RANT HERE thread

[orca2011]

Ortho rotation is killing my ability to make it to my gym. Might have to talk to them to see if I can do a flexible month payment plan or something since my schedule is so unpredictable right now.

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[Minnerbelle]

PSA: if you are a vet student, it is very rude and it makes you look like a nincompoop, when you try to advise a veterinarian on how to do something... esp after you had failed at the task yourself.

I was beyond irritated when I had a student criticize everything from my choice of catheter size, choice of vessel, and taping technique... Along with her unsolicited commentary and assessment on everything that was going on (e.g. "Oh that vein doesn't look that bad, you should be able to use that one").

I was PERSON NUMBER 4 to try, and I was able to get it in a single attempt with my choice of catheter size (that the student thought was too big), in a mangled vessel. Clearly, this is not the easiest catheter placement when 2 seasoned tech and vet were unable to place it after the student. It was especially irritating when the student then gave me a condescending "good job," then proceeded to tell me how a different taping technique would be better and how she would feel more secure with it if I would add on another piece her way. This was also a student with less experience in tech skills than I had over a decade ago. Blergh.

 

[Trilt]

PSA: if you are a vet student, it is very rude and it makes you look like a nincompoop, when you try to advise a veterinarian on how to do something... esp after you had failed at the task yourself.

I was beyond irritated when I had a student criticize everything from my choice of catheter size, choice of vessel, and taping technique... Along with her unsolicited commentary and assessment on everything that was going on (e.g. "Oh that vein doesn't look that bad, you should be able to use that one").

I was PERSON NUMBER 4 to try, and I was able to get it in a single attempt with my choice of catheter size (that the student thought was too big), in a mangled vessel. Clearly, this is not the easiest catheter placement when 2 seasoned tech and vet were unable to place it after the student. It was especially irritating when the student then gave me a condescending "good job," then proceeded to tell me how a different taping technique would be better and how she would feel more secure with it if I would add on another piece her way. This was also a student with less experience in tech skills than I had over a decade ago. Blergh.

This is driving me INSANE in my current rotation... other students making snide comments about various rDVMs who refer cases in. Some of the cases are a little frustrating because they seem simple and the client now had to make a significant drive and spend more money, but for most of them we have no idea what sort of history they were given, what the animal looked like at that time, or even maybe whether the client just wants a specialist opinion on something as important as their pet's eyes (what a concept). Ugh. I've never worked with a group of people so vocally critical and it's very frustrating to me, because I damn well know I'm not going to be a perfect vet and don't want bitchy comments following me around.

 

[Minnerbelle]

This is driving me INSANE in my current rotation... other students making snide comments about various rDVMs who refer cases in. Some of the cases are a little frustrating because they seem simple and the client now had to make a significant drive and spend more money, but for most of them we have no idea what sort of history they were given, what the animal looked like at that time, or even maybe whether the client just wants a specialist opinion on something as important as their pet's eyes (what a concept). Ugh. I've never worked with a group of people so vocally critical and it's very frustrating to me, because I damn well know I'm not going to be a perfect vet and don't want bitchy comments following me around.

True that. It's always easy to Monday-morning quarterback. And especially so when you're in an academic environment seeing like 3-4 cases a day, where you take 30 min to take hx and do physical exam and another hour or two to discuss with clinicians and get a workup, AND you have the added info on what progressed after the initial presentation to the rDVM.

When you imagine yourself just 10-12 months later, seeing 10-20 cases a day on your own and needing to make snap decisions within 10 minutes of seeing the patient, it can be really difficult.

 

[LetItSnow]

This is driving me INSANE in my current rotation... other students making snide comments about various rDVMs who refer cases in.

Hahahahahaha. I've referred/transferred plenty of clients to the university and fax'd my records thinking "Sigh. Some student is just going to rip this apart because I didn't do X, Y, or Z ..... if only they had been here to see that I don't have the equipment, didn't have the time, or couldn't convince the owner." I mean, sure, I document my recommendations ..... but people need to be *REALLY* cautious about judging another vet from a distance.

