I love both veterinary and human medicine, but I don't know how to do both

[DVMDream]

Really? C'mon. You've had those people in an exam room: "I searched on google and my dog DEFINITELY has X. And no, I won't consider any other diagnostics. I just want the test for X." [As an addendum, the only thing more frustrating than a client doing that is when the client ends up being right.]

That's diagnosing. It might be a crappy job of it, but...... People do the same thing with their kids.

All I'm saying is.... if your argument is going to be "because parents do X, it must not be practicing medicine to do X" ... then diagnosing pathology is not practicing medicine because parents do it allllll the time.

I think practicing medicine is the diagnosis and treatment of disease by a trained medical professional. I think you probably would say that it's the diagnosis and treatment of disease by a doctor. That's fine.

But in my view... CVTs, RNs, EMTs, etc... are all practicing medicine. They all have different scopes of responsibility, obviously. In your view, only MDs and DVMs are practicing medicine, and everyone else is just implementing technical tasks. Just a subtle difference.

Of course I've dealt with those people but I don't consider it diagnosing. Sure, they think they are and maybe they get lucky and are right but I just don't consider that "practicing medicine". Saying that someone was able to google head cold and be right doesn't make them practicing medicine. Just like tossing a febrile kid some Tylenol isn't practicing medicine.

I do get where you are coming from but a CVT can't do anything without a DVM. They can't give medications without the proper directions from a DVM. I consider what they do emplementing medicine. They are an essential part of the process but they aren't actually practicing medicine themselves. Maybe I'm sticking too close to the legal definition but it does exist for a reason. There are certain things that are considered under the scope of practicing medicine and anyone without a proper license can be sued for doing those things.

It's part of the reason I decided to go to vet school and not stick with being a tech. I didn't want to be told give this, do that, draw this blood. I wanted to make the decisions and come up with the treatments myself; not just be handed what to do and when.

We'll just have to agree to disagree on this one. But I don't think it makes anyone snobby to say that vet techs don't practice medicine.

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[LetItSnow]

Of course I've dealt with those people but I don't consider it diagnosing. Sure, they think they are and maybe they get lucky and are right but I just don't consider that "practicing medicine". Saying that someone was able to google head cold and be right doesn't make them practicing medicine. Just like tossing a febrile kid some Tylenol isn't practicing medicine.

I agree with you on that. But you were using a parent tossing a kid Tylenol as being equivalent to a technician administering treatment (and therefore, that can't be practicing medicine). All I'm saying is that if a parent giving meds is the same as a tech giving meds, then a parent diagnosing a problem is the same as me diagnosing a problem. Which I think is ridiculous - just like you're saying. But I don't think you can have it just one way (the technician/parent analogy) and not the other (the doctor/parent analogy).

I do get where you are coming from but a CVT can't do anything without a DVM.

Well, sure. The DVM is a required component of the delivery of medicine. The DVM is essential, and we have a unique role in that there are things <only> we can do (whereas we can pretty much perform all the tasks a CVT can perform, though perhaps not as competently). But that doesn't mean the CVT isn't practicing medicine just because they are more limited in scope. Are you saying that only absolutely required components of the delivery of medicine are practicing medicine? Why make that distinction?

The legal definition is there for a reason: so that we know what the roles are and who to go after legally when things go wrong.

But, just for fun, here's some info from the AVMA's model state practice act as it currently stands (they update it every so often)....

This language, used when defining alternative medicine: "Complementary, alternative, and integrative therapies" means a heterogeneous group of preventive, diagnostic, and therapeutic philosophies and practices that are not considered part of conventional (Western) medicine as practiced by most veterinarians and veterinary technicians."

Interesting that they said "as practiced by most veterinarians and veterinary technicians."

They also say:
"Practice of veterinary medicine" means:

1. To diagnose, prognose, treat, correct, change, alleviate, or prevent animal disease, illness, pain, deformity, defect, injury, or other physical, dental, or mental conditions by any method or mode; including the:
   1. performance of any medical or surgical procedure, or
   2. prescription, dispensing, administration, or application of any drug, medicine, biologic, apparatus, anesthetic, or other therapeutic or diagnostic substance, or
   3. use of complementary, alternative, and integrative therapies, or
   4. use of any procedure for reproductive management, including but not limited to the diagnosis or treatment of pregnancy, fertility, sterility, or infertility, or
   5. determination of the health, fitness, or soundness of an animal, or
   6. rendering of advice or recommendation by any means including telephonic and other electronic communications with regard to any of the above.

