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Pet Lover Geek: The Expanded Universe of Veterinary Medicine

This year has been challenging for everyone. COVID-19 has taught us to “expect the unexpected” and industries across the world are needing to innovate to continue providing services for their customers. The veterinary medicine industry is no different.

Lorien sits down with veterinarian, acclaimed speaker, and best selling author Dr. Jessica Vogelsang to learn about the innovations taking place in vet clinics across the country, from teletriage to curbside service. Dr. V shares her view on the “Expanded Universe on Vet Med” and what that means for pet parents today.

 

 

 

00:01 Lorien Clemens

Hey pet lovers! I'm Lorien Clemens and this is Pet Lover Geek, powered by PetHub. So seven months ago -- as I'm sure everybody listening now remembers -- most of us were put into lockdowns. We were told to go inside, shut the doors and don't come out, and it was all in response to COVID-19.

A lot of scary stuff; and it forced a lot of different industries to rethink how they were going to get their work done, how they were going to service those people that they consider to be customers. So from working from home to having to offer services virtually, just about every business that you can think of has to shift something in their operations. I mean our work here at Petub was no different.

Well, we're going to talk today about veterinary medicine because I think you could argue that that is one of the industries that probably had to shift the most. I mean, we're used to like having to physically take our dogs and our cats to the vet to get any kind of care, of any kind, and so it's a very physical , in your face, personal kind of thing.

Well now, clinics across the world are now doing curbside pickup, virtual care tools and all these different kinds of things in order to be able to still provide their clients and their pets with veterinary services without endangering vets and their clients. So lots and lots of changes around there.

And not only are they innovating -- they are literally having to innovate every single day in the vet industry, but data is actually showing that business is up. It's one of the busiest summers ever, and the New York Times just recently reported that some clinics are seeing 25% more pets than normal, which I think is probably a good thing but it also might be indicative of other things because people had to put off wellness appointments, there was a lot of increase of adoptions -- we heard about that that there's almost no dogs left to be adopted -- which is again a good thing but also now there's a lot of people that are needing to see veterinarian. So all these things are leading up to hey, the veterinary industry is changing and consumers and customers and clients are like oh, what's going on?

We're so lucky today to have one of the experts in the industry to answer all those questions about how the industry is changing. One of our favorite veterinarians on the planet, Dr. Jessica Vogelsang, she's here with us today. Hi Jessica!

02:13 Dr. Jessica Vogelsang

Hi, how are you?

02:15 Lorien Clemens

I'm doing awesome! I'm so excited that you're here with me today. I'm going to brag on you for just a little bit.

Dr. V is a veterinarian, acclaimed speaker, best selling author -- I love her book "All Dogs Go To Kevin" -- and she works tirelessly to advocate for not only the veterinarian profession but also for pet owners as well. She is all about using technology to bridge some of these barriers that we're now facing. So I want you guys to sit back and relax, we're going to take a really short break here and then right after the break we're going to be learning about these really great innovations that are happening right now in the veterinary medicine industry and how this impacts us as pet parents. Hang tight!

03:04 Lorien Clemens

Okay, Dr. V. It's so great to have you here on the show. We've had you a couple of times before and we're really happy to have you back. I can't wait to hear about the insight that you're going to give us right now in what is happening in the veterinary medical field.

I want to make sure that our listeners though understand, like we're talking to an expert here. I wanted them to see how much of a unique voice you actually are bringing to this particular conversation. So if you could give us a little bit of background on yourself: What you do today to how are you helping veterinarians communicate better with pet parents?

03:37 Dr. Jessica Vogelsang

Sure well, as you know, I have a little bit of a unique background. I started almost 20 years ago in small animal practice, and while I was doing that here in San Diego I started a blog which was considered really weird in 2009, like this idea of why would you want to talk to strangers? And they're not in the clinic? And isn't that against the law? And like all this crazy stuff. And so I just kept doing it because I just do what I think needs to happen.

And so ten years later I was working in hospice care and that was the first time that I really started thinking about how we need to do a better job of communicating with our clients without them having to be right there in front of us? Because everybody knows -- who has had to say goodbye to a pet -- the last thing you want to do at that point is taking them to the vet. So that began my exploration of, you know, hey, can we use telemedicine? And this was around 2014 and my colleagues were almost to a one absolutely not like we don't do telemedicine. That is not something we do. But of course they also told me blogs or not something we do.

