A survey by VetSurgeon.org has found that the majority of veterinary surgeons disagree that they should be allowed to prescribe medication without ever having seen the animal in person or performing a physical exam.

The survey was conducted following the recent RCVS Council decision to redefine ‘Under Care’ to allow vets to prescribe remotely.

692 veterinary surgeons took part in the survey, 88.7% of which worked in practice, 8.7% worked elsewhere and 2.6% are retired.

42.4% worked in corporate practice, 42.4% at an independent practice (spooky), 9.6% locum and 2.6% at a charity.

94% worked in first opinion practice, 5.7% in referral practice.

When asked: “Do you agree with the RCVS Council decision to allow veterinary surgeons to prescribe medication without having seen / examined the animal in person?”, 78.2% said no, 13.6% said yes and 8.2% said ‘ambivalent’.

This raises an interesting discussion about the role of RCVS Council, which the College has long said is ‘representative of’, but not there 'to represent’ the profession in self-regulating.

By any measure, this decision was not ‘representative of’ the wider body of opinion.

It could be argued that electorates vote for representatives to make more informed decisions than they themselves are able, and certainly MPs have voted in ways that are not representative of the wider body of public opinion.

But this is the veterinary profession. MPs have to represent a wide cross-section of society, some groups of which might struggle to field one working brain cell between them.

By contrast, veterinary surgeons are a highly intelligent, highly educated subset of the population, who you might assume are better qualified to make decisions on matters such as these.

So why this level of disagreement? We asked respondents to select any benefits and drawbacks they think remote prescribing will bring, from a list but with the option for them to write in any we hadn’t thought of.

When asked to select benefits of remote prescribing, the majority (70.9%) selected: “Reduced cost to the pet owner (driving/parking etc)’.

39.3% said it would bring an improvement to vets’ quality of life through more flexible working.

27.5% said animal welfare would be improved through increased access to veterinary services.

14.3% said it would bring an ‘Improved client/vet relationship’.

Of those people who selected a benefit, 49.9% said the biggest benefit of remote prescribing is a reduced cost to the pet owner (driving / parking etc).

Other benefits highlighted in the comments section were

  • Animals will receive care when physical exam is not possible, such as client illness or remote areas.
  • Ease of some chronic conditions if owner stressed by attending clinic
  • Easier access to prescription flea and worm treatments
  • Environmental benefit of not driving to vets unnecessarily
  • For fearful animals that need pre-visit meds
  • Frees up clinical time
  • If only used for existing clients, can improve relationships by offering better access
  • Improved time management so better work life balance
  • Legitimises present working practices
  • Mitigation of veterinary recruitment gap
  • Not having to examine the psychopaths

Notably, in the comments section for the benefits of remote prescribing, out of the 104 comments, 33 actually commented 'no benefit' or negatively.

When asked to select the drawbacks of remote prescribing, 94.3% selected: ‘Harm to animals caused by misdiagnoses and missed diagnoses.

68% said: Worsened client / vet relationship

60.6% said: Threat to independent practice (corporates funnelling clients from online consults to their practices).

Other drawbacks identified by respondents were:

  • Abuse of drugs (getting drugs from multiple sources with the same animal and selling them on)
  • Deskilling of new grads
  • Antibiotic resistance
  • ‘Us and them’ in the profession
  • Clients demanding remote prescription of inappropriate drugs
  • Reduced continuity of care
  • Devaluing a consultation
  • Will increase costs to owner
  • Increased stress for vets
  • May make in house OOH less viable.
  • Loss of trust in the profession as clients get different advice from vets online than off.
  • Overprescribing
  • Reduced compliance for follow up tests
  • Reduced status and respect for the profession

Amongst the written drawbacks, the biggest themes concerned abuse of drugs and antimicrobial resistance.

When those who had selected a drawback were then asked which was the biggest, 83.3% said ‘Harm to animals caused by misdiagnoses and missed diagnoses”

So in simple terms, in weighing up the pros and cons, it’s between the reduced cost to the owner on the one hand, cited by 70.9%, and harm to animal welfare on the other, cited by 94%. And the harm to animal welfare was selected by significantly more vets as the biggest concern, than reduced cost was selected as the biggest benefit.

In other words, vets think remote prescribing will make veterinary care cheaper, but at the overall cost to animal welfare.

British Veterinary Association President Malcolm Morley said: “New technology presents many opportunities to enhance existing veterinary services, with potential benefits for vets, clients and patients.

"However, we recognise there are concerns within the profession, particularly around the potential unintended consequences of the RCVS’s revised guidance on ‘under care’ in relation to animal welfare and access to veterinary services. 

"This survey echoes these concerns as well as supporting the British Veterinary Association’s call for the RCVS to commit to a post-implementation review.”

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