I take note of all the "or"s in there. It's not "and". My technicians perform quite a large number of (non-surgical) procedures. They dispense, administer, and apply drugs/medicines/anesthesia/etc (per 2.), they definitely determine the health/fitness/soundness of an animal every time they triage or do a TPR/BP/ECG and make a decision about informing me of the info now vs later, and they render advice/recommendations about every 15 minutes on the phone. That's a lot of the items listed above?

(Obviously, the AVMA's model practice act isn't a functional legal document - it's just meant to serve as a guideline for states. But clearly its authors viewed techs as practicing? I think?)

Seriously, I'm not trying to belabor the point or argue just for the sake of arguing. I think it's interesting to see how you view it. Hope you're not taking it negatively.

 

[DVMDream]

I agree with you on that. But you were using a parent tossing a kid Tylenol as being equivalent to a technician administering treatment (and therefore, that can't be practicing medicine). All I'm saying is that if a parent giving meds is the same as a tech giving meds, then a parent diagnosing a problem is the same as me diagnosing a problem. Which I think is ridiculous - just like you're saying. But I don't think you can have it just one way (the technician/parent analogy) and not the other (the doctor/parent analogy).



Well, sure. The DVM is a required component of the delivery of medicine. The DVM is essential, and we have a unique role in that there are things <only> we can do (whereas we can pretty much perform all the tasks a CVT can perform, though perhaps not as competently). But that doesn't mean the CVT isn't practicing medicine just because they are more limited in scope. Are you saying that only absolutely required components of the delivery of medicine are practicing medicine? Why make that distinction?

The legal definition is there for a reason: so that we know what the roles are and who to go after legally when things go wrong.

But, just for fun, here's some info from the AVMA's model state practice act as it currently stands (they update it every so often)....

This language, used when defining alternative medicine: "Complementary, alternative, and integrative therapies" means a heterogeneous group of preventive, diagnostic, and therapeutic philosophies and practices that are not considered part of conventional (Western) medicine as practiced by most veterinarians and veterinary technicians."

Interesting that they said "as practiced by most veterinarians and veterinary technicians."

They also say:
"Practice of veterinary medicine" means:

1. To diagnose, prognose, treat, correct, change, alleviate, or prevent animal disease, illness, pain, deformity, defect, injury, or other physical, dental, or mental conditions by any method or mode; including the:
   1. performance of any medical or surgical procedure, or
   2. prescription, dispensing, administration, or application of any drug, medicine, biologic, apparatus, anesthetic, or other therapeutic or diagnostic substance, or
   3. use of complementary, alternative, and integrative therapies, or
   4. use of any procedure for reproductive management, including but not limited to the diagnosis or treatment of pregnancy, fertility, sterility, or infertility, or
   5. determination of the health, fitness, or soundness of an animal, or
   6. rendering of advice or recommendation by any means including telephonic and other electronic communications with regard to any of the above.

I take note of all the "or"s in there. It's not "and". My technicians perform quite a large number of (non-surgical) procedures. They dispense, administer, and apply drugs/medicines/anesthesia/etc (per 2.), they definitely determine the health/fitness/soundness of an animal every time they triage or do a TPR/BP/ECG and make a decision about informing me of the info now vs later, and they render advice/recommendations about every 15 minutes on the phone. That's a lot of the items listed above?

(Obviously, the AVMA's model practice act isn't a functional legal document - it's just meant to serve as a guideline for states. But clearly its authors viewed techs as practicing? I think?)

Seriously, I'm not trying to belabor the point or argue just for the sake of arguing. I think it's interesting to see how you view it. Hope you're not taking it negatively.

Nope, definitely not taking it negatively.

I think your viewpoint is interesting, I'll have to read more and respond more when I get home.

 

[dyachei]

Actually, some CVTs can do some things without a DVM present in some states.

 

[Lupin21]

Hey man. Aren't we all, like, just practicing life anyway? Relative is such a great term. Unless there is a definition, in which case, which old dude decided that is the way it has to be? AmIright?

 

[pinkpuppy9]

I think that's a shame that your clinic is doing on call when there's an emergency clinic so far away -- not good for the vets, staff, or the patients. But it's not my business, so it's not my decision to make.

Do you mean that as in "when there's an emergency clinic only 20 minutes away?" If so, tbh, we charge less than half the quoted price of the e-clinic more often than not. I kinda think that's a good thing if it means getting a pet treatment or not. The last clinic I worked for was no more than 10 minutes away from Michigan State's CVM, and we took emergencies overnight there as well. That's something I didn't quite understand. It does suck to have that extra restriction on what I can do outside of work when I'm on call (don't work elsewhere, don't go out of town, etc.). I think it's more or less offering clients the option to go to a doctor they know and who can treat their pet at a more affordable price.

