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IT can only have been a coincidence, but it's thought-provoking nonetheless. On July 13, BBC Radio 4 broadcast a programme called ‘One Health: the vet will see you now’, in which human GP Graham Easton argued that there are areas, particularly relating to service delivery, where doctors working in the NHS might usefully learn a thing or two from vets. Meanwhile, just a few days before, the Vet Futures website posted a blog by veterinary practitioners Erwin Hohn and Adi Nell suggesting that, rather than competing with each other, veterinary businesses should work more collaboratively, and share facilities and expertise.
In their blog, posted on July 8, Mr Hohn and Mr Nell do not go so far as to say that vets should model their services on those provided by the NHS. However, they do suggest a two-way system of referral whereby, for example, a referral centre might refer what turns out to be a non-complex case back to a general practice for treatment, or a general practice might refer dogs simply requiring vaccination to a vaccination clinic, thus allowing everyone to do what they do best. They make the point that ‘this is how many human community health programmes work all around the world.’1
So, in the space of a few days, we have vets suggesting that vets can learn from doctors, and a doctor suggesting that doctors can learn from vets. Is it too much to hope that each might usefully learn from the other?
In his radio programme, which, at the time of writing, is still available to listen to online,2 Dr Easton seemed particularly impressed by the speed and relative ease with which diagnostic test and scan results could be obtained in veterinary practice; he was also impressed by the level of compassion shown to animals and clients, as well as by the continuity in care – sentiments which seemed to be shared by the clients he interviewed. An area where the NHS had the edge was in the evidence base on which treatment was based, allowing better judgements about whether patients would benefit. A fundamental difference between human healthcare and veterinary care was that human health care under the NHS was free to all at the point of delivery, whereas veterinary health care was not – but whether it was simply the fact that the veterinary model was privately funded that made it more customer-focused and efficient was, the programme suggested, debatable.
In their Vet Futures blog, Mr Hohn and Mr Nell argue that working more collaboratively with those currently thought of as competitors, both veterinary and non-veterinary, ‘would serve to advance the health and wellbeing of our patients, not just cure or prevent disease’. They also suggest that it might help to reduce stress and solve some of the work-life balance issues affecting those working in the veterinary profession, as well as pointing out that evidence-based medicine is enhanced by sharing outcomes.
It is probably true that vets compete in too many areas, and that this can lead to duplication of effort as well as of equipment and facilities. However, if the veterinary profession moved towards a system organised more on human medical lines, care would have to be taken to ensure that continuity of care, rightly highlighted as something precious in the Radio 4 programme, was not lost. The trick, ideally, would be for the medical and veterinary professions to employ the best elements of each other's systems where appropriate, to improve the services available to patients and clients.
Ten years ago, Dr Easton and the editor of this journal argued, in an editorial published simultaneously in Veterinary Record and The BMJ, that there were a number of areas where doctors and vets might work together more to everyone's benefit, and invited suggestions on this (VR, April 16, 2005, vol 156, p 493). This led, about six months later, to joint issues of the two journals exploring ideas, 3,4 although, interestingly, the idea that the two professions might learn from each other in terms of service delivery wasn't one of the aspects specifically highlighted at the time. That it is being raised now, and from two different directions, is interesting, and to an extent must reflect the challenges of meeting the increasing expectations of patients and clients. The idea that doctors and vets have much to learn from each other was appealing 10 years ago. In this, and many other respects, it is even more attractive now.