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Ep 16: Veterinary Innovation with Alison Lambert · Veterinary Ramblings

• 0:00
  Mike Brampton: Good evening everybody and welcome to the next episode of Veterinary Ramblings.
• 0:06
  Mike Brampton: My name is Mike Brampton.
• 0:09
  Julian Hoad: And my name is Julian Hoad.
• 0:11
  Mike Brampton: Wow.
• 0:13
  Mike Brampton: What a day today. How was your day today?
• 0:16
  Julian Hoad: I've been cold all day Mike.
• 0:20
  Julian Hoad: I'll tell you why. I've been sitting in the office on a zoom meeting after zoom meeting doing stuff for the school.
• 0:32
  Julian Hoad: And it's cold in there, it's the back of the house and I've been miserable.
• 0:40
  Julian Hoad: So it's good to get warm.
• 0:42
  Julian Hoad: I've got a Negroni here, its gonna warm me up.
• 0:44
  Julian Hoad: I've got my my thick sherpur jumper on
• 0:48
  Mike Brampton: Very nice too
• 0:49
  Julian Hoad: And I am sitting in front of my orchids, so I'm alright.
• 0:52
  Julian Hoad: How are you Mike? How is your day?
• 0:54
  Mike Brampton: Ah, well, I'm frustrated because I've sat in my office all day today, waiting for a courier to deliver some kit to me.
• 1:04
  Mike Brampton: And the tracking note said that they would be there between 1030 and 230.
• 1:11
  Mike Brampton: Well traffic for me this morning was quite bad. I was on the motorbike. Let's give them a little bit of latitude as 330 came.
• 1:19
  Mike Brampton: And then I sent a message saying where's my kit?
• 1:22
  Mike Brampton: I got nothing back and 430 came and went and 530 came and went so in a little bit of a fit of rage
• 1:33
  Mike Brampton: I telephoned said courier company to be told
• 1:36
  Mike Brampton: 'Well if you haven't had the delivery today, we won't be delivering today we'll deliver to you on Monday. Bye'
• 1:40
  Julian Hoad: Oh for heavens sake
• 1:45
  Julian Hoad: FFS!
• 1:47
  Mike Brampton: Yes, FFS!
• 1:58
  Julian Hoad: We need something to cheer us up don't we
• 2:00
  Julian Hoad: Do we have a nice guest tonight? Will our guest cheer us up do you think?
• 2:03
  Mike Brampton: I think I guess we'll definitely cheer us up tonight.
• 2:06
  Julian Hoad: Whose on tonight?
• 2:07
  Mike Brampton: Well, tonight, it's not Mr. Doctor Professor, Mr. Anybody.
• 2:17
  Mike Brampton: Dr. Alison Lambert is our guest tonight.
• 2:21
  Julian Hoad: Associate Professor Dr. Alison Lambert!
• 2:24
  Mike Brampton: Associate Professor Dr. Alison Lambert, Absolutely.
• 2:27
  Julian Hoad: She's the Associate Professor at Nottingham University isn't she? That's the, now she's a business lecturer there isn't she?
• 2:38
  Julian Hoad: A veterinary business lecturer. Shall we have her on, have a chat with her.
• 2:43
  Mike Brampton: Let's get Alison in and see how she is.
• 2:46
  Mike Brampton: I can see she's in the waiting room. So with no further ado,
• 2:51
  Mike Brampton: Let's get Dr. Alison Lambert in.
• 2:54
  Alison Lambert: Oh Hello.
• 2:57
  Mike Brampton: Hello, shall we call you associate professor?
• 2:59
  Julian Hoad: You can call me many things. Yes. But my names Alison really, It's all good.
• 3:04
  Alison Lambert: It's all good.
• 3:05
  Julian Hoad: Prof, we'll call you Prof
• 3:07
  Alison Lambert: I'd rather you didn't. It is an honorary thing.
• 3:09
  Julian Hoad: Hon Prof
• 3:10
  Alison Lambert: Nothing worse than one assuming stature beyond their educational capabilities.
• 3:16
  Julian Hoad: Well, well Hon Prof. Great to see you.
• 3:19
  Alison Lambert: Nice to see you too. Cheers.
• 3:22
  Mike Brampton: Good Evening! What's that you're drinking there, Alison?
• 3:24
  Alison Lambert: This is a delightful Sauvignon Blanc. Cloudy Bay Marlboro 2019
• 3:31
  Mike Brampton: Other Sauvignon Blancs are available.
• 3:34
  Alison Lambert: They are but I don't like them.
• 3:36
  Julian Hoad: But there not as nice
• 3:38
  Alison Lambert: This is a nice, slightly less acid I think than 2018, and slightly more fragrant. Personally speaking.
• 3:45
  Alison Lambert: Not that I'm a snob about Sauvignon Blanc, but, I am
• 3:50
  Julian Hoad: I think I was slightly more fragrant in 2019/2018.
• 3:55
  Alison Lambert: Do you think so?
• 3:56
  Julian Hoad: I think so. Definitely. I've heard people tell me that.
• 4:01
  Alison Lambert: Good job you don't have sniffer vision, really.
• 4:04
  Julian Hoad: Smelly vision.
• 4:06
  Julian Hoad: Really good to see you on the show tonight Alison and thanks for coming on.
• 4:09
  Julian Hoad: So you were brought up in various parts of Yorkshire and then you became a vet. And then you worked for Hills for a while. And now though now is the most exciting part of your career because you asked
• 4:24
  Alison Lambert: You missed a bit, it wasn't Hills to now, it was a Hills to somewhere to now.
• 4:28
  Julian Hoad: it was it was. Hold on. And it was Hills to Mars.
• 4:34
  Mike Brampton: Yeah
• 4:34
  Alison Lambert: I was gonna let the cat in but I've closed the door
• 4:37
  Alison Lambert: Mars was the most formative part of my career to date, I reckon.
• 4:42
  Julian Hoad: Right.
• 4:43
  Mike Brampton: Why is that?
• 4:44
  Alison Lambert: Why?
• 4:47
  Alison Lambert: It's a very good question, because at the time it didn't feel like it, but on reflection, it certainly was.
• 4:53
  Alison Lambert: I had a ball you know, because the journey to the Mars organisation for me was, you know, go to vet school, be a vet, be a vet.
• 5:02
  Alison Lambert: First job wasn't brilliant. Second job, they went bust. Third job didn't go awfully well, have I missed anybody out?
• 5:11
  Alison Lambert: Then the last job was Black Wednesday and stuff happened so and everything went a bit crazy.
• 5:15
  Alison Lambert: So I ended up selling dog food, went back and then ended up at Mars. So there's kind of this kind of torturous pathway of craziness.
• 5:24
  Alison Lambert: But Mars I wasn't a vet, I was just me, I was Alison.
• 5:28
  Alison Lambert: I was employed because I could do the job they needed doing, which was customer insights, or marketing or sales management or whatever. So I stopped being a vet.
• 5:37
  Alison Lambert: And I think that may be something that all vets should do for a while, is be a human and don't carry this badge, which is why I don't like, I don't use a doctor title.
• 5:46
  Alison Lambert: And I don't particularly like the badging that we've put on ourselves because I think it makes us, creates an expectation in ourselves of ourselves.
• 5:56
  Alison Lambert: And actually, we're people first and we're veterinary surgeons second. Do you think we need to be more human?
• 6:04
  Julian Hoad: I must admit, one of the best times of my veterinary career was driving a dumper truck for my brother's brother in law, who makes ornamental ponds.
• 6:15
  Julian Hoad: And I worked there for a month, and had a fantastic time.
• 6:18
  Julian Hoad: Absolutely great. Put my career back into more perspective.
• 6:24
  Alison Lambert: What I used to love about Mars. On reflection, I did love it, in the last couple years, it's like I was quite senior and had to be responsible and stuff.
• 6:34
  Alison Lambert: You could look at situation commercially, because you've been trained, your brain, the veterinary brain is an incredibly well trained thing.
• 6:41
  Alison Lambert: You only get into vet school because you've got some intellectual capability.
• 6:45
  Alison Lambert: I did struggle a bit to get in, I have to say, if it wasn't for Eric Pickering, the Liverpool graduates will know, Eric Pickering was a god.