 

[LetItSnow]

Do you mean that as in "when there's an emergency clinic only 20 minutes away?" If so, tbh, we charge less than half the quoted price of the e-clinic more often than not. I kinda think that's a good thing if it means getting a pet treatment or not.

It's maybe a good deal from a cost perspective, but ......... it's probably not the best for the pet, depending on how you guys are handling it. If it's the kind of thing where they call the clinic and get forwarded to the vet's phone, and the vet does a sorta phone triage and decide whether to see the patient or send it to an ER ... that might be ok. Except for the fact that what they tell you on the phone is more often than not vastly different than what the animal looks like when they bring it in (it's always 10x worse or 10x better than what they described).

And if it shows up and there's just a solo vet there and it's an animal that really needs critical attention .... bummer. They should have gone to the ER. Oh well.

ER crew are used to very, very quickly triaging a patient and getting treatment going. An animal that's truly an emergency really should be seen by people used to dealing with it if that kind of care is available - it just makes sense. It's like me cutting a FB: we're co-located with a referral practice in some of our locations, and I send every one of those FB cases to the boarded surgeon if they'll go. I only cut when the client won't go to the boarded surgeon or when I'm at one of our facilities where that's not an option. It's just what's best for the pet: putting them in the hands of the people most used to dealing with what's currently going on.

That's not a slam on GP staff, but they don't deal with that kind of thing every day any more than I do dentals every day.

I don't know what CalliopeDVM's reasoning was, but I'm in agreement that it's unfortunate. It's <potentially> bad for a patient (which means potentially bad for a client), and it sucks for the staff/dvm at your clinic to have to be on call unnecessarily. Why see emergencies if there's an ER nearby? Just ... seems silly.

 

[CalliopeDVM]

Do you mean that as in "when there's an emergency clinic only 20 minutes away?" If so, tbh, we charge less than half the quoted price of the e-clinic more often than not. I kinda think that's a good thing if it means getting a pet treatment or not. The last clinic I worked for was no more than 10 minutes away from Michigan State's CVM, and we took emergencies overnight there as well. That's something I didn't quite understand. It does suck to have that extra restriction on what I can do outside of work when I'm on call (don't work elsewhere, don't go out of town, etc.). I think it's more or less offering clients the option to go to a doctor they know and who can treat their pet at a more affordable price.

Ooops - thanks for catching that. I meant it's a shame they're doing on call when there's a clinic so close (only 20 minutes away). Sure you can sometimes treat the patient for less money, but it's really not the best for the patient (to have overworked and/or overtired vets and techs), as well as negatively affecting the QoL for those vets and staff. I've known clinic owners who say they do it so clients have a less expensive option, but my personal belief is they do it for the money and maybe to stoke their ego a little. Instead, I think it sets clients up to have unrealistic expectations (they want what the nearby ER can offer, but don't realize that the local clinic doesn't have the rested staff or level of equipment and facilities they could get there). It sucks to be up all night with emergencies, then have a full day of surgeries and appointments that begins in 3 hours (doesn't happen often, but I've been there, done that) Is it fair to those patients that you've been up all night, when you had the option to sleep the night before?

 

[pinkpuppy9]

It's maybe a good deal from a cost perspective, but ......... it's probably not the best for the pet, depending on how you guys are handling it. If it's the kind of thing where they call the clinic and get forwarded to the vet's phone, and the vet does a sorta phone triage and decide whether to see the patient or send it to an ER ... that might be ok. Except for the fact that what they tell you on the phone is more often than not vastly different than what the animal looks like when they bring it in (it's always 10x worse or 10x better than what they described).

And if it shows up and there's just a solo vet there and it's an animal that really needs critical attention .... bummer. They should have gone to the ER. Oh well.

ER crew are used to very, very quickly triaging a patient and getting treatment going. An animal that's truly an emergency really should be seen by people used to dealing with it if that kind of care is available - it just makes sense. It's like me cutting a FB: we're co-located with a referral practice in some of our locations, and I send every one of those FB cases to the boarded surgeon if they'll go. I only cut when the client won't go to the boarded surgeon or when I'm at one of our facilities where that's not an option. It's just what's best for the pet: putting them in the hands of the people most used to dealing with what's currently going on.

That's not a slam on GP staff, but they don't deal with that kind of thing every day any more than I do dentals every day.

