Episode 39 – Is Veterinary Telehealth an Opportunity to Improve Our Profession? featuring Dr. Jess Trimble

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Click here to read the entire interview, but please excuse any errors as it was automatically transcribed by Otter.ai

Stacey Cordivano 0:07 Hey there, it’s Dr. Stacey Cordivano. I want veterinarians to learn to be happier, healthier, wealthier and more grateful for the life that we’ve created. On this podcast I will speak with outside of the box thinkers to hear new ideas on ways to improve our day to day life. Welcome to The Whole Veterinarian. Stacey Cordivano 0:35 Today I’m excited to dig into the ways in which connected virtual care may help overall well being within the veterinary profession. What does that phrase even mean? Well, Dr. Jess Trimble is here to help us understand the nuances behind veterinary telemedicine. Dr. Trimble is a veterinarian who is passionate about how virtual health and new technologies can improve the lives of the whole veterinary team and enhance practice operations while also improving pet health and making care more affordable. She is an experienced general practitioner, telehealth consultant speaker and the Chief Veterinary Officer of Anipanion. Stacey Cordivano 1:19 Hi, Jess, thanks so much for sitting down to chat with me today. How are you? Jess Trimble 1:23 I am great. Thanks for having me, Stacey. Stacey Cordivano 1:25 I’m really excited to talk to you about telemedicine or telehealth because I know how excited you are about it. And I want to clarify before we even get started, that the goal of this talk is really to dig into the ways in which telehealth can benefit the overall well being in our veterinary profession. So I want to start out with that so everyone knows and then I really do want to clarify the differences in nomenclature. So can you talk a little bit about what telehealth is versus telemedicine? Jess Trimble 2:00 Absolutely, it’s pretty confusing. And unfortunately, I think it’s going to continue to be confusing because even some of our industry associations disagree a little on terminology. The main definitions that we use for now though, is that telehealth basically describes any electronic communication involving a patient. This can be with or without vsepr. It’s just this giant umbrella term was telemedicine, we’re going to talk specifically about patients we have a vsepr with diagnosis treatment prescription, where we have laid our hands on that animal at some point in time or we live in a state where we can form electronic vsepr. So telemedicine is like this itty bitty little place in the whole wide world of telehealth. You’ll also hear virtual care thrown around. It’s it’s another sort of telehealth sort of umbrella term. And then connected care is actually the terminology that AVMA likes. And it’s more the description of using telehealth and telemedicine throughout the length of the patient’s life using all these fun new technologies. So those are those are the main four terms we hear. Stacey Cordivano 3:07 Okay, perfect. And then for the purpose of this discussion, I also want to clarify that you and I are mostly going to be talking about in-house services versus outside companies that are providing telehealth, whatever that may mean. So we are going to focus on veterinarians providing telehealth services to their own patients. So just so everyone is kind of on the same page. And I’m really grateful, because when we first started talking, I approached you with the idea of potentially just throwing out all the complaints that people have with telehealth, and you were totally gamed to tackle those complaints. So are you still up for that? Jess Trimble 3:49 I’m so game for that. It sounds fun. Stacey Cordivano 3:51 Let’s do it. Okay, perfect. So I’ve obviously heard some in just, you know, normal goings on. But I also did poll on my DVM mom’s leadership group. So I’m trying to get, you know, a current perspective, I’m trying to get a small animal perspective, I’m obviously an equine perspective. So let me just get started. My first thought that people might have an issue with is, I don’t have the time to train my staff to do this, or I don’t have the staff to do it, period. And I think that also goes along with some of the other complaints that I heard… it’s too hard to implement into your normal routine or your normal flow at work. So let’s tackle that one first. Jess Trimble 4:34 Yeah, that’s a big one. I’m probably one of the most common ones. And I think I’d probably start by saying all of these complaints and worries that do pop up, they’re all valid. You know, this can be a really difficult thing to implement. And so, you know, I don’t want to say that any of these aren’t real concerns. However, there are things that we can do to work around them. So for our staff issue and the time issue, this is what I hear is that I know telehealth can save me time. But I don’t have the time to create my telehealth program. And we get wrapped in this vicious cycle of never having enough time to do the things that can save us time. And so the first thing that I encourage our clinics to do is to actually sit down and write down like the top 10 things that are the biggest time sucks for them. Like what is taking time that really shouldn’t be? Are you spending way too much time on the phone? Do you have, you know, technicians that have to deal with chatty clients when they’re just sort of saying the same thing over and over and