• 6:52
  Alison Lambert: Sadly no longer with us, but without Eric Pickering I would never got into vet school. Cuz I played hockey, and my a levels were dubious, I've got seven a levels. A through D over three years.
• 7:08
  Alison Lambert: But I could play hockey and that was kind of the prerequisite for Liverpool at that time.
• 7:12
  Alison Lambert: So I think that rebooting of intellect when you take yourself out of a veterinary context, and you go into an industrial or commercial context, you see things with a clarity, which is like sit rep
• 7:12
  Alison Lambert: stuff, triage, bang, bang, bang, job done, treatment plan.
• 7:28
  Alison Lambert: And that's business. And I think that's why I've enjoyed doing what I'm doing because you don't have to be big or clever. You just have to just use your intellect.
• 7:36
  Alison Lambert: And I think vets are highly capable of doing so many other things. So driving a dump truck was probably, give your headspace back.
• 7:42
  Julian Hoad: It was brilliant. It's really good. Yeah, yeah. There was a fantastic day where I was.
• 7:47
  Julian Hoad: We were building a three quarters of an acre pond in someone's garden. A pond, a big pond
• 7:56
  Mike Brampton: Lake
• 7:57
  Julian Hoad: In someones garden.
• 7:58
  Mike Brampton: A lake
• 7:59
  Julian Hoad: He called, he wanted a bigger pond, ornamental pond, and he was an oil baron of some sort, from one of the United Arab Emirates,
• 8:13
  Julian Hoad: and I was driving my dumper truck through his land because he wanted the soil from the pond taken and used on the other side.
• 8:28
  Alison Lambert: Excuse me whilst I get the cat
• 8:34
  Julian Hoad: And so, I was driving this dumper truck full of soil through his stables, and his young wife was there tending to one of the horses and I saw her riding a horse
• 8:45
  Julian Hoad: and I said 'Woah, woah, woah'. She said 'what?' I said 'Your horse is lame on the off four.'
• 8:51
  Julian Hoad: She looked to me, my mud bespattered garm, my hard hat, and she said 'What?'
• 8:59
  Julian Hoad: I said 'Yeah, the might be something in the foot, do you mind if I have a quick look?'
• 9:04
  Julian Hoad: Hopped off the the dumper truck and she got off the horse and I lift the foot up and say 'Do you have a hoof knife?'.
• 9:10
  Julian Hoad: She handed it to me, I dug around and said 'There's puss in the foot here, I can't do anything about this just yet.'
• 9:18
  Julian Hoad: But you need to get your farrier out to take the shoe off and get the vet in but there's puss in the foot here.
• 9:24
  Julian Hoad: And she said 'horrible little man, you've ruined my days ride.'
• 9:32
  Julian Hoad: But two days later, I got to the building site and there was a case of champagne on the dumper truck.
• 9:41
  Mike Brampton: Wow.
• 9:43
  Julian Hoad: So grateful I'd saved her horse's foot.
• 9:46
  Julian Hoad: So were drifting away from your career, because then you went and founded onswitch?
• 9:55
  Alison Lambert: Yes, I did. Out of necessity. I didn't have a job
• 9:58
  Julian Hoad: But out of necessity from the veterinary side as well, because there was no other company like onswitch and there still is.
• 10:05
  Julian Hoad: So Mike and I often say when we're talking about items on this show, we always say, you know, other such and such are available but with onswitch, there isn't really anything else available, is there?
• 10:17
  Alison Lambert: No, genuinely there isn't. I think that's because it's a niche, it's a box and a niche, which is like, the customer experience.
• 10:24
  Alison Lambert: And back in 2001, when Onswitch was founded, it had various situations before it became Onswitch.
• 10:31
  Alison Lambert: And that's a story that needs telling, why it became called Onswitch because it wasn't called that at the beginning.
• 10:38
  Alison Lambert: But that was a Mars thing, which was if you understand your customers, and you know why they do what they do and what they want.
• 10:45
  Alison Lambert: And you learn how to communicate that to them, even though they didn't know they did want it, then that's the thing.
• 10:51
  Alison Lambert: And that's a whole discipline of customer experience, marketing, all that kind of thing. Research.
• 10:56
  Alison Lambert: So when I made the decision to leave Mars on that Thursday morning, which I did, I just kind of walked out and went I can't do this anymore. Sat in the car park and cried for an hour.
• 11:06
  Alison Lambert: Said that's it, I'm outta here, which is 2001. And I needed a job, I'm unemployable.
• 11:14
  Alison Lambert: So let's start business. What do I know?
• 11:17
  Alison Lambert: I know this, because my experience thing, the Mars thing, which was a massive family owned, marketing lead organisation, and I'm a vet, you know, so let's put these two together.
• 11:28
  Alison Lambert: Now I'll go knock on a few doors and say, 'Hey, I can help you do this.'
• 11:31
  Alison Lambert: And they all just looked at me and went, 'why do we need to do that?' I said 'Because you could be better.' 'No, we're fine.'
• 11:37
  Alison Lambert: And then that same parallel process was changing the regulations for people in practices so other people came in and started doing all the things I knew how to do.
• 11:46
  Alison Lambert: And people get 'Yeah, but we do animals'. I'm going 'yeah, but they don't pay bills. They don't drive cars, they don't can't work ping machines', you know, you need to get the human.
• 11:46
  Alison Lambert: So 20 years ago, 2001, 20 years ago next year. Yeah, and it's a very interesting niche, because it's all about putting the customer human at the middle of the thinking process.
• 12:12
  Alison Lambert: If you don't get the human, you don't get the pet, you don't get the horse, you don't get the farm.
• 12:15
  Alison Lambert: You know, you've got your interfaces, you're the human. It's a human human thing.
• 12:19
  Alison Lambert: Always drives me potty when people say they want to be a vet because they love animals. And it's like, that's probably not the right reason.
• 12:27
  Julian Hoad: You've got to love the people, without the human interaction, there is no vet.
• 12:34
  Alison Lambert: There's that thing about people not being available, you know, without people there isn't a profession, the COVID experience has absolutely proved that.
• 12:41
  Alison Lambert: It has become very disconnected for colleague to colleague communication and colleague to client.
• 12:46
  Alison Lambert: Except for the farm and equine guys, obviously, because the fresh air, slightly different. But the building based work has struggled with its communication path.
• 12:55
  Julian Hoad: It has and actually I went from thinking, at the start of lockdown, where we're still treating, but grabbing the pets from the owners shouting 'Your dirty, go away' and running into the
• 12:55
  Julian Hoad: practice clutching their pets.
• 13:10
  Julian Hoad: I started thinking this is quite good. We've got 20 minutes, half an hour to examine this cat without any interruptions.
• 13:19
  Julian Hoad: For the last month or so, we've been allowing clients back into the practice and I realised why I love the job as much as I do.
• 13:27
  Julian Hoad: And it's not taking the animal in isolation and thinking Yep, there's a problem here. I can use drugs or surgery to fix it.
• 13:34
  Julian Hoad: It's actually getting to know the human animal bond and it's learning it afresh each day. And thinking, How can I make that better?
• 13:42
  Julian Hoad: Not how can I make the cat better, that's part of it. But how can I improve that bond?
• 13:47
  Julian Hoad: And it's really important in this day and age where so many people are isolated. Isolation has become socially isolating.
• 13:58
  Julian Hoad: We have a lot of people who can only relate to their pets because they can't see their family, they can't see their friends. And we need to treat that.
• 14:08
  Julian Hoad: We don't just need to get a get a dog better or a cat better and you've had problems with your cat recently haven't you Alison?
• 14:13
  Julian Hoad: Yes poor old Shamii, famous Shamii, if you follow Onswitch on Facebook, you'll know Shamii cat.
• 14:13
  Alison Lambert: Yes, you can probably hear whinging in the background, he may yet make an appea
• 14:22
  Alison Lambert: He's an eight year old, male new tonkinese for those that wish to know that actually he's a critter as well.
• 14:27
  Alison Lambert: And yes, he stayed out, dirty stop out, and had a fight with somebody a bit bigger than himself.
• 14:31
  Alison Lambert: So trip to the vets yesterday morning. All fixed and big bite wound.
• 14:38
  Alison Lambert: We thought he'd maybe done something to his shoulder or elbow, so he's had x rays and magic has happened.