So I just kind of tried to get people interested in it and didn't have too much success until March. I had this Facebook group, the Veterinary Telemedicine Facebook group that had 2 members for two years, and overnight we went to about 3,000 members! All the sudden people got really interested in telemedicine.

But, even with my background, nobody -- absolutely nobody -- could have predicted what was going to happen with COVID. It has been totally wild.

05:25 Lorien Clemens

Well, I think everybody can relate to this, whether they are dealing directly with veterinary stuff or whatever, but everybody can relate. I would like for us to like, kind of -- let's set that pin marker of what was the standard before our current state of affairs happened?

So what was the standard, you know, of when you would go into the vet, what was the expectation that the interaction and the communication would be? Because you mentioned nobody does telemedicine. That was like the answer -- no, we don't do that. So what was considered to be the standard acceptable way?

06:02 Dr. Jessica Vogelsang

Yeah, and that's really important because when you hear people debating about whether or not veterinary telemedicine is allowed in your state, the thing that they keep coming back to is the VCPR. It's the Veterinarian Client Patient Relationship. So that's the legal definition of what allows me to be your doctor and prescribe something for your pet.

In most states you cannot have a VCPR unless you examine the pet in person. So that's a really critical differentiation between veterinary medicine and human telemedicine, because they've been fighting tooth and nail for the last 40 years and I think they just now got the 50th state to say "okay, in some circumstances you can establish that relationship without a physical exam" -- like you can do a good enough job without actually having to touch the patient in some cases to say I can make decisions for this.

The veterinarians who run the state board for the most part didn't really want to do that. COVID has changed that in 18 states right now. There were four in March that allowed you to establish the relationship over telemedicine, and now there are 18. So they are changing their minds.

The most interesting thing about all of this to me is that although we really thought that would be the big debate, the biggest change still has to do with curbside medicine. That's what everybody's been focused on because in human medicine you don't want the patient in the room with you because the patient might have COVID, but in veterinary medicine that's not the case. We know it took us awhile, but now we're pretty sure, like dogs and cats, really, they don't give us COVID. So they can come in. That's fine, it's just you have to stay outside.

07:56 Lorien Clemens

So I know that a lot of us, you know, when we're calling our veterinarian they are busier than before! Can you talk a little bit about how curbside medicine has radically changed the way people now go to the veterinarian? And there are a lot of different reasons, but particularly maybe because of COVID, we've got a lot more people taking pets into the vet.

08:20 Dr. Jessica Vogelsang

Yeah, and you know, nobody expected that. Everybody thought in March that we were going to have to shut down and lay people off because nobody was going to come in. And it turned out to be the exact opposite.

You know, everybody's at home looking at their pet, thinking, oh man, you know there was that lump I've been ignoring for six months, I should bring them in. And so instead of being not busy enough, we're too busy and we're trying to manage all this curbside stuff on top of everything else and that makes us slower.

And so instead of trying to figure out how we can help people at home, now we're trying to figure out how we can scale what we're doing to help more patients. It's just a really unexpected problem for people to call and, you know, you want to see them but you don't have an appointment available for two weeks. And they're trying to figure out, gosh, you know, I don't want to go to the ER for this ear infection, but I don't know if I should wait two weeks. You know what do I do?

09:17 Lorien Clemens

We have a kitty cat here that has continual bladder issues and you know is going to be on a lifetime of special foods and everything like that. And it's at the point now when we call, because he has flare ups every now and then, they say okay just drop him off and we'll get to him when we can get him.  And we literally just go drop him off and then we come back and get him later in the day -- which is a different experience for us.

Well, so let's talk a little bit because you and I have known each other for a long time and I've been very carefully watching a lot of the developments and innovations in the industry. Veterinary technology for a long time has been, you know, big into technology and science. Obviously because it's a science. It is a field based in science, so technology is inevitably a part of that. But there does seem to be a disconnect -- at least from the outside looking in -- a disconnect of that adoption, the way of bringing in new technologies. And there's kind of this old way and new way.

Now it seems, at least when I'm talking to my veterinarian friends and looking at startups that are in the industry - they are booming! So can you talk a little bit about that?

10:24 Dr. Jessica Vogelsang

Yeah, and you know it's so funny because it is a real tech averse profession. I think the medical professions in general have this sort of distrust because so much of our relationship with our clients and our patients is built on trust, right? That face to face interaction. You know, everybody loves James Herriot and all you need is a microscope and a stethoscope in your hands and you can figure everything out.

