How good is veterinary telemedicine? These are the thoughts of a layperson. It is useful to examine this expanding aspect of veterinary practice. I’m sure that both veterinarians and clients like the idea of veterinary telemedicine. Clients will like it because they don’t have to go to a surgery which is nearly always problematic (anxious animal, parking problems?). And veterinarians might like it because they don’t have to deal with troublesome animals and risk being bitten. There are other benefits to conducting veterinary telemedicine such as improved efficiency and speed of treatment plus great convenience but there are also limitations. This is the key point to make.
There is a place for telemedicine in a veterinary practice but it seems to me, an unqualified person, that there is no substitute for seeing a patient in a consultation room combined with touching and feeling (palpations) the patient.
Proper physical examination
Veterinarians know the worth of a proper physical examination of an animal patient and it is described as the most important practical skill for a clinician to develop. It can detect minor abnormalities that were not apparent to the owner. Sometimes an owner can make a presumption that their companion animal is suffering from a known disease and therefore there is no need to re-examine the animal. This might result in an oversight because the dog or cat may have developed a new disease which has been hidden from the owner and the owner is unaware of it.
I have a PDF file which sets out how a physical exam can be conducted by veterinarian and it is extensive:
Filter of animal’s owner
This is the problem, perhaps the major problem, with veterinary telemedicine; the veterinarian has to go through the filter of the animal’s owner. The veterinarian is reliant upon the owner to tell them about health symptoms and the illnesses of their animal while the veterinarian assesses that information either through a zoom call i.e. visually, or through a telephone conversation.
It is this indirect assessment of an animal’s health and potential health problems which is the weakness. Even the best owners may have prejudged the situation because of their limited knowledge. The owner may not be able to provide the information necessary for a veterinarian to assess the problem. It may be too subjective and too unscientific. It’s this barrier to direct observation of functions, palpation and touch of the patient right front of the veterinarian which is the weakness of providing treatment at a distance.
It seems to me that it would be impossible for a veterinarian to provide proper veterinary care of a high quality to a new patient that is unknown to the practice. Veterinary telemedicine would be applicable in my mind to patients with a known history at that veterinary practice which would preclude the need for a thorough new physical examination (possibly). Even then I would have thought that it might be unwise to ignore a physical examination for the reasons stated.
Perhaps this is about making presumptions which is dangerous. A veterinarian has to start afresh and keep ticking those checkboxes to make sure that nothing new has developed.
My conclusion, as an unqualified person, would be that there are substantial limitations to veterinary telemedicine but it has a place in the armoury of a veterinary practice. The big advantage to a client is that they don’t have to drag their animal into a clinic with all the attendant problems that it poses. And if an animal is particularly distrusting and anxious about attending a veterinary clinic, no doubt the animal, too, will be pleased to be treated at a distance with the help of their owner.
Example from Dr. Daniel Randall, DVM
Dr. Daniel Randall, DVM, writing in the Veterinary Practice News, provides a personal experience which illustrates the limits of telemedicine in the veterinary practice.
He was treating a dog called Charlie. Charlie was a very difficult patient prone to biting because he hated being handled by strangers in any shape or form. He had been diagnosed in earlier visits with inflammatory bowel disease (IBD) and prescribed metronidazole, which had cleared it up. The owner called sometime later to say that the problem had returned and asked for a follow-up prescription.
Randall was no doubt encouraged to write a fresh prescription because of the difficulty of dealing with Charlie. He did it on the proviso that Charlie’s owner telephoned the clinic if the diarrhoea had not improved on the further treatment. The diarrhoea did not improve and therefore Charlie was returned to Randall for an examination which picked up a hernia which prevented him pooping in the normal way.
This was a classic example of how a fresh health problem had developed during a continuing treatment for a known health problem. And the new problem could only be detected through a hands-on physical examination. Dr. Daniel Randall used this example to illustrate the limitations of telemedicine inadvertently practice.
Below are some more articles on veterinarians.