Communication is one of the cornerstone of our services to you. The care provided to you and your pets do not end when you leave our office. You may need to contact us days or weeks after your visit. It may be for lab results, updates on response to treatment, or even something as simple as scheduling the progress check appointment.
We all have different schedules. Some of us are available in the evening; some prefer early mornings; others during our lunch breaks. Unfortunately, those times may not always match with the times our office is open. In addition, the doctor may not be available to come to the phone at those times.
For your convenience, we have a myriad of contact options.
1) Office Phone: 562-435-6331
For emergency or urgent matters during our office hours, calling us is the best method. Plus, if you prefer talking to us directly for that instant response, this is the way to go. However, if you have a non-urgent question for Dr. Tran, you may have to leave a message for her to call back later.
2) Email: staff@thefamilyvet.net
Email is probably the best option for non-urgent questions regarding your pet. You may write as much as you need, attach images, etc.... And of course, you can email us anytime. We try to reply within 24 hours, often sooner than that. Please note that online services can have intermittent outages. If you email us during our office hours and need a reply from us (i.e. from the doctor) sooner than 24 hours, you should call the office to let us know about the request.
3) E-Sevices
Use this service from our website or the mobile site to request prescription refills, perform e-Check In, and fill out Client Registration forms.
* Note: E-Check In is for scheduled appointments. If you submit one without a scheduled appointment, it does not automatically schedule one for you. You still need to contact us for an appointment.
4) Dr. Tran's Mobile Phone and Text Messages (SMS)
Clients who may need to contact Dr. Tran outside our regular office hours (i.e. critical patients, patients with chronic complicated illnesses) are provided with her cellphone number for voicemails and text messages. Please note, call the office number during office hours as Dr. Tran usually has her cellphone off during those hours.
And of course, there are the old standbys: facsimile (fax) and snailmail (regular mail).
In addition to the above contacts, we also use Twitter and our blog as ways to stay in touch with you --- in a broad general sense, not necessarily matters specific to your pets. Twitter allows us to broadcast pet-related news and tidbits in a more timely manner. We invite you to follow us on Twitter. Due to the public nature of the updates, we may not be able to answer specific questions pertaining to your pets. Please use email for specific questions about your pet care.
As a reminder, technology is not fail proof. Please follow-up if you do not get a response from us in a timely manner.
Even when our office is closed, you can still contact us.
Whether it's by phone, email, SMS, website, blog or Twitter --- we're here for you and your pets.
Tuesday, May 26, 2009
Sunday, May 17, 2009
More on Medical Records
Elias did a great job explaining the importance of medical records. I told him I'd add in my take on medical records. So, without further ado:
1) Classic example is one of allergic reactions to vaccines and drugs. Clients can tell us that Chloe had a "bad" reaction to vaccines last year. But which vaccines? And how bad was the reaction? Hives? Vomiting and diarrhea? Anaphylactic shock? Local swelling at injection site? The information helps determine the best vaccine protocol for Chloe.
2) Weight changes through the years can help raise our suspicion to diseases and endocrine disorders such as hyperthyroidism in cats and hypothyroidism in dogs.
3) Changes in lab work. Oftentimes, it is not a single abnormal lab value that makes the diagnosis in some medical conditions such as kidney or liver disease. It is the trend i.e. an increase or decrease in the values over the years that help us detect an illness, hopefully in time for a successful intervention.
I can go on and on with examples, but the underlying theme is that medical records are health journals for your pets.
Look at it this way. We do wellness screens and senior screens. I'm sure other veterinarians do also. Why? We talk about "establishing baselines" and "early detection." What good are those tests (which are not cheap) if they don't follow your pet as part of his medical history? The values of those tests do not end after the visit at which the tests were done. I am sure those test results were priceless when it was time to document Bandit had normal kidney and liver values a month before he started eating an infamous recalled product.
To discount the values of medical records is to discount the values of those wellness screens and other preventative care.
When you pay the exam and consultation fee, you are paying us for a service. That service includes documenting our exam findings and plans to keep your pets in the best health possible. That is one of the reason why even the most simple procedure (in your eyes) still take some time for us to do. We don't just give a vaccine or express the anal glands (sacs). We weigh your pet, check his temperature (if presented for vaccines), do the treatment, then note in the record information such as where vaccine was given or the fullness of the glands. Location of vaccine is important if a local swelling / reaction develop later -- sometimes years later in cases of vaccine-associated fibrosarcoma.
Saying medical records are not important is like throwing away the information you paid for all these years. Of course, as with most information, medical records follow the GIGO principle. Garbage In, Garbage Out. Hence, not all medical records are useful. But that does not mean we should not strive to get them whenever we welcome a new patient. Complete informative medical records should be the norm, not the exception. But they are in danger of being the exception if we cease to expect them, if we give in to the thought of "why bother, all we're going to get is the useless bare bones patient chart anyway."
As a veterinarian, I view our patients' medical records as reflections of all the services, expertise and care we provided. To disregard the information and values found in medical records is akin to belittling the knowledge and worth of veterinarians. And since veterinary services often come with a price tag, disregarding medical records is wasting money spent.
