with a new practice that opened up the road recently. A number of clients went there to have a look at it and all their histories were requested. When we rang to ask for permission the vast majority declined and stated they didn't want to change vets they went to have a nose around!

RE: Snail mail.

Michael Woodhouse — Sat, 19 Sep 2015 13:11:50 GMT

[quote user="Martin Atkinson"]It seems pretty obvious if another vet has requested the history the client has gone there so you have no basis on which to not send them on request as this is implied consent.[/quote]

There is another list based discussion group for vets where this was discussed recently - clients unaware that they has signed up with a new corporate. Evelyn seems to have seen the same behaviour. I've head about it happening many times, so I disagree on your first point.

[quote user="Martin Atkinson"]The whole point of obtaining records is for the welfare of the animal and it is the animal which will suffer if you deliberately withhold them because you've got your arse in your hand about then going somewhere else.[/quote]

Do you really, really think so? How many animals can you see OOH in an emergency (we see a lot of holidaymakers) where a history would genuinely affect animal welfare? Realistically all a history does it save the owners money by you not repeating what has been done.

[quote user="Martin Atkinson"]By all means contact the owner and discuss the reasons why they want to go elsewhere (maybe it's because you're not as good as you think you are - shock, horror) but if you can't do it before they are due to go to the other vet you cannot withhold the records!! [/quote]

I believe it is good practice from a business point of view and the RCVS WANT ME TO CONTACT THE OWNERS FIRST! We drew up our guidelines based on the 'Code'. This is the part I find most confusing in this thread!?!? I am doing what RCVS want me to do.

Good luck with that. Lets hope it backfires and you get the slap on the wrist for not following the code properly...

(Incidentally with compulsory microchipping then I agree that the vacc card becomes a certificate - my only issue was without decent individual identification then a vaccination card was worthless, and 100% NOT a certificate!)

RE: Snail mail.

J G Wray — Sat, 19 Sep 2015 11:54:36 GMT

[quote user="Martin Atkinson"]If you did this to me I would be reporting you to the RCVS[/quote]

Are you serious? How about a bit of negotiation first?

RE: Snail mail.

J G Wray — Sat, 19 Sep 2015 11:52:42 GMT

[quote user="Arlo Guthrie"]Mses and Misses.[/quote]

Just tried these on Hayley and Katie, clients in this am. They wrinkled their noses and decided Ms was the plural of Ms for them.

RE: Snail mail.

Martin Atkinson — Sat, 19 Sep 2015 09:37:04 GMT

[quote user="Michael Woodhouse"]I struggle to imagine a situation where I wouldn't contact an owner first, I guess if the animal was presented at another practice by a 3rd party and a history was vital.[/quote]It seems pretty obvious if another vet has requested the history the client has gone there so you have no basis on which to not send them on request as this is implied consent. The whole point of obtaining records is for the welfare of the animal and it is the animal which will suffer if you deliberately withhold them because you've got your arse in your hand about then going somewhere else. By all means contact the owner and discuss the reasons why they want to go elsewhere (maybe it's because you're not as good as you think you are - shock, horror) but if you can't do it before they are due to go to the other vet you cannot withhold the records!!

If you did this to me I would be reporting you to the RCVS. This cavalier attitude to your responsibility is similar to that you take towards incomplete vaccine records.

RE: Snail mail.

Arlo Guthrie — Sat, 19 Sep 2015 08:59:36 GMT

[quote user="J G Wray"]PS we have no probs with the plural of Mr > Messrs but Ms and Miss is different. What are the plurals there?[/quote]

Mses and Misses.

RE: Snail mail.

J G Wray — Sat, 19 Sep 2015 08:20:44 GMT

[quote user="robloxley"]If someone round the corner from me was playing silly buggers with not sending notes over I'd be pretty frustrated, and so would the owners, and maybe they'd be advised to take their frustrations to the RCVS.[/quote]

We had just this, from both ends, the other day. A dog was presented and history requested from a neighbouring practice. They declined to send it. This was because the dog was registered in the husbands name and the estranged wife presented it to us. There was no implied or actual consent to pass on the info.

The same happened in reverse with a request from up country for a history where the dog was registered in a wife's name and the husband's new girlfriend had presented it to another practice.

In both cases we encouraged an off the record discussion between managers. In both cases we agreed inter practice not to fall out about it no matter what, explain our problem to the owners, articulate clearly that we could obtain no further details and couldn't help much more, because we cannot help with domestic strife. We also commented how unhelpful this is should there be a pressing need to consult notes. This last argument cut no ice and no consent in either case has been given

We recorded all of this off the patient's notes

In practice discussion we have decided to clean up our registrations so that only one name appears on the account. We have a number of couples, mainly same sex who have both their names in the surname field

JGW

PS we have no probs with the plural of Mr > Messrs but Ms and Miss is different. What are the plurals there?

