What do you think of script 3: march of science

RE: What do you think of script 3: march of science

Anthony Dennison — Tue, 05 Nov 2024 16:29:38 GMT

[quote userid="5012" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245825#245825"]Someone I know, who joined such a 2 year corporate scheme as a new graduate 2 years ago, with a promise of a position at the end of it if mutually suited (It has gone very well, so they are) , has just been told they are being let go (Got rid of) on the basis of financial constraints (practice is very busy, do their own OOH, and has hospital status and must be raking it in) . The are being replaced with another new grad. [/quote]

Bloody hell that's rough. As an IVC practice, graduate academy places are on top of a permanent contract. Sounds to me like bad management rather than corporate issue.

Michael Woodhouse independent vs corporate mentoring of new graduates. We're a corporate, I spend a hell of a lot of time mentoring all our vets - new grads, recent grads and vets wanting to push themselves. I've seen new graduates in an independent practice with poor support, who hire new grads, burn them out after 2 years and then get new ones.

It's the leadership within the practice, not who is the overall owner of the place.

RE: What do you think of script 3: march of science

Judith Joyce — Mon, 04 Nov 2024 19:08:51 GMT

I'd say you've definitely achieved your objectives.

RE: What do you think of script 3: march of science

Arlo Guthrie — Sun, 03 Nov 2024 19:05:25 GMT

Here we go ... this episode was due for release on Friday, but I ate a scallop and I am not sure the chef had washed his hands. So I had a rough night and would probably have looked the same colour as my sweater if I filmed the next day!

Anyway, this is not yet listed publicly, but I have taken into account your points a) put herriot into context b) perhaps not so easy to choose vet care based on more simple equipment.

What I hope to convey with this film is:

a) Another reason why the bill isn't the fault of the vet standing in front of you

b) When you think of the eye watering cost of the gear, vet bills seem less expensive.

c) Society needs to talk about whether it can afford these levels of investment in veterinary care.

www.youtube.com/.../XNF13XbCRcI

RE: What do you think of script 3: march of science

Clare Tapsfield-Wright — Sat, 26 Oct 2024 16:12:56 GMT

Agree with Judith , some clients want the personal reassurance of a vet who knows them and can support them through challenges which might be self evident such as old age with arthritic changes, senility and don’t need an MRI scanner but affordable consultations so that they are helped through the process of their pets old age. I had wealthy clients who begged me not to refer them even though I felt their pet needed it.
Different clients value their pet and their vet in different ways and I think a major factor isn’t the cost per se but fear of being ripped off.

RE: What do you think of script 3: march of science

Clare Tapsfield-Wright — Sat, 26 Oct 2024 16:05:16 GMT

[quote userid="13891" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245835#245835"] Excellent facilities don't necessarily equate to excellent veterinary care either - that's all about the people and[/quote]

RE: What do you think of script 3: march of science

Judith Joyce — Sat, 26 Oct 2024 09:35:53 GMT

[quote userid="2100" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science"]Well, if you want the best for your pet and you can afford it, then find a practice with all the mod cons. If you want something more affordable, find one with more basic facilities. …. you can always request to be referred to a hospital with all the bells and whistles later[/quote]

I struggle with this concept. It tars many of the entrepreneurs, CPD junkies, those determinedly chasing their personal goals etc with the corporate brush. Large busineses (corporate or independent) get round this by branding their first and second opinion practices differently but that might not be an option for many smaller businesses. However, most are agile enough to tailor their costings so that the GP services are not charged out at referral prices, It can be a struggle, especially conventing that message to first opinion stakeholders, including (? especially) the employees. Those who can't afford referral prices are being deterred from accessing excellent GP services at affordable prices within the same business ( is that a defunct model now, or is it having a revival with the new wave of independents). Excellent facilities don't necessarily equate to excellent veterinary care either - that's all about the people and culture.

RE: What do you think of script 3: march of science

Rob Loxley — Fri, 25 Oct 2024 14:32:12 GMT

[quote userid="5012" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245825#245825"]

Someone I know, who joined such a 2 year corporate scheme as a new graduate 2 years ago, with a promise of a position at the end of it if mutually suited (It has gone very well, so they are) , has just been told they are being let go (Got rid of) on the basis of financial constraints (practice is very busy, do their own OOH, and has hospital status and must be raking it in) . The are being replaced with another new grad.

If one were even more cynical, one might assume that new grads are being employed via a new grad scheme as a source of cheap labour, then dispensed with when they could command a higher salary?

So much for the welcome to the family, caring, corporate, valueless BS.

[/quote]

I feel you should name the corporate, since this is not how they all work.
Here (CVS practice) new grads are taken on on a permanent contract as a veterinary surgeon, though there is a 6 month probationary period but I suspect this is universal in employment contracts. Unsurprisingly, given the amount of input (time, formal CPD, training, mentoring etc) that is part of our programme, we try hard to retain new grads down the line not kick them out!