I don't know what CalliopeDVM's reasoning was, but I'm in agreement that it's unfortunate. It's <potentially> bad for a patient (which means potentially bad for a client), and it sucks for the staff/dvm at your clinic to have to be on call unnecessarily. Why see emergencies if there's an ER nearby? Just ... seems silly.

Ooops - thanks for catching that. I meant it's a shame they're doing on call when there's a clinic so close (only 20 minutes away). Sure you can sometimes treat the patient for less money, but it's really not the best for the patient (to have overworked and/or overtired vets and techs), as well as negatively affecting the QoL for those vets and staff. I've known clinic owners who say they do it so clients have a less expensive option, but my personal belief is they do it for the money and maybe to stoke their ego a little. Instead, I think it sets clients up to have unrealistic expectations (they want what the nearby ER can offer, but don't realize that the local clinic doesn't have the rested staff or level of equipment and facilities they could get there). It sucks to be up all night with emergencies, then have a full day of surgeries and appointments that begins in 3 hours (doesn't happen often, but I've been there, done that) Is it fair to those patients that you've been up all night, when you had the option to sleep the night before?

Yeah, that bolded statement pretty much hits the nail on the head. I'm pretty sure we're the only GP in the area that accepts emergencies 24/7 as well. It truly does interfere with our day-to-day, even if the emergency is during regular hours. It seems like its every day that appointments/regular clients get pushed back several hours due to walk-in emergencies or new clients calling down because their dog has been vomiting for a month and NOW has to be seen. There's nothing wrong with caring for sick pets, but when you can see the wheels turning in your bosses eyes, you know she's determining which would bring in more revenue: the emergency, or the 4 routine appointments that are made to wait over an hour to be seen. She gets to sit down at her desk and eat her lunch, but we wait until we're told. I got a 10 minute lunch at 5PM yesterday. Sorry, this turned into a bit of a rant, lol.

I mean I personally don't think we have the best facilities for critical patients. That, and when we have a critical patient, the tech/vet are still seeing routine appointments all day. Not exactly best for the patient if people are not near the cages all the time. I'm not sure how other clinics do it, as I've never worked emergency before.

 

[jmo1012]

Yeah, that bolded statement pretty much hits the nail on the head. I'm pretty sure we're the only GP in the area that accepts emergencies 24/7 as well. It truly does interfere with our day-to-day, even if the emergency is during regular hours. It seems like its every day that appointments/regular clients get pushed back several hours due to walk-in emergencies or new clients calling down because their dog has been vomiting for a month and NOW has to be seen. There's nothing wrong with caring for sick pets, but when you can see the wheels turning in your bosses eyes, you know she's determining which would bring in more revenue: the emergency, or the 4 routine appointments that are made to wait over an hour to be seen. She gets to sit down at her desk and eat her lunch, but we wait until we're told. I got a 10 minute lunch at 5PM yesterday. Sorry, this turned into a bit of a rant, lol.

I mean I personally don't think we have the best facilities for critical patients. That, and when we have a critical patient, the tech/vet are still seeing routine appointments all day. Not exactly best for the patient if people are not near the cages all the time. I'm not sure how other clinics do it, as I've never worked emergency before.

i have not really eaten lunch or dinner the last 3 days as a vet, so your boss is really lucky!

 

[pinkpuppy9]

i have not really eaten lunch or dinner the last 3 days as a vet, so your boss is really lucky!

+

 

[jmo1012]

+

i also dont have a microwave currently, so when i get home at 11pm (unexpectedly) my options are crisps, eat something totally frozen, eat something cold (my fridge is pretty empty though), or wait 30+ minutes for something to cook. i'm sure you can guess which option i choose most often

 

[missdarjeeling]

Even legal definitions vary from state to state, so of course everyone will view it differently. In my old state, NY, there's a distinct legal difference between the practice of medicine and the practice of nursing. There's overlap in the descriptions, to be sure, but the definitions for practice of the profession of nursing as an NP, RN, and LPN all make reference to working in conjunction with a physician. There's also a legal distinction between practice of veterinary medicine and practice of veterinary technology, and the latter is basically defined as performing the duties required to carry out medical orders as prescribed by a licensed vet, under employment or supervision of a licensed vet. The way the laws are written, the division between practicing vet med and vet technology is very clear, but the lines separating practicing human medicine from nursing as an NP, RN, and LPN are a bit more blurred.

