RCVS Vs Albring

Re: RCVS Vs Albring

Gillian Mostyn — Wed, 02 Feb 2011 17:45:22 GMT

[quote user="Bob Russell"]The call out charges reflect the cost of running an OOH clinic. Pay a vet £250 for a night shift, get two calls cost £125 per call plus the share of the nurses wages, add running costs and profit. [/quote]

I do agree that a call out should have a reasonable fee, but I don't like your 'logic'. Charges are never based on throughput to this degree so why should visits be any different? If you do three bitch spays one day and one the next, the prices aren't different - you just took the profit one day, the loss the next. Visits and consultations OOH should be priced in the same way as everything else we do - based on the time it takes, staff wages, overheads etc. I also doubt that an OOH clinic could function if it only has one or two calls a night... so I should hope the visits alone aren't paying the staff wages!

[quote user="Bob Russell"]Our job is to provide a service at a fair cost[/quote]

agreed. Not charging them extortionately because it is an inconvenience....

Re: RCVS Vs Albring

Bob Russell — Wed, 02 Feb 2011 17:32:42 GMT

'I feel although Mr A has done himself no favours he has been dealt very harshly.'

Absolutely agree and I have only limited sympathy for him. However the actions of the DC would have been extremely punitive had this vet qualified in the UK.

There are a significant number of very grey areas that this case has shown up and this individual has been made to 'pay' for them all by being suspended. He did not act in a particularly impressive way, handled it badly but was working within an OOH system that restricted him in a way that he was damned if he did and damned if he didn't.

He was punished for limitations of the OOH providers policy (even if not the written version) and perhaps for hiding behind his veterinary nurse rather than dealing with the client personally.

The call out charges reflect the cost of running an OOH clinic. Pay a vet £250 for a night shift, get two calls cost £125 per call plus the share of the nurses wages, add running costs and profit.

The charges mentioned in the posts do not seem unreasonable but the general public need to be better educated about the costs in advance so they can prepare. They can save for that rainy day or arrange insurance.

Our job is to provide a service at a fair cost, the owners is to make sure they can pay for that service!

Re: RCVS Vs Albring

jamie winstone — Wed, 02 Feb 2011 17:09:13 GMT

I have never really understood the practical difference between a vet refusing to do a house visit and one offering to go out but at a cost that is so expensive that only the super rich or emotionally distraught client will accept the fee.

In any request for a house visit, if the case is a genuine emergency even if the owner does not accept the charge, the onus is still on the duty vet approached to deal with the emergency. It appears sometimes in this forum that if the owner does not accept the quoted charge, it suddenly becomes their problem.

I feel although Mr A has done himself no favours he has been dealt very harshly.

Re: RCVS Vs Albring

Edward Jones — Wed, 02 Feb 2011 16:49:07 GMT

Good, because I don't usually burn bridges! I don't understand why it seems odd to value your profession above your job.

Re: RCVS Vs Albring

J G Wray — Wed, 02 Feb 2011 16:42:24 GMT

[quote user="i am ed"]I would find a new job, yes. I wouldn't risk a DC hearing, no. I wouldn't leave straight away, but if there was a problem whilst finding a new job I would break practise policy in a heartbeat.[/quote]

What sort of references would you expect?

JGW

Re: RCVS Vs Albring

Edward Jones — Wed, 02 Feb 2011 16:34:30 GMT

I would find a new job, yes. I wouldn't risk a DC hearing, no. I wouldn't leave straight away, but if there was a problem whilst finding a new job I would break practise policy in a heartbeat.

Vets change jobs due to professional differences very regularly. The job market is not quite as easy as it used to be for assistants, but it's really not that bad.

Re: RCVS Vs Albring

Mark Holmes — Wed, 02 Feb 2011 16:23:48 GMT

[quote user="i am ed"]

[quote user="Arlo Guthrie"]It is idealistic in the extreme to think that every vet faced with the choice between breaking the code of conduct, or doing the right thing but losing their job, should pick the latter.[/quote]

It's up to the individual to make their choice. If it comes down to possibly losing my job or possibly losing my profession then there really is no choice at all. That's not idealistic, it's realistic about the DC's usual view on breaking the GtPC.

[/quote]

Really? Family, mortgage, sole earner. You would just leave?

Re: RCVS Vs Albring

Edward Jones — Wed, 02 Feb 2011 16:16:06 GMT

Re: RCVS Vs Albring

Hannah Wynne Richards — Wed, 02 Feb 2011 08:44:51 GMT

Mis-read your post Alison Sorry

Wynne

Re: RCVS Vs Albring

Evelyn Barbour-Hill — Tue, 01 Feb 2011 22:05:12 GMT

[quote user="alison howell"] so when a client rang wanting a visit I knew it would be extremely difficult to find anyone else, as I was obviously the closest vet available. Luckily the lady decided to bring her yorkie in by pet ambulance which was just as well![/quote]

It would of course also have fulfilled all your professional obligations if you had refused to go out but had yourself summoned the pet ambulance.