RE: What do you think of script 3: march of science

Clive Ansell — Fri, 25 Oct 2024 10:46:55 GMT

[quote userid="13891" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245819#245819"]As a cynic, I might suggest that some of the formal Corporate new graduate schemes might be motivated in part by the greater obligations on large companies (by way of formal reporting) to satisfy the Companies Act 2006 s.172? (the bit about non-financial indicators of the success of the company, including corporate social responsibility) [/quote]

If one were even more cynical, one might assume that new grads are being employed via a new grad scheme as a source of cheap labour, then dispensed with when they could command a higher salary?

So much for the welcome to the family, caring, corporate, valueless BS.

RE: What do you think of script 3: march of science

Judith Joyce — Fri, 25 Oct 2024 09:18:26 GMT

[quote userid="2100" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245814#245814"]Wouldn't it be truer to just say ‘if i was an employee’[/quote]

I've worked with some very good mentors who are employees and some not so good. Think ithat's down to professional interest, enthusiasm and personal soft skills. Is it just the financial imperative of being a boss or the mindset of some entrepreneurs.

RE: What do you think of script 3: march of science

Judith Joyce — Fri, 25 Oct 2024 09:10:24 GMT

[quote userid="4181" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245810#245810"]I think you could have suggested that without reference to it being a corporate owned practice issue?[/quote]

Interesting one, could be.. Do we need the formality of 'approved' and ' trained' to be good I know it was suggested that the old system of informal mentoring wasn't working but have things massively improved for new graduates measured by retention in the profession and job satisfaction since they were introduced. Probably more to do with practice culture than corporate vs independent? As a cynic, I might suggest that some of the formal Corporate new graduate schemes might be motivated in part by the greater obligations on large companies (by way of formal reporting) to satisfy the Companies Act 2006 s.172? (the bit about non-financial indicators of the success of the company, including corporate social responsibility)

RE: What do you think of script 3: march of science

Arlo Guthrie — Thu, 24 Oct 2024 23:28:59 GMT

[quote userid="3169" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245813#245813"]I spend a lot of time mentoring younger vets because it is within my interests to do so.[/quote]

Because you is the boss.

[quote userid="3169" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245813#245813"] If I was employed by a corporate, I think I'd rather crack on and get my work done efficiently, rather than help a new grad take 3x as long?[/quote]

Wouldn't it be truer to just say ‘if i was an employee’

RE: What do you think of script 3: march of science

Michael Woodhouse — Thu, 24 Oct 2024 23:00:23 GMT

[quote userid="4181" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245810#245810"]

I think you could have suggested that without reference to it being a corporate owned practice issue?;

[/quote]

I spend a lot of time mentoring younger vets because it is within my interests to do so. If I was employed by a corporate, I think I'd rather crack on and get my work done efficiently, rather than help a new grad take 3x as long?

RE: What do you think of script 3: march of science

Rob Loxley — Thu, 24 Oct 2024 18:16:37 GMT

[quote userid="13891" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245808#245808"]Would it be too cynical to suggest that an older vet who is employed by the same corporate as the younger one on similar terms, with no direct gain from mentoring a young graduate might be less inclined to help[/quote]

I think you could have suggested that without reference to it being a corporate owned practice issue?; I’ve not seen figures suggesting that corporates lag the independents in having approved new grad practices or trained ngp mentors, for instance?

RE: What do you think of script 3: march of science

Judith Joyce — Thu, 24 Oct 2024 13:41:11 GMT

[quote userid="2100" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245804#245804"]I'm surprised. What would you say are the main barriers to that?[/quote]

Agree lack of experienced vets to talk to. If the average stay in the profession is now something like the 6 years as RCVS has published, vets are barely hitting their stride before they leave. At the other end of the profession an awful lot of 50 somethings sold to corporates and instead of staying in harness till we dropped in the traditional fashion, have ridden off into the sunset to pastures new.

The traditional way was for the older vets to bring the younger ones on so I don't think there is a fear of asking - both sides benefit. it is that there is no one available to ask. Would it be too cynical to suggest that an older vet who is employed by the same corporate as the younger one on similar terms, with no direct gain from mentoring a young graduate might be less inclined to help.

Big shame, its not just the clinical stuff, its a great stress buster and younger vets really benefit from the support of older ones if there are complaints (especially if RCVS is involved)

RE: What do you think of script 3: march of science

Arlo Guthrie — Thu, 24 Oct 2024 12:24:23 GMT

[quote userid="12375" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245806#245806"]Experience is what you get shortly after you needed it. [/quote]

That's a brilliant quote. I shall plagiarise it ruthlessly!