My own personal definition of "practicing medicine" would include diagnosis, formulation of a treatment plan, prescription of medications, and surgery, but these definitions are so fluid that it's not really a big deal to expand that to include things that techs do. It's just that the beep boop part of my brain would caution LVTs, RNs, EMTs, etc. against publicly stating that they're practicing medicine.

 

[WildZoo]

s do. It's just that the beep boop part of my brain would caution LVTs, RNs, EMTs, etc. against publicly stating that they're practicing medicine.

You have robot brain parts??

 

[missdarjeeling]

Yeah, that bolded statement pretty much hits the nail on the head. I'm pretty sure we're the only GP in the area that accepts emergencies 24/7 as well. It truly does interfere with our day-to-day, even if the emergency is during regular hours. It seems like its every day that appointments/regular clients get pushed back several hours due to walk-in emergencies or new clients calling down because their dog has been vomiting for a month and NOW has to be seen. There's nothing wrong with caring for sick pets, but when you can see the wheels turning in your bosses eyes, you know she's determining which would bring in more revenue: the emergency, or the 4 routine appointments that are made to wait over an hour to be seen. She gets to sit down at her desk and eat her lunch, but we wait until we're told. I got a 10 minute lunch at 5PM yesterday. Sorry, this turned into a bit of a rant, lol.

I mean I personally don't think we have the best facilities for critical patients. That, and when we have a critical patient, the tech/vet are still seeing routine appointments all day. Not exactly best for the patient if people are not near the cages all the time. I'm not sure how other clinics do it, as I've never worked emergency before.

My GP place doesn't see emergencies after hours, but it's the same story with emergencies during regular hours throwing the whole schedule off kilter. Thankfully, our doctors are pretty good about sometimes telling people who call that they should go straight to emergency when it seems very likely that they'll end up having to transfer the patient anyway. Clients sometimes don't like that but they come around when we remind them it's in their best interest to pay for one exam fee in emergency instead of paying us AND then emergency half an hour later. When they still come to us, things can get crazy, which isn't much of a problem, even though it can be a bit stressful. What sucks is that some of the doctors and office people/management will then get mad at the assistants and techs for being behind when there's literally nothing we could've done better except figure out how to split the doctors in half and create more exam rooms out of toilet paper rolls and bandage tape.

Also agree with your point about facilities. It's the same for my hospital. Even with awesome staff, which includes a doctor who spends half her time doing shifts at emergency, everything's just different, and it's not the best set up for very sick pets. I worked surgery/emergency at a specialty hospital for almost two years, and every patient got checked during treatment time every hour. Regardless of what they were in for, everyone had an attitude check and a full TPR every 4 hours or so, at a bare minimum. More critical patients had more involved treatments and more frequent TPRs, and techs were assigned to blocks where all they were responsible for was making sure treatments were done and patients were doing okay. At my current place, the only in-hospital patients who get checked out regularly are those on fluids, and even then, people only check to make sure that the pump is working properly and that the amount of fluids infused is recorded. When there's a full schedule, that's all anyone has time to do, anyway, so it's not exactly ideal...

You have robot brain parts??

You have no idea how much of a pain it is to go through airport security.

 

[DVMDream]

I agree with you on that. But you were using a parent tossing a kid Tylenol as being equivalent to a technician administering treatment (and therefore, that can't be practicing medicine). All I'm saying is that if a parent giving meds is the same as a tech giving meds, then a parent diagnosing a problem is the same as me diagnosing a problem. Which I think is ridiculous - just like you're saying. But I don't think you can have it just one way (the technician/parent analogy) and not the other (the doctor/parent analogy).



Well, sure. The DVM is a required component of the delivery of medicine. The DVM is essential, and we have a unique role in that there are things <only> we can do (whereas we can pretty much perform all the tasks a CVT can perform, though perhaps not as competently). But that doesn't mean the CVT isn't practicing medicine just because they are more limited in scope. Are you saying that only absolutely required components of the delivery of medicine are practicing medicine? Why make that distinction?

The legal definition is there for a reason: so that we know what the roles are and who to go after legally when things go wrong.

But, just for fun, here's some info from the AVMA's model state practice act as it currently stands (they update it every so often)....

This language, used when defining alternative medicine: "Complementary, alternative, and integrative therapies" means a heterogeneous group of preventive, diagnostic, and therapeutic philosophies and practices that are not considered part of conventional (Western) medicine as practiced by most veterinarians and veterinary technicians."

Interesting that they said "as practiced by most veterinarians and veterinary technicians."

