Stop authorising prescription of POM-V without physical examination of the patient.

RE: Stop authorising prescription of POM-V without physical examination of the patient.

Sal the 1st — Fri, 14 Jun 2019 19:24:12 GMT

[quote user="Arlo Guthrie"]

[quote user="Sal the 1st"]what happens when the diagnosis made by virtual vet differs from the one made by actual vet?[/quote] Well, you would imagine the actual vet would supersede the online one, because he or she would have better information, having physically examined the animal.

[/quote]

That is going to be one peed off client when that happens. Hardly going to give Joe Public confidence in the profession I would have thought? Also an insurance nightmare for somebody wanting to make a claim with more than one diagnosis and the potential for both to have future exclusions if the client doesn't have a lifetime policy

[quote user="Arlo Guthrie"]

Well, I doubt many people are going to consult online in a real emergency

[/quote]

only last night I saw on one of the local dog owners pages words to the effect - my dog has been really off colour today, is really hard breathing and just lying around he has been like it all day and his tongue looks really pale. Shall I call the vet or do you think it will wait till the morning?

People don't always realise they have a blue light emergency and an online vet is only going to be able to make a diagnosis based on the information a client gives them.

I can see the brown stuff hitting the fan in a big way with this

RE: Stop authorising prescription of POM-V without physical examination of the patient.

Arlo Guthrie — Fri, 14 Jun 2019 09:43:00 GMT

[quote user="Sal the 1st"]maybe I am being thick - and I'm sure somebody will tell me. One of my main concerns would be just how would you know you have consulted a genuine vet and not somebody who has just set up a website.[/quote]

I hadn't thought of that, and now you mention it, I've not heard it raised by anyone else either (at the council meeting, or elsewhere).

Of course, if remote consultations / prescribing were only allowed via bricks and mortar practices through their websites, that would reduce the risk.

[quote user="Sal the 1st"]what happens when the patient who they have never examined needs surgery? apart from telling them to find a vet.[/quote]

That's exactly what happens. Except IVC will refer to one of their practices and effectively refund the online consultation fee. Joii / Vet AI also refunds consultation fee under those circumstances. Firstvet does not.

[quote user="Sal the 1st"]emergencies?[/quote]

Well, I doubt many people are going to consult online in a real emergency - but if they do, then the answer would be the same as if the animal needs surgery ... 'you'll need to visit a real life vet.'

RE: Stop authorising prescription of POM-V without physical examination of the patient.

Alison Clare Hickman — Fri, 14 Jun 2019 00:06:34 GMT

Sal the 1st

A very good point!!

RE: Stop authorising prescription of POM-V without physical examination of the patient.

Sal the 1st — Thu, 13 Jun 2019 18:22:10 GMT

maybe I am being thick - and I'm sure somebody will tell me. One of my main concerns would be just how would you know you have consulted a genuine vet and not somebody who has just set up a website. I know fake vets have existed and got away with it for a long time before thy were caught (2 of them very local to me) and these are people who have been doing consults with owners present- wouldn't taking the consult to telemedicine make it even easier for people like this to set up shop?

what happens when the patient who they have never examined needs surgery? apart from telling them to find a vet.

emergencies?

what happens when the diagnosis made by virtual vet differs from the one made by actual vet?

or perhaps we are moving into the realms of

www.youtube.com/watch

RE: Stop authorising prescription of POM-V without physical examination of the patient.

Arlo Guthrie — Thu, 13 Jun 2019 13:59:20 GMT

Alison Clare Hickman - for me, this really is quite simple. There are lots of potential downsides to remote prescribing - exactly as Shams' petition describes.

In the human sector, it has created a two tier healthcare system in parts of London, with apparently very bad consequences for traditional bricks and mortar dr surgeries (loads of patients left their existing practices, which then lost funding, to move to the virtual practice: Babylon).

Then there is the risk of misdiagnosis. And the risk that if animals are seen less often, then preventative medicine goes hors de la fenêtre as our french colleagues might say.

And the solution ... simple ... require that remote prescriptions are only offered by bona-fide bricks and mortar practices, initially to existing clients.

