What do you think would have the BIGGEST positive impact on the profession?

RE: What do you think would have the BIGGEST positive impact on the profession?

david kemp — Mon, 13 May 2024 08:39:58 GMT

Arlo-feel free to contact me outside vet surgeon. still working near bristol.

RE: What do you think would have the BIGGEST positive impact on the profession?

Arlo Guthrie — Mon, 13 May 2024 08:36:05 GMT

[quote userid="2300" url="~/f/non-clinical-questions/30939/what-do-you-think-would-have-the-biggest-positive-impact-on-the-profession/244581#244581"]I thought about opening “best guess vet practice”-shall we go into business?[/quote]

david kemp Well, if you're still anywhere near Bristol, perhaps we should!

RE: What do you think would have the BIGGEST positive impact on the profession?

david kemp — Sun, 12 May 2024 09:13:03 GMT

I thought about opening “best guess vet practice”-shall we go into business?

Also my best phrase. “This is what we can do.” If you want a specialist we can refer you but the price will be much much higher. I explain my experience (or lack of) and have an adult conversation.

RE: What do you think would have the BIGGEST positive impact on the profession?

Evelyn Barbour-Hill — Fri, 10 May 2024 11:49:17 GMT

[quote userid="2100" url="~/f/non-clinical-questions/30939/what-do-you-think-would-have-the-biggest-positive-impact-on-the-profession/244533#244533"]The word is affordable. [/quote]

One hears this word so often, especially in relation to new houses. It annoys me so much. Everything is affordable to someone. "Affordable" is a euphemism for "cheap".

RE: What do you think would have the BIGGEST positive impact on the profession?

Rob Loxley — Thu, 09 May 2024 19:44:52 GMT

[quote userid="16672" url="~/f/non-clinical-questions/30939/what-do-you-think-would-have-the-biggest-positive-impact-on-the-profession/244538#244538"]it baffles me that the UK is seeing a huge increase in vet fees, yet new grad vets are making less than the average university graduate[/quote]

Not sure you can correlate increases in vet fees directly with other vet staff wages either. I suspect vet fee rises have outstripped inflation, and wages not kept up with inflation, for a number of years? Maybe the spvs surveys would give a good estimate of the divergence

RE: What do you think would have the BIGGEST positive impact on the profession?

Martin Hamilton — Thu, 09 May 2024 15:24:51 GMT

[quote userid="2100" url="~/f/non-clinical-questions/30939/what-do-you-think-would-have-the-biggest-positive-impact-on-the-profession/244485#244485"]am sure was showing that a lot of the slack has now been taken up by recruiting outside the EU. I need to go and find the table I saw.[/quote]

Perhaps not for long Arlo - https://www.vettimes.co.uk/news/rcvs-migration-salary-limits-are-unsustainable/#:~:text=But%20the%20required%20rate%20for,the%20college%20and%20the%20BVA.

New visa requirements will mean that vets need to be paid a minimum of £48,100 to be eligible for a visa. I guess we'll see long-term. It'll be difficult when those willing to move abroad are typically at the start of their career, and most employers won't willing to pay a new grad that kind of money.

But of a tangent, but it baffles me that the UK is seeing a huge increase in vet fees, yet new grad vets are making less than the average university graduate....

RE: What do you think would have the BIGGEST positive impact on the profession?

Cinzia Gandini — Wed, 08 May 2024 21:05:24 GMT

[quote userid="2100" url="~/f/non-clinical-questions/30939/what-do-you-think-would-have-the-biggest-positive-impact-on-the-profession/244533#244533"] The word is affordable[/quote]

Yes because affordable doesn’t mean cheap. It’s more difficult to figure out a procedure that is good for the pet, satisfactory for the owner, effective even if simplified, and cost effective. So it’s not cheap, it’s a different approach in my opinion. Sometimes a Ferrari it’s not the best choice for commuting.

RE: What do you think would have the BIGGEST positive impact on the profession?