over? Let’s find those biggest time sucks and try and automate them with telehealth first. So let’s not jump straight to trying to diagnose something, you know, that’s like advanced level telemedicine, we don’t really have the right tools to do that. Most of the time, however, we can use telehealth for your front desk to not have to have a phone ringing off the hook. Instead, they can chat with five people simultaneously. That’s telehealth. So if we can find those little things in the day that are taking the most time and switch those out for telehealth first, suddenly, we’ll find more time than then what we had. And so it’s starting with baby steps, it’s starting with the little things, it’s not trying to jump to implementing this enormous telemedicine, you know, having an entire doctor just for that. It’s the little tweaks in workflows or in our professional staffs day first to help us find that time, if that makes sense. So little things first. Stacey Cordivano 6:31 It does. Okay, so let’s dig into a specific example of that. Yeah. So you said your front office person managing five conversations at once? What does that actually mean? Like they are on a computer messaging with people? And how have they gotten people to that point? Jess Trimble 6:49 That’s, that’s a hard question. Because this takes some marketing as well, right. Because if our clients don’t know that we have a telehealth service, they’re never going to use it. And they’re going to keep calling us. And so, you know, adopting a telehealth platform, or you know, even you know, encouraging your, your patients to use email or things like that, I’m always going to advocate for a real platform, because we can integrate with practice management systems and things like that. But just as an aside, there are free methods here too. But what we can do is, you know, say your client start coming in, and oh, I know they need to refill the medication next week, let me hand them a little business card that says download this app and send me a chat. And we can refill this five times faster, right, you want to be on hold. And so it’s starting to get your clients on board slowly, but surely, and really encouraging them to use that. And eventually, we can sort of lean them over to the platform that we want them to communicate with us. And so we’re never going to be able to get rid of phone lines entirely. But if we can have. So for instance, and opinion, my platform, we can have this chat window open, where we can see all the different people who want to talk to us. And in our sort of previous experiences, we’ve found that one front desk or one nurse can typically talk with between five and seven people simultaneously and still be able to keep up with things because your client will send a message and then they’re going to run to the bathroom or they’re going to do something else. And so we typically have time, but we have to make sure that our clients know that we have the service before we can expect them to use it. Stacey Cordivano 8:23 And I mean, in this day and age you think if they know like people are going to adopt to that because we do it for literally everything else, especially the younger generation. I mean, we are so used to door dashing and all the things Jess Trimble 8:34 and really, it’s preferred by you know, Millennials Gen Z’s, even most of the x’s they would much prefer to send a chat than they would to get on the phone. Stacey Cordivano 8:43 Okay, so that was a good piece of advice. I think starting really small rather than thinking you’re going to take on this entire telemedicine platform at once. So that’s a great great place to start. So what about the complaint that it’s hard to talk to someone if you’re doing video like they don’t know how to show you their pet their pets, not even in the room? I didn’t think of this my clients that send me videos or like the horse people are pretty savvy. It seems like I don’t know maybe they video their own horses a lot more. But I didn’t think of that. But I did hear it in small animal world like I could barely see the cat’s ear for one second, let alone like diagnose an ear infection. Jess Trimble 9:22 Sure and you know without without the data without the pictures we can do nothing and so we have to set that expectation before the telehealth visit even happens and so I encourage practices to, and we have some sample templates I think on our website too You can peek at where it says like here’s how to take a good picture you know must be clear must have bright light must be in focus. And so setting expectations with those clients are critical saying hey, we might be able to diagnose your cats you know pick something here mites through video however, we need crisp, clear pictures and video of your cat for at least 15 seconds. If you can’t achieve that, bring them in for an appointment. Right? And so we just have to have those steps and expectations laid out because right sometimes they’re gonna have a crazy fractious cat that they can’t even catch and telemedicine is pointless at that point. They just have to bring them in. So it’s it’s all about the expectation setting, in my mind, perfect and coaching. Stacey Cordivano 10:19 Right. And so then that leads me to think that I kind of skipped a step a little bit. What would you say are good cases for either telehealth, Teletriage, telemedicine, if someone was feeling like they wanted to implement this, but they’re like, I’m not going to be able to do a cranial drawer on this dog via