 

[DVMDream]

The only thing that has bothered me with rDVM's is some of the "records" we have been faxed over. Though the vet probably has no idea what the receptionist is printing out and faxing over. So they most likely don't know that many times we are only getting an itemized receipt of things that have happened. It isn't a big deal because I just call and say, "hey can we get bloodwork results, physical exam findings, etc, etc". The only time it becomes annoying is when you get a snippy receptionist who insists that they "already faxed that stuff over" so you have to spend time explaining to them that the itemized receipt is not actually a medical record. So that has more to do with the rDVM support staff.

Otherwise, the rDVM's have been rather great all around. I mean, I have no idea what the hell I am doing but they seem to have done reasonable things but what the hell do I know.

 

[Minnerbelle]

The only thing that has bothered me with rDVM's is some of the "records" we have been faxed over. Though the vet probably has no idea what the receptionist is printing out and faxing over. So they most likely don't know that many times we are only getting an itemized receipt of things that have happened. It isn't a big deal because I just call and say, "hey can we get bloodwork results, physical exam findings, etc, etc". The only time it becomes annoying is when you get a snippy receptionist who insists that they "already faxed that stuff over" so you have to spend time explaining to them that the itemized receipt is not actually a medical record. So that has more to do with the rDVM support staff.

Otherwise, the rDVM's have been rather great all around. I mean, I have no idea what the hell I am doing but they seem to have done reasonable things but what the hell do I know.

Yes, I agree. That is very annoying. Clients always come in with the stupid itemized receipt and think it is the medical record, and a lot of clinics seem to think the same because when you ask them to fax over the full record... that is what you get. There are some clinics out there where that literally is close to the only records they have...

 

[nyanko]

lol there was a low cost clinic near my internship, and they were notorious for 1) sending things over before a doctor even looked at them because they "sounded complicated" and 2) sending over "records" consisting of an invoice with bunch of vaccines and frontline purchases.

edit: also for not telling people that it would like, cost money to go to the e-clinic

 

[Coquette22]

In one of those "Oh ****" moments, I just pulled a big long string of dental floss out of my own cat's butt. She's fine. And if I hadn't seen the damn floss hanging out, I wouldn't have even known it was there.

 

[deleted498041]

Hahahahahaha. I've referred/transferred plenty of clients to the university and fax'd my records thinking "Sigh. Some student is just going to rip this apart because I didn't do X, Y, or Z ..... if only they had been here to see that I don't have the equipment, didn't have the time, or couldn't convince the owner." I mean, sure, I document my recommendations ..... but people need to be *REALLY* cautious about judging another vet from a distance.

I had a conversion with an rDVM about this the other day. Her overall point was that, as veterinary professionals, we shouldn't be so quick to jump on other vets and judge their decision making when we don't know what budgetary constraints they were given, what equipment they did or did not have, or just what the owner authorized at the time. It was definitely good food for thought for entering clinics in August.

 

[battie]

The only thing that has bothered me with rDVM's is some of the "records" we have been faxed over. Though the vet probably has no idea what the receptionist is printing out and faxing over. So they most likely don't know that many times we are only getting an itemized receipt of things that have happened. It isn't a big deal because I just call and say, "hey can we get bloodwork results, physical exam findings, etc, etc". The only time it becomes annoying is when you get a snippy receptionist who insists that they "already faxed that stuff over" so you have to spend time explaining to them that the itemized receipt is not actually a medical record. So that has more to do with the rDVM support staff.

Otherwise, the rDVM's have been rather great all around. I mean, I have no idea what the hell I am doing but they seem to have done reasonable things but what the hell do I know.

Yes, I agree. That is very annoying. Clients always come in with the stupid itemized receipt and think it is the medical record, and a lot of clinics seem to think the same because when you ask them to fax over the full record... that is what you get. There are some clinics out there where that literally is close to the only records they have...