RE: What do you think of script 3: march of science

Alastair Welch — Thu, 24 Oct 2024 11:31:04 GMT

My very strong impression (I work in horse practice so I’m not certain I am correct ) is that over the past few years there has been a hollowing out of experience within the SA profession. Many practices are staffed by a handful of inexperienced VS or sometimes there is a practice which is sole-charge run by someone with only a few years of postgraduate experience.

Experience is what you get shortly after you needed it.

RE: What do you think of script 3: march of science

KMurphy — Thu, 24 Oct 2024 10:01:29 GMT

[quote userid="2100" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245804#245804"]What would you say are the main barriers to that? [/quote]

Lack of vets generally. Lack of experienced vets more specifically. There are quite a few clinics I’ve (albeit anecdotally) heard of where there were no vets more than 3 years qualified and some where new graduates were flying solo.

RE: What do you think of script 3: march of science

Arlo Guthrie — Thu, 24 Oct 2024 08:57:37 GMT

[quote userid="12375" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245803#245803"]In many (I hesitate to say most but certainly a lot) there is no shoulder to tap. [/quote]

I'm surprised. What would you say are the main barriers to that? Lack of availability of another pair of eyes? Not wanting to ask for help for fear of looking like they are not very good at the job? Something else?

RE: What do you think of script 3: march of science

Alastair Welch — Thu, 24 Oct 2024 08:44:29 GMT

Arlo,

In many (I hesitate to say most but certainly a lot) there is no shoulder to tap.

RE: What do you think of script 3: march of science

Arlo Guthrie — Thu, 24 Oct 2024 08:07:19 GMT

[quote userid="2131" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245795#245795"]

Arlo Guthrie said:
Evelyn Barbour-Hill do you disagree with my central point, that advances in science have substantially added to the costs of veterinary care since the days when vets were armed only with a scalpel and some early antibiotics?

Not at all, although there are of course other strong factors.

[/quote]

Of course there are, and that's why I couldn't possibly cover everything in one film!

[quote userid="3169" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245801#245801"]I honestly wonder what the average age of 1st opinion vets is in this country?[/quote][quote userid="3169" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245801#245801"]They had run bloods (normal) and put on fluids and the young vet thought they could maybe feel something in the abdomen so wanted radiographs and an ultrasound. They asked me to have a look/feel. I told them in the space of 5 seconds the dog had an intussusception and needed surgery. I could feel it clearly.
[/quote]

Very interesting point. And I think this is complicated not just by the younger vet's experience, but also perhaps by their attitude to risk, and the whole way they are taught these days to tackle the diagnostic challenge in front of them. I say perhaps, because I don't know. Perhaps your example is not the best to illustrate what I mean, because it is more experience based, than risk-based. You just felt it and knew. They didnt.

But that raises another point - surely in these cases where less experience is the issue, the younger vets will most likely tap an older vet on shoulder and ask what they think (I appreciate that wont always be possible in a busy practice, but you would have thought it would happen infrequently enough not to cause a huge logistical problem).

RE: What do you think of script 3: march of science

Michael Woodhouse — Wed, 23 Oct 2024 20:21:55 GMT

[quote userid="2100" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245791#245791"]

You’ll get a veterinary surgeon trained to the same high standard as any other!

[/quote]

Yes, but......

I honestly wonder what the average age of 1st opinion vets is in this country? How likely are you to get a new grad or a foreign import working in their 2nd language? How many of those 1st opinion vets have ever done a night on call or in a dark yard away from all their diagnostics?

Earlier this year I walked into the surgery around 12.00, having been out on farm calls. A dog was sedated and the vet was looking at the first radiograph. It had come in during morning surgery (say 9.30). They had run bloods (normal) and put on fluids and the young vet thought they could maybe feel something in the abdomen so wanted radiographs and an ultrasound. They asked me to have a look/feel. I told them in the space of 5 seconds the dog had an intussusception and needed surgery. I could feel it clearly.

So, Arlo, were the bloods, scan and radiographs needed? Could the owner have declined them and had the same outcome? In my hands, yes. In a new grads hands, probably not. They need more information to have the confidence to cut. Sometimes even a stall until they can get a 2nd opinion from someone in the practice. Equally, Arlo, how would you feel with an expensive bill for surgery to find the firm mass was faeces and the dog was simply constipated, because the young vets palpation wasn't perfect and you declined all tests, that would have revealed the abdomen wasn't surgical?

It's also a reason that I get my dinner and the dog is back in the kennel waking up, and the new grad is still staring at radiographs deciding if they even need to go to theatre......

(not a dig at young vets, I was once one).

RE: What do you think of script 3: march of science

Evelyn Barbour-Hill — Tue, 22 Oct 2024 23:13:28 GMT

[quote userid="2100" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245791#245791"]

Evelyn Barbour-Hill said:
Another essence is the profit of the insurance company.

