Question about GP DVMs vs. Rehab DVMs

[Guest guest]

Hi.I work in a large referral hospital with multiple specialties.  All of our CCRP/CCRT DVMs until just recently were also DACVS.  We now are happy to have a CCRT/DVM on board.  The administration is concerned that we could be stepping on GP DVMs toes when managing such cases with pain management issues, osteoarthritis/DJD concerns, etc. especially with regards to medications, supplements, and injections.  I want our department to be able to offer " full service " rehab.  I wonder, those of you who are CCRT or CCRP and DVMs, could you tell me what you feel comfortable managing differently than the GP/rDVM and what do you refer back?  Obviously communication is essential and each case will be handled individually, but I do need the administration to see the potential.

Thanks.Amie Hesbach

[Guest guest]

Hi, Amie- at GVR, the DVM's will prescribe meds for pain control that are directly related to the diagnosis that was referred in to them, such as NSAID's/tramadol/gabapentin. Any other issues, such as UTI's, etc. gets referred back. We also send out progress notes to the rDVM,s, to keep them up to date on our treatment. I don't know of any issues this has presented with referral sources-it seems to work for us. Hope that helps! Sent from my HTC Inspireâ„¢ 4G on AT&T----- Reply message -----To: <VetRehab >Subject: Question about GP DVMs vs. Rehab DVMsDate: Tue, Jul 24, 2012 9:50 am

Hi.I work in a large referral hospital with multiple specialties.  All of our CCRP/CCRT DVMs until just recently were also DACVS.  We now are happy to have a CCRT/DVM on board.  The administration is concerned that we could be stepping on GP DVMs toes when managing such cases with pain management issues, osteoarthritis/DJD concerns, etc. especially with regards to medications, supplements, and injections.  I want our department to be able to offer " full service " rehab.  I wonder, those of you who are CCRT or CCRP and DVMs, could you tell me what you feel comfortable managing differently than the GP/rDVM and what do you refer back?  Obviously communication is essential and each case will be handled individually, but I do need the administration to see the potential.

Thanks.Amie Hesbach

[Guest guest]

Hi Amie, This was a pitfall for me years ago, but I think I am learning to avoid the pit falls every day (I am still learning!!!) . I started my rehab center in 2002 but I am still a practicing GP. Here are the two interesting scenarios I have experienced 1) A Veterinarian refers you a case that they would like rehabbed. They value your professional judgement and are happy for you to make suggestions regarding pain management and ongoing care of their patient...EASY! Communicate any changes to the veterinarian and the owner, everyone is happy. The owner knows how valuable their personal veterinarian is, their relationship is maintained and you get to reinforce how smart the family vet was for caring for them so well. 2) An individual finds your services on the Internet or from a client referral; NOT EASY! Be careful and pay extra attention to communication. Remember that the original veterinarian (who did not refer for rehab) is likely to be feeling insecure, at risk of losing a client, dumb for not referring, inadequate for a number of reasons etc etc.. Tread lightly, promote the original vet at EVERY opportunity, even when you don't feel like they did the best for that patient. Always give the rDVM (who did not R) the benefit of the doubt. I always call and ask if it is ok to prescribe additional drugs, I always thank them for referring even when they did not refer. I try to find things to compliment the GP about, both to the owner and to the veterinarian. I am not being insincere, there is always something positive to find. As rehab veterinarians it is our duty to promote the GP relationship with his or her clients. I believe that one moment of silence with a raised eyebrow can cause serious harm to a referral relationship. We all know that clients can and do interpret whatever they hear to mean whatever they want. Everyone has to be true to themselves and certainly there are cases of just sheer stupidity where a pat on the back is not in order. In general, however,I believe we are all trying to make pets lives better. Be kind with good intentions and MOST of the time we will all get along and work together. This is obviously a hot button for me! I believe this issue to be one of the MOST important things after patient care in determining our success or our failure as rehab vets. Good luck, email or call if you have any thoughts or questions. Pam Nichols DVM,CCRP Sent from my iPadDr. Pam Nichols cell office

Hi, Amie- at GVR, the DVM's will prescribe meds for pain control that are directly related to the diagnosis that was referred in to them, such as NSAID's/tramadol/gabapentin. Any other issues, such as UTI's, etc. gets referred back. We also send out progress notes to the rDVM,s, to keep them up to date on our treatment. I don't know of any issues this has presented with referral sources-it seems to work for us. Hope that helps! Sent from my HTC Inspireâ„¢ 4G on AT & T----- Reply message -----To: <VetRehab >Subject: Question about GP DVMs vs. Rehab DVMsDate: Tue, Jul 24, 2012 9:50 am

Hi.I work in a large referral hospital with multiple specialties. All of our CCRP/CCRT DVMs until just recently were also DACVS. We now are happy to have a CCRT/DVM on board. The administration is concerned that we could be stepping on GP DVMs toes when managing such cases with pain management issues, osteoarthritis/DJD concerns, etc. especially with regards to medications, supplements, and injections. I want our department to be able to offer "full service" rehab. I wonder, those of you who are CCRT or CCRP and DVMs, could you tell me what you feel comfortable managing differently than the GP/rDVM and what do you refer back? Obviously communication is essential and each case will be handled individually, but I do need the administration to see the potential.

Thanks.Amie Hesbach