Arlo Guthrie — Wed, 08 May 2024 20:12:47 GMT

[quote userid="2457" url="~/f/non-clinical-questions/30939/what-do-you-think-would-have-the-biggest-positive-impact-on-the-profession/244521#244521"]

However, I would say that the attitude and knowledge of clients has changed significantly from when I graduated. It isn't just about newer vets being needlessly defensive - people really are harder work. We've had a couple of cases recently where our newer vets have done nothing wrong, and tried to be pragmatic, but where clients have been very unreasonable about what can be achieved within their budget.

The old conversations, along the lines of 'I can do tests and know for certain, or use my best educated guess and be right 95% of the time' are no longer so straight forward.

Google also plays a massive part. People go online and get told their vet was clearly negligent and someone else would have done a much better job.

[/quote]

Very good points.

I suppose my first thought is that there isn't much by way of affordable care for the masses.

If there was, alongside the practices offering 'clinical excellence', and it was very clear which practices offered which, then that might in fact ease the problem with clients being unreasonable about what can be achieved within the budget. Quite simply: "You came to us because we sell Fords. If you actually wanted the Ferrari, that's available up the road."

And I think that were such a two tier system in place, it might actually neutralise a lot of the social media griping, because if I go to a cheaper offering, and treatment is unsuccessful, then, well, I can't really complain.

I think a lot of people thought I was mad a few years ago when I said that I'm tempted to set up a practice called 'We'll give it our best shot' (which would do as much as possible with as little as possible). The more time passes, the more I kick myself for not putting my money where my mouth is!

Anyway, back to the OP - and the sense I have from your posts so far is that even 'pragmatic' is not direct enough. The word is affordable.

RE: What do you think would have the BIGGEST positive impact on the profession?

Gillian Mostyn — Wed, 08 May 2024 12:01:49 GMT

[quote userid="9199" url="~/f/non-clinical-questions/30939/what-do-you-think-would-have-the-biggest-positive-impact-on-the-profession/244479#244479"]I so wish undergraduates of today could experience some of this. [/quote]

I'm a 1999 graduate and agree with a lot of what has been said about the loss of the 'art' of contextualized care.

The old conversations, along the lines of 'I can do tests and know for certain, or use my best educated guess and be right 95% of the time' are no longer so straight forward.

Google also plays a massive part. People go online and get told their vet was clearly negligent and someone else would have done a much better job.

As I say, I think changes need to be made. But we can't just go back to how things were, because too much has changed.

RE: What do you think would have the BIGGEST positive impact on the profession?

Noweia — Sun, 05 May 2024 14:00:48 GMT

As a female late 30s with no kids, I found intense 10 hour days very draining. My current job has slightly shorter hours and a 4 day week (with one Sat morning in 4). This is important to me as it gives me time off during the week for medical appointments/housework/catchup nap so my weekend is not full of this and I can actually have time to do my hobbies and recover from them. I work to live, not live to work.

(Autistic and ADHD causing chronic fatigue causing depression)

RE: What do you think would have the BIGGEST positive impact on the profession?

Arlo Guthrie — Thu, 02 May 2024 17:55:01 GMT

[quote userid="4181" url="~/f/non-clinical-questions/30939/what-do-you-think-would-have-the-biggest-positive-impact-on-the-profession/244481#244481"]I suggested reduced recruitment pool post brexit [/quote]

Rob Loxley sorry, yes, have added that. Although funnily enough, I was looking at some data not so long ago which I am sure was showing that a lot of the slack has now been taken up by recruiting outside the EU. I need to go and find the table I saw.

RE: What do you think would have the BIGGEST positive impact on the profession?

Rob Loxley — Thu, 02 May 2024 14:02:40 GMT

[quote userid="2100" url="~/f/non-clinical-questions/30939/what-do-you-think-would-have-the-biggest-positive-impact-on-the-profession/244480#244480"]Any others?[/quote]

I suggested reduced recruitment pool post brexit

RE: What do you think would have the BIGGEST positive impact on the profession?

