TheSkinVet Corporate Social Responsibility
As stated on the Home page my service is pro-active, evidence-based whenever possible, tailored for each individual case, fully explained and independent.
Independent
I am an independent, peripatetic consultant attending multiple dermatology sessions in clinics throughout the South East. Not only do the clinics refer their own cases to me, as well as cases from their other branch surgeries, but external referral cases are also welcomed into these centres from neighbouring practices.
As a fully independent consultant, I am not constrained by any corporate or individual practice rules regarding prescription of specific medications or diets, nor utilisation of specific laboratories, nor the recruitment of the best additional specialists for complicated cases. This total clinical freedom allows me to make specific diagnostic and treatment decisions, with the referring practitioner and client in mind, in the best possible way for each individual case. I will only run clinics in practices that give me total clinical freedom.
Empathy
Since qualifying in the nineties I have worked full-time, almost solely in small animal practice and consequently I have seen dermatology cases on a daily basis, dealing with mild, sub-clinical dermatitis to chronic, severe, lifelong dermatitis and dermatopathies, as well as life-threatening dermatology emergencies. This wealth of experience allows me to empathise with my referring Vets in general practice. As I see them on site I am also able to give them advise in passing on many other cases.
I have had to advise clients, from all manner of backgrounds, with varying budgets and often very specific needs, on how best to investigate, treat and manage their pet’s dermatological conditions. In addition, I can empathise fully with the considerable burden created by owning a dog with chronic skin disease as my family have owned two dogs with chronic atopic dermatitis and one dog with recalcitrant otitis. It also means that I am acutely aware of how chronic dermatitis affects a pet’s quality of life as well that of the owners.
The Veterinary Dermatology discipline leads the way, through evidence-based publications, in understanding not only the affect of chronic medical conditions on their patients but also on their caregivers: Caregiver burden, treatment complexity, and the veterinarian-client relationship in owners of dog with skin disease; Quality of life of dogs with skin disease and of their owners. Part 2: administration of a questionnaire in various skin diseases and correlation to efficacy of therapy & Development and validation of a questionnaire to evaluate the Quality of Life of cats with skin disease and their owners, and its use in 185 cats with skin disease.
Continuing Education
As you can read in the Background page, I know it is my responsibility to keep up-to-date with worldwide developments in companion animal (and human) dermatology diagnostics, treatment and management for the betterment of my dermatology service.
Evidence-base
In all the cases I see I will try to use treatment and management protocols based on scientific studies and not potions and remedies based on hearsay and anecdotes. In order to practise evidence-based medicine, and therefore give the best service to my patients, I have close and regular contact with all the veterinary pharmaceutical companies manufacturing efficacious dermatologicals. The veterinary dermatology discipline has more evidence based information than any other discipline. There is a wealth of good scientific evidence especially on the treatment of our most common condition – canine atopic dermatitis. I utilise prescription ectoparasiticides, medicines, topicals, diets and supplements whose release has been supported by robust, scientific research and development. These products are produced by all manner of companies from the multinational pharmaceutical giants, UK-based veterinary businesses and dedicated scientific pet nutrition companies to the niche dermatology-only specialist companies. Although I considered a key opinion leader by the drug & nutrition companies, I have no conflicts of interest and am freely able to use whatever is the best medication or diet for each case.
Travel
By journeying to several clinics on a peripatetic basis, and ensuring that my clinics are as full as possible on each trip, I am able to reduce the sum total overall travelling distances for all of those involved in these clinics. Shorter travel times also reduce the time outlay for clients and also the stress caused to the pets. All the clinics have off-road parking. From Spring 2024, I have been driving a mini-SUV EV to my outlying clinics to further reduce my carbon footprint: https://vetsustain.org/
As you can see from the preceding Clinics page ( http://www.theskinvet.net/other-information/clinics/ ) , I have ensured that all my dermatology clinics are easily accessible by public transport. They are all within very short travelling distances of railway stations (no more than 1.3 miles) as well as bus routes. In fact, when able I walk to my nearest dermatology clinic and have travelled by rail to some of my other clinics when possible.
