PDSA being a pain in the a***

RE: PDSA being a pain in the a***

Martin Atkinson — Fri, 28 Oct 2016 10:41:18 GMT

[quote user="Utlendigur"] RCVS prof-con informed me the records belonged to the owner and I couldn't release them to either the breeder or the vet taking over the case without the owner's consent[/quote]Its a different scenario to a simple request from another vet for a clinical history when that the client has already given his/her details and the animal's welfare may be compromised if the records are not forthcoming. In this case it is purely a legal matter and a big grey area.

However, in response to Wynne's subsequent observation: if the breeder wanted to take legal case action and a court of law subpoenaed the records this trumps any RCVS ruling and then you would be legally obliged to hand them over, so there is a way out of it.

RE: PDSA being a pain in the a***

Hannah Wynne Richards — Fri, 28 Oct 2016 07:56:22 GMT

Yet Royal College claim their rules are meant to uphold animal welfare and the integrity of the profession................... yet they expect you to be an accessory to criminal conduct under both the Animal Welfare Act, and also fraud!

You couldn't make it up.

Wynne

RE: PDSA being a pain in the a***

Utlendigur — Thu, 27 Oct 2016 21:58:49 GMT

[quote user="Clive Ansell"]

[quote user="Martin Atkinson"]The clinical notes do not belong to the client they belong to the practice but the owner can ask for a copy. Provided you do not pass on personal details of the client, which by default the requesting practice already has anyway, I don't believe that you need to ask the client's permission before acquiescing to any request from another vet for the animal's clinical history. The only time I would initially refuse a request would be if it was from a non-veterinary professional.[/quote]

That has always been my interpretation too. Permission is not needed for transfer of clinical notes only from one veterinary professional to another. No personal or financial data, just clinical notes.

[/quote]

I thought that too until a case where a recently acquired miniature puppy was seen OOH for a traumatic episode and lameness. The owner didn't bother to come back as asked - until the second vacc, and xrays done then showed a nasty malunion fracture. The owner then returned the pup to the breeder claiming it had always been lame. RCVS prof-con informed me the records belonged to the owner and I couldn't release them to either the breeder or the vet taking over the case without the owner's consent (like that was going to be given) - putting the owner's right to lie (and defraud the breeder?) and lack of care above the welfare of the pup, which would then need another GA and xray.

RE: PDSA being a pain in the a***

Bob Russell — Thu, 27 Oct 2016 16:30:30 GMT

A client refusing to allow a history to be sought is a different matter. I will see a patient sometimes but remain very non-committal until I have a better picture of the situation. It is often a misunderstanding or bad debt.

RE: PDSA being a pain in the a***

Martin Atkinson — Thu, 27 Oct 2016 16:08:24 GMT

[quote user="Bob Russell"]To refuse seeing a patient is over the top but there are occasions where I will decline treatment pending history arrival if it affects the potential safety of the treatment.[/quote]There are occasions when I have refused to see a client because they've refused to allow me to get a history, we can't then work in an environment of mutual trust (I then phone the vet any way if they've admitted who it was for a quiet word). Once the other vet turned out to be a friend of mine and the client had stormed out because she said he was rude. A couple of hours later she phoned back and said wasn't coming back to us either as I'd been rude and we (me and my vet friend) would get on together. How prophetic of her. We had a laugh about that when we next met up.

If they've come for a second opinion or there is an ongoing problem then I will examine the patient before we get the history to save having to make another appointment but I won't make any observations or offer any treatment until I've got it.

RE: PDSA being a pain in the a***

grumpyoldman — Thu, 27 Oct 2016 15:57:16 GMT

Overall I am glad they do what they do ,without them bad debt would be a serious problem with them its a minor irritation. Some of their vets can be less than tactful over fees etc ,which is a bit rich when your getting paid a salary anyway whether the client pays you or not, but I would not wish to trade places with them.

RE: PDSA being a pain in the a***

Rob Loxley — Thu, 27 Oct 2016 15:33:43 GMT

[quote user="David Mills"]

Really? Let's remove your prejudice for a second and examine the premises:

1. You or your client are asking a charity with limited funds for help.

2. You expect charities to communicate with you about this, what, before you apply? In case you apply? According to your expectations, it's the charities responsibility to communicate with you just in case you apply.