Re: RCVS Vs Albring

vs0u — Tue, 01 Feb 2011 21:19:06 GMT

No - it means they rang me the day before, having tried all their closer vets. No way would they ever consider opening without a vet. I know you don't like OOH clinics but that is a bit of an extreme reaction!

Re: RCVS Vs Albring

Hannah Wynne Richards — Tue, 01 Feb 2011 09:14:06 GMT

Alison Does this mean the OOH clinic was open, but had noveterinary surgeon available, sowere phoning around in a panic when the nurse/receptionist was unable to fob someone off ? If so,had the contributing practices been informed, and was their monthly subscription reduced ?If not,then a lot of practitioners were blithely unaware that they had no OOH cover,although they had paid for it

Wynne

Re: RCVS Vs Albring

vs0u — Tue, 01 Feb 2011 00:04:47 GMT

I don't think £250 is too much to charge for a visit OOH - but the fee doesn't equate to the vets take home pay. If you are calling in a nurse as well and using a taxi it will be more, plus the employer will take a good cut, there will be vat etc...

[quote user="Peter Ding"]Perhaps Alison should insist that for those rates of pay, any OOH employer should indemnify her against loss of earnings should she fall foul of GtPC in following the Practices rules.[/quote]

I have never worked for an employer that did not allow visits. So I can't see that I would fall foul of GtPC for that reason. Anyway if I didn't agree with their rules I would ignore them. I do think some vets like to hide behind company rules and health and safety when really they just can't be bothered. I would expect most OOH clinics to have a policy about home visit requests, usually carefully worded to put people off admittedly, but the golden rule I have been told there a million times is 'Never say we don't do visits'! The other golden rule of 'always tell them how much it will cost' normally solves the problem! In this case the OOH clinic did have such a policy and the locum vet did not follow it - what practice would cover loss of earnings caused by disciplinary action due to not following their policy?

I had a tricky situation once when I was called in at short notice (to cover for another vet who had gone off sick) to a clinic about 2 hours away. It seemed that all the vets in the country had gone away to a certain congress, so when a client rang wanting a visit I knew it would be extremely difficult to find anyone else, as I was obviously the closest vet available. Luckily the lady decided to bring her yorkie in by pet ambulance which was just as well!

Re: RCVS Vs Albring

Peter Ding — Mon, 31 Jan 2011 10:52:02 GMT

Perhaps Alison should insist that for those rates of pay, any OOH employer should indemnify her against loss of earnings should she fall foul of GtPC in following the Practices rules.

I can perfectly understand and agree with much of Mr/Ms Phipps argument, however imho it is fundamentally flawed. If some OOH providers can already make economically viable arrangements to markedly reduce the number of likely problems over out of hours visits then they all can.

As others have pointed out it is the OOH provider who should emulate best practice already in use at other OOH providers in order to comply with the GtPC. If they don't, as the professional who will carry the can, you are obliged to do something about it.

Such arrangements don't have to be perfect, just better than those in place currently, as in this case those working practices were unacceptable and the vet was clearly at fault in not speaking directly to the client in question and doing more for them on a quiet night.

We all know the current status quo and GTPC ; if one is not happy with them or the companies own rules, one should not work for them without appropriate insurance/indemnity. When in Rome....Roman law applies: it's grossly stupid to emulate Romans who manifestly break the law.

Re: RCVS Vs Albring

Mark Holmes — Mon, 31 Jan 2011 10:39:22 GMT

Are you suggesting that £250 is too much to expect? We currently charge that for an out of hours home visit. So the market will take it. It would cost an ooh clinic alot more to pay full time staff to cover very occasional circumstances remember we are talking single figure circumstances a year.

So I think you could push for £250 a call out and if you can get £250 why expect less?

Re: RCVS Vs Albring

vs0u — Sun, 30 Jan 2011 22:50:52 GMT

[quote user="Mark Holmes"] If our local OOh service (we don't use one but there is one locally) asked me to be on some form of register to be called in this sort of emergency. Offered £250 for me to do the occasional visit in the night which might take 30-90 minutes. I would be happy to be on that list.[/quote]

Me too! I would only have to do 2.5 30-minute visits per week to earn the same as I used to working for an OOH clinic full time (48 hours a week)! Unfortunately I doubt they would pay that much - they currently pay locums less than that for a 15 hour night shift... And clients say we are in it for the money!

Re: RCVS Vs Albring

trekking vet — Thu, 27 Jan 2011 18:33:48 GMT

Clive, I have read most of the posts relating to this very interesting topic and what really strikes me is how ambiguous and contradictory this ruling passed by the RCVS(DC).

Instead of RCVS V's Albring, this case should be renamed individual vet V's corporate policy V's animal welfare V's owners' responsibilty.

I think many veterinary surgeons have been in similar situations as faced by Mr Albring and that is even with a second vet on call. There is an issue of security and that no vet is happy undertaking a house call late at night, to a person one does not know(apart from telephone conversations) to a place that one has never been to before. How many practices have recently invested thousands of pounds of security equipment and yet it is seen as perfectly normal to send a vet out to a situation where he-or more likely she- is completely vunerable and powerless.

