No exemptions to making decisions based on evidence - Veterinary Practice
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InFocus

No exemptions to making decisions based on evidence

Periscope continues the series of reflections on issues of current concern.

IN my experience vets tend to be
plain speakers. That may or may
not be a good thing but I certainly find it helpful to know exactly
what someone is thinking and to
understand precisely what they
mean after having spoken to them.

Naturally the technical
words that many of
us use on a daily basis
and whose meaning is clear to us can
confuse clients or even prevent them
understanding the whole gist of what
we are trying to tell them. The use of
appropriate words is, therefore, of
huge importance in ensuring that ideas,
thoughts and instructions are correctly
communicated between individuals.

I was encouraged to ponder this by
an article on the BBC website belittling
the use of business jargon and in
particular referring to the morass of
guff spoken by Pfizer’s CEO, Ian Read,
when appearing before a committee of
MPs to explain the proposed takeover
of AstraZeneca.

Phrases such as “putting together
the headcount”, “build a culture of
ownership”, “opportunity to domicile”,
were thrown around, apparently leaving
MPs confused and frustrated.

I was further encouraged to write
about the subject by the launch of
the new logo for RCVS Knowledge,
an independent charity aimed at
promoting the use of evidence-based
veterinary medicine (EBVM).

I was most interested to read
executive director Nick Royle’s
description of the logo: “The new
logo reflects who we are as an
organisation and how willing we are to engage the veterinary profession
in open, collaborative conversations
and projects that bring good-quality
evidence to practices.”

Now I am sorry to sound negative
but to me that is just guff and
management-speak. The logo is pleasant enough but if you have to go
to the trouble of explaining what it
means then I would suggest that you’ve
thoroughly wasted the presumably
thousands of pounds that you’ve paid
some marketing company to go ahead
and develop it.

As you can
see, the logo
consists of a
circle enclosing
a few words and
an empty speech
bubble. Without
Mr Royle’s kind
explanation I
would have been
more likely to
consider that it
reflects one of the
following:

  • That the organisation RCVS
    Knowledge has nothing to say on the
    subject of EBVM;
    that the organisation RCVS
    Knowledge is full of empty thoughts
    on the subject of EBVM;
  • That the organisation RCVS
    Knowledge is waiting for an idea
    to pop into its head before saying
    anything useful on the subject of EBVM. Perhaps I just
    lack imagination but
    working out Mr Royle’s
    interpretation, without his
    words to guide me, would
    have left me floundering
    for many years to come.

There is, of course, a
very serious side to this.
Evidence-based veterinary medicine is
something that is much talked about
but for those at the sharp end of
practice very difficult to keep up with.

There are hundreds of papers
published on veterinary medicine every
day and to keep abreast of these is
a full-time job for a whole team of
analysts and educators. So I applaud
the idea behind the organisation that the logo
represents, just not
the management-
speak message that
accompanies it.

An organisation
such as RCVS
Knowledge is
imploring us to
base our clinical
practice on
evidence. Full
marks for that.
However, in keeping with this very important and
laudable aim, I would ask Mr Royle
to produce the evidence that the new
logo, when seen for the first time by
vets and vet nurses, causes them to
exclaim that “it reflects who RCVS
Knowledge is as an organisation”, etc.

You may think that
I am being a bit picky here but it is surely a
case of “monkey see,
monkey do” and so I
would expect that an
organisation which
promotes an evidence-
base to decision making
would base its own views
and opinions on equally
verifiable evidence.

Taking this a step
further, I would ask the RCVS
disciplinary committee to further
justify its actions in removing
Munhuwepasi Chikosi from the RCVS
Register from an evidential viewpoint.
The reaction to the committee’s actions
from a large number of members
of the profession is evidence that
many (perhaps most vets) would have acted in exactly the same way as Mr
Chikosi if faced with a similar set of
circumstances.

It appears, therefore, that the
decision taken by the disciplinary
committee was not well-based on
the evidence of what an “average
veterinary surgeon” would have done
under the circumstances (one of the
tests used to determine the outcome
of a charge of negligence in a civil
court) but was instead arrived at as a
matter of opinion by those sitting in
judgement.

That being the case, I would humbly
suggest that rather than Mr Chikosi
being forced to follow the proscribed
path to having his name restored –
demonstrating acceptance, repentance
and due humility, plus apologising – the RCVS should in fact eat a little
humble pie, apologise to Mr Chikosi
for the mistake and distress caused,
and restore his name to the Register
forthwith.

Based on the evidence, it should
surely have been the outcome of the
original investigation that there had
been no misconduct and that Mr
Chikosi had acted with great practical initiative in a difficult
and challenging
situation.

So RCVS
Knowldege, well
done for setting out
to help practitioners
improve the treatment
of animals committed
to their care through
the use of the best
treatments identified
from the evidence
available.

Please though, don’t
degenerate into management speak, or believe that the organisation itself (or
the parent RCVS) is exempted from
utilising the evidence base in its own
decision-making processes. Making
decisions based on the evidence is
something that we should all aspire to,
and the RCVS is no less required to do
so in this respect than the rest of us.

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