This, of course, is already quite legal!

So yes:

[quote user="Alison Clare Hickman"]So, my final thought is, it ain't really broken so let's not try and reinvent the wheel; however some tweaking for flexibility in it would be a great marketing/sales tool...not necessarily the right reason?[/quote]

Absolutely agree with you, except I wouldn't be apologetic about thinking of it as a great marketing / sales tool. Marketing/sales is just about finding out what your customers want and giving it to them. There is no shame in that, especially when the net result is an improvement in animal welfare.

Rest my case, M'lud.

RE: Stop authorising prescription of POM-V without physical examination of the patient.

Alison Clare Hickman — Thu, 13 Jun 2019 08:16:40 GMT

'shirely shome mammoth confusion here'

Erm, well I'm confused!!!!!

Is this a tongue twister challenge!? Arlo Guthrie

My 2 Bob ... Can hear the VS concerns re dx remotely (sometimes it's hard enough to dx even with the animal in front of you). Can see the issues / needs differ between LA and SA practice (individual patient dx versus flock/herd dx). Can understand client view point of easier access to a VS and 21C immediate access expectations (24/7 from comfort of own home and far less stress to pet). Plus might be more cost effective (to consumer)

I guess I'm on the fence as I can see both merits for and cons against it. As with all things it is fraught with potential misuse and abuse as there is a level of trust.that could easily be broken. One misdx and the whole house of cards collapses (for that VS, for the whole process).

So, my final thought is, it ain't really broken so let's not try and reinvent the wheel; however some tweaking for flexibility in it would be a great marketing/sales tool...not necessarily the right reason?

?????

RE: Stop authorising prescription of POM-V without physical examination of the patient.

Arlo Guthrie — Tue, 11 Jun 2019 18:25:24 GMT

[quote user="Ian M"]..works in theory if someone is willing to come along and spend hours trying to trap a slightly injured or sick feral or wild animal which clearly just needs a short course of antibiotics or anti-parisitics in food. Trouble is, you'll stress it out by doing so, making it less likely to get better, and also you'll be making it harder to catch the next time, when it really does need trapping. Unless you are personally offering drop what you are doing and unconditionally give up hours of your own time to trap these animals - or are alternatively happy to let them suffer untreated and become flystruck if they can't be caught, your proposal falls down slightly doesn't it.[/quote]

Shirely shome mammoth confusion here Ian M

Shams' petition is to try to prevent the RCVS from allowing remote prescription.

At the moment, vets can only prescribe to animals in under their care, which means having seen them in person, so to speak, recently enough.

However various telemedicine companies are now trying to set up services providing video diagnosis and treatment for animals online.

See: https://www.vetnurse.co.uk/b/veterinary-nursing-news/archive/2018/11/07/the-remote-prescription-debate-that-could-redefine-what-it-means-to-be-a-vet.aspx

and more recently:

https://www.vetnurse.co.uk/b/veterinary-nursing-news/archive/2019/05/17/two-more-online-veterinary-consultation-providers-join-the-field.aspx

Sham's petition is to ask the RCVS not to allow these companies to prescribe medicines on the basis of a remote consultation, ie without actually having see the pet.

My view is that I think video consultations could have a really important place when offered by existing bricks and mortar practices to their own clients. I'm not sure I really see the point in remote consultations being offered by other companies, and in fact I think they could cause real difficulties for animal welfare.

RE: Stop authorising prescription of POM-V without physical examination of the patient.

Ian M — Tue, 11 Jun 2019 00:07:32 GMT

...works in theory if someone is willing to come along and spend hours trying to trap a slightly injured or sick feral or wild animal which clearly just needs a short course of antibiotics or anti-parisitics in food. Trouble is, you'll stress it out by doing so, making it less likely to get better, and also you'll be making it harder to catch the next time, when it really does need trapping. Unless you are personally offering drop what you are doing and unconditionally give up hours of your own time to trap these animals - or are alternatively happy to let them suffer untreated and become flystruck if they can't be caught, your proposal falls down slightly doesn't it.