[/quote]

I'd like them to communicate with us when the client applies for assistance
Last case in point was for PDSA Pet Treatment Fund assistance (we aren't in PDSA hospital catchment and owners had contacted PDSA themselves for assistance): Hyperthyroid cat, unable to tablet, good candidate for thyroidectomy. We provided a fixed price quote for the op which we stuck to. PDSA would not commit to how much they would contribute until the op had been done but led the client to believe it would be significant and upto 50% of the cost, and client was happy to pay the rest. In fact they contributed £60 - which I'm guessing you can imagine wasn't anywhere near 50% - leaving the owner with a large unexpected extra bill.
Why the PDSA couldn't tell us this pre-op is lost on me? We do work for Cats Protection, Dogs Trust and our local rehoming shelter and they are completely up front about what they can and can't contribute and everyone knows where they are.

RSPCA 'central' are upfront about what they will help with, how much they can contribute (50+vat) and cases where they can't, and everyone knows where they are. Beyond this any requests to the local branch get an answer promptly; all is happy.

RE: PDSA being a pain in the a***

Anthony Todd — Thu, 27 Oct 2016 14:18:04 GMT

+1 and the lot; just using common sense really....

RE: PDSA being a pain in the a***

Bob Russell — Thu, 27 Oct 2016 13:58:43 GMT

We will request a history, note it on the records then get on and see the patient. Life is too short.

To refuse seeing a patient is over the top but there are occasions where I will decline treatment pending history arrival if it affects the potential safety of the treatment.

PDSA tend to be slow or don't send history's but they are up to their necks in cases so I tend to forgive them! They do see my patients where clients are eligible so overall they help far more than hinder.

RSPCA clinics can be helpful but we don't expect any payments for treating patients directly. Not worth the hassle!

RE: PDSA being a pain in the a***

Anthony Todd — Thu, 27 Oct 2016 12:32:50 GMT

[quote user="Clive Ansell"]Our RCVS code to professional conduct is quite clear on the issue.[/quote]

Yes, I am aware but all that usually happens is that, if there is some "problem" or non-logistical reason why the animal is presented, the animal doesn't get treated and the owners wises up and says nothing to the next vet they choose.

We all should have the wit to suss out when a history is really necessary and when a demand/refusal to treat without it means the animal often gets no treatment at all.

Most owners have genuine reasons for the move [like the charity examples mentioned] so what do you do if the history is just "not available"?

Often these owners says "thanks", then tell you the reason, animal is fixed, reassurance given and the profession's standing is enhanced.

Of course every incident is different but a blank refusal "without history" is, obviously depending on the presentation, unhelpful to everyone, certainly the animal.

RE: PDSA being a pain in the a***

Clive Ansell — Thu, 27 Oct 2016 12:17:29 GMT

[quote user="Anthony Todd"]Come on, you knockers, "V&D", even I know, and how often is the history vital and in excess of what the owner tells you. If something is significant then you stop and find out but usually it's bleeding obvious and just antagonises the owner and delays treatment and for no good reason.[/quote]

Our RCVS code to professional conduct is quite clear on the issue.

5.3 Relevant clinical information should be provided promptly to colleagues taking over responsibility for a case and proper documentation should be provided for all referral or re-directed cases. Cases should be referred responsibly.

Taking over a colleague’s case

5.5 Although both veterinary surgeon and client have freedom of choice, in the interests of the welfare of the animals involved, a veterinary surgeon should not knowingly take over a colleague's case without informing the colleague in question and obtaining a clinical history.

5.6 When an animal is initially presented, a veterinary surgeon should ask whether the animal is already receiving veterinary attention or treatment and, if so, when it was last seen; then, contact the original veterinary surgeon for a case history. It should be made clear to the client that this is necessary in the interests of the patient. If the client refuses to provide information, the case should be declined.

5.7 In an emergency, it is acceptable to make an initial assessment and administer any essential treatment before contacting the original veterinary surgeon.

RE: PDSA being a pain in the a***

Anthony Todd — Thu, 27 Oct 2016 12:01:11 GMT

[quote user="David Mills"]Would you rather go out and collect the wildlife yourself?[/quote]

That's what we had to do on every "wildlife" emergency we ever had, and dispose of the PTS muntjac which is another story....

