So ,does anyone understand this ?

RE: So ,does anyone understand this ?

Bob Russell — Wed, 02 Jun 2021 08:22:08 GMT

A pretty dreadful survey but quite liked the 'slider' way of answering!

RE: So ,does anyone understand this ?

helen herinckx — Tue, 01 Jun 2021 18:01:13 GMT

I also completed the survey and reassured that I’m not the only one who didn’t understand some of the questions ( memories of exam time and frantically trying to understand the Q before attempting to answer - oh horrors!)

RE: So ,does anyone understand this ?

robert ingle — Tue, 01 Jun 2021 12:38:53 GMT

Looks like an exploration of the teacher-pupil power dynamic.

In other words Marxist waffle

RE: So ,does anyone understand this ?

Evelyn Barbour-Hill — Tue, 01 Jun 2021 10:47:15 GMT

Stefania, Helena, and others, don't just complain here. Write to Belgravia House! Address your letter to the President .

RE: So ,does anyone understand this ?

Stefania Glowka — Tue, 01 Jun 2021 10:19:09 GMT

Dear Helena,

Last night, nudged by a reminder from the RCVS, I tried to complete the survey. I failed at the first hurdle as I could not understand the opening question. I retired last year after 25 years in small animal practice in UK. English is my fourth language. 30 years ago, when I moved to UK, my first job, working for the largest veterinary database in the world, was to translate from 13 languages to English. If I cannot understand the language of the survey, there is little hope for other overseas graduates. Or perhaps it was a right decision to retire as my mental faculties are not up to scratch any more...

RE: So ,does anyone understand this ?

Arlo Guthrie — Fri, 28 May 2021 19:27:11 GMT

[quote userid="6897" url="~/001/nonclinical/f/life-in-practice-discussions/29854/so-does-anyone-understand-this/230470#230470"]This is taken from an article in the current RCVS GDP Adviser Training programme:[/quote]

bob lehner thanks for the inspiration for the 'and finally': https://www.vetsurgeon.org/001/nonclinical/f/life-in-practice-discussions/29790/the-veterinary-news-and-now-for-something-completely-different/230524#230524

RE: So ,does anyone understand this ?

Anthony Todd — Fri, 28 May 2021 17:40:06 GMT

[quote userid="6297" url="~/001/nonclinical/f/life-in-practice-discussions/29854/so-does-anyone-understand-this/230522#230522"]We used to have a client who spent several months each Summer in Scotland (we are in South East England), taking their cat with them. It was normal for clinical notes to be sent back and forwards when the owner went or came back.[/quote]

Crikey, common sense, plain good manners, and professional! Can't have vets using these!

Ahhh, we better have a regulation!

Can't have vets using those things [see above] without comprehensive regulation making it more time-consuming, opaque, and with possible severe sanctions.............

Mmmmm, someone's been watching too much "Yes Minister!!

I need to point out to some that that was a comedy show NOT real life!!

RE: So ,does anyone understand this ?

Thomas Johnson — Fri, 28 May 2021 14:47:07 GMT

[quote userid="6353" url="~/001/nonclinical/f/life-in-practice-discussions/29854/so-does-anyone-understand-this/230514#230514"]

One of things I find most galling about the consultation is the way it illustrates the very inconsistencies that the RCVS needs to eradicate. For example...

'If an animal is registered with more than one primary care practice, the practices should be required to share clinical records'

[/quote]

We used to have a client who spent several months each Summer in Scotland (we are in South East England), taking their cat with them. It was normal for clinical notes to be sent back and forwards when the owner went or came back.

RE: So ,does anyone understand this ?

Evelyn Barbour-Hill — Fri, 28 May 2021 14:20:54 GMT

[quote userid="6353" url="~/001/nonclinical/f/life-in-practice-discussions/29854/so-does-anyone-understand-this/230514#230514"]

'If an animal is registered with more than one primary care practice, the practices should be required to share clinical records'

[/quote]

Of course I've always been happy to share such clinical notes as may be relevant where it's sensible for an animal to be attending another practice as well as mine. What I would resent is being told that I MUST, just because the owner decided to register with another primary care practice, without asking me.

[quote userid="6353" url="~/001/nonclinical/f/life-in-practice-discussions/29854/so-does-anyone-understand-this/230514#230514"]I believe that an animal can only be registered with one primary care practice which holds ultimate responsibility for overseeing its treatment. I would suggest that whenever a client choses to seek another opinion (an entirely proper consumer choice), and that this requires/necessitates the passing on of clinical records, then the animal should be judged to have left the care of the original practice. Before the animal comes back under the care of the initial practice (and it resumes professional responsibility for OOH etc) the owner needs to approach the practice, which of course may exercise its quite proper choice and decline the request...[/quote]

Well put. My opinion exactly. I have several times declined to take the client back in such circumstances.

[quote userid="5904" url="~/001/nonclinical/f/life-in-practice-discussions/29854/so-does-anyone-understand-this/230519#230519"]Most vets have the wit to operate a telephone if they need to if and only if they need to.[/quote]

Indeed, and they can generally do emails too – and in the sensible real world it happens all the time. Veterinary surgeons have always been, on the whole, pretty good at cooperating with colleagues in other practices, in a courteous and informal way without needing to shuttle entire life histories back and forth.