They also say:
"Practice of veterinary medicine" means:

1. To diagnose, prognose, treat, correct, change, alleviate, or prevent animal disease, illness, pain, deformity, defect, injury, or other physical, dental, or mental conditions by any method or mode; including the:
   1. performance of any medical or surgical procedure, or
   2. prescription, dispensing, administration, or application of any drug, medicine, biologic, apparatus, anesthetic, or other therapeutic or diagnostic substance, or
   3. use of complementary, alternative, and integrative therapies, or
   4. use of any procedure for reproductive management, including but not limited to the diagnosis or treatment of pregnancy, fertility, sterility, or infertility, or
   5. determination of the health, fitness, or soundness of an animal, or
   6. rendering of advice or recommendation by any means including telephonic and other electronic communications with regard to any of the above.

I take note of all the "or"s in there. It's not "and". My technicians perform quite a large number of (non-surgical) procedures. They dispense, administer, and apply drugs/medicines/anesthesia/etc (per 2.), they definitely determine the health/fitness/soundness of an animal every time they triage or do a TPR/BP/ECG and make a decision about informing me of the info now vs later, and they render advice/recommendations about every 15 minutes on the phone. That's a lot of the items listed above?

(Obviously, the AVMA's model practice act isn't a functional legal document - it's just meant to serve as a guideline for states. But clearly its authors viewed techs as practicing? I think?)

Seriously, I'm not trying to belabor the point or argue just for the sake of arguing. I think it's interesting to see how you view it. Hope you're not taking it negatively.

That same act then also goes on to specify the "practice of veterinary technology":

1. "Practice of veterinary technology" means:
   1. To perform patient care or other services that require a technical understanding of veterinary medicine on the basis of written or oral instruction of a veterinarian, excluding diagnosing, prognosing, performing surgery, or prescribing.
   2. To represent, directly or indirectly, publicly or privately, an ability and willingness to do an act described in subsection 17(a).
   3. To use any title, words, abbreviation, or letters in a manner or under circumstances that induce the belief that the person using them is qualified to do any act described in subsection 17(a).

Then it goes on to clarify supervision:

1. "Supervision":
   1. "Direct supervision" means a licensed veterinarian is readily available on the premises where the patient is being treated and has assumed responsibility for the veterinary care given to the patient by a person working under his or her direction.
   2. "Indirect supervision" means a licensed veterinarian need not be on the premises; has given either written or oral instructions for treatment of the patient; is readily available by telephone or other forms of immediate communication; and has assumed responsibility for the veterinary care given to the patient by a person working under his or her direction.

And then it goes on to further clarify a distinction between practicing veterinary medicine and veterinary technology here:

No person may practice veterinary medicine or veterinary technology in the State who is not a licensed veterinarian or the holder of a valid temporary permit issued by the Board or a credentialed veterinary technician unless otherwise exempt pursuant to Section 6 of this Act.

And then further section 7 also clarifies veterinary technicians and technologists and specifically states "practice of veterinary technology":



Section 7 — Veterinary Technicians and Technologists

1. No person may practice veterinary technology in the State who is not a veterinary technician or technologist credentialed by the Board.
2. A veterinary technician or technologist who performs veterinary technology contrary to this Act shall be subject to disciplinary actions in a manner consistent with the provisions of this Act applicable to veterinarians.
3. Credentialed veterinary technicians and technologists shall be required to complete continuing education as prescribed by rule to renew their credentials.

Section 8 also clearly makes a distinction between "practicing medicine" and veterinary technology:

Section 8 – Status of Persons Previously Licensed
Any person who holds a valid license to practice veterinary medicine or is credentialed as a veterinary technician in the State on the date this Act becomes effective shall be recognized as a licensed veterinarian or a credentialed veterinary technician and shall be entitled to retain this status so long as he or she complies with the provisions of this Act, including periodic renewal of the license.


I mean, clearly there are two different distinctions within the same document. However, it is clear that a technician can't perform any of their duties without a licensed veterinarian directing what is going on. Also, the act makes it very clear that in order for any "practicing of medicine" to occur a valid VCPR must be established and a veterinary technician can not do that.

I am not saying that veterinary technicians don't do anything medically involved, clearly they do. I just don't agree that they are "practicing medicine". The vet is "practicing medicine" and the vet techs are implementing that medicine and caring for the patient or "practicing veterinary technology".

Though it is interesting that a law website I found mentioned that one can be convicted of practicing veterinary medicine without a license by stating they are a veterinarian or a veterinary technician or assistant. So something else to take into consideration.

Seems like the "practicing medicine" line is rather blurry.

