What was the impact of Mr Chikosi for you?

RE: What was the impact of Mr Chikosi for you?

bevs2251 — Fri, 20 Oct 2017 04:36:16 GMT

So the Referral/Emergency Veterinary Centre Central Coast, NSW, Australia, advised me that they would not send a vet out after hours to an impaling or HBC etc. Usually the Police are called who then can contact a council ranger. As everyone now refers to the emergency centres, I assume this is what happens.

Anyway, good luck with getting a Gen Y/Millenial vet out OOH without an assistant to deal with cases like this !

RE: What was the impact of Mr Chikosi for you?

Niall Connell — Thu, 19 Oct 2017 21:23:20 GMT

[quote user="Gillian Mostyn"]

[quote user="Niall Connell"]Most owners managed in to the centre but home visits did take place occasionally.[/quote]

Fair enough, and sorry for any offence caused. I was told differently by a vet who worked for them recently.

[/quote] No offence caused, Gillian. Best wishes, Niall

RE: What was the impact of Mr Chikosi for you?

Gillian Mostyn — Thu, 19 Oct 2017 15:57:00 GMT

[quote user="Niall Connell"]Most owners managed in to the centre but home visits did take place occasionally.[/quote]

Fair enough, and sorry for any offence caused. I was told differently by a vet who worked for them recently.

RE: What was the impact of Mr Chikosi for you?

Gillian Mostyn — Thu, 19 Oct 2017 15:53:54 GMT

[quote user="Clive Ansell"]if you were still a boss and an employed assistant or a locum working sole charge for you had to close up shop at 5.30pm taking their only nurse with them on an essential visit....[/quote]

Difficult one, that. In all but title I still am 'the boss' but I am also accountable to my boss too!!

I would hope that the staff would have looked at all possible alternatives (ringing me/another vet, ringing another local practice etc) but, if they truly needed to attend an emergency then yes, I would support them.

You may be surprised to know this has happened a couple of times. The vet and nurse have both left to attend an urgent (albeit not 'essential') visit, leaving just the receptionist in the building. On these occasions they are instructed to keep the door locked and only open it for known people/clients. Hopefully they will (and have) been happy to rebook or wait once the nature of the problem is explained. Obviously, if an emergency happened to arrive they would have to send it elsewhere.

I think you have to treat the animals you KNOW need your help, rather than refusing to on the basis of what MIGHT need it.

As far as not being paid...the staff know that for non-client visits the visit fee is taken up front. In an emergency...well, that's just part of our lot as vets. Lack of payment would never stop me giving first aid, so I couldn't blame my staff for feeling the same.

RE: What was the impact of Mr Chikosi for you?

Niall Connell — Thu, 19 Oct 2017 10:12:40 GMT

[quote user="Gillian Mostyn"]

The PDSA is a charity but they only run vet hospitals. Apparently they will not provide home visits...although they are certainly covered by the same code as the rest of us.

[/quote] Hi Gillian, I worked for the PDSA. I did carry out some home visits OOH in the East End of London and Glasgow, either by myself or with a vet nurse or an auxiliary, including a call one weekend many years ago when I visited an RTA dog in Larkhall, which was 18 miles away from our Glasgow centre. Most owners managed in to the centre but home visits did take place occasionally.

RE: What was the impact of Mr Chikosi for you?

Clive Ansell — Thu, 19 Oct 2017 08:02:31 GMT

Interesting one recently.

I did a one week locum earlier this year in a practice I had never been to before, and while discussing T&C's I mentioned that I have a car with business use insurance, so able to carry out home visits or travel between branches etc.

The reply came back that "it would not be needed as all patients are seen at the surgery, and we do not carry out any home visits."

RE: What was the impact of Mr Chikosi for you?

Clive Ansell — Thu, 19 Oct 2017 07:56:26 GMT

[quote user="Gillian Mostyn"]The code is there to show how we should be behaving as a professional. Most vets, I would hope, would attend an animal in extremis. Those that would/could not would be expected to explain why.[/quote]

Yes, I think most of us would if we could.

out of interest; if you were still a boss and an employed assistant or a locum working sole charge for you had to close up shop at 5.30pm taking their only nurse with them on an essential visit, thus turning away several clients and lets say for arguments sake that 2 left the practice and registered elsewhere, and another was forced to go to an OOH clinic incurring higher fees; then lets say you don't get paid for the visit - would you be happy with that, and would you fully support the colleague?

RE: What was the impact of Mr Chikosi for you?