So I think what our profession is sometimes forgetting is that when you talk about telemedicine, you know, you're not trying to replace that relationship. You're really just trying to be more efficient in the way that you communicate things. And so I don't want to take any of that away, you know, when your vet still is going to need to touch your cat if you think there's a bladder infection, tests you need to do. What we're trying to make more efficient is all the other stuff leading up to it. You know your questions, like, hey, is this an emergency? This has been going on for a while or their diet changes.

There's so much just communication and that's what the technology is about. It's about facilitating us getting to the conversation, not about what I do in order to make a diagnosis. And I think that's the part that I'm really wanting our profession to understand a little more. You know, clients don't want you to diagnose something over the computer. They get you have to come in. What they want is just to be able to find you and access you, and right now that's really hard to do.

11:52 Lorien Clemens

Yeah and the way we actually just do everything as consumers is completely different now than it was even five years ago. I want to talk a little bit about - you mentioned your blog earlier and your blog is one of my favorite blogs -- so want to talk a little bit about, in your blog you talk about the old way of thinking and the new way of thinking. You call it the Expanded Universe of Vet Med.

I'd love it if you can tell us what that is, what does that look like and give us examples of veterinarians that are doing that right now.

12:25 Dr. Jessica Vogelsang

We sort of get in this bubble and think as a pet owner that the only person or place you ever get information is your veterinarian in the exam room when you walk in the door. And maybe that was the way, a long long time ago, but the internet has changed so much of that.

If you have a question you don't have to wait for me to call you back. You can get information from all sorts of places, sometimes good, sometimes bad. So there's this big expanded universe that includes not only the other people in your clinic -- you know, the technicians who can help, the website which gives you lots of information, and then you have random websites. You have other vets out there who may or may not be saying the same things that you would. And then you've got random folks. You know, I write a blog as a vet, and there are plenty of people that write blogs as pet owners or pet advocates and they all have varying degrees of expertise. So just like everything else, you know, it's really hard as a pet owner. It's a blessing and a curse to have access to this information but to not necessarily know which you should trust.

So when I talk about the expanded universe, I'm really talking about pet owners trying to navigate that space and veterinarians and veterinary professionals understanding that, you know, you're not here to necessarily give all the answers. Sometimes what you're meant to do is help guide people and know that they're going to be going to these other sources and just help them find the right ones. And that's really critical, especially right now when we're just too busy. We can't answer every question -- we're not online 24 hours a day!

14:10 Lorien Clemens

And are there veterinarians or models out there that you think are moving towards that? Or is it still kind of something that's a vacuum that's needed to be filled?

14:17 Dr. Jessica Vogelsang

Well, there's a lot of different models out there. There are two practices that are startups right now. There's Bond in New York and Modern Animal in LA, and they've actually built themselves from the ground up to be this sort of distributed model where they've got technicians available 24/7 that you can talk to and you drive up and drop off your pet. So those models are there.

I'm starting to see some of the bigger practices like Banfield and VCA that operate hundreds of animal hospitals, have chat available now 24/7. So you don't have to go and Google is this an emergency. You can actually talk to someone right from Banfield or VCA. It may not be your doctor, but it's somebody who is associated with the practice who can say gosh, you know that's an emergency, yes, or no this can wait till tomorrow or wait a couple days and that's really important. And I think as pet owners, of course you're going to want that. I want that.

15:23 Lorien Clemens

Yeah, absolutely. And to some extent I already get that for my human health care and I look at my fur kids the same as I look at my human kid, like they're my family. So I want to have that same level of care, so I expect it now.

This is a great conversation! We're going to take a quick little break and when we come back we're going to pick Dr. V's brain about specifically other ways that COVID has impacted clinics beyond just the curbside pick up, which clearly is a major shift for everybody, and what it's done to the way that veterinary care looks like today and perhaps into the future. Hang tight folks, will be right back!

16:15 Lorien Clemens

OK, we are back pet lovers! Now, before the break Dr. V was walking us through some of the ways the old veterinary care looks versus a lot of the new ways of thinking. And as you mentioned, some of the things like the curbside pick up are directly COVID-impacted; things that we've had to do that have been forcing clinics to embrace newer ways of thinking.

I'd love it if you could also talk a little bit about other types of technologies that maybe if they're not being used right now, you foresee them coming in the future.

16:47Dr. Jessica Vogelsang

Well, you know messaging is huge. I think a lot of times when people talk about telemedicine you think about, you know, getting in front of a screen and having this video visit with your doctor, because that's how we're doing it a lot of times on the human side. But I don't know if you ever tried this, but trying to get your cat to cooperate for a live video visit, not that helpful! And so we're actually finding that using messaging is really really efficient, especially if it's not an emergency. You can actually do a great visit using chat. We call it asynchronous communication, right?