One of my least favorite parts of working at the last clinic I worked at was that the vet who owned the clinic would never authorize us to fax over medical records without the owner coming in to speak to her directly. The other clinic couldn't call and the owner couldn't call. It had to be the owner needed to come in to get the records. . It was awkward for me because I was thrown in as a receptionist with no prior experience, so it was always uncomfortable to have to tell clients that I could not fax in the records until they came in and spoke to the doctor. Meanwhile the relief vet that covered Sundays and Mondays would always refer if she didn't feel comfortable with the situation, which was great. A lot of her clients would get the second opinion/specialty referral and then come back to us for their GP stuff. Not many of the other doctor's clients came back after they finally got their records. :/

 

[pinkpuppy9]

One of my least favorite parts of working at the last clinic I worked at was that the vet who owned the clinic would never authorize us to fax over medical records without the owner coming in to speak to her directly. The other clinic couldn't call and the owner couldn't call. It had to be the owner needed to come in to get the records. . It was awkward for me because I was thrown in as a receptionist with no prior experience, so it was always uncomfortable to have to tell clients that I could not fax in the records until they came in and spoke to the doctor. Meanwhile the relief vet that covered Sundays and Mondays would always refer if she didn't feel comfortable with the situation, which was great. A lot of her clients would get the second opinion/specialty referral and then come back to us for their GP stuff. Not many of the other doctor's clients came back after they finally got their records. :/

Even if the owner was at an emergency clinic? For my work, the doctor had to approve everything being sent out except vaccine history (for boarding/grooming places). I've never worked at a clinic where the doctor needed to know every record request. I think it was because she wanted to know who was going elsewhere.

 

[dyachei]

One of my least favorite parts of working at the last clinic I worked at was that the vet who owned the clinic would never authorize us to fax over medical records without the owner coming in to speak to her directly. The other clinic couldn't call and the owner couldn't call. It had to be the owner needed to come in to get the records. . It was awkward for me because I was thrown in as a receptionist with no prior experience, so it was always uncomfortable to have to tell clients that I could not fax in the records until they came in and spoke to the doctor. Meanwhile the relief vet that covered Sundays and Mondays would always refer if she didn't feel comfortable with the situation, which was great. A lot of her clients would get the second opinion/specialty referral and then come back to us for their GP stuff. Not many of the other doctor's clients came back after they finally got their records. :/

there's a nearby clinic that does this. They instituted a sign for records policy when they started losing business to us (we opened a year ago). It has backfired for them

 

[cowgirla]

One of my least favorite parts of working at the last clinic I worked at was that the vet who owned the clinic would never authorize us to fax over medical records without the owner coming in to speak to her directly. The other clinic couldn't call and the owner couldn't call. It had to be the owner needed to come in to get the records. . It was awkward for me because I was thrown in as a receptionist with no prior experience, so it was always uncomfortable to have to tell clients that I could not fax in the records until they came in and spoke to the doctor. Meanwhile the relief vet that covered Sundays and Mondays would always refer if she didn't feel comfortable with the situation, which was great. A lot of her clients would get the second opinion/specialty referral and then come back to us for their GP stuff. Not many of the other doctor's clients came back after they finally got their records. :/

I worked for a clinic that not only required owners to come in person, they had to fill out a two page form about why they were leaving/where they were going and pay a $10 fee to have records copied. Request had to be approved by the manager or boss before they could be copied, so it wasn't eve n like the owners could come in and leave with their records the same day. Needless to say it made for a lot of cranky people and a clinic that closed its doors less than two years later. Not the greatest business move. This came right after the owner fired the former owner who had started the practice 40 years earlier.... Needless to say his very large following left when he did.

 

[cheathac]

I was offered a position in the fall working in radiation oncology therapy!! I will be working in diagnostic lab as well. Can't believe I will already be applying next cycle.... it's so unreal. Just have to keep my grades up this next year.

 

[LetItSnow]

Even if the owner was at an emergency clinic?

I rarely get - or have time for - records from a client's GP. And honestly, I don't care much. I'm not there to deal with all their problems - just the acute issue. I ask about medical history, allergies, meds, vax status.... But I don't worry much beyond a basic history focused on today's problem. It's not like taking a vet school history.

Exception is a case transferring in directly for critical care - I need at least transfer records. Most clinicians take the time to call and round me in on their cases though, which I feel is just good medicine. Gives us a chance to talk through expectations, tx plan, what the client knows or doesn't know, etc.