 

[LyraGardenia]

My GP place doesn't see emergencies after hours, but it's the same story with emergencies during regular hours throwing the whole schedule off kilter. Thankfully, our doctors are pretty good about sometimes telling people who call that they should go straight to emergency when it seems very likely that they'll end up having to transfer the patient anyway. Clients sometimes don't like that but they come around when we remind them it's in their best interest to pay for one exam fee in emergency instead of paying us AND then emergency half an hour later. When they still come to us, things can get crazy, which isn't much of a problem, even though it can be a bit stressful. What sucks is that some of the doctors and office people/management will then get mad at the assistants and techs for being behind when there's literally nothing we could've done better except figure out how to split the doctors in half and create more exam rooms out of toilet paper rolls and bandage tape.

Also agree with your point about facilities. It's the same for my hospital. Even with awesome staff, which includes a doctor who spends half her time doing shifts at emergency, everything's just different, and it's not the best set up for very sick pets. I worked surgery/emergency at a specialty hospital for almost two years, and every patient got checked during treatment time every hour. Regardless of what they were in for, everyone had an attitude check and a full TPR every 4 hours or so, at a bare minimum. More critical patients had more involved treatments and more frequent TPRs, and techs were assigned to blocks where all they were responsible for was making sure treatments were done and patients were doing okay. At my current place, the only in-hospital patients who get checked out regularly are those on fluids, and even then, people only check to make sure that the pump is working properly and that the amount of fluids infused is recorded. When there's a full schedule, that's all anyone has time to do, anyway, so it's not exactly ideal...

The GP clinic I work at also doesn't see emergencies after hours, because there's an emergency clinic 10-15 minutes away, although we do see emergencies when we're open. The emergency clinic here isn't 24/7; the're only open after hours and on weekends/holidays. However, we're affiliated with the emergency clinic, so we're able to send referral forms with critical patients so that they don't have to pay the emergency fee, and the vet will call over to say "hey, here's who's headed your way tonight, and here's what we did." A lot of the time we get emergencies in at 5 pm or later, because we're open until 7 Monday through Thursday and most clinics in town close at 5, but it works out in that we're able to stabilize the patient and get treatment going, and then send them to the emergency clinic for overnight care.

It's a really bad day if we get more than 30 minutes to an hour behind on scheduled appointments. We take as many walk-ins/emergencies as we reasonably can, but we make an effort to stick to the schedule as much as possible, and scheduled appointments take priority unless there's a true emergency. If one vet is slammed and the other has time, she'll offer to see the other vet's appointments if the clients don't mind. Very rarely will we let people come in with emergencies if they can't get there before we close. The most I've ever had to stay past close is an hour and 45 minutes, and that's rare, usually because there was an emergency surgery late in the day.

We also could definitely have better protocols for treating emergencies. Even if something happens like a patient seizing or arresting in the exam room, I'm not really trained to deal with that, and I feel like I should be. We try to check on hospitalized patients as often as possible, but yeah, if we're busy it might not happen for a while. It's better during the busier summer months when we have three techs working, and one is dedicated to working in the back (we don't have separate kennel staff), but once summer is over it's usually two techs working, one per doctor that's there, and we take care of things in the back in between appointments.

 

[LetItSnow]

We also could definitely have better protocols for treating emergencies.

It seems like you've got a pretty decent process set up: see them during the day as best you can, and txfr them to your overnight ER at close. If your ER is only open outside business hours, that's the best you can do! It's hard for a GP facility to schedule much in the way of dedicated resources for emergencies because it just doesn't make much sense business-wise.

I'm not knocking GPs that see emergencies in your situation - you're doing the best you can and that's just what the client/animal will have to live with. I just thought it seemed strange for a clinic that has a nearby ER to ... sorta ... see cases after hours by having a vet on-call. Really, their staff, clients, and animals would be better served by just having their after-hour phone message say "For emergencies, please call Name of Nearby ER at xxx-xxx-xxxx. Their address is ....." That gets the (potentially critical) patient into appropriate hands as quickly as possible, rather than messing around with some on-call DVM who may return the phone call immediately or may not and then may end up just sending the patient to the ER anyway. Or worse, the client underplays the situation on the phone and the DVM has them come in, and then the DVM gets there and realizes it needs more resources than a solo DVM with no technician can provide.

But I feel like your set-up makes sense. You mentioned not being trained to deal with a patient seizuring/arresting, but that's ok - what's the first thing you do when that happens? You call for help. There. You just did what you needed to do. A seizuring patient needs immediate treatment, but not on the "next 5 seconds" level; there's plenty of time for a doctor to walk over and give direction. So you call for help and then do what you can to keep the patient safe/comfortable. For an arresting patient, all you need to remember is: 1) Call (calmly, only as loud as necessary to be heard) for help, 2) Start compressions. Everything else can be directed by someone who IS trained.