Gillian Mostyn — Thu, 19 Oct 2017 07:28:40 GMT

[quote user="bevs2251"]I think most people here would call the RSPCA first, or the Police. Injured strays are the domain of the local councils here in NSW, Australia, with local vets required to provide first aid only, or euthanasia, if in extremis.[/quote]

Both these situations are the same in the UK.

[quote user="bevs2251"]What does your RSPCA/PDSA do in these OOH situations - do they send vets out at 2am for an impaled cat/dog/deer ? [/quote]

The PDSA is a charity but they only run vet hospitals. Apparently they will not provide home visits...although they are certainly covered by the same code as the rest of us.

The RSPCA would ring the local vet. (The RSPCA also has vet hospitals ..again, they are bound by the same code but I have no idea whether they would do a home visit, even in extremis.)

The code is there to show how we should be behaving as a professional. Most vets, I would hope, would attend an animal in extremis. Those that would/could not would be expected to explain why. (Such as the bloke near me who refused. The police didnt report him, luckily for him). I really don't see why that is unreasonable.

RE: What was the impact of Mr Chikosi for you?

bevs2251 — Thu, 19 Oct 2017 05:21:32 GMT

[ Would you attend if a cat was impaled on a fence? A dog trapped by its leg under a car? A deer with a fractured leg writhing around in the road? (That one happened...another local SA practice refused to attend despite the police instructing them to. Apparently they were too busy consulting...the incident was approx 500m from their front door.!!! We went, even though we were further away.) ]

Guess I would but have not ever been in this situation in 30+ years practice (even during my UK stint back in 1988). I'd certainly walk 500m to inject Zoletil into a thrashing injured stray/wildlife case, then euthanase it, if indicated.

I think most people here would call the RSPCA first, or the Police. Injured strays are the domain of the local councils here in NSW, Australia, with local vets required to provide first aid only, or euthanasia, if in extremis. In country/urban areas, a local vet may have to go out to an impaled cat/dog/goat/horse. I have had the Police bring injured strays in to the clinic OOH in their paddy wagons for us to treat pro-bono (as new graduate). Only ones they could handle though - if the dog was in so much pain biting and attacking, I guess they'd call a vet out or the RSPCA.

Many of our large OOH centres are an extension of the specialist centres. Most urban/suburban vets in the large cities now refer OOH to these. I'm not sure what they do in the examples you cite - I'm going to a talk tonight at one so will ask. Presumably, they have an animal ambulance to pick up injured strays. Not sure if they would send a vet out to an impaled dog/horse - the Police might have to deal (shoot) with this one (our Police are allowed to carry guns but aren't necessarily very adept at shooting a thrashing dog/horse in the right spot !).

What does your RSPCA/PDSA do in these OOH situations - do they send vets out at 2am for an impaled cat/dog/deer ?

Justifying every decision with a written essay in the client notes is certainly the 21st Century way. Quite used to that as NSW happens to be one of the most litigious places on the planet !

RE: What was the impact of Mr Chikosi for you?

Gillian Mostyn — Sat, 14 Oct 2017 22:28:02 GMT

Why do you have to be rude? If you feel able to debate your point, why resort to sarcastic comments?

I just don't see what the Nazi approach to animal welfare has to do with whether the UK has a good record on animal welfare compared to other countries? Even if the Nazis did look after animals better than other governments of their time, is that relevant to this discussion?

RE: What was the impact of Mr Chikosi for you?

J G Wray — Sat, 14 Oct 2017 21:52:26 GMT

[quote user="Gillian Mostyn"]

I don't see how that is relevant TBH.

[/quote]

I’m not surprised.

RE: What was the impact of Mr Chikosi for you?

Gillian Mostyn — Sat, 14 Oct 2017 21:48:02 GMT

I don't see how that is relevant TBH.

RE: What was the impact of Mr Chikosi for you?

J G Wray — Sat, 14 Oct 2017 21:40:10 GMT

[quote user="Gillian Mostyn"]

Do you think so? I know that there is always room for improvement, but I would have thought that the UK's laws are, to a great extent, pretty good WRT animal welfare in comparison to most countries? What 'history' do you think contradicts this?

(I know the badger cull, hunting etc are certainly controversial...but not as much as bullfighting, poor zoo licensing, inadequate care for stray animals and such!)

[/quote]

There’s a sort of summary here which is an example of a lesson from history about the high point of animal welfare legislation in a nation state other than the UK which went far beyond modern day Britain and how hunting, animal welfare, animal rights, slaughter law and vivisection can all become very political - and it was well supported by vets.

https://en.m.wikipedia.org/wiki/Animal_welfare_in_Nazi_Germany

I‘ve mentioned it before

RE: What was the impact of Mr Chikosi for you?

