Remote consulting

Welcome to Onswitch’s latest blog, this time on remote consulting.

During the current period of lockdown, we’ll be sharing regular updates that we hope will help your business stay on track during these difficult times. You can also get video updates on our Facebook page, where the team are posting short clips of practical tips, useful information and community welfare advice as and when we think of anything that might help.

Please do let us know if there are subjects you’d like to know more about, and we’ll do our best to oblige – we’re all in this together!

#OneVetTeam

Many of you will be familiar with the 7 Steps, a simple and clear set of guidelines to help vets and nurses deliver superior consults, developed from the Calgary Cambridge model used in medical and veterinary schools across the world. As the name suggests, there are seven steps to a great consult:

1. Prepare yourself
2. Create rapport
3. Ask open questions
4. (Obvious pet / horse examination)
5. Make recommendations
6. Check and signpost
7. Au revoir

Ordinarily these steps are easy to follow, but with veterinary practices now being told to close to all visitors except genuine emergencies, vets are looking at alternative ways to deliver care for patients that we’re not able to be in the same room with. For many practices, the answer is to offer consultation via telephone and video calls. These are still chargeable and effective, but they do require a shift in mindset for the average vet.

Firstly, some practical considerations when sitting down for a video call:

• Make sure you look professional. A scrub top and name badge help you come across as knowledgeable and reassuring, even if you’re not in the consult room. Pyjamas are not OK!
• Consider the backdrop – nothing confidential in view and nothing too busy and distracting behind you
• Frame the shot so your full face is visible and you’re close to the camera, no views of ceilings and the top of your head

Bringing structure to your remote consulting with the 7 Steps

As a robust communication tool, the 7 Steps stands up pretty well when used for remote consulting. It’s still possible to carry out every step except number four, obvious physical exam. Even here there are some workarounds – with advance notice clients can send in pictures of their pet’s condition, they can also move their camera or device across the animal as instructed by the clinician in order to capture helpful visual data, as well as recording heart and respiration rates so that at least the vet has some clinical information to work with.

Accepting that whilst helpful, these are still compromises, it’s even more important to get all the other steps right. Especially number three. We must ask generalised questions in order to collect information and ascertain priority focus for the client:

• When was Bobby last well?
• What has been going on?
• What are you most concerned about?

More important than asking the question is listening to the answers. When remote consulting we must park our preconceptions as to what the client is concerned about, try not to jump three stages ahead and actively listen to what the client is saying. We should be doing this anyway of course, but with remote consulting it’s even more vital as a source of evidence on which to base our diagnosis and treatment.

There’s a short video on our Facebook page if you’d like to watch Alison discussing the broader points of remote consulting from her kitchen. And if that seems like a weird thing to want to do, the truth is we’re all going to be doing a lot more of it in the coming weeks and months!