 

[bunnity]

I rarely get - or have time for - records from a client's GP. And honestly, I don't care much. I'm not there to deal with all their problems - just the acute issue. I ask about medical history, allergies, meds, vax status.... But I don't worry much beyond a basic history focused on today's problem. It's not like taking a vet school history.

Exception is a case transferring in directly for critical care - I need at least transfer records. Most clinicians take the time to call and round me in on their cases though, which I feel is just good medicine. Gives us a chance to talk through expectations, tx plan, what the client knows or doesn't know, etc.

What about cases that went to the rDVM same day and then transfer for higher level of care? When I worked in private practice and had to stabilize-and-transfer cases, I took a lot of care with making sure records made it to the emergency clinic so they would know what drugs I'd given, what bloodwork looked like before fluids, etc. I'd hate to spend all that time if it wasn't useful to the emergency vet.

 

[Gwenevre]

I got sunburnt on Saturday. Didn't think it was too bad, but I'm absolutely ready to jump out of my skin it itches so much!!

 

[pinkpuppy9]

I rarely get - or have time for - records from a client's GP. And honestly, I don't care much. I'm not there to deal with all their problems - just the acute issue. I ask about medical history, allergies, meds, vax status.... But I don't worry much beyond a basic history focused on today's problem. It's not like taking a vet school history.

Exception is a case transferring in directly for critical care - I need at least transfer records. Most clinicians take the time to call and round me in on their cases though, which I feel is just good medicine. Gives us a chance to talk through expectations, tx plan, what the client knows or doesn't know, etc.

I'm thinking more about the "saw the GP a few days ago for this, and today things took a bad turn" kind of thing, not exactly a referral. I mean, it makes sense that most e-clinics never see full records since a lot of emergencies happen after hours. We do get a lot of calls during hours that say "so and so is here, the dog broke out in hives, yada yada."

 

[Innerspeaker]

So someone sent the CREEEEPIEST, disturbing voice mail to our clinic at about 3 AM yesterday morning. Whoever it was conveniently left his name AND call back number for us, so the doctor decided out of curiosity to contact it that afternoon. Dude who answered frantically denied everything.

Some people . . .

 

[dyachei]

So someone sent the CREEEEPIEST, disturbing voice mail to our clinic at about 3 AM yesterday morning. Whoever it was conveniently left his name AND call back number for us, so the doctor decided out of curiosity to contact it that afternoon. Dude who answered frantically denied everything.

Some people . . .

maybe it was ambien induced?

 

[Innerspeaker]

maybe it was ambien induced?

Not familiar with Ambien side effects, but the person in the voicemail did sound kinda drunk/high. We figured he was either on something, or someone hijacked his phone pretending to be him. :/

 

[dyachei]

Not familiar with Ambien side effects, but the person in the voicemail did sound kinda drunk/high. We figured he was either on something, or someone hijacked his phone pretending to be him. :/

having been on ambien for insomnia before....you sound very high, have no idea what you are saying and don't recall it the next day. this is the same med where some people were sleep eating.

I only took it a few times and sent multiple messages to people that I had no recollection of messaging.

 

[Innerspeaker]

Ah, I see! That's interesting.

 

[twelvetigers]

having been on ambien for insomnia before....you sound very high, have no idea what you are saying and don't recall it the next day. this is the same med where some people were sleep eating.

I only took it a few times and sent multiple messages to people that I had no recollection of messaging.

Ah, I see! That's interesting.

Not just sleep eating, like... you hate eggs, but you drive to the store, buy a dozen, then cook them up and eat them all, do the dishes, and go back to bed. Then wake up the next day with no recollection of any of it.

 

[Minnerbelle]

What about cases that went to the rDVM same day and then transfer for higher level of care? When I worked in private practice and had to stabilize-and-transfer cases, I took a lot of care with making sure records made it to the emergency clinic so they would know what drugs I'd given, what bloodwork looked like before fluids, etc. I'd hate to spend all that time if it wasn't useful to the emergency vet.