Gillian Mostyn — Sat, 14 Oct 2017 16:13:24 GMT

(I know the badger cull, hunting etc are certainly controversial...but not as much as bullfighting, poor zoo licensing, inadequate care for stray animals and such!)

RE: What was the impact of Mr Chikosi for you?

J G Wray — Sat, 14 Oct 2017 15:05:57 GMT

[quote user="Gillian Mostyn"]With respect, the UK has some of the strongest animal welfare legislation in the world. Vets are not exempt from that. It is something we can all be proud of. [/quote]

Take care with that statement because it is a peculiarly Anglo-Saxon view and history does not bear witness to Albion's laws being the high water mark in this area.

RE: What was the impact of Mr Chikosi for you?

Gillian Mostyn — Sat, 14 Oct 2017 14:37:48 GMT

[quote user="bevs2251"]If only one vet and one nurse providing emergency service for several practices, why on earth should they be expected to provide OOH house calls ?[/quote]

They aren't, except where the welfare of the animal dictates it.

[quote user="bevs2251"]The VSB quickly advised that we were only obligated to provide first aid, and if we were concerned about our safety, we had no obligation to provide an OOH house call. [/quote]

Same as the UK then.

Would you attend if a cat was impaled on a fence? A dog trapped by its leg under a car? A deer with a fractured leg writhing around in the road? (That one happened...another local SA practice refused to attend despite the police instructing them to. Apparently they were too busy consulting...the incident was approx 500m from their front door.!!! We went, even though we were further away.)

[quote user="bevs2251"]the need to justify with written documentation in case of future complaint if one refuses to attend[/quote]

Being asked to justify your decision is part of being a professional..no? Unless you don't think the general public, and your regulatory body, have the right to question you?

With respect, the UK has some of the strongest animal welfare legislation in the world. Vets are not exempt from that. It is something we can all be proud of.

RE: What was the impact of Mr Chikosi for you?

bevs2251 — Sat, 14 Oct 2017 03:34:40 GMT

[So how do clients cope in Australia, US etc, where virtually all small animal clinics in virtually all capital cities down to moderately sized regional cites (covering close to 90 % of the population) pass their out of hours work to large centralised emergency clinics? Not entirely sure, but they do, and there are usually animal ambulance services and mobile vet services that will cover almost all of the more serious and justifiable call out requests.]

So glad I'm not a UK vet ! As an Aussie vet having locummed in UK back in 1988 (pre emergency centre days), I have done my fair share of OOH. Several years back (last century now), NSW vets brought our regulatory body to heel regarding OOH house calls when a vet was threatened with being stabbed (Biker) if he didn't attend to his dog at his home (had been in a dog fight, likely with another Biker's dog). This vet put a letter out to all the AVA members about our responsibility in this situation where our own lives are put at risk. At least Police have guns and tasers. We all responded that our lives and safety trumped any requirement to do an OOH house call. The VSB quickly advised that we were only obligated to provide first aid, and if we were concerned about our safety, we had no obligation to provide an OOH house call.

When I did do OOH, I only ever did the occasional OOH house call to clients that I knew well. Refused in all other circumstances. Always advised to come to clinic. Often the client would be there before me as I lived 20 minutes+ from the clinic I last ever did any OOH for.

As noted, the idea of a vet in the 21st century in Australian cities providing OOH house calls is laughable. Besides, the millenial vets would be up in arms if they had to do this ! Barely can get them to work a 38 hour week !! Of course, large animal practices still do OOH and OOH house calls. One reason why it is so hard for these practices to attract staff.

If only one vet and one nurse providing emergency service for several practices, why on earth should they be expected to provide OOH house calls ? They need to be at the practice to service incoming clients and the animals already present needing attention. I think this 'obligation' by your RCVS, or the need to justify with written documentation in case of future complaint if one refuses to attend, is crazy. Sounds like your code/guide needs further refining.

RE: What was the impact of Mr Chikosi for you?

J G Wray — Wed, 27 Sep 2017 09:19:16 GMT

[quote user="Chris Barker"]

[quote user="J G Wray"]

Safety issues whilst on house visits.

Whilst the Code may make reference to a professional assessment of need, there seems to be little acknowledgement of this aspect of domiciliary visits.

Where is the insight from RCVS on this?

[/quote]

Hmm Read the Code Quite a lot on this really... (My highlighting in bold)

3.37 In deciding whether or not to attend away from the practice, veterinary surgeons should consider all relevant factors, which may include:........