video, what might I’m like throwing around dog terms that I don’t know. What might a clinic start with? Jess Trimble 10:48 that’s going to be depended a lot on personal comfort level as well as state law. Because for instance, in Michigan, I can form any electronic vcpr. Most of the other states I cannot and so state law depends a lot on how much we can do. But if we consider the the minimum that everybody can do, that’s advice and education. Technicians can do that just as well, too. And so when we’re thinking about comfortable places to start, my first question is what do you have for staff, because if it’s just you, you probably don’t have time to do great telehealth with advice and education and teaching, you know, you’re just trying to get through your day. However, if we have a tech who’s really good at it, and is normally doing your rechecks Hey, we can bump her over. And that’s a really great place to start because she can do neuter rechecks via video or by pictures pretty easily all day long. And so depends on your staff depends on what type of practice you have, you know, if you’re an ER vet versus a wellness vet, totally different, I typically encourage people to start with the things that we know will be slam dunks, like, neuter rechecks is a super easy one, you know, the complication rate is really low. Most people can take a decently clear picture of the incision for us. I also really like to do behavior and nutrition through telehealth because then they can actually show me their house and be like, hey, look, here’s the bag of dog food I feed because you know, when they come in, they’re like, Oh, it’s the blue bag on the third shelf, you know, they can actually show you what they’re feeding how they’re feeding behavior. Also, we know that when we bring them into a clinic, their behavior is going to be totally different. Doing that by video is often far more successful. And then things like dermatology rechecks chronic and palliative care. I love you know, those old creatures that just need their pain meds refilled. You know, why are we trying to throw them in a car when they can barely get out of bed sort of thing. So it depends on your type of practice. depends on your personal comfort level. If we do get to the point there where people are asking you to do things that you’re not comfortable with, it’s just like you would in regular practice. You tell them no and you tell them to come in or you tell them no and you refer them to er, I think there’s this big misconception that we have to diagnose things through telehealth. And I would say greater than 95% of the time telehealth is not about diagnosis at all. It’s just about the support and the guidance and say we did have a suspect cruciate you throughout cranial drawer. So now I’m going to talk about dogs with cruciate disease. I’m not going to diagnose a dog with cruciate disease via telemedicine that’s insane, right, I need a sedated exam. I got to do the whole orthopedic exam. But what I can do is look at that limping Labrador, and say, you’ve got to start cage resting. Here’s the things we need to talk about, you know, when you come into the clinic, the estimates going to be approximately this for sedated x rays, you might need surgery which might cost this and then they have some time to think about it, and really absorb that education. And then when they come into the clinic, they’re way more prepared, both financially and mentally to do the things that you want them to do to help them. Stacey Cordivano 13:51 That’s a great point, a little bit of time to process. So in clinics that you are seeing utilize telehealth, obviously, I’m sure there’s a range, but what is it looking like? Is there a dedicated doctor and tech for this? Is it part of the day? What How have you seen it work well? Jess Trimble 14:10 Sure. So I’ve three examples, I guess that pop in my mind. First one is a clinic that we have, that they use it only for after hours and weekend care. So this is a like a two doctor practice but the one veterinarian who owns it prefers to be available after hours for all of his clients. And he decided to switch to telehealth so that he could more easily see those pictures and videos of things coming in. As well as have that just automatically attached to his medical record is far easier. So he was previously available by phone all the time. Now he is able to go in and sort of triage those chats because everything comes in as a chat for him first and then if he needs to, he can convert it to video. It’s just a much easier flow for him and It’s much more comfortable because he can see those pictures and videos and know that he’s making a better call than not being able to see anything at all. So he’s been doing that for a couple years. It’s it’s worked really well for him. Not everybody wants to be on 24 seven, though, right? So we have, there’s an ER clinic super busy. It’s like a nine or 10 doctor clinic. And they have three technicians that are telehealth only. And what they’re doing is when an animal walks in the door, they’re still very much curbside. And so that pet owner has to still hang in the car while their pets inside. And so they are on the phone or doing video calls with this pet owner getting history, and then giving them updates through the day. And then once the doctor is done, that doctor is telling the technician, you know, X, Y and Z needs to happen, here’s the estimate, here’s the discharge, then that technician is getting back on video with the pet