DVM6: Watching Vets' Backs and Bridging the Gap in Veterinary Care Through Telemedicine

This week's episode of #Petworking is a longer one, but is definitely a topic worth extra attention, so thanks in advance for taking the time to listen.

Televet services are a rapidly expanding component of the veterinary ecosystem. Broadly defined, televet services are the use of technology to remotely provide veterinary care to pets and animals. Televet became increasingly popular in recent years, driven in large part by the COVID-19 pandemic, as more people turned to virtual consultations and telemedicine.

Televet services can include virtual consultations, video conferencing, remote monitoring of pets, and online prescriptions. These services can be accessed through various platforms, such as dedicated televet apps, websites, or through veterinary clinics offering telemedicine services.

An important concept to understand when evaluating televet is VCPR (Veterinary Client Patient Relationship). It refers to the relationship between a veterinarian, their client (pet owner), and their patient (the animal). VCPR establishes the legal and ethical framework for the veterinarian to provide medical advice and treatment to the animal.

In the United States, the American Veterinary Medical Association (AVMA) has established guidelines for telemedicine to ensure that the VCPR is maintained even in virtual consultations. The guidelines state that veterinarians should have a pre-existing relationship with the client and the animal, either through an in-person consultation or through the provision of medical care, before providing telemedicine services.

The guidelines also require that the veterinarian is licensed in the state where the animal is located and that they have access to the animal's medical records. Furthermore, the veterinarian must provide appropriate medical advice and treatment, which may involve referral to an in-person consultation or emergency care, depending on the severity of the condition.

Because of VCPR guidelines, many of the televet services on the market today are unable to provide true telemedicine services to their clients. Some platforms provide general education on a disease process, while others provide teletriage services, which assess the urgency and severity of a pet's medical condition. However, teletriage services are generally limited to the assessment of whether the animal requires immediate attention or can wait for a scheduled appointment. Without the establishment of VCPR, true telemedicine services – i.e., medical advice, diagnosis, and treatment – cannot be provided.

Frank DeCecco DVM, MBA , founder of DVM6 , has a developed a very interesting televet model, where he contracts directly with veterinary clinics to provide televet services as a veterinary relief model. Frank informed me that he came up with the name DVM6 because of his background serving as a veterinarian in the military. The "6" in DVM6 is taken from the military phrase "watch my 6," which means "watch my back."

Frank's goals with DVM6 are multi-faceted, and include increasing access to care within the animal healthcare system, providing support to clinics and hospitals that are dealing with staffing pressures, and getting vets and vet techs who have left the profession to return to practicing as part of DVM6's televet model.

Frank noted that the crux of the problem is the fact that pet ownership continues to increase, while more and more vets are leaving the profession, exacerbating staffing shortages even further. As he told me:

"People in VetMed are by and large, very kindhearted, very empathetic, willing to do anything to help animals. And that leads to them overextending themselves time and time again. And like I said earlier, it's just not sustainable. So, as things rolled on the past couple of years, more and more people have burnt out. More and more people have gotten compassion fatigue and are unable to do the clinical job anymore and they've walked away from the profession. So we've lost good people, experienced people, and the demand continues to rise. Pet ownership continues to increase. Demand for vet services continues to increase. So all there is a yawning gap in what our clients want and need and what we can provide."

Frank believes that between 10-20% of a clinic's daily appointments are things that pets don't need to be in the room for, and this is where he sees televet as a prime solution to the issues plaguing the industry. DVM6's model establishes VCPR by contracting directly with clinics for relief shifts, and partners with those clinics to ensure that they retain their clients' business. Because DVM6's model establishes VCPR and partners with the client's regular veterinarian, they have access to the pet's medical records, and can provide true telemedicine services to the clients. This results in several advantages, including increased access to veterinary care, convenience, and reduced stress on pets and their owners. It can also help veterinarians to reach a wider audience, save time and resources, and provide efficient care.

Compared to other models that rely on teletriage services, Frank sees DVM6 as differentiated because it is partnering with the client's regular practitioner, and preserving continuity in care. Speaking about competing models in the televet space, Frank painted a striking picture of what he sees as DVM6's biggest differentiator.

"It's all telehealth because they can only talk in very broad generic terms about things. They can't speak to your pet individually because they don't have a VCPR. And so yeah, they can do triage to a certain extent and they can do telehealth, but they can't do telemedicine. [...] I think the differentiator is improving the health of the pet, and I feel like you can't do that unless you're partnered with the primary care veterinarian."

Frank strives to educate his potential clients that explain that DVM6 is a partnership and the company wants to build loyalty between the pet parent and their primary care veterinarian. He admitted that this was a significant challenge, as many practices don't understand the altruistic nature of his business, and have found themselves competing with televet providers in the past. However, Frank is very cognizant of the pressures of running a practice, and the negative impacts on mental health that can arise from "having a workload that is insurmountable and caring so much about what you do." To that end, DVM6 is focused on providing work-life balance, not only for its employees, but for those clinics that it is contracted to support.

"[...] work-life integration is foundational for what we do, what we want to offer. So, if I'm removing a pressure release valve on the pressure cooker that is a vet clinic, not only do I want the pet to get awesome care, I want the doc and the tech to leave when their shifts are over. I want them to live the rest of their life. I want them to go on that hike. I want them to spend time with their family, because that's what we do on our side."

To that end, DVM6 sees huge potential in its model because it offers vets and vet techs who have left the profession a means of returning to practice, but in a setting that is remote-friendly, less physically demanding, and offers greater flexibility. Frank described it as recapturing some of the "brain drain" that the profession has experienced in the last several years.

"The relief veterinarian in my world has become incredibly popular the last couple of years. And we've seen a great spike in people leaving the day-in, day-out, full-time positions to work on their schedule. And so I know there's a huge population out there who wants flexibility in their schedule. Work from home has never really been an option for VetMed. We've got talented people, certified registered veterinary technicians are troves of information and doing triage is right in their wheelhouse. And a lot of them hit a wall after being in the profession. 8, 10, 12, 15 years, they're not getting paid what they're worth. They're not getting paid what they deserve. Their body is being broken by the job and they leave. They leave and they take their brain full of experience with them. And those are the people that we recruit as contractors. As our demand increases, we pick up more supply. And I haven't seen anywhere near a bottom in that supply. There are people who are qualified, credentialed, experienced, empathetic, who want to work from home, who want to have flexibility. And the more we can offer them good pay for what they do, which we do, the more they're loving the idea and then they can stay in the game. And then that builds up what we can offer on the supply side. Taking some of that brain drain back and allowing these people to still be active in their profession in a way that suits them and their lives. Not everyone wants to be chained to running the clinic floor 50 hours a week."

Ultimately, televet offers huge potential to alleviate pressure within clinics, bring vets and vet techs back to the profession, and hopefully alleviate some of the lack of access to care that has plagued the animal healthcare industry in recent years.

Take a listen to the episode to hear more of Frank's thoughts, and our discussion on the revolutionary potential of televet services.