I think CPR training is smart/necessary for a private practice, but when it comes right down to it - if you actually have a patient arrest on you, call for help and start compressions. That's the most important thing to remember.

 

[LyraGardenia]

It seems like you've got a pretty decent process set up: see them during the day as best you can, and txfr them to your overnight ER at close. If your ER is only open outside business hours, that's the best you can do! It's hard for a GP facility to schedule much in the way of dedicated resources for emergencies because it just doesn't make much sense business-wise.

I'm not knocking GPs that see emergencies in your situation - you're doing the best you can and that's just what the client/animal will have to live with. I just thought it seemed strange for a clinic that has a nearby ER to ... sorta ... see cases after hours by having a vet on-call. Really, their staff, clients, and animals would be better served by just having their after-hour phone message say "For emergencies, please call Name of Nearby ER at xxx-xxx-xxxx. Their address is ....." That gets the (potentially critical) patient into appropriate hands as quickly as possible, rather than messing around with some on-call DVM who may return the phone call immediately or may not and then may end up just sending the patient to the ER anyway. Or worse, the client underplays the situation on the phone and the DVM has them come in, and then the DVM gets there and realizes it needs more resources than a solo DVM with no technician can provide.

But I feel like your set-up makes sense. You mentioned not being trained to deal with a patient seizuring/arresting, but that's ok - what's the first thing you do when that happens? You call for help. There. You just did what you needed to do. A seizuring patient needs immediate treatment, but not on the "next 5 seconds" level; there's plenty of time for a doctor to walk over and give direction. So you call for help and then do what you can to keep the patient safe/comfortable. For an arresting patient, all you need to remember is: 1) Call (calmly, only as loud as necessary to be heard) for help, 2) Start compressions. Everything else can be directed by someone who IS trained.

I think CPR training is smart/necessary for a private practice, but when it comes right down to it - if you actually have a patient arrest on you, call for help and start compressions. That's the most important thing to remember.

We do handle the aspects you mentioned well, but as far as tech preparedness for dealing with really critical animals, I think we could do better. Situations like an animal arresting happen very rarely, being a GP clinic, but even less severe emergencies stress me out precisely because we don't deal with them all the time. I've never been trained on doing CPR or compressions. :/ But mainly I meant what @missdarjeeling was talking about as far as it would be nice to have a regular system of checking and doing treatments on hospitalized patients, rather than just whenever we think of it and get a moment away from appointments.

 

[LetItSnow]

We do handle the aspects you mentioned well, but as far as tech preparedness for dealing with really critical animals, I think we could do better. Situations like an animal arresting happen very rarely, being a GP clinic, but even less severe emergencies stress me out precisely because we don't deal with them all the time. I've never been trained on doing CPR or compressions. :/ But mainly I meant what @missdarjeeling was talking about as far as it would be nice to have a regular system of checking and doing treatments on hospitalized patients, rather than just whenever we think of it and get a moment away from appointments.

Yes, agreed. Any ill patient that is hospitalized should have a treatment plan that includes a monitoring+therapy+nursing plan.

 

[cheathac]

I haven't read through the thread but here's an idea... research? In the diagnostic lab I work in, a researcher was growing breast cancer in mice. We took the tumors and made slides. This would combine the two.

 

[Minnerbelle]

I haven't read through the thread but here's an idea... research? In the diagnostic lab I work in, a researcher was growing breast cancer in mice. We took the tumors and made slides. This would combine the two.

Or more like... neither. You don't really practice medicine (human or veterinary) as a basic science researcher.

 

[cheathac]

I'm not sure what type of researcher she was... you may not practice medicine but you are combining both animal and human health...

 

[Minnerbelle]

I used to do the growing grafted human tumors in mice as well as growing tumors in genetically modified mice thing. While it does in a way combine animal/human health, it is a very focused type of thing and it is very different in practice/motivation than participating in clinical medicine. For someone who is considering working as a PA and vet tech, I don't think mice research (basic science) is really any sort of compromise.

 

[pirateyoho]

What about some kind of field work dealing with zoonotic diseases and public health? While this could veer toward research rather than "practicing medicine," it would certainly tie vet med and human med together, especially if you were also considering the health of the animals involved (as opposed to just viewing them as vectors from a purely human public health perspective).

And you wouldn't need both a DVM and an MD to do it, either.