• 14:44
  But the beauty of the whole experience was no phone calls. It was like text: Cat not well bringing him in. Great see you at 10. Fantastic.
• 14:53
  But the beauty of the whole experience was no phone calls. It was like text: Drop off, here's cat, fix cat. Okay, we're doing this. We're doing that, we're doing the other, here's his X ray.
• 15:00
  But the beauty of the whole experience was no phone calls. It was like text: Here's his fluids. Here's what's happening. His bloods are showing this. It's a big hole. He'll stay the night.
• 15:05
  Updates: He's good. Can you pick him up at 3? Jobs a good'un. Here's your bill.
• 15:11
  Updates: Pick up Cat. Cat home.
• 15:14
  ShamiCat: Meow!
• 15:14
  Alison Lambert: Right on cue, do you want to come in? Shall I get him because he's literally there.
• 15:23
  Mike Brampton: Yeah, get him, bring him up!
• 15:26
  Julian Hoad: He's going 'Oh no, it's those baldy guys, I'm clearing off'
• 15:26
  Alison Lambert: Oh don't run away, come here
• 15:30
  Mike Brampton: Yeah and that blokes just called me cat in Mandarin
• 15:39
  Alison Lambert: He's run away just to prove a point, but he's fine bless him. Just picking up on what we were saying earlier
• 15:52
  Julian Hoad: So no phone calls?
• 15:54
  Alison Lambert: I didn't ring, I just went, Oh, cat not well, I'm coming down can I just leave him with you. And the communication between the practice, Okay, I know the practice, you know.
• 16:05
  Alison Lambert: But they do that. That's not me getting special treatment, it's how they handle their client base.
• 16:10
  Alison Lambert: And so I got a video this morning just say he's fine. You know, can you come and pick him up at three? And I go Yes. Then I get and here's his account. Im going 'Thank you. I'll pay the excess and do
• 16:10
  Alison Lambert: the claim' and yada yada.
• 16:23
  Alison Lambert: And so simple, you know, very connected, even though not through a phone call. And that's one of the big things I suppose is that, you know, when I look at you know,
• 16:35
  Alison Lambert: you pick up the phone and you go, you don't ring Ryanair do you to book a flight. 'Hello, Mr. Ryanair. Can I book a flight?' You don't do that.
• 16:43
  Julian Hoad: I don't because I know they're gonna add everything to it when I do that. So I avoid Ryanair, but
• 16:48
  Alison Lambert: It's seamless experience and the cat's fine, even though he's moaning.
• 16:51
  Alison Lambert: He wants to go out, it's blowing force nine and he's got a big green bandage on his leg. But no, he's good.
• 17:00
  Alison Lambert: Thank you to Werrington Vets for looking after Shamii. And, and having me as a client.
• 17:06
  Julian Hoad: Well done so, Werrington Vets is that? Wherabouts is that?
• 17:09
  Alison Lambert: Werrington Vets in Peterborough. They look after my critters and they tolerate me.
• 17:14
  Julian Hoad: Well, I think Werrington Vets are doing a great job, well done Werrington Vets!
• 17:18
  Mike Brampton: I'll raise a glass to that, well done Werrington Vets.
• 17:24
  Julian Hoad: You had a conference?
• 17:26
  Alison Lambert: We had a conference in June. Yes. But it didn't happen physically.
• 17:30
  Mike Brampton: Right.
• 17:31
  Alison Lambert: Because we weren't allowed and on a serious note, there are industries who are utterly devastated because they can't legally trade such as the hospitality and the events guys
• 17:43
  Alison Lambert: and the huge amount of people who I know through theatre, and you know, they arts who are utterly devastated by this, you know,
• 17:52
  Alison Lambert: and so I think the veterinary professional, given there trading up on last year, and most practices seems to be having a bit of a boom time.
• 18:01
  Alison Lambert: Everyone's not having the same pandemic, I think, a little humility sometimes is not such a bad idea.
• 18:05
  Julian Hoad: Absolutely, we're all struggling in different ways, I think, but some people are really, really struggling, having a desperately poor
• 18:17
  Alison Lambert: Yeah, and, you know, the conference, we made the decision to go ahead and record all the speakers, but not in real time.
• 18:26
  Alison Lambert: So then we put it all together so that people could view it later. And on reflection, that was probably one of the daftest decisions I've ever made.
• 18:34
  Mike Brampton: Why?
• 18:34
  Alison Lambert: We should have just done it in real time. Because the speakers were booked to do it physically.
• 18:39
  Mike Brampton: Yeah
• 18:40
  Alison Lambert: You're going to be here and do it. It's just not happening now. But can you just sit at home and do that same slot now.
• 18:46
  Alison Lambert: But the moment we said, we'll do it before the end of June that drifted, for a lot people their diaries got stretched.
• 18:53
  Alison Lambert: And I think the discipline of having it's now and it's this time, and it's this day, I think we should have stuck with that.
• 18:58
  Alison Lambert: But we thought we'd make it easier for people but that didn't really work. We won't do that again.
• 19:02
  Julian Hoad: Can we still access it? Sorry Mike
• 19:06
  Mike Brampton: Did that come across in their presentations?
• 19:09
  Alison Lambert: No, no, I don't think so. I think everybody, all the speakers, there's 25 hours, or five streams, 25 hours of content, from lots of different people doing lots of different
• 19:09
  Alison Lambert: perspectives from across the globe.
• 19:23
  Alison Lambert: And they all have, their content is around that aspect of the whole customer experience delivery, whether that's from the front desk, from the consult room, from leading and managing teams or in a
• 19:23
  Alison Lambert: difficult situation.
• 19:37
  Alison Lambert: So they all had a good story to tell us, some great content.
• 19:40
  Alison Lambert: It's just, you know, when you look back you go Could I have done it differently? And the answer is Yes, I could have because I could have said we're going ahead with the shedule as planned, but you're
• 19:40
  Alison Lambert: just gonna be sat at home.
• 19:50
  Alison Lambert: Whereas we said we're not going ahead. We can do it before and it just, people's lives are busy you know, you ask a lot of people and they're speaking you know
• 20:00
  Alison Lambert: They get their pay and because they've given their time and what have you, but we should have stuck to a diarized and next year, we will do something live but digitally, I think
• 20:14
  Mike Brampton: Oh, okay, so we've discussed a number of times that gin is so much more than a breakfast drink.
• 20:23
  Julian Hoad: Hmm. Much more.
• 20:26
  Mike Brampton: So allowing for the time differences. You spoken there, Alison, that you had speakers from Australia? Is this the CX conference?
• 20:36
  Alison Lambert: Yes, yes. So CX Congress 2020. So I think it's the sixth or seventh one this year.
• 20:43
  Mike Brampton: Right.
• 20:44
  Alison Lambert: So we had four speakers from Australia and they covered all sorts of interesting perspectives.
• 20:54
  Alison Lambert: And so, Cath, she talked about how she owns a practice but she manned the front desk throughout the pandemic.
• 21:02
  Alison Lambert: Kate Toyer, Kate's experience, they had their practices in Batemans Bay and they were devastated by the fires.
• 21:12
  Alison Lambert: You remember the Australian Navy rescued people from Batemans Bay? Well their practice is at Batemans Bay so they'd just recovered from fire. And then they were into you know, the pandemic and Kate's
• 21:12
  Alison Lambert: stories a very powerful story.
• 21:27
  Alison Lambert: And Steve Joslin from Veterinary dB, he's a great guy, amazing beard.
• 21:34
  Julian Hoad: Just like ZZ Top, wasn't he?
• 21:37
  Alison Lambert: Yeah, great guy. Talk about future, you know, using the microchip as a, you know, like a Bluetooth thing with a bit of magic to know that you've got this blockchain enabled
• 21:37
  Alison Lambert: certification of activity.
• 21:51
  Alison Lambert: Way beyond my pay scale, but really interesting.
• 21:54
  Alison Lambert: Brooke Schampers whose an emergency vet on the Gold Coast. So those guys all talked about their aspects of what they do on the customer experience, and ultimately, the patient outcomes.
• 22:05
  Alison Lambert: Available, to download if you go on the Onswitch website and you can pay to view and also the back collections from the previous years as well.
• 22:12
  Alison Lambert: So there's the Cx Congress collection, really nice bunch of people, all who've got a different perspective.