Practice receptionists are not always so good at this, nor the junior nurse who's been told to "ring up and get a history".

RE: So ,does anyone understand this ?

Anthony Todd — Fri, 28 May 2021 10:48:52 GMT

I can see many reasons, apart from the obvious one of having more than one practice, obviously convenience.

["I always take my 29 dogs to the Bahamas when I go on holiday" is an obvious one], and everyone can think of other legitimate examples.

Most vets have the wit to operate a telephone if they need to if and only if they need to.

Owners will think this edict is constrictive and unnecessary!

RE: So ,does anyone understand this ?

Iain Richards — Fri, 28 May 2021 10:07:16 GMT

IS there some undue influence of the USA here? I understand that you can get direct acess to the equivalent of a consultant, without going through a GP as in the UK. Is this perhaps what they are thinking about? It wouldn't surprise me, not least as much of this process was driven by the very flawed Standards Report , which used US data (and still hasn't used available UK data) to support the "telemedicine will be of benefit to animal welfare" argument.
It's quite annoying to still see this mantra in RCVS discussions, all without an evidence base

RE: So ,does anyone understand this ?

Chris Barker — Thu, 27 May 2021 18:26:05 GMT

One of things I find most galling about the consultation is the way it illustrates the very inconsistencies that the RCVS needs to eradicate. For example...

'If an animal is registered with more than one primary care practice, the practices should be required to share clinical records'

I realise that there are owners who seek to do this, and then play one practice against another, but they are hardly likely to broadcast the fact to either practice! But the idea of being registered with two primary care practices is a nonsense that any review should eliminate, for when push come to shove which practice holds ultimate responsibility? Which is required to offer 24/7 cover....? The welfare of the animal is easily compromised when the chain of responsibility is muddied in this way.

I believe that an animal can only be registered with one primary care practice which holds ultimate responsibility for overseeing its treatment. I would suggest that whenever a client choses to seek another opinion (an entirely proper consumer choice), and that this requires/necessitates the passing on of clinical records, then the animal should be judged to have left the care of the original practice. Before the animal comes back under the care of the initial practice (and it resumes professional responsibility for OOH etc) the owner needs to approach the practice, which of course may exercise its quite proper choice and decline the request...

In this way practices can resist the demands of those owners who seek to abuse the system, while ensuring that limited service providers/remote vets recognise, and fulfil, the professional responsibility they take on by taking an animal 'under care'.

RE: So ,does anyone understand this ?

Iain Richards — Thu, 27 May 2021 08:49:17 GMT

The physical examination of individual animals paradox that seems to be a sticking point, does not need to be the issue a strict reading of the regulation might suggest (and I would posit that 4.11 has been drafted carelessly). If you take the whole of section 4 into account and treat the animals under treatment as an epidemiological group, everything falls into place.
So the group of calves with pneumonia can be treated on the balance of probabiliies, having examined one or two, as can the group of cats with chlamydial conjuctivitis. The lame dog in a house can have NSAIDs for arthritis, but not it's littermate.

Simples

I think!

RE: So ,does anyone understand this ?

Anthony Todd — Wed, 26 May 2021 21:56:55 GMT

Am I correct in believing that some POMV products are available, under different names, without any prescription or patient requirement at all?

I am referring to some worming drugs and preps?

RE: So ,does anyone understand this ?

Chris Barker — Wed, 26 May 2021 19:30:19 GMT

[quote userid="12375" url="~/001/nonclinical/f/life-in-practice-discussions/29854/so-does-anyone-understand-this/230484#230484"]the College will have long ago worked out the outcome of their proposals.[/quote]

There could be more than an element of truth in this.

The Veterinary Medicine Regulations use, but do not define, the phrase ‘under his care’. The RCVS has offered its interpretation of what constitutes ‘under care’ (Code of Conduct Supporting Guidance 4.9-4.11) but ultimately it would be for the Courts to decide the meaning of this phrase.

Currently the RCVS is discomforted by the statement within paragraph 4.11 that ‘A veterinary surgeon cannot usually have an animal under his or her care if there has been no physical examination; consequently a veterinary surgeon should not treat an animal or prescribe POM-V medicines via the Internet alone.’

To many this wholly defensible requirement to require a physical examination protects the welfare of the animal concerned, minimising the risk of misdiagnosis or missed diagnosis being made when assessing an animal remotely.

However the strength of the statement within para 4.11 means that the definition of ‘under care’ is very narrow, and it places the RCVS is a difficult situation when it seeks to justify ‘rules’ which allow, in certain circumstances, the prescribing of POM-V pharmaceuticals without physical examination (eg. farm animals, game birds, fish, etc).