And I mean, I am already well familiar with this because any vet will tell you like our neighbors and our families are doing this to us all the time anyway. Like, hey, does this look right and they'll send you some horrible picture that you can't make out and it's all blurry. And then because we can't help ourselves we're like hold on, you know, I need a better picture. And so we are already doing it, you know, we know that it works, so I think we're going to see a lot more of that type of thing.

This is the one thing I would tell you as a pet owner. If this is something you want and you probably do make sure your vet knows that because there's such a big perception out there, of well, you know, I would do that, but pet owners don't want to pay for that. And I am thinking of course they do! You just haven't asked them.

18:23 Lorien Clemens

Totally, and that's such a good point Jessica, because like we make these assumptions as providers of whatever that oh, people aren't going to pay for that. I can't tell you how many times, at least in our business, that we offer something and we're thinking well maybe they want it. And sure enough, they do. And then there's other things that we were certain they'd be willing to pay for. Nope, you know, and so you don't know until you've asked.

And I'd love it if you could talk a little bit more about -- because you did allude to this -- about the whole idea of like, is this an emergency or not? There are some emerging models out there, businesses out there that are all about basically teletriage -- I guess for a better word. Like do I need to go in right away or is this really something I could watch? Could you talk a little bit about that because there's a difference between getting on the phone with my vet or getting on video or whatever with my vet and then just trying to find out do I need to take him in or not?

19:19 Dr. Jessica Vogelsang

Yeah yeah. And so, that's a really great question because that's something that I think a lot of people misunderstand. We're all familiar with the concept of the nurse advice lines, and so you know that this is not your regular doctor or your regular nurse, but they're giving you really solid advice, right? Gotta give the Tylenol every four hours, etc. if the fever spikes, blah blah, blah then you go in. There is an equivalent for veterinarians and right now most of those services are just like freestanding services.

WhiskerDocs is one, I worked for them for about a year a couple of years ago as their Medical Director. AskVet is another one, Pet Triage, there is several out there and they are all staffed by professional veterinarians or technicians. Their sole job is to tell you yes that's an emergency or no it's not, how quickly you need to be seen, and what to look for that would make that situation change. Sometimes it's really obvious, you know, if it's a broken leg, it's always you need to go in right now. Other times, less so. You know if you have a dog who is vomiting and you don't know what questions to ask and you go online, you may get some really bad advice. So you really need to ask a professional who's going to know. Whether or not it's a puppy is going to make a difference, you know, how many times an hour they are vomiting. All of these very, very specific things that could mean the difference between an absolute emergency and something that could wait, or something that you can watch at home. And so that's the value of those triage services.

And some of the bigger practices may offer that. If you have pet insurance, a lot of insurances cover that, so just be aware that that's something if you have insurance you should look into, but if not you can go to these websites on your own. Anybody can do it anywhere in the world and they have a fee for just a one-time chat or call. And they are fantastic. They give very, very solid advice.

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21:24 Lorien Clemens

That's great, I would love it if you could also talk about too -- because I know that there's actually some folks that I've talked to just recently who haven't stepped foot in a veterinarian since this whole thing happened, and now they're kind of worried like, well, gosh, he's coming up ready for his vaccinations and I'm not sure. Like are they open? What's going on? I've heard they're not actually seeing people. Can you give kind of just a quick like this is what you need to expect at this point going into the vet; and how you can be best prepared to get the best experience for both you and your pet.

21:51 Dr. Jessica Vogelson

Yeah yeah. So for sure at the beginning everybody was delaying the wellness services because they wanted to sort of clear the runway for just the emergencies and preserve masks and gowns and all that kind of stuff. So we're starting to see people get more stuff.

Now just be aware if your dog is due for vaccines, you know tomorrow, there may be still a little bit of a delay. A lot of places are still backed up, so make the appointments early and ask them what's the process when I check in? Hopefully they're communicating that with you, but you may want to ask because some people have you text when you get there or you come up to the door or you call them. And, you know, it's nice to know ahead of time because it's really stressful if you're sitting in the car and you don't know what you're supposed to do and you wrestle your dogs to the front door and they point to the sign saying go back to your car and call. Like I wish I would have known, you know, so have all that information ahead of time.