• 22:21
  Alison Lambert: And we desperately need to just see that bit, we do so much clinical CPD, and we have too I get that.
• 22:28
  Alison Lambert: But you can only get the owners to say yes to treatment plans and do the right thing for patients, if you get the human and make it easy for them. You know, that's the key to it.
• 22:37
  Julian Hoad: It is and actually it's not just about getting owners to consent to treatment. And it's not just about getting more money for the practice.
• 22:48
  Julian Hoad: It's actually about enjoying your life and having a bit of mental well being as well. If you can improve your communication as a vet, then there are fewer misunderstandings.
• 23:01
  Julian Hoad: Clients get more out of it, you get more out of it, there are fewer complaints, and much more enjoyment to be had
• 23:07
  Julian Hoad: I absolutely, I've said it before I say again, I love the job I do, love it. I've got some amazing clients who I've known for a good percentage of my life now.
• 23:20
  Julian Hoad: Most of my clients are actually my friends, the new vets that are coming out, I think, struggle because they're often not able to be in practices for as long.
• 23:34
  Julian Hoad: They're not able to be in practices for as long hours, either. The nature of practice has changed.
• 23:41
  Julian Hoad: So when I first started, I was on call most of the time it seemed.
• 23:47
  Julian Hoad: You see people before breakfast, after breakfast, middle of night, and you do get to know them very well.
• 23:54
  Julian Hoad: You get to see them pyjamas and all when they rushed into the practice late at night.
• 24:01
  Julian Hoad: So the the newer vets have to make a relationship with the client on a nine to five basis. And unless they get skills from well, from you, because there are no other people giving those skills, then
• 24:01
  Julian Hoad: they really struggle.
• 24:21
  Julian Hoad: They can deal with the clinical stuff, okay. But they can't deal with the human side of things so well,
• 24:29
  Alison Lambert: You make a very interesting perspective. And I think our generation are very much in danger of saying in the good old days it looked like this
• 24:35
  Alison Lambert: and it can be heard that way. It's not intended that way.
• 24:38
  Julian Hoad: Oh, no, that's no, no, no, no, believe me, I didn't.
• 24:41
  Julian Hoad: I didn't like the good old days of being on call 7 days a week and 305 days a year, but there are differences.
• 24:51
  Alison Lambert: And the key though is that that experience of being the only person who was there to make the decisions
• 25:00
  Alison Lambert: I, for me, one of the things that I would do if I changed the way vet's qualified, went through education and then worked in the first 2-3 years,
• 25:08
  Alison Lambert: I actually think doing on call for two years makes your decision making easier because it's like, the worst that can happen is nothing happens,
• 25:19
  Alison Lambert: I can do something to change the outcome for this patient. And I'm the only one here
• 25:24
  Alison Lambert: And Bill's experiences of I don't know the answer, but I'll do my damnedest and that's okay. We talk a lot about resilience.
• 25:31
  Alison Lambert: And there's a huge debate about whether you can teach resilience or whether resilience is a thing that becomes a learned because of incremental things,
• 25:40
  Alison Lambert: and I do think that not doing out of hours in the beginning. It's going from one extreme maybe to another, there was rich learning in that its on me,
• 25:52
  Alison Lambert: There's nothing better than that feeling of that GDV coming in and you going, If I do nothing, it dies, if I do something it may live, and that's a massive thing. I remembered it.
• 26:02
  Alison Lambert: I mean, I was not an orthopaedic surgeon by anybodies stretch of imagination, but I'd looked after a greyhound, we had a dog track.
• 26:12
  Alison Lambert: And we you know, my boss at the time was very good with greyhounds and I wasn't particularly good with greyhounds.
• 26:18
  Alison Lambert: However, this Greyhound got back to running which you know, for a Greyhound whose injured and can compete again and the man, bless him he bought a trophy to present the Greyhound track.
• 26:33
  Alison Lambert: You know how you sponsor a race? He sponsered a race, he created a trophy. And I had to present it.
• 26:39
  Alison Lambert: It's like, mate, I'm a crap surgeon. But you dog can run. It wasn't very good before it was injured. And it's still not very good now, but it's alive.
• 26:48
  Alison Lambert: But he was so pleased that I could do something.
• 26:52
  Alison Lambert: But today that wouldn't be possible because someone would say that's a referral, you know, and I think the Ying Yang of how do I learn to be comfortable with tissue handling and skills, If I never do
• 26:52
  Alison Lambert: any, you know?
• 27:06
  Alison Lambert: How do you go from no tissue handling to doing anything if you don't have the incremental moments and I don't know...
• 27:17
  Mike Brampton: There's two things you say there, both of you. And I think it's very important.
• 27:22
  Mike Brampton: I've come across it in elite sport in my career. And you never actually approach becoming a champion until you, you believe with your heart that you are that champion, and you act like that champion.
• 27:40
  Mike Brampton: And that's one and you've reminded me there of an interesting tweet I saw from a good friend of mine, who I've known since he was year 2 Veterinary student,
• 27:53
  Mike Brampton: and he's qualified, he's now three years-four years post grad. And he's got an internship. And you highlight a point there that he actually tweeted, that today, he faced the situation without calling
• 27:53
  Mike Brampton: for help.
• 28:14
  Mike Brampton: And he sort of crossed that room and he suddenly realised that he hadn't got that help available. It wasn't on the end of the phone, it wasn't on the internet, etc.
• 28:24
  Mike Brampton: He was going to have to man up, make that decision and move forwards with the treatment protocol. And he made those decisions. It came good. It worked.
• 28:37
  Mike Brampton: And I think he's now assumed that mantle of a veterinary surgeon for the first time in his career. He's done so many marvellous things throughout.
• 28:49
  Mike Brampton: And now 4-5 years, postgrad, he's to make that critical decision. He hadn't got the support.
• 28:57
  Mike Brampton: He didn't rely on the support, he made that decision, and has now grown as a man, as a veterinary surgeon moving forward.
• 29:08
  Alison Lambert: Do you know, I mean, having just said it's, you know, my generation, our generation is in danger of saying in the good old days it looks like this,
• 29:13
  Alison Lambert: but the idea of being five years before I would make an independent decision, that seems like an awfully long time, as a professional colleague, to be in the position to be uniquely making the
• 29:13
  Alison Lambert: decision for the first time
• 29:28
  Mike Brampton: You're right.
• 29:29
  Alison Lambert: And I, I get it, you know, the vet school curriculum is packed with you know, modern kit & equipment and diagnosis
• 29:37
  Alison Lambert: I mean, ultrasound just wasn't invented when I qualified and the internet wasn't either, you know, this was the ultrasound you know, the ends of your fingers and it's why my generation can still feel
• 29:37
  Alison Lambert: adrenal gland is because we can,
• 29:50
  Mike Brampton: Yeah
• 29:50
  Alison Lambert: We can't scan them because we don't know how to turn a scanner on, but we can do this.
• 29:55
  Alison Lambert: Somewhere in there, we've lost the experiential piece which, when the medics and the house doctor rotations, I think that bit works for them.
• 30:05
  Alison Lambert: Because everybody gets a chance of having to be the person who makes the decision about something. And I know a lot of people don't like what I'm going to say next, but I genuinely think we really
• 30:05
  Alison Lambert: face into education
• 30:15
  Alison Lambert: We're creating some very highly skilled, highly intelligent people who, when they come out, they're faced with something that they haven't ever done is astonishing.
• 30:24
  Alison Lambert: Like, you know, having never done a series of everyday dentistry, everyday neutering, everyday lumps and bumps, how can you not be ready for that?
• 30:32
  Alison Lambert: And my nephew's are tradesmen in Australia, ones an electrician, ones a carpenter. And and as they went through their apprenticeship, their skills were incrementally built.
• 30:44
  Alison Lambert: So when they pass, they can do it. And I don't get one we don't. And I know I've had this conversation with the academics and the education people, and they just tell me, it's not possible.
• 30:54
  Alison Lambert: But why can't we have a modern apprenticeship approach to incremental learning?
• 30:59
  Julian Hoad: Absolutely
• 31:00
  Alison Lambert: That would take away all the issues of fear and confidence, exposing to little steps,
• 31:05
  Mike Brampton: Absolutely yeah
• 31:06
  Alison Lambert: It's like gaming isn't it, you know, your level 15 on a game or whatever. You don't start there. You start at level 1, then 2.