owner and going over everything. And so they’re using it entirely for communication of the doctor’s recommendations, because the doctors are so overwhelmed and slammed, they don’t have time to really talk to the clients. So they’re basically giving their technicians a stack of things to talk about and saying, okay, go Go and talk. So it’s saving their doctors a ton of time that way, and then the technicians are able to sort of take their time and really make sure that that client is absorbing what’s going on since they can’t be in the clinic. Stacey Cordivano 16:20 And there’s not a lot of pushback from clients about not actually speaking to the doctor? Jess Trimble 16:25 not in that situation. Being ER, they’re very upfront about the fact that, you know, this is a slammed ER, this is what’s going to happen. It’s it’s the expectation setting. She said also this er clinic sometimes has up to nine to 10 hour wait times they’re slammed. So it’s it’s worked well to save their doctor’s time. And then we have another clinic that does sort of what we talked about earlier, spay neuter rechecks only for telehealth sort of how they’re getting their feet under them. Right now, they’ve been doing this for a few months. And what they’re doing is they’re baking the cost of that recheck into the cost of the surgery, and then saying, Hey, we want to talk to you in a week, download this app, take a picture, send me a chat with this picture. And then we’ll you know, make sure that everything’s looking good. And so the recheck has already prepaid. And all they need to do is take a peek at a picture and the technicians run that entirely. If there is anything concerning they can just show the picture to the doctor and say, you know, Hey, does this look we’re not and go from there. Stacey Cordivano 17:27 Interesting. Oh, okay. I like it. Stacey Cordivano 17:30 I feel I’m getting off of my complaints. But I feel like I feel like there’s an underutilized source of veterinarians here. And that is, I guess, because I am one and I know several who have left but mothers who are at home, who are not working for whatever reason. I’m kind of wondering, like whether it’s equine or small animal, why you wouldn’t hire someone yourself to just do virtual stuff for you not even in the clinic, assuming you can get them on board with your culture and your ways of you know, following up with things like that seems like it could be a good option. I don’t know, I’m obviously not the first person I think of that. But Jess Trimble 18:13 Hiring virtual staff is something that I think I’m not going to say is going to save our profession. That is obviously the wrong thing to say. But I think utilizing our underutilized colleagues in a virtual manner, is really going to be key to our success as a profession. Because I left clinical work, my husband left clinical work, my friend on the road, she left clinical work, right. We are fleeing. However, I did telehealth, and I loved it didn’t burn me out as badly, you know, I could have a more flexible schedule. And so, you know, I look at some of these Facebook groups like the veterinarians with chronic diseases and the DVM moms, there are 1000s and 1000s of veterinarians who want to use their brains, but cannot be in clinic for you know, x y&z reason. And so, if we can get clinics comfortable with having virtual staff, first of all, because it’s definitely a culture shift and a different way of doing things. However, we also need a little bit of regulatory shift, I think, to get it to be truly successful, because if we can’t have an electronic vsepr, it can be difficult for those veterinarians who are virtual to like truly work at their full capacity. And getting into electronic music pair is a very sticky subject and there’s a lot of people for it, a lot of people absolutely against it. But I do think that in some small ways, it’s going to be important to helping our clinics function for those little things, you know, Oh, you’ve got a tiny little scratch on your shoulder like that doesn’t need to come in. But at the same time, like Do we have to have, you know, some big official electronic VCPR for it? No, we just need someone to look at it and be like, Oh, yeah, it’s no big deal. You know, clean it a little for some of us. weren’t on it, and let’s check in tomorrow. And I think that’s where these veterinarians can be super helpful. It’s triage in the little things. It’s during the more complicated rechecks it’s having a hard conversations about end of life quality of life palliative care, it’s diagnosing some of those small things, you know, I can diagnose a flea allergy dermatitis from across the room, you know, we see a bare red butt covered in fleas. It’s not too hard to diagnose some of these things. So I will say that there was a point in time where I was having to hire veterinarians, for both in home care and one for a virtual position. It took me two weeks to get a single resume for my in home position. And I had like 36 resumes and 12 hours from my virtual position. So veterinarians are begging for this work. We just as clinical veterinarians have to figure out how to shift our own workflows to bring them in and allow them to help us because they want it we need it, we just aren’t connecting the dots. Stacey Cordivano 20:57 Can I clarify something? So if if I have a valid client patient relationship with Smokey, and I hire someone through my clinic, another veterinarian. Do they have a VCPR? Or does that depend on the state or no? Jess