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Easing the emergency burden: ethical dilemmas faced by the out-of-hours vet
  1. Thomas Emily
  1. Emily Thomas
    , BA, VetMB, DECVECC, DACVECC, MRCVS, Royal (Dick) School of Veterinary Studies, Easter Bush Campus, Midlothian EH25 9RG e-mail: ethomas3{at}

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THE scenario of a companion animal presented out-of-hours for evaluation of a minor illness is only too familiar to many of us. However, the ethical dilemmas that this poses are infrequently discussed. Most practices have minimal staffing and limited diagnostic capability out-of-hours, and an out-of-hours pricing premium typically applies. The out-of-hours vet therefore faces conflicting pressures when confronted with a minor ailment. On the one hand, it is likely that the patient will receive more cost effective and possibly better care if treatment is delayed until normal working hours. The time used to treat a non-emergency patient may also detract from the provision of care for a genuine emergency. On the other hand, there may be pressure from the client to provide immediate care. The vet may also be indirectly influenced by commercial performance measures, such as call conversion rate. Finally, and most importantly, it can be difficult to differentiate minor from major illness based on the client’s history alone: any vet that has been presented with a moribund patient that ‘is not quite himself’ will have learned to err on the side of caution.

The short communication by Williams and others (2017), summarised on p 90 of this week’s issue of the Veterinary Record, shows that …

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