Come on, you knockers, "V&D", even I know, and how often is the history vital and in excess of what the owner tells you. If something is significant then you stop and find out but usually it's bleeding obvious and just antagonises the owner and delays treatment and for no good reason.

[expects floods of "diabetic coma" etc examples]

RE: PDSA being a pain in the a***

Hannah Wynne Richards — Thu, 27 Oct 2016 11:59:22 GMT

David Hear hear

Wynne

RE: PDSA being a pain in the a***

David Mills — Thu, 27 Oct 2016 11:20:45 GMT

[quote user="Martin Atkinson"]No prejudice just a reasonable expectation.[/quote]

OK, whatever you say

[quote user="Martin Atkinson"]We are asking a charity with considerable reserves of funds by all accounts[/quote]

Do you have any reserves in your business? If so, why, if this is your logic?

[quote user="Martin Atkinson"]to assist in it's raison d'etre - animal welfare.[/quote]

And helping individual animals at private vet prices is the best way to do this, do you think?

[quote user="Martin Atkinson"]foist off wildlife casualties on to us and expect us to deal with them FOC.[/quote]

Have you read the Code to Professional Conduct?

Would you rather go out and collect the wildlife yourself?

[quote user="Martin Atkinson"]No. I expect them to be able to tell the truth about what he funds are for.[/quote]

Ah, OK. Or you could simply go and look at the annual accounts yourself. Or do you expect a copy of them hand-delivered on bended knee?

[quote user="Martin Atkinson"]Clearly there is a lack of communication when a large number of members of the public think that funds are available to assist in the treatment of pets which through no fault of their own happen to have impecunious or no owners.[/quote]

Do you know how many calls are made to the RSPCA daily about injured stray animals or possible cases of animal abuse? Do you know how many animals the PDSA treat per year? Or do you expect this information spoon-fed to you because you work in private practice and occasionally have need to apply for funds.

Give someone enough rope...

RE: PDSA being a pain in the a***

Hannah Wynne Richards — Thu, 27 Oct 2016 11:06:04 GMT

The annual income of either the PDSA or the RSPCA is peanuts when compared to the annual income of the NHS

Wynne

RE: PDSA being a pain in the a***

Martin Atkinson — Thu, 27 Oct 2016 10:33:53 GMT

[quote user="David Mills"]Really? Let's remove your prejudice for a second and examine the premises:[/quote]No prejudice just a reasonable expectation.

[quote user="David Mills"]You or your client are asking a charity with limited funds for help. [/quote]We are asking a charity with considerable reserves of funds by all accounts to assist in it's raison d'etre - animal welfare. They are quick enough to foist off wildlife casualties on to us and expect us to deal with them FOC.

[quote user="David Mills"]You expect charities to communicate with you about this,[/quote]No. I expect them to be able to tell the truth about what he funds are for. Clearly there is a lack of communication when a large number of members of the public think that funds are available to assist in the treatment of pets which through no fault of their own happen to have impecunious or no owners.

RE: PDSA being a pain in the a***

David Mills — Thu, 27 Oct 2016 10:04:43 GMT

[quote user="Martin Atkinson"]As Rob suggests maybe better communication by the charities on this matter may help.[/quote]

Really? Let's remove your prejudice for a second and examine the premises:

1. You or your client are asking a charity with limited funds for help.

If you can't see the illogical nature of your posting, and the colouring by prejudice, then you're lost I'm afraid. It's almost as if you want charities to advertise their services widely. And yet in the same breath you will string up owners for not taking responsibility for their animals. Cake, wanting, eating.

RE: PDSA being a pain in the a***

Clive Ansell — Thu, 27 Oct 2016 09:44:12 GMT

I don't tend to get too bothered or stressed by, and don't waste much time on it either - history is requested, but if not forthcoming I proceed without usually.

RE: PDSA being a pain in the a***

Martin Atkinson — Thu, 27 Oct 2016 09:15:30 GMT

[quote user="J G Wray"]

There is an apocryphal tale about clinical notes and acronyms which goes something like this

A client moved practice, the new vets received the clinical notes, the new vet went through the notes with the client who queried the acronyms, particularly "DBTO"

History does not record the outcome

[/quote]This related to a case which was referred and referral vet let the client see the clinical notes. When the client asked the meaning of this acronym the referring vet replied 'animal brighter than owner'. History does record that a complaint was made and it made it to the pages of the VDS newsletter. My take on this was that the referring vet was a pillock for dobbing a colleague and in no position to speculate what another vet's acronym stood for. He should have kept his thoughts to himself as it could have an entirely different meaning as far as he knew.