• 31:14
  Alison Lambert: And I know it sounds simplistic, and I know that I'm in danger of annoying people by saying, I do think we need a professional apprenticeship.
• 31:20
  Alison Lambert: It works for accountancy, it works for law, it works for other high skilled professionals.
• 31:26
  Mike Brampton: It's an interesting concept.
• 31:28
  Alison Lambert: But you know, you could. The Nottingham degree is two degrees, the three year degree is a science degree so people can leave after three years if they feel that the veterinary pathway
• 31:28
  Alison Lambert: isn't for them.
• 31:39
  Alison Lambert: So they have a BSc equivalent, primary research, they can do the stuff and then move on. And some people do they need that get out clause for the five year course.
• 31:48
  Alison Lambert: Because you're not same person three years after, you know,
• 31:51
  Julian Hoad: Especially not at the age that you go in.
• 31:54
  Alison Lambert: It's a lot, isn't it? And then the last two years are the clinical years, it's like you've done the science piece. Now let's do this bit.
• 32:01
  Alison Lambert: The bit that is the, unless it's a distributed model its, there is the veterinary hospital there. It's good to see real people.
• 32:08
  Alison Lambert: It's kind of a halfway and it's not a million miles, I don't think, from looking at a professional apprenticeship.
• 32:14
  Julian Hoad: Moving back, we talk of risk aversion, don't we these days in the new grads. And who can blame a new grad these days in this climate of litigation,
• 32:29
  Julian Hoad: Who can blame them for being the risk averse?
• 32:32
  Alison Lambert: Hang on. What's the actual risk of being sued as a veterinary surgeon in the UK?
• 32:38
  Julian Hoad: Well, to be honest, I don't know the actual risk, but I do know
• 32:41
  Alison Lambert: Not a lot, and as a new grad its no higher I think if I remember right from the last stats I saw.
• 32:47
  Mike Brampton: Okay.
• 32:47
  Julian Hoad: No. Because clients aren't fools, clients know that you're a new grad. And you're honest and tell them you're a new grad. And then they will give you some form of leniency.
• 33:00
  Julian Hoad: But I think a lot of new grads are taught to be very risk averse. They're taught its a bad world out there.
• 33:07
  Alison Lambert: Thats my issue, yeah. It isn't bad world, it's just the world.
• 33:10
  Julian Hoad: It's not. And they're taught that, rather than being taught, this is how to communicate what you know, and what you don't know.
• 33:20
  Mike Brampton: Are there any particular lessons that UK vets could learn from, not that we got that many UK vets listening to the show, most seem to be an American, from Australia?
• 33:31
  Alison Lambert: The big thing for me is that if you want to scale a multisite operation, so you want to have, you know, 50 100 200,000 2000 practices in the image of an operating model, you've got to
• 33:31
  Alison Lambert: define the operating model.
• 33:46
  Alison Lambert: You can't leave it up to people to make it up as they go along today, like Monday, we're gonna do it this way. Bugger it, next week, we'll do another way. You can't do that.
• 33:55
  Alison Lambert: It's got to be systemized and the best systemized businesses are the ones we're all very familiar with, whether that's Starbucks or Costa, or McDonald's or Bob Jane tires or you know somebody who did
• 33:55
  Alison Lambert: a systemized thing.
• 34:08
  Alison Lambert: And, and that's been exceptional consistency with everyday people. You don't need superstars in the building, our profession relies on superstars in the building. And it's draining.
• 34:18
  Alison Lambert: You know what it's like, you know, if you've got a pair, you've got a vet and nurse pair if they're working together, magic happens.
• 34:25
  Alison Lambert: You've got a different pair. You still doing cat spays at four o'clock and it's like, what happened?
• 34:30
  Alison Lambert: You haven't systemized it and it takes a bit of legwork. And it means that you say you can have all the clinical freedom in the world. Absolutely.
• 34:39
  Alison Lambert: But the way we do it here is and we systemize it so that people are brilliantly trained and inducted and that they know what the right things to do are
• 34:47
  Alison Lambert: You take all the blahblah out too, much blahblah, layers of management, squash, legal, local site with the autonomy, they know what they're meant to do. So just do this.
• 35:02
  Julian Hoad: So it's easy to see how individual vets in private practices can improve, simply by going through your courses, are you able to do anything with the corporates?
• 35:17
  Alison Lambert: We'll work with anyone who pays their bills to be honest. We've never said we'll only work with certain people, I've always said, you know, we'll work you, you pay your bills.
• 35:26
  Alison Lambert: If you don't pay your bills, we're won't work with you. Or if we don't like you, we won't work with you. I've said that to a few people.
• 35:32
  Alison Lambert: You've got to have a values alignment, some people don't get it. And it's not gonna work, you know, you meet those people and go ahh stuff it, it's not going to happen.
• 35:43
  Alison Lambert: So we work with large groups, multisite operators, we work with people in different countries where English isn't first language.
• 35:50
  Alison Lambert: So you know, the principles of what we do are translatable.
• 35:54
  Alison Lambert: we work across three, three key things, which is first contact resolution, first call resolution, first consult resolution.
• 36:01
  Alison Lambert: So if someone lands in your digital space, they've got to be able to book online, order online, communicate with you, do stuff without picking the phone up, that's what we do.
• 36:10
  Alison Lambert: If they do have to pick the phone up, then you have to then say, their only ringing us because we haven't fixed it. So they need us now.
• 36:18
  Alison Lambert: So we need to connect them to a vet at the end, connect them to the vet, connect them to doctor, whatever it is in your country.
• 36:23
  Alison Lambert: And then first consult resolution is they're in front of you now, so go to good medicine now, because they've left it four days because we try to fix it.
• 36:31
  Alison Lambert: So don't wait and see. You know, bad medicine is 'we'll see how it goes. Oh, let's try.' Nope, done all that. Done the white fish, done the box rest, done the hosing. Fix it.
• 36:45
  Alison Lambert: So if you get those three right, then everything kind of flows from that culture. It's all about culture. But it's about someone managing it.
• 36:53
  Alison Lambert: The fact that McDonald's and those guys can make it work. It's just like, this is what we do guys, we do it like this.
• 36:53
  Alison Lambert: So you know, measure, train, you know, inspire. The whole thing, it's like all things in life. It's not rocket science, genuinely.
• 37:11
  Mike Brampton: What is it that the Australians are getting that the UK practices aren't?
• 37:16
  Alison Lambert: Well, a lot of tick paralysis. Their horrible diseases. So they have to have a bloody system.
• 37:23
  Mike Brampton: They have horrible creatures over there.
• 37:25
  Alison Lambert: If you're an emergency setting in Australia, and someone rings up and goes, I think my dog's been bitten by snake, I think it might be tick, you don't fanny around.
• 37:34
  Alison Lambert: You've got 20 minutes mate, this is our protocol. This is how we deal with it, get to an emergency centre.
• 37:40
  Alison Lambert: I just think they've got more, here's your choice,, if you do this, your dog might live, it's you do this your dogs gonna die. The end, there isn't a well we could do this or could do that. Very
• 37:40
  Alison Lambert: direct.
• 37:51
  Mike Brampton: So this is this is part of the Australian. I mean, I loved my time in Australia. I'm gonna go back there as soon as I can.
• 37:59
  Mike Brampton: That they are very direct, it's almost a take it or leave it. It's a, it's a brace yourself Sheila. You know, that's their definition of foreplay, isn't it?
• 38:11
  Alison Lambert: I think that perhaps isn't the best analogy, I think they have a clear view of what's possible.
• 38:17
  Mike Brampton: Oh, okay. clear view. I apologise for that.
• 38:23
  Mike Brampton: I find the Australians very direct, so what you're saying, you're almost talking there about procedures and protocols Alison and almost checklists?
• 38:34
  Alison Lambert: Am I, am I really? I think I'm talking about cultural belief that by the time someone picks a phone up and goes I'm ringing the vet because I'm a bit worried about my dog. In Australia
• 38:34
  Alison Lambert: that could be terminal.
• 38:50
  Mike Brampton: Yeah.
• 38:51
  Alison Lambert: Your worried about your dog, come in and if they choose not to come in, that's on the owners head
• 38:56
  Mike Brampton: Yeah, ok.
