Virtual veterinary visits: The good and bad
Due to the COVID-19 pandemic, the use of virtual visits has skyrocketed in veterinary medicine. Drs Cline and Saker explain why virtual visits can be helpful to get nutritional insights and more on patients, how virtual care sets patients up for a successful and productive visit, and more.
View full video transcription below.
Adam Christman, DVM, MBA: COVID-19 has presented so many challenges as we know; cut to the rise of virtual care. I tend to think of when our practices are so busy, I feel like nutrition sometimes goes by the wayside just because we just have to get through something that might require higher precedence. Where do you think virtual care falls into play with nutritional counseling? Have you found it successful, where you can do some one-on-one nutritional counseling? What's your feedback on that?
Martha Cline, DVM, Diplomate ACVN: Since the pandemic, I've been utilizing more virtual care for some of my patients and some of my clients, and we do video conferencing, and we do it through an app that we have and where it's been really helpful is actually getting to see a little bit more of the environment that the pet lives in. Also, sometimes when donors come into the exam room, they may forget what they're feeding at home. I absolutely have. As a nutritionist, I have people that will come in for an appointment, and they're not exactly sure what food they're feeding at home. And so actually, taking that nutrition history at home can sometimes be a really big asset. Since I'm not a general practitioner, some of the ways that I would think where this potentially—from a nutritional standpoint—might be really helpful [is] let's say you have an appointment where you have a 20-minute appointment, and you've done kind of your screening, nutritional evaluation, but you realize there needs to be a much bigger conversation about nutrition happening, maybe that's a good opportunity to follow up with a virtual visit. So that way they have access to all the food and items in the home, you can get...the owner can potentially give you a better history. And then you could do that follow-up kind of virtually with them.
Korinn Saker, DVM, PhD, Dipl. ACVN: When COVID-19 started, we basically shut down the teaching hospital except for emergencies. So, we had to do virtual appointments and you know, I've really started...I've grown to enjoy them because you can see much more. Some [virtual appointments] are on zoom, some of them are telephone, but the Zoom ones are like as Dr. Cline indicated, are really helpful. And so, we usually start at our nutrition appointments by sending them some forms, a very small amount of forms to fill out so we have some background and then we use that virtual meeting to ensure that the information that they've given us is up to date and to determine what their goals are and you know, meet their pet and what we can do for them. And then once all that is obtained then we go back and we put together you know, we complete the consults and then email it to them. So, they have the opportunity to ask a lot of questions and you know, you'd think that you don't have enough time to do that and that you'd get bogged down but I think it works actually easier than the exam room because the other thing is the pets very relaxed. You're not sitting there half an hour fighting with the dog or the cat to do something and the owner constantly saying that because their pets not behaving well. So, I like it and you can help the owners give you information by explaining how to do conditioning on their pet you know, body condition scoring, take measurements, waist and you know thorax, and different kinds of measurements that can be helpful. If there might be a dermatological issue that diet might help, you can have them show you the paws or parts of the body that are being you know...excoriations or inflammation or something like that.
Adam Christman, DVM, MBA: I tend to find that you have their more undivided attention whether the kids may burn in the exam rooms or dogs on panting we keep worried about the cat and carrier. So you really have that face-to-face virtual interaction that I think really sets the client up for success, would you say?
Martha Cline, DVM, Diplomate ACVN: Yeah, absolutely. And I think a lot of clients have been really appreciative, especially in the last year and a half to have that access to us, for us to be available through them through that kind of teleconsulting. Because again, it's not comfortable for everybody to be out.
Korinn Saker, DVM, PhD, Dipl. ACVN: And I think it is also for people who have pets that don't like to travel. I mean, I think it's really helpful for them, you know. It's such a relief to not have to try and force their pet into the car, you know, the dog that vomits, the cat that's screaming the whole way, you can't get into the cat carrier kind of thing. I think the only downside that I can see from my job is that the students really miss having animal contact. But it is what it is right now.
Adam Christman, DVM, MBA: It is, but it's also a great tool that can easily be added into any practice. Yes, you're a board-certified veterinary nutritionist, but I think for general practitioners, it sounds like based on what you're saying you can make your schedule accordingly to say, maybe from 12 to 2, I'm going to set up nutritional counseling consults or rechecks or follow up weight management. Do you find that that could work into GP?
Martha Cline, DVM, Diplomate ACVN: Yeah, and there are obviously limitations with teleconsulting—by not having the animal with you, or maybe getting an accurate weight or body condition score—those are huge limitations that we can find. And so, I have a lot of value in seeing my patients in person, and I think I will always incorporate it going forward is really with that follow-up. So, being able to do some of the follow-ups, especially after the initial assessment, and where I've been able to see the pet. And so we have sometimes clients that drive a really long time to get here, again, the stressful cats, the stressed-out dog coming in…it's nice to do the follow-up appointments, and they're like sleeping on the couch next to the owner, you know, so some of that...it has a lot of advantages as well.
Adam Christman, DVM, MBA: Yeah, that's so nice to hear. I want to close by asking you this: because we were talking about yet some support staff that kind of cause some disparages, share with me—if you could—or give me some soundbites to the pet parent that comes in and says, "Well, this person at the pet store told me that I have to give my cat this otherwise, I'm a bad pet parent, and now you, doctor, are telling me that I need to do this," and then the technician is in the middle of the exam. You [think], "Ah, I don't know what to do." What are some things or soundbites that you can provide a pet parent or a technician with when those situations arise?
Martha Cline, DVM, Diplomate ACVN: I think acknowledging that the pet owner has potentially thought about the food that it's picking out for its pet. [Pet owners] obviously want to do the best thing for their pet, and then finding common ground with that client and acknowledging that we're both really on the same page here, we want to do what's best for your pet, and focus on the pet health aspect of it. Then focusing on pet health, and then moving into a diet recommendation, can be an effective way of kind of communicating that because it's challenging for pet owners to go into a pet store and get different opinions, or be on social media and get different opinions, or talk to the neighbor and get different opinions, and one thing I'll remind clients is that something that may have worked well for that pet may not necessarily work well for your pet. And so again, when I'm making a nutritional recommendation, I'm basing it on that individual animal and the needs of that animal. And so what does this animal need? And now how are we going to get that? And then we talk about what our diet options would be from there.
Korinn Saker, DVM, PhD, Dipl. ACVN: Yeah...mentioning that, yes, each animal is an individual. So, as you said, this cat could have diabetes and need this particular diet; this cat could have diabetes and need a different diet, because there may be some other, you know, other underlying issue going on as well. But I think it's also important to let your whole team know, as well as the client, that the recommendations that you're making are based on science, you know, that's an important aspect. The research that's gone behind formulating these diets is based on good science in that you're using that information as well as your skills as a nutritionist to make the best recommendations for the pet.
Adam Christman, DVM, MBA: Yeah, I like that a lot. Follow the science because marketing can be a little overwhelming sometimes. Well, this has been so good. Thank you so much, Dr Korinn Saker, Dr Martha Cline, thank you for your expertise and insight for this. And we hope you enjoyed this as well. Thank you so much. And thank you to our friends for Blue Buffalo for supporting this.
