By Steve Dale, CABC
Don’t’ get swept away by the virtual care wave, or be taken in by misinformation. If you think about it, I suggest you know better.
It’s true, there’s an absolute need for virtual care or telehealth. However, as I whip out my crystal ball, I suggest this wave of direct-to-consumer providers looms disaster for pet parents, and in turn for the profession.
True enough – there remains intense frustration in many urban areas, people can’t often get into see their veterinarian in a timely manner. In rural communities, the nearest clinic may be an hour drive or more. And then there are cats – who even in the cat-friendliest or Fear Free practices, just don’t want to go. Or elderly or disabled pet parents who themselves can’t easily go. Virtual care can be a solution for your clients but not with the vast majority of direct-to-consumer providers.
While there’s no veterinary client patient relationship (VCPR), pets can’t tell you what they’re feeling and pet parents aren’t always accurate translators.
Dog is limping. Well, I suppose the veterinary professional can see nothing is stuck in the dog’s paw. Beyond that a NSAID is prescribed (maybe one affiliated with the provider?), but perhaps the pet parent doesn’t recall a reaction to a NSAID from five years ago. The biggest issue is throwing a medication as a dart at the dart board, hoping for a bullseye but without a diagnosis. So, what is the diagnosis? Is it lumbar, maybe it’s a cruciate tear, maybe osteosarcoma, maybe even GI pain?
The pet parent is happy – for now. As everyone wants an instant soup answer. However, what if ultimately it is the wrong answer?
As the American Veterinary Medical Association has pointed out – even pre-pandemic – you can do virtual care in your practice, which has many benefits. One today is simply that clients don’t have to go elsewhere.
Take the same limping dog scenario in a virtual visit with a client. You can see this dog’s history. Obviously, dependent on that history, a palpation and radiograph may be in order rather than throwing a NSAID at the problem and hoping for the best.
If your practice begins to initiate virtual care (and only with clients having a VCPR) imagine the upsides – beginning with credentialed technicians and nurses who now can work their full license and do what they do best – communicate to clients. As a follow up to surgery, keeping tabs on chronic conditions and offering “how to lessons” from giving injections for diabetes to administering IV fluids, and much more including behavior consultations (assuming there’s a qualified team member). To accomplish traditional behavior consults for more complicated issues such as inappropriate elimination or cats scratching at all the wrong places or separation anxiety, an hour may need to be carved out of exam room time.
Of course, there should be a fee for the tele-health service. Regarding surgery follow up, the fee can be “baked into” the surgery and itemized as such. As long as the fee is fair – most pet parents will welcome the opportunity to do something far more comprehensive than a telephone call.
In my view, an excuse to not share this additional revenue with credentialed technicians is nothing more than excuse.
According to new data, pet parents prefer to speak to a veterinary professional whom they have a relationship with.
True enough, virtual visits are not for everyone, though these days even grandma has an iPad or iPhone. Many busy pet parents prefer the flexibility or may live a distance away. Also, perspective employees may not want a full time gig but prefer part-time and to work from home, which virtual care can allow for.
Laws are constantly changing regarding VCPR, but in most places there’s not supposed to be a diagnosis without VCPR. However, the only reason why people go online in the first place is to get a diagnosis. So, the providers may not call their “conclusions” or “opinions” a diagnosis – but that is exactly what it is. And that treatment plan may include a pharmaceutical which often isn’t supposed to happen either.
The line by proponents of all-out direct to consumer virtual care is “some care is better than no care.” However, I disagree when the alternative may be poor care. Whatever happened to “do no harm?”
After all, that professional at the other end of the Zoom or whatever platform it may be might not be licensed in the same state as the client, which means the client has no recourse if there’s a problem. In fact, sometimes the veterinary professional is out of the country. Can there be confusion due to language? How up to date are they really on U.S. medicine?
And does your practice receive a report on what that professional from the direct-to-consumer provider has suggested to the client? Maybe yes – maybe no. That virtual visit may be up to the client to interpret.
I worry that most direct-to-consumer offerings, and if Amazon and Walmart get into the act – their interest is solely for money grabs. I have no issue with making the almighty dollar but not at the expense of pets or pet parents. And I have no clue how this can’t hurt the reputation of veterinary professionals down the road. Despite what most believe the AVMA actually supports virtual care with VCPR, and has been doing so even pre-pandemic. More information can be found on their website, (https://www.avma.org/resources-tools/avma-policies/telemedicine) but they will also answer questions by phone and legalese can be complex and varies state by state. Having said that, with a VCPR, you can and arguably should be doing telehealth on your own so there’s no need for your clients to search elsewhere.