• 38:56
  Alison Lambert: Because here we you know, we know our appointment offer rate on all the calls that we do, we've just done a massive research project for someone to see what's been happening over
• 38:56
  Alison Lambert: August and September with you know, a scenario
• 39:07
  Alison Lambert: So we've rung every practice in Britain that does small animal work, with a 'just got a puppy, how much are vaccines?'
• 39:13
  Alison Lambert: Very standard scenario, everyone's got a puppy and of those, I think it was 31% offered to see that puppy.
• 39:21
  Mike Brampton: Wow.
• 39:21
  Alison Lambert: 31% offered to see which by your mathematics, if you quick, means that 69% didn't
• 39:33
  Alison Lambert: Why did we not invite them in? They've got a baby dog, they've run a vet practice. Why not offer to connect them because that puppy needs a lifetime of care and it needs to be health checked. It needs
• 39:33
  Alison Lambert: a load of stuff.
• 39:44
  Alison Lambert: Whereas in Australia, I find that they have a refreshing approach to Well, you've rung us, so here go. If you don't come in then that's on your head.
• 39:54
  Alison Lambert: It's cultural. I think it's cultural. Yes, you could work with, you know, checklists and the Checklist Manifesto. It's something which, you know, until we put procedural stuff in at key parts, I think
• 39:54
  Alison Lambert: it has to happen, airline safety, etc, etc.
• 40:07
  Alison Lambert: I think theres a layer of culture above that. Because if you just do checklists, without culture, it becomes methodical, very dull, and people resent it.
• 40:16
  Alison Lambert: We're doing this so that we save lives or planes don't crash, or patients live longer, or they survive anesthesia, or we make the best of it.
• 40:22
  Alison Lambert: I think there's a cultural piece that says we do this because we care and what's the right thing
• 40:26
  Julian Hoad: Well, that's right there. There's the other layer as well, where someone phones up, a client you know phones up, it's got a new puppy.
• 40:32
  Julian Hoad: You want to actually see it. And you want to say benji for heavens sake bring it in.
• 40:38
  Alison Lambert: Your not answering the phone though are you?
• 40:41
  Julian Hoad: No, but actually, most of my receptionists, they're all interested. And they'll say to me, 'Julian, Look, I'm sorry, I know that you're fully booked today. But you know, you know.'
• 40:56
  Mike Brampton: IT'S A PUPPY!
• 40:57
  Julian Hoad: 'They've got a new puppy, you've got to see it, it's coming in at six o'clock. Is that alright?'
• 41:04
  Alison Lambert: But they know that you're okay with that. Because you've set the culture.
• 41:08
  Mike Brampton: Yeah.
• 41:08
  Alison Lambert: You've said this is what we do here. someone gets a puppy, we see the puppy because it's the right thing. We like puppies, but the puppy needs to see us.
• 41:14
  Alison Lambert: You've set the culture and it's trickled down.
• 41:16
  Julian Hoad: Yeah.
• 41:16
  Alison Lambert: Culture is what happens dround here. What happens down here, someone rings us with a puppy, Julian sees it. You've set it. It's not the same everywhere.
• 41:24
  Alison Lambert: It's like 'Oh it's 10 to seven on Friday. Everyone can just bugger off. I'm not seeing puppies they can come in on Monday.' That's culture as well.
• 41:32
  Alison Lambert: But I just think the urgency of the Australian culture, I think they have an urgent crack on, don't fanny around, jobs are good'un. I think the culture is totally different. It suits my approach.
• 41:43
  Julian Hoad: I remember seeing a practice and there were a couple of Australian vets there and they were rather nice actually,
• 41:54
  Julian Hoad: and one of them said, 'Hey, Julian do you wanna come round for a BBQ tonight?' And I said 'Yeah, alright.'
• 42:04
  Julian Hoad: 'It's gonna be a nice night. We're just gonna be you know, just wearing our thongs and stuff'. And I though 'Ahhaha'
• 42:09
  Alison Lambert: The thong problem.
• 42:14
  Julian Hoad: Fantastic, Brilliant!
• 42:16
  Alison Lambert: popping a thong?
• 42:18
  Julian Hoad: So I turned up, well thongs are flip flops aren't they
• 42:22
  Alison Lambert: They are, and you pop a thong when your bits come out.
• 42:25
  Julian Hoad: I'd never been so uncomfortable in my life. Honestly. Put my shorts on over my mankini and it went right up. Nuff said. Mike's been there, he knows. It's not comfortable.
• 42:43
  Alison Lambert: Thats the trouble with language, isn't it. Is one word means one thing and it might mean another. But yeah, they have a different culture Mike.
• 42:53
  Mike Brampton: Yeah, and for the guys in America, a thong in Britain is a string bikini bottom, and a thong in Australia.
• 43:05
  Mike Brampton: We call a flip flop or a shoe, which is where the little piece comes up between your big toe and your next toe.
• 43:13
  Mike Brampton: What do they call them in America?
• 43:15
  Alison Lambert: You know that's what I was just thinking I don't know
• 43:17
  Mike Brampton: Help me out here guys, what is a thong in America?
• 43:21
  Julian Hoad: Remote consults have taken off haven't they
• 43:26
  Alison Lambert: Well, have they?
• 43:29
  Julian Hoad: what can you tell us about that? I'm gonna say, I hate them.
• 43:36
  Alison Lambert: Are you doing video or phone?
• 43:37
  Julian Hoad: Both
• 43:39
  Alison Lambert: Right. Which do you prefer?
• 43:40
  Julian Hoad: Neither? No, actually, out of both I prefer phone.
• 43:44
  Alison Lambert: Do you?
• 43:45
  Julian Hoad: Yeah.
• 43:46
  Alison Lambert: Interesting, isn't it?
• 43:47
  Mike Brampton: Go on
• 43:51
  Julian Hoad: Just because the people that we tend to do the video consults with are completely unable to point the video at the problem area of their pet.
• 44:02
  Julian Hoad: And so I find it much easier to get them to explain
• 44:06
  Alison Lambert: This is brilliant. Because this is priceless. Because you're wanting to do through video, what you would do through fingers and eyes. You can't you're not there.
• 44:17
  Alison Lambert: So you have to use your ears. And listen, and then go. Yes, I can vaguely see it doesn't look quite right. In.
• 44:26
  Alison Lambert: Or actually I can see and what you've said, it will be okay. So you triaging and your not doing a diagnostic?
• 44:32
  Julian Hoad: No, no, we're not. We're doing a best case scenario for triage.
• 44:35
  Alison Lambert: Yeah. And you may know like you said, you know your clients, so you've got an established vet client patient relationship. So your VCPR is in place.
• 44:43
  Alison Lambert: So I know Bobby, I've known Bobby's mom and dad- VCPR, vet client patient relationship, critical.
• 44:49
  Alison Lambert: If you have one established, you can have a relationship with people because you know them. If you haven't gotten established, it's the first time you spoke to them.
• 44:57
  Alison Lambert: You don't have one established and for our North American colleagues. That's alegal. requirement and it varies state by state. For disease process as well.
• 45:05
  Alison Lambert: So you need a VCPR for each disease presentation in the US.
• 45:09
  Alison Lambert: So dog presented seen once for a lameness, that same dog presented for a sore eye, you need to physically assess the eye to have a VCPR for eye issue. So it's disease process.
• 45:19
  Julian Hoad: I'm getting one of these headaches? Oh, no, I've caught up its fine.
• 45:23
  Alison Lambert: The reason being, that if you have a VCPR, whether it's phone or video, you kind of know them.
• 45:27
  Mike Brampton: Yeah.
• 45:28
  Alison Lambert: So you could kind of make it work. If you don't know them, your trying to do your diagnostic consult, and you don't know them. So it's not working for you.
• 45:35
  Alison Lambert: I just went to the BMJ paper, which is just sitting on my desk, which is the medics looking at how they use video consults for human medicine.
• 45:43
  Mike Brampton: Yeah
• 45:44
  Alison Lambert: There are drawbacks. One of which is we don't really get to touch the people, see the bit we want to see, cuz you can't see eyes.
• 45:53
  Alison Lambert: You know, it's like, if you're a human with uveitis, you're gonna go like this and go, my eyes not right. It doesn't really work.