Trimble 21:15 Depends on the state entirely, I just had this conversation with a clinic in Illinois, actually, in Illinois reads that if a veterinarian, I forget the exact wording, but if one veterinarian says that it’s okay for another veterinarian to consult on their patient, then you can and so in that case, a virtual veterinarian can sort of enjoy that hospital VCPR, where as long as I have access to the medical records, and access to that other veterinarian, I can, but not every state is like that, you know, for instance, California has these really horribly restrictive vcpr. Stacey Cordivano 21:49 Okay, I didn’t I guess I didn’t realize that. I sort of just assumed it was hospital based or clinic based that’s in Jess Trimble 21:56 every state is different. Stacey Cordivano 21:57 Okay. Okay. All right. So let’s hop back over to the struggles that people face. One of those is VCPR laws, but I feel like we’ve touched on that a bit. What about someone who says, I can make more money in person? Because I’ll do more procedures, I will run more tests, things like that. Jess Trimble 22:17 I mean, they’re probably right. In that case, yes, you’re gonna make more money. If that patient is in your hospital and you’re doing a surgery versus doing a consult. That means there’s no question and the difference in revenue there. However, how are you interacting with that patient before? And after that day that you have them in hospital making all that money off of them? How are you maintaining them as a patient? How are you helping that patient when they don’t need to be in clinic and get the expensive stuff but just have the little things? So no argument in my mind that yes, a day of surgeries is far more profitable than a day of telehealth. But again, you know, telehealth is not about making a ton of money in that day telehealth is about expanding those relationships. It’s about seeing patients sooner, you know, I can go on and on telehealth is about all of these things. And I think too, the mistake here is that, in my mind, veterinarians should not be the main providers of telehealth, it should be our front desk staff. It should be our technicians. They can triage, they can educate, they can give advice, they can make those refills. Those are the ways that we’re really going to be making up the difference. I think in profit and efficiency with telehealth, no one’s gonna argue that a day of dentals is gonna make you more money. Stacey Cordivano 23:37 Okay, I think that’s an important clarification that the focus is not necessarily on the veterinarian. Interesting. Another big complaint that comes up a lot, I would say, especially in equine medicine, but I saw it on the small animal side, too. How do we start charging for this when I’ve been doing this for free for so long? With a caveat that while I was writing these notes down, I then thought to myself, who cares if they get mad if we started charging them because everyone’s overworked and kind of needs to weed out their clients anyway. But aside from that, what do you say when people say how do we start charging for this? Jess Trimble 24:14 Honestly, I say just about what you just the truth, you know, so to backtrack just a little bit, there was a period of time before I worked in my current position where I was part of one of those third party telehealth platforms. We were just providing education and advice. And we found that those people who were coming for this education and advice had no problem going to a veterinarian, they just needed to know when and how much it would cost and what to expect. And so we discovered it was a really fantastic client acquisition tool. You know, if we could provide just a little bit of telehealth, these guys would come right in. And we started talking to some of our practices in this way, like, Hey, you can acquire clients if you do this. And they’re like, we don’t want any more clients. I have enough clients. No more clients, please. So gaining clients is not a problem right now. We’re all drowning, we all have too much to do. And so honestly, we’re gonna make a few mad. And do we really care if we’re losing like our bottom of the barrel clients because of that? Maybe Maybe not. So my technique and my strategy when we’re going from free to paid is expect to make some people mad. And that’s okay, we can’t make everyone happy. But going cold turkey, for me is my favorite way to do it. So if everybody has your cell phone number, create an automated message. And even if it’s just you copying and pasting the same thing in says, you know, all advice from Dr. Trimble is now being provided through x platform. And then I even put in parentheses like reply, stop to unsubscribe so that they think that it’s automated. And they’re like, Ah, you know, she’s, she’s upgraded your technology, and then they have to go into the app. And then within the app, it says, to have a quick consult with the veterinarian. And it’s pick a number of $10, to have a recheck it’s $15. And they can pick what they want. And if they’re too cheap to pay my advice, prices, they can go somewhere else. And I have no problem with that. And so going the cold turkey route is sort of the way that I prefer. And it’s, it’s a really good boundary setter, too, because now we no longer have people texting us all hours of the day at night, because if they know that they have to pay a little for advice to probably respect that a little bit more and not paying you quite so frequently. But if we can keep the