Telemedicine article

RE: Telemedicine article

Bob Russell — Mon, 06 Jul 2020 09:26:04 GMT

Or in other words the RCVS needs to tighten up on its wording. None of this would be legal in Europe.

Just wait for the first big cock-up!

RE: Telemedicine article

Thomas Johnson — Mon, 06 Jul 2020 09:14:04 GMT

[quote userid="6103" url="~/001/nonclinical/f/life-in-practice-discussions/29168/telemedicine-article/224060#224060"]no, I just went around and around following the links and could not suss that out.[/quote]

From the Joli terms and conditions:

"13. Joii are currently able to prescribe medication during the COVID-19 pandemic. Joii are uncertain whether they will continue once the current restrictions are lifted. Any changes to the service will be communicated."

RE: Telemedicine article

patrick murphy — Sat, 04 Jul 2020 15:05:03 GMT

no, I just went around and around following the links and could not suss that out.

RE: Telemedicine article

Jo Dyer — Fri, 03 Jul 2020 21:32:24 GMT

OK so that seems to be offering teleadvice/teletriage, maybe with dispensing of POM-VPS meds (that bit's not clear). The teletriage bit is similar to what Vetfone have been doing (by phone) for years for some insurance companies to avoid unnecessary OOH claims.

I can see no evidence of prescribing of POM-Vs for patients for whom a physical examination cannot be provided, which would be the red line.

RE: Telemedicine article

niall morton — Fri, 03 Jul 2020 18:10:35 GMT

www.animalfriends.co.uk/.../

RE: Telemedicine article

Jo Dyer — Fri, 03 Jul 2020 17:52:20 GMT

[quote userid="6103" url="~/001/nonclinical/f/life-in-practice-discussions/29168/telemedicine-article/224045#224045"]they are advertising free care and consults, and sending out appropriate prescriptions! I do not know how this can possibly be correct.[/quote]

Please can you send a link to this information, or screenshots etc? I can't find anything on a quick Google search.

RE: Telemedicine article

Bob Russell — Fri, 03 Jul 2020 16:01:00 GMT

They are taking advantage of the temporary COVID dispensation on prescribing.

More fool the idiots that take advantage of this and more fool the regulator that does not challenge it.

RE: Telemedicine article

patrick murphy — Fri, 03 Jul 2020 15:16:48 GMT

they are advertising free care and consults, and sending out appropriate prescriptions! I do not know how this can possibly be correct.

RE: Telemedicine article

Iain Richards — Thu, 02 Jul 2020 14:36:07 GMT

BVA under care working group will report in due course. BVA members can view our thoughts so far and can still contribute.

RE: Telemedicine article

David Mills — Thu, 02 Jul 2020 10:21:25 GMT

Is the BVA going to be making this point any time soon? Or is the covid love in still ongoing?

RE: Telemedicine article

Bob Russell — Thu, 02 Jul 2020 09:12:12 GMT

They are offering "free" vet or nurse consultations. Not sure how legal this is (even at the moment) when it comes to prescribing. Presumably the people involved are encouraged not to do anything too expensive!

RE: Telemedicine article

Evelyn Barbour-Hill — Wed, 01 Jul 2020 19:00:35 GMT

Mr. Iain Richards has caused the hammer's striking surface to meet quite exactly upon the head of the nail.

[quote userid="6103" url="~/001/nonclinical/f/life-in-practice-discussions/29168/telemedicine-article/223963#223963"]I have not seen anyone mention Animal Friends, although I might have missed it. Regarding their adverts on tv and prescription service?[/quote]

I haven't heard of this. Tell us more. I only know of Animal Friends as an insurance company with a Monty Python policy on paying out.

RE: Telemedicine article

patrick murphy — Tue, 30 Jun 2020 14:15:37 GMT

I have not seen anyone mention Animal Friends, although I might have missed it. Regarding their adverts on tv and prescription service?

RE: Telemedicine article

Alistair Graham-Evans — Tue, 30 Jun 2020 10:26:01 GMT

In Australia since Covid an insurance company has been advertising free online consultations and they use patient history that has been sent with previous claims.

I questioned the relevant Vet Surgeons Board about this and they said they are powerless to act on it as the service is free.

If any of my patients has a mis-diagnosis and harm resulting from this I shall show no mercy!

RE: Telemedicine article

Iain Richards — Mon, 29 Jun 2020 08:09:07 GMT

[quote userid="6353" url="~/001/nonclinical/f/life-in-practice-discussions/29168/telemedicine-article/223919"]Mine too, because of an obsession with service to the public and insufficient regard for those who actually deliver the service of which the College is so proud. But then it is a Regulator so one can only expect so much 'understanding'. This consumer obsession was aggravated during the tenure of Nick Stace, under whom most of the initiatives were started. But once started you cannot easily stop 'em. I've did all I could while on Standards Committee but was side-lined four years ago, and it is very difficult to turn the tanker when you are not in the wheelhouse. And so it will be essential that people respond promptly and in detail when the Under Care-OOH consultation reopens, as the current Chair of Standards is so determined to be even handed that I fear the practicing Profession risks being ignored unless it speaks vocally and repeatedly through the proffered channels[/quote]

Chris speaks wisdom on this. For all the suggestions of vested interest pushing remote prescribing, I feel a far bigger issue is as he says - the college is reinventing itself as a consumer rights organisation, somehting for which it has no legal remit. It has to uphold professional standards and take action agaist those falling short of those standards, something I'm happy to support. In doing so it protects the public (as a body) and animal welfare agaist poor standards. "Improving access" is not part of this. Especially when the issue of access has no credible evidence to support it.

