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20 Years of Change…

20 Years of Change…

I qualified as a vet in 1992, twenty years ago. I can hardly believe it, how the years have flown by and how things have changed within the profession. My first position as a fresh faced, wet behind the ears 22 year old, was at a very traditional, well established small animal practice in Edgbaston, Birmingham. Back then, I remember going for the interview in my newly purchased for graduation, pinstripe suit, and being amazed that I’d got offered the job straight away. I’d only qualified several weeks prior to starting and the fear as a new graduate seeing clients, operating and putting pets to sleep for the first time still lives with me.

If a pet is presented with an ailment, a diagnosis would be attained by taking a decent history and performing a thorough clinical examination. The senior partner at the practice would remind me on a daily basis, that using my fingers and hands were the best diagnostic tool I could ever possess, and that there was hardly a need for new fangled blood tests. Rarely did we take blood samples, or perform medical investigations,or send tricky cases to referral centres (mostly because back then they were few and far between) yet the practice was very very successful and we’d often have people queuing outside the door waiting to come in just as the clinic was due to close at 7pm. I’ve often thought to myself, why this was. There was no marketing (no internet, therefore no practice website, Facebook, Twitter or Blog), the signage was poor, there was parking for maybe 5-6 cars max, and the fees were higher than average for the area.

It came to me several years later whilst working in London why this practice did so well. Trust in the practice and experience is everything to the animal owner. You could potentially be the worst vet in the world with no clinical acumen, yet because of your bedside manner and empathy, then clients would flock to you from miles afar. Now I’m not saying that the senior partner had no clinical ability- that he had in spades, but he also had a wonderful connection with client and pet which was was why he was so successful.

Of course times have changed, and long gone are the days when one could just hang your plate up and wait for the clients to come in their droves. Practice promotion is important, as is signage, the downturn in economy and recession and increased competition have all had a major impact on how we run our business, but even 20 years ago as it is now, it is all about the client experience.

Competition of course is a healthy thing to have. It means that as a practice, City Road veterinary centre in Truro is constantly evolving and having to think of new ways to stay ahead of the game. Novel ways to promote ourselves, to attract new clients and to keep hold of the clients that we might otherwise neglect. But there is competition and there is competition. When I qualified, at Bristol university in 1992 there were 40 of us in my year. Now there are several hundred new graduates per year. It is the same across the board in all Vet Schools in the UK, and with new Vet Schools opening up, there is going to be more qualified veterinary surgeons this year than ever before.

The main problem with this is that there’s not going to be enough jobs for graduates. If they are fortunate to get a position then I suspect that, it will be a while before that graduate has the necessary experience or confidence to flourish. What will happen, if one isn’t able to get a position as a vet? Will that mean taking a lower paid position within a practice ( e.g as Veterinary technician or Nurse) or offering one services for no pay? How is one then going to be able to pay back the 45K+ tuition fees accrued over a 5 year course, not to mention cost of living loans and fees.

The lack of job could lead to new graduates setting up practice either privately or as is becoming more common by becoming a joint venture partner within the retail park corporate leading to further competition, squeezing the traditional independent veterinary practice further. The general consensus amongst the veterinary profession is that this will lead to a downward spiral in a “race to the bottom” as practices try to undercut each other in order to gain new clients. It’ll be a lose-lose situation all round because as veterinary prices drop so will the standards as corners are cut, animals suffer, staff pay suffers and so on.

As a newly qualified graduate in 1992, I was very fortunate to be offered a position in a very busy practice which allowed me to get up to speed very quickly. I had the chance to perform many operations which new and recently qualified graduates these days may never get the chance to do. This is mostly because of the increasingly popular “referral” culture that many veterinary surgeons possess these days, and possibly the fear of litigation in case it doesn’t go exactly to plan . I hear that in other parts of the country especially the South- East, performing a CT or MRI scan is deemed very much normal protocol as part of a normal medical investigation. It’s no wonder that Insurance premiums are increasing exponentially.

In 1992, specialist clinics were rare, veterinary illness insurance to cover the cost was in it’s infancy , so if one had a relatively involved procedure, it was a case of either the primary vet performing it or putting the pet to sleep.

In Cornwall, there are a few referral clinicians, but there’s certainly no CT or MRI scanning going on. In a way, the ethos of practicing veterinary medicine at City Road veterinary centre reminds me of my first job all those years ago. Yes we do run blood tests, take XRays,and perform ultrasonography, but we also rely on our hands, fingers, senses and experience as much as anything in order to diagnose.

Rosie …

I mentioned in my last blog that I am still seeing new conditions on a weekly basis. I saw Rosie in our Sunday morning clinic just before New Year. She was presented with her left eye half closed and in some discomfort. On closer examination, I saw that a large 5mm long thorn had penetrated through her cornea, had broken off and was floating in the anterior chamber of the eye. I gave Rosie some eye medication and pain relief and arranged to see her the following morning.

Left: Thorn visible to right of blade | Right: Eye 3 days post op

One of the many benefits of the internet is being able to gain information very quickly (although when clients come through the consulting room clutching reams of printed information and self diagnosing their pet’s ailments, I often despair), so I was able to research how I might be able to retrieve this thorn, never having performed a similar operation before. More importantly, I emailed my very good friend, Simon Hayes, who is an amazing veterinary ophthalmologist in North London. He gave me very concise, clear instructions on how to incise into the eye, remove the thorn, and suture everything up again. (Not as simple as I’ve described).

On New Years eve, I discussed with Rosie’s owners, the treatment options available, and possible referral to a specialist for the procedure to be performed there. For the owners that was not an option financially so we agreed to “have a go” at City Road, bearing in mind that if things didn’t go to plan, Rosie might have to lose her eye.Rosie’s eye was operated on that morning. I took a photo of her eye 3 days later and she is doing incredibly well. Put it this way, I am astounded how good the eye looks, but I might never have even attempted performing the operation at all if I wasn’t given the chance to gain the experience I did in my first job 20 years ago.

Until next time….