cost low enough that it’s not a huge barrier, then they’re still going to use it right. And so charging is something that we can talk about extensively. But there’s definitely a balance between, I want to charge enough that they’re not going to use it flippantly all the time, but I want to charge a little enough that they’re still going to be able to use it. Stacey Cordivano 26:55 a side question and like not to dive too much into charging. But you would then suggest having a charge for like a texting consult as well as from just like a phone or video consult? Jess Trimble 27:08 totally depends on sort of who you are and what demographic you have as your clients. But so for instance, within our platform, we give options for like 10 different prices. And we always want people to come through chat first. Because then I can look at it and say like, Yes, I’ll take this and I can chat with him or bump them to video, or I can look at that and go, you know what your horse that’s laying down and kicking outside and hasn’t moved in three hours, like no, I’m not going to see that you need to go straight to the university, and not waste my time actually not waste any of our time. And so it’s a really nice way to triage those. But anyway, have them come in through that chat first. And then if it’s something that only takes three seconds, I can discount it and not charge them a thing. And that’s fine, or I can charge them the full, full price. So you know, you always have control of whether or not you truly want to charge. But I always prefer that they go in with the idea that they should expect to charge to talk to me. But regardless, within those charges we generally put into like, you know, need to refill or schedule appointment $0, you know, so that they can just quickly jump in and talk to us and so you can set it up however you want to whatever makes sense for your practice. Stacey Cordivano 28:25 Got it. Okay, well, I have to say, I thought I would maybe have new hurdles for telehealth or telemedicine after you know curbside and the pandemic and everything but when I asked around it, they all kind of seemed to be the same. And I feel like we’ve covered a lot of them. So my last real question to you is, are there any other aspects that we haven’t talked about that you find beneficial for our overall well being or how telehealth can improve our lives and decrease burnout and all the things? Jess Trimble 29:01 Yeah, I think the the question of the year here is how we can help our veterinary teams live their lives without quite so much stress and burnout. And I would say that the one question that I have seen, maybe not changed, but pop up more frequently through the pandemic is that time question, right? Because we’re, we’re bleeding staff, you know, through the pandemic, so many people have left, and so we’re getting more and more short staffed, it’s going to become more and more of a problem. And so being able to utilize our colleagues in that virtual manner, I think is truly going to be one of the biggest shifts to help our personal well being both on the person who’s in clinic, and for the person who has to work virtually, because you want to be able to use your knowledge in your brain, right. And so that’s a great thing for the doctor or the technician on the other end of the computer, but then for that team that’s working in the clinic, you know, let’s kick out the things that don’t need to be there to a virtual service. Again, it’s those aggressive dog For a behavioral console, you don’t want those in the clinic. You know, let’s, let’s keep them at home. And so it’s finding all of those little things, do the day that make your life difficult, and figure out how to shift them virtually, that definitely can help your team in a lot of different ways. One from like, keeping, you know, whatever client you despise having in the building, like use them as your first beta tester and be like, hey, you’re special, we’re gonna have you use this app from here on out, right? So it’s, it’s finding those people, it’s finding those procedures, it’s finding those little workflows that will make your clinic go a little smoother, but then also having ways for your team to have more flexible working hours. If you have that technician that has to go pick up her kids at two o’clock on a Tuesday, and has to stay home, why can’t she you know, do some discharges from home in the afternoon, there’s no reason she can, you know, the number of times I’ve seen technicians or veterinarians have to quit or find new jobs because their workplace can’t be flexible for them. It’s so disappointing where, you know, if we can allow them to do some work from home hours, that would change everything. And there’s so much that obviously, we can do virtually when it we’ve just talked about it for less than 30 minutes here. So I think that’s that’s really a big one is if we can allow our workplaces to be more flexible, and actually understand that we’re humans and not robots. And we have to be able to go home and do these things and you know, adapt to Oh, my goodness, my kid is sick, and I have to go pick him up from school. This is where that can really help provide us some relief. Stacey Cordivano 31:36 Awesome. Awesome. I do have one more question, actually. And this is selfish. But do you have any more examples for the large animal side of things where telehealth might be utilized better than what’s happening now? Jess Trimble 31:49 Well, yes, I suppose in you know, the, the problems