RE: Snail mail.

Gillian Mostyn — Fri, 18 Sep 2015 23:45:16 GMT

A second opinion is just that, a second opinion. It is not an expert opinion.

Histories are more often requested simply because the client wants to move practice, where there isn't an ongoing medical condition. The reason can be financial, location or due to a recommendation but is rarely, in my experience, due to a specific issue with the original vet.

RE: Snail mail.

Michael Woodhouse — Fri, 18 Sep 2015 23:24:52 GMT

Section 14 COPC 'Confidentiality'

14.3 The client’s permission to pass on confidential information may be express or implied. Express permission may be either verbal or in writing, usually in response to a request. Permission may also be implied from the circumstances, for example where a client moves to a different practice and clinical information is requested or where an insurance company seeks clarification or further information about a claim under a pet insurance policy. However, whenever practicable the client’s express consent to the disclosure should be sought.

http://www.rcvs.org.uk/advice-and-guidance/code-of-professional-conduct-for-veterinary-surgeons/supporting-guidance/client-confidentiality/

I struggle to imagine a situation where I wouldn't contact an owner first, I guess if the animal was presented at another practice by a 3rd party and a history was vital.

I knew I'd read it somewhere.

RE: Snail mail.

Rob Loxley — Fri, 18 Sep 2015 23:16:25 GMT

If someone round the corner from me was playing silly buggers with not sending notes over I'd be pretty frustrated, and so would the owners, and maybe they'd be advised to take their frustrations to the RCVS.

RE: Snail mail.

Evelyn Barbour-Hill — Fri, 18 Sep 2015 22:52:33 GMT

If i were seeing a lame dog for a second opinion (which I would not be, I don't believe one should do second opinions on anything one does not have special knowledge and expertise in, but leave that aside) I'd just want to know the history of the lameness, which could easily be read out over the phone, or, better still, given verbally over the phone by the veterinary surgeon concerned. I couldn't care less whether the dog had Endogard or Milbemax in 2003 or when its last distemper booster was. If such facts did become important, I could enquire later.

I don't understand those up-their-own practices that expect an entire and detailed life history including the one-day diarrhoea he had seven years ago, and get all shirty when I say I can't actually spare the time to get it emailed to them in the next five minutes. Though to be fair, if it's the vet who makes the call they are never so demanding, it's the snooty receptionists and junior nurses; and they seem incapable of taking down a swift dictated history. I can often tell 'em everything they need on the phone. What's the problem?

[quote user="Michael Woodhouse"]If you have a vet in a pet shop near you, you might be amazed how many history requests are made after people thought they had entered a prize draw etc[/quote]

Ho yus. We ask them "Is Mrs. Bloggs with you with a sick animal now?" No, she isn't. "Has she made an appontment to see you about something?" No, she hasn't. "Well, if Mrs Bloggs ever asks for a consultation with you, I'll be very happy to send you the history"

RE: Snail mail.

Michael Woodhouse — Fri, 18 Sep 2015 22:19:12 GMT

It's about maintaining the standards of the practice. This frequently is a quick and simple process, BUT there are times when people have to wait. I don't get greatly frustrated waiting for history, no. I do believe there are perfectly legitimate reasons why it may not be possible, or desirable, to instantly fire over a history. There is no way we would be sending it over without checking with the owner first. A single call to the owner allows everything to be done at once - it works for us.

RE: Snail mail.

Gillian Mostyn — Fri, 18 Sep 2015 22:07:10 GMT

[quote user="Michael Woodhouse"]Firstly it is a very useful thing from a business point of view to find out why someone wants to go elsewhere. [/quote]

You can do that later, after sending a history

[quote user="Michael Woodhouse"]The main reason we proof read is that the PMS doesn't have a spell check built in and sometimes stupid spelling mistakes or typos creep in. Occasionally comments outside the immediate clinical condition of the animal are included and you need permission to pass that information on or it must be removed. It makes us look unprofessional and potentially breeches the DPA.[/quote]

We all make typos ...hardly a major issue. And as for a Director checking every history for rypos and relevance...a receptionist can do that, no?

[quote user="Michael Woodhouse"]If you have a vet in a pet shop near you, you might be amazed how many history requests are made after people thought they had entered a prize draw etc[/quote]

Fair enough. We have a lot of corporates round here (>50% of practice's) and I have never seen or heard of that happening.. Don't think the RCVS would look kindly on it.

