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Virtual Visits

September 24, 2013
by Karin Christopher, DVM
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About 2 years ago I discussed  my veterinary profession with an entrepreneurial family member who  has made a successful business of selling dirt on-line, and currently has an idea for making popcorn that will likely get patented after some fine-tuning.  His mind is always working, coming up with new ideas to improve efficiency and the client experience.  So, I asked him, as a dog owner, “What would you change about taking your dog to your veterinarian.”  He responded by saying we should do it on-line.  Mind you, he is nearly a generation younger than me so access and working through the internet is not a virtual- experience, it is the reality he knows.  My response was quick, “That is impossible and unethical in the world of veterinary medicine. “  The conversation went to other creative but currently unworkable ideas.  I appreciated his viewpoint.

I’ve thought about that conversation occasionally and it really hit home when I read that the American Veterinary Medical Association, our nation’s 150-year-old voice for over 84,000 veterinarians, approved the “Remote Consulting” policy that states that the “AVMA opposes remote consulting by veterinarians to diagnose a condition or treat a patient in the absence of a veterinarian-client-patient relationship.”   Why, then, is this okay for humans you may ask?  With websites like Virtuwell and Online Care Anywhere it seems that there would be a place for this in veterinary medicine.  Even in human on-line care, the scope of treatment is very limited.

Here is why virtual medicine cannot work effectively for our veterinary patients…

  1. Dogs, cats, mice, rabbits, ferrets, etc. cannot talk.  I know, I know…I put words in my pets’ mouths all the time, but it’s not the real deal.  Animals actually hide their pain more often than showing it.  This is a survival instinct.  They don’t point out the mass that’s been growing for 2 months under their tail.  Without the ability to communicate a history like we give to our human medical doctors, animals cannot effectively be seen virtually.
  2. You cannot see, touch, smell and listen through the internet.  Not yet.  This may be possible someday but I don’t even believe in my lifetime.  When I perform an exam, even while you the owner are giving me a history, I am paying attention to your pet; how they hold their head and tail, how they move and walk, how they sound.   I smell the mouth for infection, diabetes or kidney disease which can each have distinct odors.  The external body is felt for masses, lesions or enlarged lymph nodes.  Obvious respiratory noises can be heard without help but more often, abnormal heart and lung sounds need the amplification of a stethoscope.
  3. The lack of consistent, face-to-face interaction with someone diagnosing and treating your pet would make for a more difficult “relationship.”  I’ve always equated the problem solving techniques that a veterinarian uses to diagnose, to those of pediatrician’s.  We both work with patients that don’t talk.  I personally don’t mind seeing different human doctors but I do want my children to see their same doctor.  We have established a relationship, and trust is built on that relationship.  I can advocate for myself but I want to make sure I’m working as a team when it comes to the care of my children who are not able to speak for themselves…just like our pets!

Karin Christopher, DVM