Most places right now are starting to see the Wellness stuff ahead and we don't know what's going to happen, but when you look at the predictions we're thinking that another wave of COVID is going to come in the winter, kind of across the country. So just be aware that this may be a temporary opening up in the schedule and things may get really, really busy once again. So do it now if you are due. Get it set.

23:22 Lorien Clemens

Definitely. One thing before I let you go. I'd like it if you can kind of look into your crystal ball for me and tell me what do you think's next? Because if COVID taught us anything it is to expect the unexpected and to be ready to have everything, you know, just be upended and have all of your expectations be set aside. So what do you think is next in that future of veterinary medicine, telemedicine, what have you?

23:52 Dr. Jessica Vogelsang

I mean, I'm really taking active steps to encourage this -- is that there are going to be a lot more veterinarians, technicians who work from home as telemedicine becomes more accepted and more legal. You may not really see a big difference because if you're doing that visit where you're texting or getting a lot of your information out in this expanded universe -- instead of having to come back in -- what that means for you is that the care is going to be more accessible again. You know, because there's so many vet clinics right now who just don't have enough vets, or enough technicians to see everyone that needs to be seen. We really need to start embracing this in order for us to help serve everyone.

I'm really hoping that this expanded universe means that people who have difficulty affording care are going to have more options. You know that's something that's really important to me and I think to lots of pet lovers. And so you know, we're not going to solve those problems with what we're doing right now. We need to get a little more creative about how we make ourselves available to people, and I think that's really important.

If COVID has taught us anything, anything at all, it's that pets mean so much more than we thought, you know, and they have been for so many of us an absolute lifeline during this time of isolation.

25:18 Lorien Clemen

Oh yeah, 100%. I actually just got chills listening to you say that because it's the truth. I mean, uh, it's so difficult, everything. I think I've read a number of articles now saying that everyone in the world is grieving for all the things that we've lost. Not only the human life that's been lost but just the lifestyle that we all had gotten --frankly -- really used to.

I really appreciate you saying that about, you know, equity in vet care because there are a lot of folks who love their pets deeply, but they can't afford it. And with COVID and losing jobs and things like that, a lot of that disparity between the haves and have nots and who's able to afford that top level of that care for their pets. That's a widening gap. So I really appreciate you talking about that. I think that could be a whole podcast itself.

26:09 Dr. Jessica Vogelsang

Oh my gosh, tell me about it. And that's been an evolution, you know, on my part as well. It's something that I feel really, really passionate about because there's something that you see people say a lot, you know, if you can't afford the vet, don't get the pet. I think we need to come to a reckoning about that because this is a much bigger problem than any one individual can solve, and so I think we all need to come together for some solutions because there is not a human on this planet who doesn't deserve what I've gotten to experience from my pet in the last six months, and I think pretty much all your listeners would feel the same way.

26:50 Lorien Clemens

100%. Yeah, thank you so much Dr. V for joining us today. I always learn a ton when I'm talking to you. I know our listeners do too. They really appreciate everything that you bring. Let's make sure that we know how to get a hold of you --  or not necessarily get directly a hold of you -- but how can we learn more from you? Don't give out your cell phone number! How can people learn more about the work that you do, keep an eye on what's happening and all of that?

27:15 Dr. Jessica Vogelsang

So my website that I've had forever is pawcurious.com, and if you are in the veterinary profession and want to know more specifically about virtual care, we have a separate website for professionals. It's drjessicavogelsang.com.

27:30 Lorien Clemens

Well, it's humbling to know that during a time of such uncertainty that industries can innovate to provide best services to clients and customers and our beloved fur kids. And I personally am really excited to see what's happening in the veterinary field as it continues to grow and then embrace the tools that will not only make pet parents' lives easier, but make the pet's life better as well.

That's it for today. I really appreciate you coming on. Thanks for joining us and I hope you're back in the future to talk more.

28:02 Dr. Jessica Vogelsang

Thank you! It was great coming on and thank you for having me.

28:05  Lorien Clemens

Now in a couple of weeks we're going to be back and we're going to be talking with more industry experts about all things pets. Haven't quite decided what it's going to be. There's so much going on right now in the world, but I'm sure it will be fun and geeky and wonderful.

We would love it if you could give us a rating on your favorite podcast platform. You can find us on Spotify, Google podcasts and Apple podcasts and until then we will see you next time pet lover!

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Pet parents can access more of Dr. V’s resources at https://pawcurious.com/ and veterinary professionals can connect with her at https://drjessicavogelsang.com/

 

 

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