For all those reasons, we encourage clients to request medical records whenever they anticipate a change in veterinarian(s). We remind clients who are relocating to let us know in advance so we can provide the medical records to the new veterinarian(s).
To say complete medical records are not needed is to do a disservice to all involved --- pets, clients, and veterinarians.
1) Classic example is one of allergic reactions to vaccines and drugs. Clients can tell us that Chloe had a "bad" reaction to vaccines last year. But which vaccines? And how bad was the reaction? Hives? Vomiting and diarrhea? Anaphylactic shock? Local swelling at injection site? The information helps determine the best vaccine protocol for Chloe.
2) Weight changes through the years can help raise our suspicion to diseases and endocrine disorders such as hyperthyroidism in cats and hypothyroidism in dogs.
3) Changes in lab work. Oftentimes, it is not a single abnormal lab value that makes the diagnosis in some medical conditions such as kidney or liver disease. It is the trend i.e. an increase or decrease in the values over the years that help us detect an illness, hopefully in time for a successful intervention.
I can go on and on with examples, but the underlying theme is that medical records are health journals for your pets.
Look at it this way. We do wellness screens and senior screens. I'm sure other veterinarians do also. Why? We talk about "establishing baselines" and "early detection." What good are those tests (which are not cheap) if they don't follow your pet as part of his medical history? The values of those tests do not end after the visit at which the tests were done. I am sure those test results were priceless when it was time to document Bandit had normal kidney and liver values a month before he started eating an infamous recalled product.
To discount the values of medical records is to discount the values of those wellness screens and other preventative care.
When you pay the exam and consultation fee, you are paying us for a service. That service includes documenting our exam findings and plans to keep your pets in the best health possible. That is one of the reason why even the most simple procedure (in your eyes) still take some time for us to do. We don't just give a vaccine or express the anal glands (sacs). We weigh your pet, check his temperature (if presented for vaccines), do the treatment, then note in the record information such as where vaccine was given or the fullness of the glands. Location of vaccine is important if a local swelling / reaction develop later -- sometimes years later in cases of vaccine-associated fibrosarcoma.
Saying medical records are not important is like throwing away the information you paid for all these years. Of course, as with most information, medical records follow the GIGO principle. Garbage In, Garbage Out. Hence, not all medical records are useful. But that does not mean we should not strive to get them whenever we welcome a new patient. Complete informative medical records should be the norm, not the exception. But they are in danger of being the exception if we cease to expect them, if we give in to the thought of "why bother, all we're going to get is the useless bare bones patient chart anyway."
As a veterinarian, I view our patients' medical records as reflections of all the services, expertise and care we provided. To disregard the information and values found in medical records is akin to belittling the knowledge and worth of veterinarians. And since veterinary services often come with a price tag, disregarding medical records is wasting money spent.
For all those reasons, we encourage clients to request medical records whenever they anticipate a change in veterinarian(s). We remind clients who are relocating to let us know in advance so we can provide the medical records to the new veterinarian(s).
To say complete medical records are not needed is to do a disservice to all involved --- pets, clients, and veterinarians.
Wednesday, May 13, 2009
Regarding Medical Records
Simply put, a medical record is the set of notes that a veterinary facility keeps for each patient. Many pet owners confuse their receipts with medical records. Other times, the pet owner assumes that they can verbally summarize the medical records when asked. However, the medical record is much more detailed. It should include obvious items such as any laboratory results that your pet has had done, including specific blood values, and often times includes less obvious items, such as the location of where a particular vaccine was given, or the changes in your pet's weight.
Because they provide crucial medical information on your companion, attending veterinarians will usually want to review these records as part of a thorough exam. This is especially true if the veterinarian is unfamiliar with the patient, as when a different doctor is in the office seeing your pet, or when you are visiting a new clinic for the first time.
Excluding medical services such as radiographs (x-rays) and ultrasounds, most medical records are in the form of handwritten notes that the attending veterinarian and his or her staff accumulate in the course of providing medical care to your loved one. Sometimes, a medical record may consist of electronic/typed notes. Finally, many medical software packages allow the user to readily produce "patient chart" printouts that summarize visits but do not convey the information that is in the medical record. Here frequently occurs a problem for the pet owner. When you are seeing a new veterinarian and request your pet's medical records so that the new veterinarian can review them, some animal clinics will provide the incomplete patient chart summary - an electronic printout that is of little use to the new physician. In short, it's like asking for a photo of your child, and getting a silhouetted drawing instead.
The quandary may be easier to describe in more familiar terms. Consider your own medical care. You may have office visit receipts for copayments, or insurance forms that describe what was done and what was paid for by the insurance. You may even have a letter from your own doctor that states your last lab results as "normal." These are often similar to the information provided by patient chart summaries. In contrast, a medical record is the actual patient chart that your doctor possesses. It is the chart that you may see the doctor walk-in with, or that you may see the nurse inputting into a computerized records system. It is your record that records everything from medications prescribed (including WHY they were prescribed), to the temperature reading that is probably measured every time you walk into the office.