In summary No vet is expected to put their personal safety at risk when attending animals, either in the clinic or on a visit. Even if a visit seems to be warranted they can decline if they have fears for their safety and if there is no way they can mitigate the perceived risk. But they should document the reasons for future reference in case a complaint is made

[/quote]

Has this been tested yet? The code now looks pragmatic and your words encourage defensive behaviours, recording reasons for non-attendance ( where will this end as in recording justification for not doing x,y,z?), but how do we know where the bar is set for reasoned or reasonable grounds?

These questions should be expected from enquiring minds.

RE: What was the impact of Mr Chikosi for you?

Judith Joyce — Tue, 26 Sep 2017 18:24:39 GMT

Are PIC and CEG also expressly directed not to bring their own preconceptions and prejudices to the task as is the case with DC? My recent experiences would suggest not. In my case, and bearing in mind that there there was no complaint against me, it would appear that CEG was empowered to inform a client that I had been given advice for a misdemeanour without investigation either into my conduct or whether the allegation was true (it wasn't). "Act professionally" is a dangerous directive devoid of objectivity - not sage.

RE: What was the impact of Mr Chikosi for you?

Chris Barker — Tue, 26 Sep 2017 17:45:06 GMT

[quote user="Glen McIntosh"]Would it be going too far to say that it is almost as if the code should be thought of as a reference manual for members of the DC and PIC that helps protect the ethical and conscientious majority from well meaning but wrong headed prosecutions by these committees?[/quote]

Not at all, for this is exactly what it is. PIC and DC are called upon to judge our professional conduct against the obligations laid down in the Code. DC members are expressly directed NOT to bring to the task their own preconceptions and prejudices - legal advisors are present at hearings, who's role is to remind DC members that they are to judge the evidence alone against the Code and not to introduce personal opinion.

RE: What was the impact of Mr Chikosi for you?

Chris Barker — Tue, 26 Sep 2017 17:34:01 GMT

[quote user="J G Wray"]

Safety issues whilst on house visits.

Whilst the Code may make reference to a professional assessment of need, there seems to be little acknowledgement of this aspect of domiciliary visits.

Where is the insight from RCVS on this?

[/quote]

Hmm Read the Code Quite a lot on this really... (My highlighting in bold)

3.37 In deciding whether or not to attend away from the practice, veterinary surgeons should consider all relevant factors, which may include:....

f. the ability of the veterinary surgeon to make the visit safely;

g. the possibility of another person attending with the veterinary surgeon;

3.38 Veterinary surgeons who decide not to attend away from the practice should inform the owner or person making the request. Veterinary surgeons should document any advice given and the reasons for the decision in case of a future challenge.

3.41 Veterinary surgeons are not expected to tolerate threatening, aggressive or violent behaviour or to compromise their personal safety when attending to animals.

3.43 When considering whether to attend away from the practice, veterinary surgeons should consider their personal safety and that of anyone else who may need to accompany them. Each case should be evaluated individually giving due consideration to its own circumstances. Veterinary surgeons are entitled to decline to visit where they have overriding personal safety concerns.

3.44 Certain areas or locations may represent a higher personal safety risk. Generic assessment of the risks of visiting certain areas may help veterinary surgeons decide on any precautions to take.

RE: What was the impact of Mr Chikosi for you?

J G Wray — Tue, 26 Sep 2017 17:29:38 GMT

[quote user="Sarah McGurk"]You never know. Jo Dyer may get a posse together..[/quote]

Oh I think we do know.

RE: What was the impact of Mr Chikosi for you?

Sarah McGurk — Tue, 26 Sep 2017 15:42:46 GMT

[quote user="J G Wray"]

As for the constitution of Council and the rest of RCVS. It will always and forever be what serves RCVS best.

[/quote]

You never know. Jo Dyer may get a posse together...

No pressure now Jo!

RE: What was the impact of Mr Chikosi for you?

J G Wray — Tue, 26 Sep 2017 15:33:37 GMT

[quote user="Neil Wheadon"]So returning to the original question 'Whose going to nominate Mr Chikosi to go up against 'the usual suspect[/quote]

Eh? The question was

What was the impact of Mr Chikosi for you?

Just sayin

As for the constitution of Council and the rest of RCVS. It will always and forever be what serves RCVS best.

RE: What was the impact of Mr Chikosi for you?

Anthony Todd — Tue, 26 Sep 2017 15:32:49 GMT

[quote user="Anthony Todd"]The key is that the vet called to visit may still be "judged"[/quote]

Wow, it is happening!!

See current "Bullying" thread!