Arlo Guthrie — Thu, 02 May 2024 12:51:55 GMT

[quote userid="2490" url="~/f/non-clinical-questions/30939/what-do-you-think-would-have-the-biggest-positive-impact-on-the-profession/244470#244470"]Ive said it before but our biggest asset which was public trust in our profession has been squandered because the coin counters didn’t recognise its intrinsic value. Prices were jacked up, investigations and tests , scans etc were pushed on every dog that coughed or vomited and massive unnecessary bills trashed the reputation of vets being on the clients side and broke that trust. Now we are reaping the rewards as vets in practice face suspicious owners who think they are going to be ripped off. Once burned with a bill of a several grand then they don’t go back without walking in suspicious and adversarial. . As I’ve pointed out before up here in Halifax people are notifying the practice that their dog has already died without being seen , they haven’t brought it for treatment . This was almost unheard of in the past and I find it shocking. [/quote]

Very eloquently put!

David Mills coming back to your reply (delayed by start of month newsletters).

[quote userid="8991" url="~/f/non-clinical-questions/30939/what-do-you-think-would-have-the-biggest-positive-impact-on-the-profession/244422#244422"]Decent list, though my concern it is a mixed bag of behaviours (1-3) and causes (4).[/quote]

Yes, but a behaviour can also be a cause! Mine is a list of issues which I think are contributory to the problem. ie causes, rather than symptoms.

I'll repeat my list now, and add your points and one or two others to the list of inflationary pressures or ones that reduce job satisfaction, or both

Gold standard mentality (I know the term is now frowned on, but the mentality persists)
Refer-all culture (various 'drivers' for this), leading to increased costs and less job satisfaction (from doing interesting stuff in house)
Defensive medicine (again various things driving this) leading to increased costs
Regulatory pressures (for example, excessive application of cascade, but I also include messaging from the College on various issues).
Fear of risk (which applies both to practitioners and to owners)
Fear of challenging clients (subsuming to clients wishes)
Continued inappropriate undergraduate and postgraduate training.
Corporatisation (this is too simplistic, but I am putting it here for the moment!)
Brain drain of older, experienced practitioners
Feminisation of the profession, more working part time
Increased recruiting costs
lack of exposure to contextualised care
lack of proper expectation setting for new grads.
reduced recruitment pool post brexit

Any others?

It's a long list of issues, but on the positive side, many are things that people can do something about. Corporatisation and feminisation perhaps not, but maybe ways of mitigating.

I was thinking a starting point would be to survey everyone and ask you to put them in order of importance, so we can then look at them in order of importance. But I am not sure that works. How would you know which are the most important of these. Perhaps I could ask simply - whihc of the following do you think are contributing to increased veterinary costs or a reduction in job satisfaction for veterinary professionals.

[quote userid="9199" url="~/f/non-clinical-questions/30939/what-do-you-think-would-have-the-biggest-positive-impact-on-the-profession/244479#244479"]Writing here is preaching to the converted. How do we get it out there?[/quote]

Stay tuned. Part one = identify the issues, Part two = devise solutions, Part three = get them out there!

RE: What do you think would have the BIGGEST positive impact on the profession?

Will Lazenby — Thu, 02 May 2024 12:36:13 GMT

Writing here is preaching to the converted. How do we get it out there? You and I were taught and learned alike and I so wish undergraduates of today could experience some of this. We went out from vet school as rookie vets, yes. But we were more or less prepared for what was to come and knew how to use the knowledge we were surrounded with and as you rightly say, it was an exchange of new knowledge for old experience and we all benefitted. I have been invited to speak with students at a GUVMA meeting. I just want to know why they chose this course, what they expect to be doing in 5 years 10 years and trying to persuade the vet schools to encourage old vets (I mean a lot older) to speak with students before we are all gone or even better socialise with the students and try to understand. I cannot see how opening more and more vet schools and stretching their resources thinner and thinner is improving anything. It is just producing more underprepared vets who are going to end up , being thoroughly, stressed, disillusioned and miserable and dropping out., .

RE: What do you think would have the BIGGEST positive impact on the profession?