• 46:00
  Alison Lambert: And there are limitations and to say there aren't, is to misrepresent the situation, what there are is massive opportunities.
• 46:08
  Alison Lambert: For me, video top trumps phone, because you can see, and, and if you already know, like, for Shamii, Shamii needs to go back in two days for dressing change and so many days for checkup.
• 46:20
  Alison Lambert: He won't be going back, I will take the dressing off and I will look at it and I'll send the picture and go is it okay? I also remember I'm an MRCVS and I should know that. But hey,
• 46:32
  Julian Hoad: We do that for post op checks now, and I don't think we'll ever stop doing it.
• 46:39
  Alison Lambert: Yeah. In the same way that the video was sent to me from the practice to say, he's okay, I could have said that video saying what do you think.
• 46:46
  Alison Lambert: That is also remote medicine, but with an established vet client patient relationship framework. And there's a huge place for remote medicine as a continuity of care.
• 46:57
  Alison Lambert: We've established a relationship we know you, you know me, I know that patient. Continuity of care, you can't get in or it's a bit tricky today.
• 47:04
  Alison Lambert: He's done this. What do you think? Perfect.
• 47:08
  Alison Lambert: It's not the answer to everything. And I do think perhaps we're barking up a few trees on remote prescribing without established VCPR.
• 47:16
  Mike Brampton: Interesting.
• 47:18
  Julian Hoad: I hadn't thought of it as being a VCPR before, but there are so many of my friends who will send me videos or photos of their pets. And I know them very well.
• 47:28
  Julian Hoad: And they'll say, Jack's doing this today. Is that alright? No, that's not alright. He'll go blind is the answer or whatever.
• 47:36
  Julian Hoad: Or yeah, that's absolutely fine. Yeah, he's doing well, or no, stop him doing that and replace the strawberry jam, you know, whatever the whole litany of possibilities exist.
• 47:50
  Alison Lambert: 40% of your annual health checks, have got something else going on, which is a very strong argument for not having remote prescribing without established VCPR.
• 48:00
  Julian Hoad: Absolutely.
• 48:02
  Julian Hoad: If I could correct you there and in the most positive way. It's not 40% of people, 40% of vaccines has something else going on. 40% of consults have something picked up.
• 48:14
  Julian Hoad: And so there's a minimum of 40% has something else going on. And you could argue that a lot more have but they get missed.
• 48:22
  Alison Lambert: I think what he did, hang on a minute. I can't remember what he did. He reviewed when it was picked up?
• 48:32
  Julian Hoad: It was picked up. It wasn't then necessarily. So there's that sort of Venn diagram, isn't there?
• 48:39
  Alison Lambert: yeah.
• 48:40
  Alison Lambert: Of the problems that exist, the problems are picked up and the problems were picked up
• 48:43
  Alison Lambert: The chances are that 40% understates because that was noted and picked up. So there probably would be more. Yes,
• 48:48
  Julian Hoad: yeah.
• 48:48
  Alison Lambert: But the point being is that you shouldn't be dishing out PYV's without putting your hands on them
• 48:53
  Julian Hoad: Yep, almost half the patients, you jab vaccine in, have something else that really needs addressing.
• 49:01
  Julian Hoad: Exactly
• 49:02
  Julian Hoad: But actually it shows the importance of an annual vaccination
• 49:07
  Alison Lambert: Or an annual health check. We might not need the vaccine.
• 49:10
  Julian Hoad: I know. I know. Absolutely. We call it annual vaccination and we pick up on things otherwise, but you're absolutely right Alisons, it's a health check.
• 49:21
  Alison Lambert: It's a mot, it should be a licence to own like if you're gonna own this flock or herd, once a year you have to have a veterinary intervention that they're well and what's going on.
• 49:32
  Julian Hoad: The number of clients who come in and say 'Any problem with Fido here?' 'No, no problem at all. Oh, all except he appears to have lost a leg during the last year.'
• 49:47
  Julian Hoad: 'Do you know I haven't noticed that'. It's not quite like that. But the owners often don't pick up on on even serious things, not through any fault of their own at all.
• 49:58
  Julian Hoad: But because there not qualified to read certain clinical signs. And so that's the benefit of an annual check. And then some would argue, a biennial check will be more useful,
• 50:16
  Julian Hoad: because actually, if you can pick up on things very early on, there's nothing worse than seeing a dog or a cat for an annual check and saying, 'oh, my goodness, you know,
• 50:29
  Julian Hoad: 'there's a problem here, there's a lump, I can feel, there's little point in doing the vaccinations today, because actually, there's cancer, there's a problem here or whatever that we can't do much
• 50:29
  Julian Hoad: about.'
• 50:46
  Julian Hoad: And that would have been picked up more often in the human field, because there would have been a symptom. And those cats don't have symptoms, they display clinical signs,
• 50:59
  Julian Hoad: and we can read these clinical signs as astute owners, or I'm not saying that the owners is going to miss things. Because that would be an awful thing, wouldn't it?
• 51:14
  Julian Hoad: If you dog, or cat, comes out with a problem and you've missed it. If you've missed it, it's not because you're not an astute owner, it is because they are clinical signs, not symptoms
• 51:25
  Julian Hoad: and symptoms of what we feel with a disease. And as humans, we can feel a disease far more quickly than an outward display of that disease is presented.
• 51:37
  Mike Brampton: I think, well, there's another aspect to that Julian I think.
• 51:40
  Mike Brampton: And that is, theres two strains running here. One is that I rock up to my GP every year and go It's time my annual check.
• 51:53
  Mike Brampton: He goes, 'What, your the fittest patient I know.' I go 'No, but I've always had an annual check.' And that goes back to my days as ski racer, and a cyclist where we used to have six monthly checks to
• 51:53
  Mike Brampton: make sure that we're hitting our numbers.
• 52:11
  Mike Brampton: But the other thing is, is that when you live with a person or live with an animal the progressive nature of a disease or problem is not noticed.
• 52:27
  Mike Brampton: When you then see that person or that animal after a year or six months, you suddenly notice.
• 52:35
  Mike Brampton: And obviously in human terms, we go, 'Oh, you're looking well.' = Fat
• 52:42
  Julian Hoad: Yes, yes.
• 52:44
  Mike Brampton: You're looking well, you've gained two stone, why have you gained this 2 stone in the intervening period? Because the last time I saw you, you were skinny as a rake.
• 52:55
  Mike Brampton: And the value of that is that the last time you saw Mrs. Jones's Trickywoo. A spaniel, cockapoo, or whatever.
• 53:09
  Mike Brampton: You have fixed in your mind, perception of that animal as it was six or 12 months previously. Suddenly, they've got a lump here.
• 53:20
  Mike Brampton: They're overweight, or they're underweight, or something else. And you look at your records. And you say, Well, I measured Trickywoo, at 20 kilos.
• 53:31
  Mike Brampton: Why is Trickywoo 30 kilos today? 30% increase in body, you know, what's been going on.
• 53:39
  Mike Brampton: And then you further investigate. So to a certain extent, I mean, I'm fully with you on the annual mot, on the vital service, but you are depreciating the value of of time.
• 53:58
  Mike Brampton: And seeing that patient afresh, and noticing the differences in, in what's presenting, because in your mind, that animal is thin, fat, or whatever, and suddenly, they're presenting as fat thin or
• 53:58
  Mike Brampton: whatever.
• 54:19
  Julian Hoad: We had a client a few months back send a picture of a dogs eyes, she said it's got a nasty thing on his eye.
• 54:29
  Julian Hoad: And so we said send us a picture of his eye. So, she did and it was this out of focus sort of greyish whitish thing and so my receptionist looked at and said Any chance of sending a clearer picture?
• 54:43
  Julian Hoad: So, an hour later, the client sends another photo and theres this similaly out of focus, sort of petri dish picture, no , any any chance of a better picture?
• 55:00
  Julian Hoad: So the client sent a picture of, she'd drawn something in felt tip and said it looks a bit like that. So the receptionist said yes, I think you need to come straight in.
• 55:14
  Mike Brampton: So, tell me, Julian Have we got, now I know Alison's a keen fan of the RCVS and, Alison's giggling now.
• 55:24
  Alison Lambert: No, It's just that could be misinterpreted.