The RCVS would undoubtedly like to see the definition of ‘under care’ broadened; this would allow the maintenance of the status quo, protecting the exceptions detailed above. It could also ease the difficulties presented by inconsistent application of our regulations when applied to limited service providers and in relation to OOH provision. But such broadening would require the requirement for a ‘physical examination’ to be dropped, the consequences of which are evident to most in first opinion practice. And it would not address the demographic change which mean that fewer and fewer veterinary surgeons are ready to contribute to the maintenance of the OOH service

But I suspect this 'hoped-for' relaxation of the definition will be the primary drive behind the consultation. And the response of the RCVS should the response from the profession to their favoured relaxation be a solid 'NO' will be interesting...

RE: So ,does anyone understand this ?

Alastair Welch — Tue, 25 May 2021 17:56:56 GMT

Colleagues should recognise that the College will have long ago worked out the outcome of their proposals. The consultation simply ticks the box to say ‘we’ve consulted’. We should not be surprised if it’s not written in a user friendly way, you don’t really think they are interested in what we actually think do you?

RE: So ,does anyone understand this ?

Arlo Guthrie — Tue, 25 May 2021 16:24:05 GMT

[quote userid="6897" url="~/001/nonclinical/f/life-in-practice-discussions/29854/so-does-anyone-understand-this/230481#230481"]so is directed at any MRCVS who is undertaking the GDP training[/quote]

As I thought. I'm just gobsmacked that nobody involved in the production of the module looked at it, and said 'Hang on a moment, this isn't really what you might call English. Perhaps we should get an interpreter in first.'

[quote userid="2131" url="~/001/nonclinical/f/life-in-practice-discussions/29854/so-does-anyone-understand-this/230482#230482"]I've passed the text to one or two schoolchildren of my acquaintance, with the suggestion of quoting it to their teacher if their homework is criticised.[/quote]

Priceless. I think I shall give it to my daughter for the same purpose. Good idea.

RE: So ,does anyone understand this ?

Evelyn Barbour-Hill — Tue, 25 May 2021 16:23:06 GMT

[quote userid="2100" url="~/001/nonclinical/f/life-in-practice-discussions/29854/so-does-anyone-understand-this/230480#230480"]Who on earth is that article pitched at, Bob?[/quote]

I've passed the text to one or two schoolchildren of my acquaintance, with the suggestion of quoting it to their teacher if their homework is criticised.

RE: So ,does anyone understand this ?

bob lehner — Tue, 25 May 2021 16:14:29 GMT

[quote userid="2100" url="~/001/nonclinical/f/life-in-practice-discussions/29854/so-does-anyone-understand-this/230480#230480"]Who on earth is that article pitched at[/quote]

Well, it's taken from a paper in the American journal Academic Medicine, entitled 'Relationship as the backbone of feedback' and is part of Module 2 of the Vet GDP Adviser training programme - so is directed at any MRCVS who is undertaking the GDP training. It's classed as 'Essential reading'....

I've read though the article again - and basically it seems to say something along the lines that if the trainer and trainee get along well and have a happy and healthy relationship, with mutual respect, then the feedback between them will be better than otherwise.

I know absolutely nothing about the world of academic educational psychology - but it seems to have a somewhat arcane language all of its own, possibly not readily comprehended by an outsider....?

RE: So ,does anyone understand this ?

Arlo Guthrie — Tue, 25 May 2021 15:20:07 GMT

[quote userid="6897" url="~/001/nonclinical/f/life-in-practice-discussions/29854/so-does-anyone-understand-this/230470#230470"]''Feedback conversations between longitudinal teacher–learner dyads could be mapped onto a relationship-centered communication framework[/quote]

Who on earth is that article pitched at, Bob?

RE: So ,does anyone understand this ?

Evelyn Barbour-Hill — Mon, 24 May 2021 17:25:56 GMT

[quote userid="6297" url="~/001/nonclinical/f/life-in-practice-discussions/29854/so-does-anyone-understand-this/230474#230474"]which would mean you could also use 'horizontal dyad' about 2 members of staff at the same level![/quote]

Oh dearie me

RE: So ,does anyone understand this ?

Joyce Whitehead — Mon, 24 May 2021 17:24:33 GMT

Having seen Bob’s quote I’m very glad I’ve delegated the GDP training to someone younger than me...

RE: So ,does anyone understand this ?

Thomas Johnson — Mon, 24 May 2021 16:50:14 GMT

[quote userid="6897" url="~/001/nonclinical/f/life-in-practice-discussions/29854/so-does-anyone-understand-this/230472#230472"]Thank you for that useful information. But what then is a 'longitudinal dyad'?[/quote]

I'm guessing it's between a member of staff and someone above or below them, which would mean you could also use 'horizontal dyad' about 2 members of staff at the same level!

RE: So ,does anyone understand this ?

Evelyn Barbour-Hill — Mon, 24 May 2021 15:38:58 GMT

You couldn't make it up.

[quote userid="6897" url="~/001/nonclinical/f/life-in-practice-discussions/29854/so-does-anyone-understand-this/230472#230472"]But what then is a 'longitudinal dyad'?[/quote]

Sounds a bit rude to me, frankly.

RE: So ,does anyone understand this ?

bob lehner — Mon, 24 May 2021 15:36:33 GMT

Thank you for that useful information. But what then is a 'longitudinal dyad'?