In France, to exercise his profession, a veterinarian must have a home professional, declared to the order of veterinarians. There are several kinds, the most important being: the Veterinary Office, Veterinary Clinic and the veterinary hospital. Professional homes are defined by article R. 242-54 of the rural code and the Decree of 4 December 2003, published in the o.j. No. 298 and acting as the code of ethics of the College of veterinarians. The veterinarian at home, which has very strict status, defined by article R242-57, is an exception: “veterinary called is home the physical or legal person authorized to practice medicine and surgery of the animals which, with no professional home of exercise, is exclusively at the domicile of the customer.”. It may therefore exercise without restriction the medicine and surgery of the animals at the home of the patient. However, other sections of the Code Rural (and in particular the Art.) (R 242-33), require that all veterinary has in no case under conditions that might compromise the quality of his acts. This is why, as is the case of the medical home for humans, some interventions do not performed home (heavy surgery, including hospitalizations).
Historically, the veterinarian went his client, primarily because he had to treat large animals (horses, cattle,…), difficult to move. In the 1970s, pet medicine develops considerably, particularly in major cities. Copying the pattern of human medicine (“SOS doctor” was founded by Dr. lascar in 1966 to deal with emergencies in the Paris region), and in response to a request of the owners of animals, it is at this time that the first veterinary service at home (friend VETO) takes birth in France, Dr. Atwop, both medical and veterinary initiative. Very quickly, he becomes aware of the impossibility to home, and in good conditions, all emergency. The need to hospitalize a number of patients is necessary. He then approximates the veterinary hospital founded in Paris by Gustave Eugène Frégis, to create a coherent chain of care and thus ensure emergency in conditions consistent with current scientific data.
For a few years now, the veterinary services at home are present in large and medium cities. These are:
- is the so-called “emergency” services; the structures involved particularly in major cities.
- or services known as “generalists”, the veterinarian at home then having activity comparable to that of a “classical” veterinarian: it uses an adapted equipment and carries all of the tools necessary for its activity.
To defend their interests, promote their mode of exercise and the standardize, since March 2009, veterinary practitioners at home are grouped in an association: the AVAD (Association of veterinarians at home) (link to the website of the association)
The mode of operation
Veterinary emergency home
Depending on the services and their importance, calls are received by a Secretary via a switchboard or the veterinarian directly. In this telephone contact, the great difficulty is to assess the seriousness of the situation and the nature of the care to implement. In human medicine, the physician who manages the appeal is still in relationship with a direct line with the UAS, he can converse with his patient and evaluate enough precisely the situation. In veterinary medicine, including economic, this schema does not exist and is the interlocutor of the emergency can only to “interpret” what feels the animal through the words of the client. In accordance with the basic ethical duties of the veterinary profession, to limit the loss of chance and giving customers all the elements to make the best decision for their pet, from the first contact, therefore important to remind them that if his condition appears to be degraded, it may be better to hospitalize without delay in a structure equipped for emergencies.
Veterinary practitioner home
As for a conventional Veterinary Office, appointments are taken by telephone. Veterinarian visits on-site and carries out the necessary examinations for diagnosis and puts in place the adequate treatment. In some cases, as for the consultation of the general practitioner in human medicine, complementary examinations will be required (e.g. radiography) or the State of the patient will require hospitalization. General Home veterinarian will then propose hospitalization in a hospital structure near. Conversely, more than more care not requiring steps to move the animal, more in addition to veterinary clinics refer some follow-up (dressings, blood glucose monitoring, etc) to veterinarians at home in their region.
For the client, the benefits are many: do not move, not to do suffer the stress of transport to the animal, but still not losing time to wait in waiting room or, more accurately, use the wait of the veterinarian to do things at home, which arranges particular assets. In the case of a veterinary emergency at home, the veterinarian at home supports fully the urgency. If needed, he can advise the owner to his animal to its usual veterinarian the next day to any further tests. In the case of a veterinarian at General home, veterinarian supports fully the cases (illness, but also vaccination, electronic identification). In some serious cases, it may advise the hospital. If veterinarians first home working alone, several structures already propose a shift of a veterinarian accompanied by a veterinary assistant.
In the same way, the veterinarian at home has more specific and adapted materials to its mobility to thus bear an accurate diagnosis: analyses biological and medical, microscopy, ultrasound, etc. Some emergency at home have mobile resuscitation structures (oxygen). As in Veterinary Clinic, some reviews may require a tranquilisation or anesthesia which is then carried out at home. Note that the veterinarians at home does not x-ray for security reasons. In practice, the majority of routine Veterinary Clinic reviews are conducted at home. Only specialized examinations that also require hospitalization day are entrusted to the local veterinary hospitals.
Veterinarians at home and veterinary hospital Centres: competitive or complementary?
The majority of care in the life of an animal in urban areas are feasible at home, emergency or not. More rare but real, situations where a quality hospital structure is necessary must be taken into account with the best efficiency. In practice, veterinary at home and veterinary hospitals are major chain of care, necessarily complementary, one doing what the other is not, for the benefit of pets.