Ditto. Now that I'm on the rDVM side of things, if I think the pet could end up in the ER, I make copies of the records/rads and give it to the owner to hold on to, or fax over an FYI set of records to the ER i have a great relationship with. They can also see our rads.

If my clients just spent $600 on a workup with me during the day, they better not be repeating the same things unless absolutely indicated.

 

[jmo1012]

Ditto. Now that I'm on the rDVM side of things, if I think the pet could end up in the ER, I make copies of the records/rads and give it to the owner to hold on to, or fax over an FYI set of records to the ER i have a great relationship with. They can also see our rads.

If my clients just spent $600 on a workup with me during the day, they better not be repeating the same things unless absolutely indicated.

its such a bummer to be on the receiving end without that workup, and not knowing what was truly done and if it was "negative" at the time. i wish more people had your mentality! it also stinks when the owner cant remember and i think that it would be critical for a case one way or the other if the answer was yes or no.

 

[dyachei]

its such a bummer to be on the receiving end without that workup, and not knowing what was truly done and if it was "negative" at the time. i wish more people had your mentality! it also stinks when the owner cant remember and i think that it would be critical for a case one way or the other if the answer was yes or no.

I expect you to yell at me if I ever send you a case like that...

 

[LetItSnow]

What about cases that went to the rDVM same day and then transfer for higher level of care? When I worked in private practice and had to stabilize-and-transfer cases, I took a lot of care with making sure records made it to the emergency clinic so they would know what drugs I'd given, what bloodwork looked like before fluids, etc. I'd hate to spend all that time if it wasn't useful to the emergency vet.

I mention those in "case transferring directly in for critical care."

Absolutely I appreciate (and need) records for those cases. Most clinicians I deal with also call to talk through the case of they're transferring me a more serious case.

I treat those almost as more of a tag-team doctoring so that I can better support the rdvm's relationship with their client. That said, some rdvm's can get too bossy and forget that I have my own license to protect and I have to do what I feel is best, within reason. It's a balancing act.

 

[LetItSnow]

Ditto. Now that I'm on the rDVM side of things, if I think the pet could end up in the ER, I make copies of the records/rads and give it to the owner to hold on to, or fax over an FYI set of records to the ER i have a great relationship with. They can also see our rads.

If my clients just spent $600 on a workup with me during the day, they better not be repeating the same things unless absolutely indicated.

I will often repeat diagnostics. I avoid it when possible - esp blood work - but frequently repeat rads because often I don't get them or they are poor quality bordering on non-diagnostic. But, if I do it I generally either don't charge the client or I charge them a substantially reduced cost for that particular diagnostic. Blood work I really only repeat if I'm suspicious of an error, there's reason to expect a change, or I need addl values that weren't done.

Generally I avoid repeating diagnostics - that's usually no good for anyone and I can better use that money for care or other dx. But I absolutely will do it if I feel it is necessary.

 

[jmo1012]

I expect you to yell at me if I ever send you a case like that...

i'm always grateful for clients who at least bring me an itemized bill. helps me know that your sick pet wasnt vaccinated today, it was actually given cerenia i probably wasnt all that far from you when i spent last month in clearwater

 

[NStarz]

When the pharmacist fills a script for 20 pills instead of 120 (20 pills will last me a total of 5 days so I need to go back again this week). I had no time to visit the first time. Grrrr.... And they're going to give me grief about it because the script says they filled 120.

 

[nyanko]

I will often repeat diagnostics. I avoid it when possible - esp blood work - but frequently repeat rads because often I don't get them or they are poor quality bordering on non-diagnostic. But, if I do it I generally either don't charge the client or I charge them a substantially reduced cost for that particular diagnostic. Blood work I really only repeat if I'm suspicious of an error, there's reason to expect a change, or I need addl values that weren't done.

Generally I avoid repeating diagnostics - that's usually no good for anyone and I can better use that money for care or other dx. But I absolutely will do it if I feel it is necessary.

When I was on ER during my internship, I did the same, if I had to repeat rads or take additional views because the primary DVM only took a lateral whatever, for example, I would not charge the client or would charge way less.