in smallies and large animal world are largely the same. But there’s also that huge difference in our large animal colleagues have so much driving to do and you spend so much time in a car and sometimes you get out there and either you aren’t needed or the creature hasn’t even been caught yet, or, you know, pick a problem a million problems, but one of the things that I hear from equine professionals especially is clients, abusing their access to their personal cell phone and things like that, so you know, put up that paywall just get the app, or whatever it is you choose to use, put that paywall up, set those expectations with your client, because you know, they’re paying like 50 bucks a month on show sheen and hoof polish, they can pay 10 bucks for a tele consult, you know, it’s not that big of a difference for them to pay just a little bit more to talk to you. And then it really does set up that boundary in that respect. But then if we can get them to send you those pictures and videos, so that you can triage things appropriately. You know, if we’ve got this old horse with arthritis that we know just needs to be refilled. There’s no reason they can’t send you a video and you can see that lameness. That’s the same lameness that you’ve been seeing for the last year. And, you know, sure, here’s a refill. And oh, by the way, I’ll be sort of in your area in a week. So I’ll come by then, you know, to be able to route things appropriately for you and triage things appropriately so that you’re not wasting your time driving from one side of the county to the other, I think can really be beneficial. Stacey Cordivano 33:23 Great. Well, I really appreciate your time and all the insight that you have. And you know, this certainly isn’t an ad but you, you do work for a telehealth platform. And I saw that Anipanion has several race approved CEs. So I do want to mention that to people because I learned a lot from watching them. And it’s always good to get a few CE credits for free. So I’ll definitely link those in the show notes. I also came across fairly recent AVMA guidelines for the use of telehealth in veterinary practice, I’ll make sure to link that one as well. And anything else that you feel like you have to get out? Or where can people find you? Jess Trimble 34:05 I would say just head over to Anipanion. If you go to the CE, I believe my email is like listed in every single one of those videos, I love to talk to people. You know, I absolutely love sitting down with practices and like looking at their personalized workflow and their staff and like figuring out those little tweaks, because none of this is one size fits all and no platform is right for everybody. And so really sitting down and talking through things is where we like to shine. So feel free to reach out. I’m happy to chat with anybody about it. Stacey Cordivano 34:38 Awesome. If you could say the number one thing that you most love about telehealth, what would it be? Jess Trimble 34:46 Or the number one, I’m going to go with something that we haven’t even talked about which is access to care. All of the millions of people and animals that cannot physically get into a clinic or cannot get you know their horses in a trailer. Telehealth gives us the ability to help a lot of people that can’t get help otherwise. Stacey Cordivano 35:04 Very cool. I also ask all of my guests, what is one small thing that has brought you joy this past week? Jess Trimble 35:12 Whoo, this is gonna be completely ridiculous. But I’m cleaning out my office and my husband’s office, and I’m scraping the popcorn ceiling from the 70s. It’s totally crazy, so much joy when it’s gone. Stacey Cordivano 35:27 That’s awesome. That’s a great one. Perfect. Well, just thank you again, so much. I really appreciate all the knowledge you shared. And I think this is a great jumping off point for some people to dig into it a little bit more. Thanks. Jess Trimble 35:40 Thank you for having me. It’s been fun. Stacey Cordivano 35:43 Thanks again to Dr. Jess Trimble for her time and expertise. Here are three things that I learned during our conversation in this episode. Number one, techs and support staff are priority players in implementing this telehealth game. Number two, training clients is key. Getting them used to always coming in through a chat system is the way to go. Number three, think outside of the box when hiring virtual staff. It can be a game changer for your practice. And on that note, I was really thinking on the spot when I mentioned my question about moms being at home and being underutilized. I definitely realized there are more people in our profession who are not able to be in the clinic for one reason or another and I certainly did not mean to exclude anyone. I just know that there are populations of people who want to work and the ones I come in contact with most often just happened to be moms but definitely want to include everyone when we are thinking outside the box here. I hope you enjoyed the episode. I hope you were also inspired to think a little bit differently after hearing our discussion today. Please check out the show notes for any links or ways to connect with Dr. Trimble. As always, thank you so much for sharing some of your time with me. If you enjoyed this podcast, please share with a friend or hop over to leave me a review on Apple podcasts. You can also give me a follow on Instagram @thewholeveterinarian. I will talk to you again soon.


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