RE: Telemedicine article

Chris Barker — Mon, 29 Jun 2020 07:33:08 GMT

[quote userid="12375" url="~/001/nonclinical/f/life-in-practice-discussions/29168/telemedicine-article/223911"]My fear is that the College will use the Covid situation to railroad through their plan to remove some of the obligations with the result that technology based platforms are able to sell lots of low-margin pharmaceuticals for the easy stuff and leave the hard bits in the middle of the night for somebody else.[/quote]

Mine too, because of an obsession with service to the public and insufficient regard for those who actually deliver the service of which the College is so proud. But then it is a Regulator so one can only expect so much 'understanding'. This consumer obsession was aggravated during the tenure of Nick Stace, under whom most of the initiatives were started. But once started you cannot easily stop 'em. I've did all I could while on Standards Committee but was side-lined four years ago, and it is very difficult to turn the tanker when you are not in the wheelhouse. And so it will be essential that people respond promptly and in detail when the Under Care-OOH consultation reopens, as the current Chair of Standards is so determined to be even handed that I fear the practicing Profession risks being ignored unless it speaks vocally and repeatedly through the proffered channels

RE: Telemedicine article

Alastair Welch — Sun, 28 Jun 2020 20:48:36 GMT

I suspect that a large number of us have been using some form of telemedicine for a long time. The key for me is that it is tied to a physical practice and that there is a genuine client-VS relationship, with expectations and obligations on both sides.

My fear is that the College will use the Covid situation to railroad through their plan to remove some of the obligations with the result that technology based platforms are able to sell lots of low-margin pharmaceuticals for the easy stuff and leave the hard bits in the middle of the night for somebody else.

RE: Telemedicine article

Mark Holmes — Sun, 28 Jun 2020 20:46:11 GMT

[quote userid="6437" url="~/001/nonclinical/f/life-in-practice-discussions/29168/telemedicine-article/223908"]

It works well for me, especially for the reptiles. I can get a good look at their setup and most need good quizzing re husbandry.

I can get them to send faecals to wormcount.com and prescribe on the results.

Ive prepared videos showing clients how to medicate.

And can send clients into the surgery if needed.

[/quote]

Reptiles die slowly Mark - I guess you’ve got time to piss about!!

(please take this with the humour with which it was intended)

RE: Telemedicine article

Mark Rowland — Sun, 28 Jun 2020 20:15:09 GMT

It works well for me, especially for the reptiles. I can get a good look at their setup and most need good quizzing re husbandry.

I can get them to send faecals to wormcount.com and prescribe on the results.

Ive prepared videos showing clients how to medicate.

And can send clients into the surgery if needed.

RE: Telemedicine article

Evelyn Barbour-Hill — Sun, 28 Jun 2020 20:01:56 GMT

The day it becomes possible to palpate down a telephone line is the day I might consider possibly reconsidering my condemnation of telemedicine.

RE: Telemedicine article

Gillian Mostyn — Sun, 28 Jun 2020 15:49:25 GMT

[quote userid="7232" url="~/001/nonclinical/f/life-in-practice-discussions/29168/telemedicine-article/223898"]It takes 10 minutes for the client to log follow the link and get their camera and mic to work. [/quote]

I wouldn't be keen on video consultations for all the reasons you describe. Our reception tells the client to send photos or video and we ring them at our convenience, so I can just make a few phone calls whenever I get chance.

It isn't appropriate for all cases, but it is great for many simple issues.

RE: Telemedicine article

Jo Dyer — Sun, 28 Jun 2020 13:53:48 GMT

[quote userid="2831" url="~/001/nonclinical/f/life-in-practice-discussions/29168/telemedicine-article/223886"]Do you know if there is a way of accessing the survey directly? I've not received an email.[/quote]

I think it has to be personalised to you. Check they've got your email address correct on your RCVS account on the website, but if the email doesn't appear, give RCVS a call.

RE: Telemedicine article

Mark Holmes — Sun, 28 Jun 2020 13:21:00 GMT

[quote userid="8991" url="~/001/nonclinical/f/life-in-practice-discussions/29168/telemedicine-article/223893"]30 minutes?! Ours on average are around 10-15 minutes, with 25/vet/7.5h day. Mind boggles.[/quote]

It takes 10 minutes for the client to log follow the link and get their camera and mic to work. Then they chase the dog around the room for 5 minutes. You then have to talk them through holding the animal correctly before getting them own to the clinic because you cannot confidently see what they are along you to comment on.

On top of which many common conditions you will want to administer something to or sample. Ears need to take cytology, Gastro cases recover much better with maropitant. You often end up thinking “Sod it it’s easier to just see them” and might as well have just arranged to do just that to begin with.

ill certainly be voting against generalised remote prescribing when the RCVS consults on it.

RE: Telemedicine article

Gillian Mostyn — Sun, 28 Jun 2020 12:44:57 GMT

I'm with David with this, I think it has been useful. I can get through telephone consultations in the same time frame as face-to-face ones, as you don't have all the faff and small talk. It has been the animals without owners consultations that have been hard work and time consuming.

I also agree, though, that some experience, confidence and good decision-making skills are needed. I've seen enough ST lameness, anal sac draining fistulas and interdigital cysts to know what questions to ask. I can also decide quickly what needs seeing, and where worst case scenario needs to be considered.

It should be tied to a bricks and mortar practice for animals that have been seen at least once in the premises, but I do think that vets, like doctors, are capable of deciding where remote prescribing is appropriate.

RE: Telemedicine article

David Mills — Sun, 28 Jun 2020 10:34:52 GMT

30 minutes?! Ours on average are around 10-15 minutes, with 25/vet/7.5h day. Mind boggles.