Clare Tapsfield-Wright — Wed, 01 May 2024 18:47:04 GMT

I agree with much that is written here. I would add that graduates in their first year or two in practice need the support of more experienced vets and the has been lost in many practices and will get worse as lack of retention continues and vets leave causing a vicious cycle of disillusionment and lack of decent mentoring.

I don’t see how a CD with a couple of years experience can possibly support younger colleagues as well as do their own job and have the sacred work life balance . Vets need to be guided through their early years in practice , allowed to fly but with a safety net of an older experienced colleague. The old also learn new stuff from the younger ones and it’s win win. In house unofficial second opinions were always part of practice and nurturing younger colleagues should be part of the job.

Working long days is tolerable if you have job satisfaction , varied work , interesting stuff , learning, doing some surgery that you were scared of doing, camaraderie of making a difference with your team , not soulless consulting hour upon hour and referring anything interesting .

I think before any progression or certificates etc graduates should do a decent length of time in practice and learn what is normal and how many cases recover without thousands of pounds of testing and defensive medicine. As someone else said , it is possible to treat some cases without a definitive diagnosis and we should respect the finances of our clients and revert to contextualised care similar to the reinvention of the bleeding wheel.

Ive said it before but our biggest asset which was public trust in our profession has been squandered because the coin counters didn’t recognise its intrinsic value. Prices were jacked up, investigations and tests , scans etc were pushed on every dog that coughed or vomited and massive unnecessary bills trashed the reputation of vets being on the clients side and broke that trust. Now we are reaping the rewards as vets in practice face suspicious owners who think they are going to be ripped off. Once burned with a bill of a several grand then they don’t go back without walking in suspicious and adversarial. . As I’ve pointed out before up here in Halifax people are notifying the practice that their dog has already died without being seen , they haven’t brought it for treatment . This was almost unheard of in the past and I find it shocking.

Don’t get me wrong , there are great practices a wonderful vets out there . There are appreciative clients with money to spend on fees and insurance but there are a lot of people with lockdown dogs who haven’t got disposable income and they simply can’t afford it.

Get some vets into vet schools and vet media who can present a sensible treatment plan for basic vet treatments which preserve animal welfare without bankrupting the owners.

Give vets variety when they qualify , encourage them to learn how to do surgical procedures in general practice without referring everything. It will increase their job satisfaction , bond them with clients and colleagues and maybe they will stay in practice. It worked for me and I’m female and had a family while working and while I have no further qualifications I think I was a good vet and I never stopped learning over forty years or so. An experienced general practitioner should be respected and valued even if we don’t have a string of letters after our names , at least I could do a successful diaphragmatic hernia surgery, repair a fractured bone or do a Caesar and go home feeling that I’d made a difference.

I’ll get off my soap box now

RE: What do you think would have the BIGGEST positive impact on the profession?

Arlo Guthrie — Wed, 01 May 2024 18:40:08 GMT

[quote userid="9199" url="~/f/non-clinical-questions/30939/what-do-you-think-would-have-the-biggest-positive-impact-on-the-profession/244468#244468"] Just decided to give up after 46 years. [/quote]

Wow, that must have earned you a carriage clock or four!

Congratulations!

RE: What do you think would have the BIGGEST positive impact on the profession?

Will Lazenby — Wed, 01 May 2024 18:03:30 GMT

I went to a 40th reunion 6 years ago and 60% were still working. Just decided to give up after 46 years.

RE: What do you think would have the BIGGEST positive impact on the profession?

ian bates — Wed, 01 May 2024 07:50:02 GMT

My wife is part time - has been since having kids, we're both 47 and still very much feeling the family demands!! - does that ever end?!?!

RE: What do you think would have the BIGGEST positive impact on the profession?

Neil Wheadon — Tue, 30 Apr 2024 15:35:59 GMT

Another one for a survey isn’t it, because frankly the wrong people are being asked or speaking up and that dictates opinion/policy. Ask the quiet ones.

I’ll give an example,it’s a little on the edge, but take this in the spirit that it’s intended.