RE: PDSA being a pain in the a***

Martin Atkinson — Thu, 27 Oct 2016 09:08:08 GMT

[quote user="David Mills"]I do so love it when people think they understand how and why charities spend their money.[/quote]As Rob suggests maybe better communication by the charities on this matter may help. However for the most part I would think that 99.99% of the population would think that a charity which promotes its purpose as being animal welfare would want to assist in erm....animal welfare!

[quote user="J G Wray"]Nope, we declined to pass on clinical notes just the other day without the registered owner's permission .[/quote]The clinical notes do not belong to the client they belong to the practice but the owner can ask for a copy. Provided you do not pass on personal details of the client, which by default the requesting practice already has anyway, I don't believe that you need to ask the client's permission before acquiescing to any request from another vet for the animal's clinical history. The only time I would initially refuse a request would be if it was from a non-veterinary professional.

RE: PDSA being a pain in the a***

J G Wray — Thu, 27 Oct 2016 09:07:23 GMT

[quote user="Luca Poddighe"]To reply to the original message passage of history between practice it is often a source of stress for vets, I've recently received an history that reported only name and address of the pet and owner and "V and D". Don't find it brilliant?[/quote]

There is an apocryphal tale about clinical notes and acronyms which goes something like this

A client moved practice, the new vets received the clinical notes, the new vet went through the notes with the client who queried the acronyms, particularly "DBTO"

History does not record the outcome

RE: PDSA being a pain in the a***

Luca Poddighe — Thu, 27 Oct 2016 08:26:30 GMT

[quote user="J G Wray"]If you don't like it then take it up with those lovely people at RCVS....not PDSA, cos in this case, as you tell it, PDSAare playing by the rules.[/quote]

And maybe we should really do it, because our first commitment should be granting the animal welfare (obviously it is much more complicate without a scrap of previous history) rather than comply to rule of Data protection when they are of clear hindrance.

To reply to the original message passage of history between practice it is often a source of stress for vets, I've recently received an history that reported only name and address of the pet and owner and "V and D". Don't find it brilliant?

RE: PDSA being a pain in the a***

Braden Collins — Thu, 27 Oct 2016 01:09:28 GMT

In Western Australia, our guidelines say we need to hand over the records when requested by another vet. The responsibility is with the vet requesting the history, not the one providing it. Makes for a much smoother process.

RE: PDSA being a pain in the a***

J G Wray — Wed, 26 Oct 2016 21:47:07 GMT

[quote user="Clive Ansell"]

Does anyone else find them a pita over what should be a quick and simple process of sending clinical notes, in confidence, from one practice to another.

[/quote]

Nope, we declined to pass on clinical notes just the other day without the registered owner's permission . The request was from a husband who , so they said , had taken on the dog after a divorce, when the dog was registered with us in the wife's name.

If you don't like it then take it up with those lovely people at RCVS....not PDSA, cos in this case, as you tell it, PDSAare playing by the rules.

RE: PDSA being a pain in the a***

David Mills — Wed, 26 Oct 2016 20:46:23 GMT

[quote user="robloxley"]Maybe this is a reflection on how well the charities communicate with the practices that are their 'front line'.[/quote]

Or maybe it's a case of "front line" practices looking for someone to blame? (I suspect it's easier to do this than have a difficult conversation with a client). Or, more likely, it's just an excuse for people to sound off about how charities market themselves to garner donations (= a logical fallacy). Or it's some sort of weird entitlement that somehow charities have to justify themselves to private practice. It's weird, because the standard of communication from private practice to our hospitals can extends to a collapsed animal and "bup 0.2mls" scrawled on a scrap of paper, with a non-eligible client attached.

Everyone has an opinion - normally ill-informed - of what charities should be doing, spending their money on, how much money they have and so forth. It's tiresome. And lazy.

I can't speak on behalf of the PDSA as I've no idea about their criteria for deciding how much money to give to an individual cause. I suspect they'd be more than happy to talk you through it. The RSPCA can and will negotiate with private practices about doing their work in areas where no clinic/hospital is, which is audited and reviewed each year.

Anyway we've been here before etc etc.