I’m not sure I understand your point. Are you really trying to say that the increasing costs of veterinary care have not been largely responsible for the increase in premiums???

[/quote]

Not at all. Just pointing something out.

[quote userid="2100" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245791#245791"]

Evelyn Barbour-Hill said:
Yes, hunt out El Cheapo. Just remember you'll get what you pay for.

You’ll get a veterinary surgeon trained to the same high standard as any other!

[/quote]

So.....?

[quote userid="2100" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245791#245791"]Evelyn Barbour-Hill do you disagree with my central point, that advances in science have substantially added to the costs of veterinary care since the days when vets were armed only with a scalpel and some early antibiotics?[/quote]

Not at all, although there are of course other strong factors.

RE: What do you think of script 3: march of science

Arlo Guthrie — Tue, 22 Oct 2024 19:05:50 GMT

[quote userid="2131" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245789#245789"]Are you sure of that? Maybe it's true of the corporates and those independents that are run like corporates.[/quote]

Yes! The point of the film is that the march of science costs money. James Herriot practised in the 1940s. There was no CT, no ultrasound, no linear accelerators, no lab equipment to speak of. This is all stuff that costs a lot of money. Money that vets did not have to spend back in the day.

[quote userid="2131" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245789#245789"]Yes, hunt out El Cheapo. Just remember you'll get what you pay for.[/quote]

You’ll get a veterinary surgeon trained to the same high standard as any other!

[quote userid="2131" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245789#245789"]Another essence is the profit of the insurance company.[/quote]

I’m not sure I understand your point. Are you really trying to say that the increasing costs of veterinary care have not been largely responsible for the increase in premiums???

Evelyn Barbour-Hill do you disagree with my central point, that advances in science have substantially added to the costs of veterinary care since the days when vets were armed only with a scalpel and some early antibiotics?

RE: What do you think of script 3: march of science

Evelyn Barbour-Hill — Tue, 22 Oct 2024 17:42:32 GMT

[quote userid="13891" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245782#245782"]The piece has great impact. Not my area of expertise but is this a bit too sensationalist. I think it does the older and past vets a disservice, suggesting that they almost practised witchcraft (sorry, my hyperbole). James Herriot was a graduate, working to scientific principles and applying them with the tools he had available. That included the power of the clinical history and thorough clinical examination, creating differential lists and applying what licensed medicines (including antiobiotics) which were available. You hit a bit of a raw nerve with me there. Take the example of abdominal palpation which sometimes seems a dying skill, which can reveal a lot before resorting hi tech diagnostic aids. [/quote]

I agree with every word.

[quote userid="2100" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245784#245784"]OK - I used James Herriot as the name everyone relates to, and which gives a mark in time. But maybe it would be truer to say: In the days BEFORE James Herriot. Does that work better? [/quote]

Not really. 80-90% of your readers won't have any idea "when James Herriot was".

[quote userid="2100" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science"]businesses have invested in all this kit, and the costs are being borne by everyone, not just the patients that need them. [/quote]

Are you sure of that? Maybe it's true of the corporates and those independents that are run like corporates.

[quote userid="2100" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science"]If you want something more affordable, find one with more basic facilities. ….[/quote]

Yes, hunt out El Cheapo. Just remember you'll get what you pay for.

[quote userid="2100" url="~/f/non-clinical-questions/31066/what-do-you-think-of-script-3-march-of-science/245784#245784"]a) There is a subsidy going on ... it's insurance. Premiums have increased because of the increasing costs of ever more rarified procedures, and we all pay for that, regardless of whether we need the procedure. It's the essence of insurance.[/quote]

Yes, it's the principle of insurance. Another essence is the profit of the insurance company.

RE: What do you think of script 3: march of science

Judith Joyce — Tue, 22 Oct 2024 12:17:04 GMT

Agree completely about the insurance.

Struggling to make it three so I am cheating a bit.

Think good diagnostiac ultrasound probably comes in the expensive kit - although there is sometimes first opinion pressure to do a quick cheap scan to have a 'quick look' at a particular bit of anatomy ( I think this horrifies ultraonographers) at little or no specific charge.

Arthroscopy comes in the expensive bracket.

so I've plumped for:

Xrays come in that bracket but generally -costed and charged specifically

Lab machinery - again increasingly sophisticated and expensive but generally costed and charged specifically (although repeat tests might not)

Microscopy - possibly the cheapest? Possibly more frequently not specifically charged for coat brushings, skin scrapes and cytology.

But you are right, all veterinary practices tend to have the above kit and its possibly not used profitably becomes part of the costs in the general overhead. Bit out of touch but RCVS PSS used to insist that all these facilities were available at each branch at the level of General Practice (haven't looked recently). Very inflationary,

Not sure if this counts, but conferring with colleagues in the corridor, over coffee, or over the phone (all generally not charged) has developed into charged telemedicine.