• 55:27
  Julian Hoad: You just wondering where this is going to, I think, are you asking about a CPD certificate?
• 55:32
  Mike Brampton: I'm just wondering whether we've got a CPD certificate for this evening
• 55:34
  Julian Hoad: We do, look here we go. This says certificate for you to keep.
• 55:41
  Alison Lambert: Aww
• 55:42
  Julian Hoad: It says This certifies that Alison Lambert has joined
• 55:48
  Mike Brampton: That's you Alison
• 55:49
  Julian Hoad: Veterinary Ramblings and taught u
• 55:49
  Alison Lambert: Me
• 55:53
  Alison Lambert: Excellent.
• 55:54
  Julian Hoad: Now. The pictures around here may need some sort of explanation. So..
• 56:00
  Mike Brampton: What's with the picture of the llamas?
• 56:03
  Julian Hoad: Well, there alpacas
• 56:04
  Mike Brampton: Whats withthe picture of the alpacas Julian??
• 56:09
  Julian Hoad: Well, it's really because Alison was brought up in a farm in Yorkshire
• 56:13
  Alison Lambert: We didn't have any alpacas
• 56:14
  Julian Hoad: No but I couldn't find, what I don't want to do is have to pay copyright for photos when I've got so many thousands on my camera.
• 56:22
  Julian Hoad: I didn't have any photos of a farm in Yorkshire.
• 56:26
  Julian Hoad: So this is one just down the road from me. We're having targeted CPD, so there's a target.
• 56:35
  Julian Hoad: Okay, and we're really wanting to highlight your company Onswitch. I've didn't have any pictures of switches because they're rather boring to draw or paint or photo. So I got a picture of a
• 56:47
  Mike Brampton: looks like a lighthouse,
• 56:49
  Julian Hoad: A lighthouse. And basically, if you own lighthouse, you'd be buggered without an Onswitch, wouldn't you?
• 56:55
  Alison Lambert: Yes, thereby hands a tail on the name as well. Because there's no off switch.
• 57:00
  Julian Hoad: There is no off switch in a lighthouse. You're absolutely right. So there we go its my lighthouse.
• 57:05
  Julian Hoad: And I thought there you go, you're providing a rainbow which gives this amazing pot of gold for those that follow your training.
• 57:18
  Mike Brampton: A cornucopia of knowledge shining
• 57:21
  Julian Hoad: A cornucopia of knowledge signed me and him and written there. Him and me. So there we go.
• 57:31
  Alison Lambert: Splendid.
• 57:33
  Mike Brampton: So, so anybody can download the certificate. And depending on the length of the podcast, present that to the RCVS as their CPD for the evening
• 57:43
  Julian Hoad: It's not valid though is it Mike? What do you have to do? You do the CPD and then what do you have to do?
• 57:54
  Mike Brampton: You have to reflect. So Alison, can I invite you to join us in a moment of reflection on the CPD that we've provided this evening please?
• 58:20
  Mike Brampton: There's no schoolboy giggles there, are they
• 58:22
  Julian Hoad: None at all, serious reflection there.
• 58:26
  Mike Brampton: Serious reflection
• 58:28
  Julian Hoad: So Thank you, Alison, for that.
• 58:30
  Mike Brampton: Thank you very much indeed Alison.
• 58:31
  Julian Hoad: Wonderful evening of CPD
• 58:32
  Alison Lambert: Pleasure
• 58:33
  Mike Brampton: Yeah, absolutely. We're obviously at that time of the night. Alison, I have to prepare you for this. Traditionally, Julian tells us joke.
• 58:44
  Alison Lambert: Oh, right. Okay.
• 58:46
  Mike Brampton: It might be polite to laugh.
• 58:49
  Alison Lambert: Before he tells it?
• 58:51
  Julian Hoad: It is probably best, you won't you laugh afterwards.
• 58:53
  Mike Brampton: I'll cue you. When it's time to laugh,
• 58:58
  Julian Hoad: I'll be honest, I completely forgot that I do a joke. I don't know why.
• 59:03
  Mike Brampton: But you always do a joke.
• 59:04
  Julian Hoad: I know. I completely forgot but I then thought halfway through this evening's chat, I thought, I've got to do a joke.
• 59:13
  Julian Hoad: And then Alison said something that triggered in my mind the joke that I should do.
• 59:19
  Mike Brampton: Okay
• 59:20
  Julian Hoad: Here we go and we'll pick up the connection later, its a current joke. So it mentions the the pandemic but
• 59:28
  Julian Hoad: It's about this chap who has a very strong connection with his dog and every day. Five past seven in the morning, he leaves his house.
• 59:37
  Julian Hoad: He walks down the road to a local shop. And he gets his paper. The dog comes with him and he pays for the paper
• 59:46
  Julian Hoad: puts the paper in his dog's mouth and dog walks back. Every day he does that for, at least five years and this dog loves this routine
• 59:59
  Julian Hoad: and one day the poor chaps got Coronavirus, and he can't go out of the house. He feels pretty miserable as well.
• 1:00:05
  Julian Hoad: And he says to the dog said, 'We're not going this morning, we're not going to the shop' and the dog looks miserable.
• 1:00:13
  Julian Hoad: He's just, he used to it, this is his day, five past seven. Every morning, he goes out with his master. He walks in the shop. And he thinks I can't do it. I'm miserable.
• 1:00:24
  Julian Hoad: And the owner picks up on this because of the close relationship. And he says, 'I'll tell you what, do you think you know the way to the shop?' and the dog goes (excited bark)
• 1:00:35
  Julian Hoad: He puts his wallet in the dog's mouth. 'Go along. Go and see Bill at the village shop and get the paper and bring it back.' So off goes the dog.
• 1:00:47
  Julian Hoad: And the man lies back, he's got a temperature. Really sore throat. He's feeling miserable. He's lying back in bed. He drifts off for a while and he wakes up about an hour later, he thinks dogs not
• 1:00:47
  Julian Hoad: back yet?
• 1:01:01
  Julian Hoad: And he gives another hour he thinks he's still not back. Where is he?
• 1:01:06
  Julian Hoad: He knows he shouldn't go out but he's worried about his dog. And so he puts his coat on and puts his mask on. And he walks to the village shop.
• 1:01:16
  Julian Hoad: About a mile down the road. He hears this sort of grunting noise coming from an alleyway. And he looks into the alleyway and there's his dog.
• 1:01:26
  Julian Hoad: Making love to this gorgeous cocker spaniel. He says 'Rover Oh my god, you've never done this before.' And dog says 'Well in fairness, you never give me the money before.'
• 1:01:49
  Mike Brampton: Season three and we've got a joke we can all laugh at
• 1:01:52
  Julian Hoad: I thought of that joke because you said quote, 'The animals don't pay the bills.' Well, there we go. Here's one that does.
• 1:02:08
  Alison Lambert: Rover does, bless him.
• 1:02:10
  Mike Brampton: What a fabulous joke. What a wonderful, wonderful end to a marvellous evening.
• 1:02:16
  Julian Hoad: What a great evening. A fantastic evening.
• 1:02:20
  Alison Lambert: It's been good funactually, not knowing what I was walking into. And I've still got half bottle of wine left.
• 1:02:28
  Julian Hoad: I've got half a bottle of whiskey.
• 1:02:29
  Mike Brampton: Well, we'll deal with that. I think I've got about a quarter bottle of gin left
• 1:02:35
  Julian Hoad: Oh that's taken a hit hasn't it?
• 1:02:36
  Mike Brampton: Well, yeah one or two.
• 1:02:38
  Mike Brampton: But on that note, on that note, Alison Lambert, thank you so much for joining us this evening.
• 1:02:49
  Mike Brampton: And join us in the future for another episode of veterinary ramblings and until the next time may your dog go with you
• 1:02:58
  Julian Hoad: may your dog go with you
• 1:03:02
  Mike Brampton: Cheers
• 1:03:07
  Mike Brampton: CUT! Did you enjoy yourself Alison?
• 1:03:11
  Alison Lambert: Yeah, no, it's like being at the bar at BSAVA isn't it?
• 1:03:16
  Julian Hoad: It was a great evening. Someone like that, she has so much talent, so much experience so much to give back to the profession.
• 1:03:29
  Mike Brampton: In so many ways, in so many areas.