 

[battie]

Even if the owner was at an emergency clinic? For my work, the doctor had to approve everything being sent out except vaccine history (for boarding/grooming places). I've never worked at a clinic where the doctor needed to know every record request. I think it was because she wanted to know who was going elsewhere.

She generally tried not to refer to emergency clinics because we have extended hours and she's willing to take any emergency if she's in the building. I actually can't think of a single time we referred someone to an emergency clinic over us in the six months I was there, if the owner was there. If the relief vet was there, the head tech was way more open to sending people to emergency clinics if it was something intense, and the relief vet was more than willing to let her. Otherwise, we took anything and everything. Sometimes I didn't think it was a benefit to the pet.

there's a nearby clinic that does this. They instituted a sign for records policy when they started losing business to us (we opened a year ago). It has backfired for them

This clinic was only open for a year and a half when I started and we didn't have very many regular clients. Lots of new clients and I think it was because this vet had practices (like this) outside the norm for the area.

I worked for a clinic that not only required owners to come in person, they had to fill out a two page form about why they were leaving/where they were going and pay a $10 fee to have records copied. Request had to be approved by the manager or boss before they could be copied, so it wasn't eve n like the owners could come in and leave with their records the same day. Needless to say it made for a lot of cranky people and a clinic that closed its doors less than two years later. Not the greatest business move. This came right after the owner fired the former owner who had started the practice 40 years earlier.... Needless to say his very large following left when he did.

I won't be surprised if this clinic goes under eventually. There isn't a consistent clientele and the turn over rate is horrible. I had the second longest run there after the head tech who had been there for a year and a half. Otherwise, we went through four techs and six assistants while I was there. Two other assistants left a few months after I did and now there is just one doctor and two techs. :-/.

If that experience ever taught me anything, it is a few little things I wouldn't want to have to do as an owner.

 

[Jess Monster]

I fractured a bone in my ankle on Friday and have to wait until next Monday for my ortho appointment. I'm finishing up moving from one place to another so it's very hard for me to completely avoid bearing weight on my leg.

I usually catch myself well, but this time my center of balance was completely thrown off and my ankle rolled too far when I heard a loud audible SNAP before I went down hard on my opposite knee. Frankly, I'm pissed off at my soon-to-be old rental company for not maintaining the concrete around my apartment. Large holes in the concrete at the bottom of the stairs are not exactly conducive to an ankle friendly environment.

Based on what the doctor said in the ER it may not be a bad fracture so I'm hoping it won't keep me from driving for too long.

 

[pinkpuppy9]

She generally tried not to refer to emergency clinics because we have extended hours and she's willing to take any emergency if she's in the building. I actually can't think of a single time we referred someone to an emergency clinic over us in the six months I was there, if the owner was there. If the relief vet was there, the head tech was way more open to sending people to emergency clinics if it was something intense, and the relief vet was more than willing to let her. Otherwise, we took anything and everything. Sometimes I didn't think it was a benefit to the pet.



This clinic was only open for a year and a half when I started and we didn't have very many regular clients. Lots of new clients and I think it was because this vet had practices (like this) outside the norm for the area.



I won't be surprised if this clinic goes under eventually. There isn't a consistent clientele and the turn over rate is horrible. I had the second longest run there after the head tech who had been there for a year and a half. Otherwise, we went through four techs and six assistants while I was there. Two other assistants left a few months after I did and now there is just one doctor and two techs. :-/.

If that experience ever taught me anything, it is a few little things I wouldn't want to have to do as an owner.

And I thought my ex-clinic was bad...2 techs, 2 receptionists gone in 6 months. Not to mention the fact that we interviewed 8 or so people for my assistant position and like 10 for a receptionist spot. All but one either turned us down or no-showed for their first day haha. People can tell when they're walking into a sh*tshow.

 

[DVMDream]

Cancer sucks, it can go die in a fire.

 

[LetItSnow]

She generally tried not to refer to emergency clinics because we have extended hours and she's willing to take any emergency if she's in the building. I actually can't think of a single time we referred someone to an emergency clinic over us in the six months I was there, if the owner was there. If the relief vet was there, the head tech was way more open to sending people to emergency clinics if it was something intense, and the relief vet was more than willing to let her. Otherwise, we took anything and everything. Sometimes I didn't think it was a benefit to the pet.