I am sure animals have been transported in considerable distress/pain to vet clinics in the past but if you ask most owners, they would prefer to take their pet to the vet clinic without asking any questions. The issue here is that this dog was not a 'small animal' it was extremely large and heavy. One begs to ask how did she manage transporting, comfortably, this dog in the past?

The truth of the matter is that the RCVS took the easy option and hung Mr Albring out to dry. It would have been too messy to tease out the issue of the dogs' owners responsibility, employers culpabilty and security of veterinary staff. Yes,this dog did suffer in his final hours, of that there is no doubt. But blaming it all on one person is very unfair.

Re: RCVS Vs Albring

Michelle Tapp — Thu, 27 Jan 2011 18:09:31 GMT

One of our member practices very helpfully set up a rota whereby there's one of their vets that we can call if we receive a house visit request from one of their clients and we find ourselves unable to find cover for the clinic or are unable to attend within a suitable time period. We have only had to call on their help once in the last year and a half. Knowing that that backup is there is great and the practice is happy to do that to ensure their clients receive the standard of care we would all like them to even when things get hectic in the clinic as it can often do.

Michelle

Re: RCVS Vs Albring

Clive Ansell — Thu, 27 Jan 2011 17:35:57 GMT

[quote user="Gillian Mostyn"]

[Gillian goes away, waiting for her OOH clinic to ring saying they now need member practices to carry out home visits....]

[/quote]

Joking apart, I think the only way to resolve this issue is for OOH clinics to have a bank of vets and nurses (Ideally and for safety reasons there needs to be 2 staff members in the clinic and 2 attending the visit) on a back up rota for the purpose of home visits. This can only be made up of vets and nurses from user practices and could be on a compulsory or voluntary basis.

It needs to be properly costed; vet and a nurse on back up call, appropiately paid when called out, plus vehicle access and the appropriate fee charged, or subsidised and the cost recouped from an across the board increase in fees.

Re: RCVS Vs Albring

Glen McIntosh — Thu, 27 Jan 2011 17:23:03 GMT

[quote user="Gillian Mostyn"]

I think we'll have to agree to disagree on this one....

[Gillian goes away, waiting for her OOH clinic to ring saying they now need member practices to carry out home visits....]

[/quote]

I agree.

[Phipps goes away, to speak with the duty nurse:

Duty Nurse: "Gotta punter on the phone who wants a house visit. His poodle has a broken nail and he is a bit tipsy so he can't drive."

Phipps: "Tell him he's dreaming."

Duty nurse: "OK."

Phipps: "No. Hang on. Belay that order! Lets give Gillian a call......]

Re: RCVS Vs Albring

Bob Russell — Thu, 27 Jan 2011 16:59:41 GMT

I will check again but I don't remember there being any 'proof' that he lied. The DC decided that the owner was credible, the nurse apparently less so and the vet was absent without leave so was therefore probably guilty by default.

If he lied or falsified records he should face serious sanctions as should we all.

As for a veterinary union I have no real objection - someone has to improve the situation especially for younger vets. Facing the DC, we do have VDS thank goodness to help in that eventuality. As yet I have not been in the situation of needing that type of help so cannot comment on how supportive they are but I have always found them extremely good elsewhere.

Re: RCVS Vs Albring

Hannah Wynne Richards — Thu, 27 Jan 2011 16:45:03 GMT

Gillian -hopefully, I'm mature enough to disagree with someone over 1 thing,but still agree over another-if not,I certainly should be

Wynne

Re: RCVS Vs Albring

Mark Holmes — Thu, 27 Jan 2011 16:40:23 GMT

[quote user="Hannah Wynne Richards"]

Mark Practices don't HAVE to be in the PSS and they shouldn't apply tobe unless they are able to HONESTLY fulfill ALL the criteria

Gillian I am in TOTAL agreement with you this time

Wynne

[/quote]

No they don't and no they shouldn't but if they are and emergency clinics and have to be, then the PSS should ensure there are adequate policies in place and the practice owner should ensure they are able to and willing to comply to both aspects. Which ever way you look at it PSS and Vetcall management carry a large amout of the responsibility. How can you argue with their requirement that an MRCVS needs to be on the practice 24hrs a day and then blame that MRCVS for declining a home visit when he is not respnsible for providing adequate cover. Its completely illogical.

Re: RCVS Vs Albring

Gillian Mostyn — Thu, 27 Jan 2011 16:39:10 GMT

[quote user="Hannah Wynne Richards"]Gillian I am in TOTAL agreement with you this time[/quote]

hahaha - makes a change eh?

Re: RCVS Vs Albring

Hannah Wynne Richards — Thu, 27 Jan 2011 16:26:19 GMT

Mark Practices don't HAVE to be in the PSS and they shouldn't apply tobe unless they are able to HONESTLY fulfill ALL the criteria

Gillian I am in TOTAL agreement with you this time

Wynne