[quote user="Michael Woodhouse"]If you ring me for a history and the dog needs urgent treatment and is away on holiday then I am quite happy giving a verbal update over the phone![/quote]

Does it have to be on holiday? What if it was one of your competitors that rang?

[quote user="Michael Woodhouse"]It's about maintaining standards and being professional, whilst running a business[/quote]

IMO, it is about allowing clients to see another vet without making that process deliberately difficult for them. I'm not saying that you should stop what you're doing and rush around for them, but neither is making another practice wait days reasonable. Have you never been the one frustrated by having to wait???

RE: Snail mail.

Michael Woodhouse — Fri, 18 Sep 2015 22:00:47 GMT

It's in our T&Cs that a history will not be released until the account is cleared. I'm not giving any information away - they could owe £2 for a worming tablet. Telling another practice they are a bad debtor is not allowed.

In an emergency then we would always waive the rule.

RE: Snail mail.

Gillian Mostyn — Fri, 18 Sep 2015 21:57:28 GMT

[quote user="Michael Woodhouse"]Also we will not send a history until the invoice is settled. Quite happy telling another practice that.....[/quote]

That really isn't allowed Michael. Financial information relating to the client is confidential and cannot be disclosed. I also doubt the RCVS would agree with you regarding withholding a history until an account is settled.

RE: Snail mail.

Michael Woodhouse — Fri, 18 Sep 2015 21:46:47 GMT

Also we will not send a history until the invoice is settled. Quite happy telling another practice that.....

RE: Snail mail.

Michael Woodhouse — Fri, 18 Sep 2015 21:44:42 GMT

Gillian Mostyn - it's not about being awkward. Firstly it is a very useful thing from a business point of view to find out why someone wants to go elsewhere. Has there been a misunderstanding? Do they not like the new vet? Unhappy with their treatment? It means we can look at what we may be doing wrong and do better (in a similar vein, we always ask why someone has decided to move to the practice).

The main reason we proof read is that the PMS doesn't have a spell check built in and sometimes stupid spelling mistakes or typos creep in. Occasionally comments outside the immediate clinical condition of the animal are included and you need permission to pass that information on or it must be removed. It makes us look unprofessional and potentially breeches the DPA.

You are right that owners can request to see their records. That request must be in writing and I believe we have 40 days to comply and may charge a fee for producing them. Whilst I wouldn't charge, it would undergo the same checking by one of the directors.

If you have a vet in a pet shop near you, you might be amazed how many history requests are made after people thought they had entered a prize draw etc

If you ring me for a history and the dog needs urgent treatment and is away on holiday then I am quite happy giving a verbal update over the phone!

It's about maintaining standards and being professional, whilst running a business.

RE: Snail mail.

Gillian Mostyn — Fri, 18 Sep 2015 21:27:15 GMT

Clients are entitled to their clinical history on demand Michael. They would be in their rights to ask for a printout at any time....without any 'modifications'.

I find it really annoying when another practice is deliberately awkward about passing on a history...and always makes mW wonder what they are trying to hide.

(I don't get this 'consent' thing. I understand why. It just baffles me that another practice would think we'd ask for a random client's history, without us being asked to do so.)

RE: Snail mail.

Michael Woodhouse — Fri, 18 Sep 2015 21:02:57 GMT

[quote user="Martin Atkinson"]they deliberately delay sending histories because although they're up themselves when my clients went there now they're drifting back they resent it. [/quote]

We have a policy that if another practice requests a history then it is printed out and checked through by one of the directors and the owner has been contacted for their consent to send and to find out why they are looking to go elsewhere. It's a good opportunity to sort out misunderstandings. I've known it take 10 days before we've managed to get in touch with someone, so no history sent before them. Some are done all inside 10 minutes.

On my list of important jobs, checking histories for people wanting to go to other practices is about at the bottom of my list.

RE: Snail mail.

Martin Atkinson — Fri, 18 Sep 2015 18:36:28 GMT

I'd still see it but tell them that you can't give them an opinion or any treatment unless it is an emergency before you get the clinical history. This happens frequently with the practice up the road from me that I'm always moaning about, even though they can fax or email it seems they deliberately delay sending histories because although they're up themselves when my clients went there now they're drifting back they resent it.

RE: Snail mail.

Evelyn Barbour-Hill — Fri, 18 Sep 2015 16:49:46 GMT

Presumably you phoned the previous practice. Could they not reel off the history over the phone?