Unless "extended hours" means "overnight" there are still cases that should be referred. I feel sick when I think about animals in critical shape sitting in a kennel unattended overnight. I mean, if the client can't afford it or doesn't want to pay - fine! But the client should at least be given the option of better care.

Why does your head tech make the decision about referring? That is not a tech's job.

I had a tech get on my case for hospitalizing a HBC because it was doing great, in her opinion (it was an annoying dog, and she understandably didn't want to watch it all night). In my opinion it was, too. But it had gotten whacked on the head and had head injuries to prove it, so I'd be negligent if I didn't talk to the owners about head trauma and recommend monitoring. Would I have lost sleep if it went home? Not at all. But techs shouldn't be making that decision.

 

[hedgiehog]

I was hooking up my new countertop dishwasher today and broke something off my faucet. While trying to fix the faucet lightning struck really close to my trailer. Lost power in half my house. Thankfully all the appliances and lights came back on after fidgeting with the power boxes. Turns out the modem and router underwent a surge that came up through the wire. While going out to buy a new modem/router and food my car battery died and I was stranded in the rain. Get home and set up the new router stuff and there's a problem. Mediacom thinks the lightning hit something outside so they are sending someone to work on it. The earliest available appointment is August 4th. I'm due for some good luck now.

 

[jmo1012]

Unless "extended hours" means "overnight" there are still cases that should be referred. I feel sick when I think about animals in critical shape sitting in a kennel unattended overnight. I mean, if the client can't afford it or doesn't want to pay - fine! But the client should at least be given the option of better care.

Why does your head tech make the decision about referring? That is not a tech's job.

I had a tech get on my case for hospitalizing a HBC because it was doing great, in her opinion. In my opinion it was, too. But it had gotten whacked on the head and had head injuries to prove it, so I'd be negligent if I didn't talk to the owners about head trauma and recommend monitoring. Would I have lost sleep if it went home? Not at all. But techs shouldn't be making that decision.

we get pressured by the techs and office managers to make questionable medical decisions as interns and its getting really frustrating. i absolutely value their opinions, but ultimately it's my medical license, and ultimately i'm the one that learned the nitty gritty details and have to live with the decisions.

so many sad cases this week, sigh.

 

[battie]

Unless "extended hours" means "overnight" there are still cases that should be referred. I feel sick when I think about animals in critical shape sitting in a kennel unattended overnight. I mean, if the client can't afford it or doesn't want to pay - fine! But the client should at least be given the option of better care.

Why does your head tech make the decision about referring? That is not a tech's job.

I had a tech get on my case for hospitalizing a HBC because it was doing great, in her opinion. In my opinion it was, too. But it had gotten whacked on the head and had head injuries to prove it, so I'd be negligent if I didn't talk to the owners about head trauma and recommend monitoring. Would I have lost sleep if it went home? Not at all. But techs shouldn't be making that decision.

I completely agree that cases that need monitoring should be sent elsewhere, particularly since we have the most well known emergency hospital in Colorado 15 minutes away. There were several occasions where I asked if the clinic owner minded if I stopped by to check on dogs/cats that were over-nighters because I wasn't sure the decision having them stay was the best decision. I can think of two cases immediately off the top of my head where is was not to the benefit of the pet to stay with us, and both ended up passing away. One hit me hard because she died overnight while at our clinic and I had checked on her the night before. It was a case where our clinic owner started treatment, but a relief vet (who had never worked with us before) was the one that did most of the care throughout the weekend. Her first question was why was this dog with us and not down the street. All the head tech could say was that the clinic owner convinced the owner to stay with us.