I went to a talk hosted by BVA at London Vet Show a year or so ago. There were 2 speakers with an audience of maybe 100 vets. Both went into detail of their mental health and how they had been to the depths of depression only to bounce back and they had found a way to cope. This produced the usual round of applause but I was left thinking and did say this privately to BVA that really they are asking the wrong people to speak here.
It is the long term GP’s that should be on that stand. Not only can we learn what makes them tick, but we can at least feel a little better about ourselves. This observation relates to this answer, I suspect mother of 2 has found that you can drop work, but you can’t drop the family, we can all learn from that.

Neil

RE: What do you think would have the BIGGEST positive impact on the profession?

serena holmes — Tue, 30 Apr 2024 10:58:25 GMT

Yes, I found it interesting you mentioned something I have seen for years but is rarely talked about. You’re right, women seem to become part time in their 30’s when it becomes affordable, due to children, and don’t seem to return to full time in their 40’s. As more experienced at this point, so paid more, perhaps they don’t feel the need to do more hours?

RE: What do you think would have the BIGGEST positive impact on the profession?

Arlo Guthrie — Tue, 30 Apr 2024 10:38:58 GMT

[quote userid="8137" url="~/f/non-clinical-questions/30939/what-do-you-think-would-have-the-biggest-positive-impact-on-the-profession/244453#244453"]It seems, in my experience, most women in their 40’s are part time versus men of the same age[/quote]

serena holmes hi - I think we are saying the same thing, no? Although I was thinking that mostly it was related to competing family demands, so I thought it would probably affect 30 somethings more than 40 somethings for whom the competing family demands might be starting to lessen??? But of course people are having children later in life, so maybe I'm just out of touch.

When you say most women in 40s are part time, what do you think is the main cause of that? Is it family demands or something else?

RE: What do you think would have the BIGGEST positive impact on the profession?

serena holmes — Tue, 30 Apr 2024 09:41:23 GMT

Interesting you bring up feminisation of the profession in regards to recruitment. It seems, in my experience, most women in their 40’s are part time versus men of the same age, which must have a massive impact on the number of vets in practice.

RE: What do you think would have the BIGGEST positive impact on the profession?

Alasdair Hotston Moore — Tue, 30 Apr 2024 07:35:46 GMT

[quote userid="8991" url="~/f/non-clinical-questions/30939/what-do-you-think-would-have-the-biggest-positive-impact-on-the-profession/244422#244422"]However in terms of other causes[/quote]

Very little I would disagree with here, although we might both sound like those who have always said the world is going to pot. A tradition as old as the ancient Greeks

RE: What do you think would have the BIGGEST positive impact on the profession?

Rob Loxley — Tue, 30 Apr 2024 07:18:08 GMT

[quote userid="6765" url="~/f/non-clinical-questions/30939/what-do-you-think-would-have-the-biggest-positive-impact-on-the-profession/244437#244437"]Isn’t “contextualised medicine “ what many of us have been doing for decades!?[/quote]

Of course! So why has it become the buzz-phrase; is it having pushed for a "gold standard" which is unaffordable for many?

RE: What do you think would have the BIGGEST positive impact on the profession?

Alistair Graham-Evans — Mon, 29 Apr 2024 14:42:12 GMT

Thank you David for explaining what the silent majority of experienced GP’s are thinking.

Many younger vets see the same things too!

Isn’t “contextualised medicine “ what many of us have been doing for decades!?

When we have students doing training in our clinic I tell them to stay in the consultation rooms for as long as possible to learn about real life.

My knowledge of corporates is all second hand but I have worked in about 40 independent clinics and seen the good, bad and ugly so I’m sure there are corporate - owned clinics providing a good affordable service if allowed some autonomy.( as explained by Neil?) If a clinic is corporate though, then advertise as such rather than pretending to be a small independent still.

Some things make me cringe - at the moment my pet hate is emergency centres performing blood gas analysis on almost every sick or traumatised case ( often multiple times) when the result will have zero impact on the treatment.
Another is the term “gold standard”. I prefer “appropriate “

Our local referral centre will sometimes send us cases that will be euthanased due to the owner finding their estimate unaffordable but we can help in a pragmatic, affordable way ( and still make a profit). Not sure if their management knows this.