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InFocus

A talk about telemedicine

“I believe virtual care will help the veterinary community meet the needs of the growing number of pet owners while ensuring clinics are used for the most-needed cases and hands-on pet treatments”

In a recent interview with us, Dr Rachel Lord, VetMB, MRCVS, answers questions about her choice to begin practising veterinary telemedicine and the changes, challenges and benefits she has experienced along the way.

Dr Rachel Lord

What led you to start practising telemedicine?

I started practising telemedicine with Vetster to make veterinary care more accessible and convenient for my clients. I believe virtual care will help the veterinary community meet the needs of the growing number of pet owners while ensuring clinics are used for the most-needed cases and hands-on pet treatments.

Do you use the platform full-time, or do you still do face-to-face in-practice work? Do you think the two types of practice can fit together?

I still maintain my face-to-face practice, where I enjoy general consulting, cardiology and dentistry and regularly treat dogs, cats and other small mammals like rabbits and guinea pigs. I see virtual care as complementary to in-clinic care by providing pet parents with ongoing support for their pet’s care.

I see virtual care as complementary to in-clinic care by providing pet parents with ongoing support for their pet’s care

What are the most common cases clients use telemedicine for?

Virtual care assists with a wide range of common concerns, including rashes, allergies, vomiting/diarrhoea, behavioural concerns, minor cuts and wounds, dietary concerns and nutritional advice, new-pet advice and training, and general pet health and wellness.

How does telemedicine differ from in-practice care?

In my telemedicine practice I have a specific focus on general health advice, second opinions and possible over-the-counter recommendations. I also offer advice related to medications, treatments and diagnostics that owners may be pursuing with their in-clinic vet.

Our prescribing ability is obviously limited at the moment, but instead we offer clients a triage system when they are unsure if they need to visit a veterinary clinic. Sometimes I advise that they do need a trip to a clinic, but often I am able to offer them advice that negates the need for an emergency consultation.

The fact we have a longer time per consultation in telemedicine, if necessary, means that we can have a more in-depth discussion with the owner than is often possible in the clinic setting

I also think the fact we have a longer time per consultation in telemedicine, if necessary, means that we can have a more in-depth discussion with the owner than is often possible in the clinic setting.

Are there any cases that are more difficult to treat or cases which telemedicine isn’t appropriate for?

I do sometimes see cases that obviously need an in-clinic examination, such as breathing abnormalities or abdominal pain, for example. But I can triage these and advise that a physical examination is necessary for the well-being of the animal.

Does virtual care mean you’ve had to change your approach to client interactions?

I like interacting with clients, so I don’t think I have changed my approach. However, I am able to spend more time discussing complicated conditions now.

How have you found clients’ reactions to telemedicine? Are these any different from what you see in practice?

I have seen a very positive reaction to telemedicine. Most clients are extremely grateful for the help I am able to give them, whether this is for a second opinion on their animal’s condition, triage to assess if they need to visit an emergency clinic out of hours or simple advice on common conditions such as diarrhoea or a sneezing cat.

What benefits has telemedicine provided?

For me, telemedicine has provided a separate source of income that I can tap into whenever I am not in the clinic. And for clients, it has provided an extremely useful alternative to an in-clinic consultation.

Through telemedicine, I can see quite a few cats that are terrified of going to the vet, and the owners are so grateful that they can get advice without having to cause the cat undue trauma

We are so busy as vets these days that I often see patients for non-urgent consultations that cannot get a consultation at their regular vet for three weeks. Through telemedicine, I can see quite a few cats that are terrified of going to the vet, and the owners are so grateful that they can get advice without having to cause the cat undue trauma.

Has the transition to telehealth raised any challenges? If so, how have you managed to overcome them?

On top of not being able to prescribe POM-V drugs via telemedicine, there are certain instances when an in-person examination is necessary. Often the history is enough to make an educated guess about what is going on, but there are some instances where you really need to lay your hands on the animal. In these cases, I simply advise that the animal needs a physical check over at a brick-and-mortar practice.

Often the history is enough to make an educated guess about what is going on, but there are some instances where you really need to lay your hands on the animal

What do you do if there is a problem with the technology, for instance if you can’t connect or if something goes wrong on the platform?

The high-quality video calling on the platform I use is quite secure, so I haven’t had issues connecting with clients so far. If I happen to get a lot of feedback through the speaker, I simply phone the owner and continue the discussion over the phone.

What advice would you have to vets or nurses interested in virtual care?

Go for it! It’s a very rewarding option. I really enjoy the interactions I have with my online clients. When I’m not so constrained by the pressures of in-clinic work, I feel I can offer very good service in my own time and at my own pace.

When I’m not so constrained by the pressures of in-clinic work, I feel I can offer very good service in my own time and at my own pace

What is the most rewarding thing about telemedicine?

Getting a lovely review and knowing that you have truly helped a client and their animal is the most rewarding part of virtual care.

What has been the most memorable case you’ve treated using the platform?

I have had many lovely cases, but I spoke to a client recently who had a pruritic dog that was just being given glucocorticoids whenever the owner went to his vet. I was able to discuss the full step-by-step work-up of a pruritic dog – a discussion that takes a lot of time and often is just not able to be done in a 10- to 15-minute consultation. This was a perfect consultation to be done via telemedicine.

Rachel Lord

Dr Rachel Lord, VetMB, MRCVS, is a veterinary surgeon from Bedford, England. She recently joined veterinary telemedicine marketplace Vetster.


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