As far as the head tech making decisions like referrals, I think it mostly came from the clinic owner pretty much only trusting the head tech, and only marginally at that. The relief vets were all told from the get go to follow Susan's lead on "hospital policy". The hospital policy was to keep as many clients with us. Granted, Susan didn't follow that hard core when the doctor wasn't there. She would rather refer people to the emergency clinic down the road or to places like PetAid. Sadly, there were points where I think she made better decisions for clients we never even saw than had they actually come in the door to see us and talked to the clinic owner. I agree that the techs shouldn't be the ones making the decision for who to send to a referral, but I do think in a lot of cases that came through our phone line, that tech did do right for some clients by referring them elsewhere. I understand that the clinic has to make money. Running a business is hard, especially a baby practice. But I didn't agree with several of the decisions where the clients weren't referred elsewhere so that we were the base medical provider for that procedure.

Edited a few times cause English is hard....

And with the clinic owner there, I wasn't allowed to even refer people to places if we didn't do that sort of pet (so like sending a snake owner to the emergency clinic down the street because they have an exotics vet during the day several days a week). She said that was the responsibility of the pet owner to find that information and that we were not free advertising for that other hospital.

 

[LetItSnow]

I understand that the clinic has to make money. .

For sure. But that shouldn't be to the detriment of the patient. It's not like it approaches malpractice or something like that .... I'm not leveling that sort of "accusation." But if you have a critical care patient, and a critical care facility nearby, and you keep the patient unattended overnight without at least <offering the option> to the owner of going overnight at the critical care facility .... I feel like that's prioritizing making money over patient welfare. I can't speak for other ER doctors, but I try REALLY HARD to facilitate the rdvm's relationship with the client. I always speak supportively of the rdvm. I stick with their treatment plan so long as it's reasonable, even if it's not what I would necessarily do. And I never refer for more advanced care without talking to the rdvm first (unless it's one that from past experience I know is happy to have me do that). So from where I'm sitting, it's a shame for a clinic to not even offer a client the chance to take their animal to a facility like mine if they could benefit from it.

 

[wheelin2vetmed]

Not familiar with Ambien side effects, but the person in the voicemail did sound kinda drunk/high. We figured he was either on something, or someone hijacked his phone pretending to be him. :/

This girl I dated took ambien. She woke up one night and baked an entire bag of potatoes; didn't remember a damn thing the next morning.

 

[battie]

For sure. But that shouldn't be to the detriment of the patient. It's not like it approaches malpractice or something like that .... I'm not leveling that sort of "accusation." But if you have a critical care patient, and a critical care facility nearby, and you keep the patient unattended overnight without at least <offering the option> to the owner of going overnight at the critical care facility .... I feel like that's prioritizing making money over patient welfare. I can't speak for other ER doctors, but I try REALLY HARD to facilitate the rdvm's relationship with the client. I always speak supportively of the rdvm. I stick with their treatment plan so long as it's reasonable, even if it's not what I would necessarily do. And I never refer for more advanced care without talking to the rdvm first (unless it's one that from past experience I know is happy to have me do that). So from where I'm sitting, it's a shame for a clinic to not even offer a client the chance to take their animal to a facility like mine if they could benefit from it.

Totes agree. It's critical for the welfare of the patient. While ultimately not the main reason I left that clinic, keeping patients we should have referred is one of the biggest reasons I started not wanting to be at that clinic any more and why I didn't return there when I needed a job again.

 

[Minnerbelle]

This girl I dated took ambien. She woke up one night and baked an entire bag of potatoes; didn't remember a damn thing the next morning.

I wonder if my bf would bake me potatoes too if I gave him some ambien. Hmmm

 

[wheelin2vetmed]

I wonder if my bf would bake me potatoes too if I gave him some ambien. Hmmm

Nothing says I love you like 20 pounds of baked potatoes.

 

[dyachei]

I wonder if my bf would bake me potatoes too if I gave him some ambien. Hmmm

i think I messaged an SDNer while I was on it. I have no recollection of that

 

[orca2011]

Got back from CrossFit exhausted and looking like someone dumped a bucket on me to find the power out. All I want is AC. luckily it's a bit cooler outside.

 

[Coquette22]

Nothing says I love you like 20 pounds of baked potatoes.

Oh you've been to PEI?

 

[Doktor Timo]

It's absurd how much time gets wasted at this school running around trying to find which service has the patient's actual physical record because our computer system is from roughly 1850 and isn't capable of holding an entire record. It's 2015, there has to be a better way.