Unfortunately for those clients reliant on public transport, the large multidisciplinary referral centres are now often situated in suburban, or rural, industrial estates which are often a considerable distance for local transport hubs.
If travel is not an option then the other affordable solution I offer is an E-Consultation
( http://www.theskinvet.net/veterinary-surgeons/e-consultation/ ).
Insurance
Recently one insurance underwriter, Royal Sun Alliance, has started to dictate which referral centres can be used by their clients for specialist, non-emergency referrals. If you chose to see another specialist, even if he/she is much closer than RSA ‘preferred network’ specialist you will be penalised financially. Luckily if your practice has a peripatetic visiting consultant then the company accepts that your pet is best treated by them at your pet’s own clinic. But if you are a client of a practice who does not have a visiting consultant then the financial penalty for not seeing their nominated consultant is a considerable percentage of what you are likely to have to pay for a dermatology consultation & investigation (around 67% or two thirds of my average fee). If you find yourself in a situation of having to travel very far to avoid incurring a penalty I may be able to visit your practice.
My concern with this system is that clients may ultimately not decide to pursue a referral at all if the travelling distances are much greater than seeing a local, fully qualified specialist who may be ‘just around the corner’. I am concerned that patient welfare may become compromised due this present system.
The financial penalty levied by RSA is the same no matter what speciality the pet needs to see. It is a much smaller relative percentage penalty for an orthopaedic consultation and operation (around 4% of the fee) and so consequently most clients accept the penalty so that they do not have to travel so far. Other insurance underwriters may be planning to follow suit with RSA’s recent decisions.
Luckily, I have been added to RSA’s ‘preferred network’ at one of my clinics, Wilbury in Hove. This means that if you consider that you are within travelling distance of Hove, & your insurance is underwritten by RSA, then you will not suffer from this penalty system if you bring your pet to see me.
Sponsorship
I am also proud to announce that I was sponsoring the Hove Rugby Club U8s squad for the 2022-2023 season & hope to sponsor the U10s season!
Charity Support & Work
I have seen multiple PDSA dermatology cases & several RSPCA dermatology cases for cruelty assessments.
I am proud to support several charities – the UK’s national Down’s Syndrome Association ( DSA, https://www.downs-syndrome.org.uk/ ), my local Down’s Syndrome Development Trust, The Rocking Horse Children’s Charity (The Royal Alex Children’s Hospital, Brighton, http://www.rockinghorse.org.uk/ ) and The Evelina Children’s Heart Organisation ( The Evelina London Children’s Hospital, https://echo-uk.org/ ) all of which have wonderfully supported my son Adam during his learning and development, as well as his two open-heart reconstructive surgeries, his ear, nose and throat operations, his episodes of pneumonia and his acute hypoglycaemic attacks. For example I have ridden the Capital-to-Coast bike ride to raise money for the DSA seven times and I help to raise awareness of Down’s Syndrome by selling badges and collecting donations for World Down’s Syndrome Days ( 21st March ) at my son’s school. In recognition of Balfour Primary School’s mainstream educational support of Adam I have offered a free Dermatology Consultation (and in-house tests) for a pet as part of the Friends-at-Balfour annual silent auction. Here’s a lovely jazz contribution from Sting: The Hiring Chain
In 2017, I requested a prostate specific antigen test (PSA) was added in to my routine NHS health check. I was diagnosed with early prostate cancer after a further PSA, an MRI scan & biopsy (T2M0N0, Gleason 3+3). I opted for a robot-assisted, radical prostatectomy which I am very glad to say was successful with minimal side effects. As is the case with 40% of men, my cancer score increased to Gleason 3+4 when the organ was fully assessed by histopathology. With the help of Prostate Cancer UK, I am working to raise awareness about this, most common of male cancers, amongst my contemporaries, colleagues & friends.
My late Labrador Retriever. ‘Tap’, was a registered, DEA+, blood donor for both the local Veterinary Hospitals with Out-of-Hours emergency services (PETS and VetCall) – I hope to have a new Puppy this year.