Consider the images in this blog post. (For privacy we've deleted sensitive patient information). Can you guess which one is the medical record, the receipt, and the "patient chart summary?" Can you see details in the medical record that are not included in the summary or in the receipt?
Knowing about medical records helps you provide better care for your loved one in several ways. Because of the time and effort that goes into compiling them, as well as the information conveyed in thorough medical records, they are a critical, valuable asset of your companion's care - they are part of what you pay for when you visit your veterinarian. Several lessons can be learned here. For one, we strongly urge you that when you visit a new veterinarian, you contact your previous veterinarian and request that they forward medical records to your new veterinarian. Second, we encourage you to ask your current veterinarian what her or his medical records policy is. If your veterinarian has the best interests of your companion in mind, they should provide all detailed records without hesitation, as they are necessary and essential to providing your companion with the best possible medical care. Finally, when seeking a new veterinarian, see if he or she requests that you obtain your pet's past medical records. This is always an encouraging sign that your new companion is being seen by a more thorough veterinarian.
Finally, it should be mentioned that by California law, medical records must be maintained for 3 years from the date of last visit. After that, the veterinarian may dispose of them.
More on Medical Records
Because they provide crucial medical information on your companion, attending veterinarians will usually want to review these records as part of a thorough exam. This is especially true if the veterinarian is unfamiliar with the patient, as when a different doctor is in the office seeing your pet, or when you are visiting a new clinic for the first time.
Excluding medical services such as radiographs (x-rays) and ultrasounds, most medical records are in the form of handwritten notes that the attending veterinarian and his or her staff accumulate in the course of providing medical care to your loved one. Sometimes, a medical record may consist of electronic/typed notes. Finally, many medical software packages allow the user to readily produce "patient chart" printouts that summarize visits but do not convey the information that is in the medical record. Here frequently occurs a problem for the pet owner. When you are seeing a new veterinarian and request your pet's medical records so that the new veterinarian can review them, some animal clinics will provide the incomplete patient chart summary - an electronic printout that is of little use to the new physician. In short, it's like asking for a photo of your child, and getting a silhouetted drawing instead.
The quandary may be easier to describe in more familiar terms. Consider your own medical care. You may have office visit receipts for copayments, or insurance forms that describe what was done and what was paid for by the insurance. You may even have a letter from your own doctor that states your last lab results as "normal." These are often similar to the information provided by patient chart summaries. In contrast, a medical record is the actual patient chart that your doctor possesses. It is the chart that you may see the doctor walk-in with, or that you may see the nurse inputting into a computerized records system. It is your record that records everything from medications prescribed (including WHY they were prescribed), to the temperature reading that is probably measured every time you walk into the office.
Consider the images in this blog post. (For privacy we've deleted sensitive patient information). Can you guess which one is the medical record, the receipt, and the "patient chart summary?" Can you see details in the medical record that are not included in the summary or in the receipt?
Knowing about medical records helps you provide better care for your loved one in several ways. Because of the time and effort that goes into compiling them, as well as the information conveyed in thorough medical records, they are a critical, valuable asset of your companion's care - they are part of what you pay for when you visit your veterinarian. Several lessons can be learned here. For one, we strongly urge you that when you visit a new veterinarian, you contact your previous veterinarian and request that they forward medical records to your new veterinarian. Second, we encourage you to ask your current veterinarian what her or his medical records policy is. If your veterinarian has the best interests of your companion in mind, they should provide all detailed records without hesitation, as they are necessary and essential to providing your companion with the best possible medical care. Finally, when seeking a new veterinarian, see if he or she requests that you obtain your pet's past medical records. This is always an encouraging sign that your new companion is being seen by a more thorough veterinarian.
Finally, it should be mentioned that by California law, medical records must be maintained for 3 years from the date of last visit. After that, the veterinarian may dispose of them.
More on Medical Records
Monday, April 27, 2009
In The News: Confusing News over NUTRO Pet Food Investigation
Update 4/28/2009 FDA issued statement: "Nutro Products, Inc. is not currently under investigation."
Update 04/27/2009 CNN corrected their Nutro story, confirming that FDA is not investigating Nutro Pet Foods.
Update 04/27/2009 - 2 pm Additional reporting from VIN News Service includes interview with freelance journalist Lisa Wade McCormick and Nutro spokeswoman Monica Barrett.
"Swine Flu" and political news will likely dominate the airwaves, keeping this ConsumerAffairs article from much airplay or coverage. The article reports of an FDA investigation on NUTRO Pet Food brought on by a series of unexplained illnesses and deaths. ConsumerAffairs noted that consumers (their readers) have been complaining for more than two years about illnesses believed to be linked to NUTRO Pet Food.
ConsumersAffairs followed up with an article on NUTRO's denial of the investigation. ConsumerAffairs remained steadfast on the existence of an FDA probe, evident by FDA's denial to ConsumerAffairs' request for a list of all complaints and lab results collected on NUTRO in the past two years. The request was filed under the Freedom of Information Act (FOIA) and was denied since:
"The document(s) constitute record(s) compiled for law enforcement purposes, the disclosure of which could reasonably be expected to interfere with enforcement proceedings."
ConsumerAffairs concluded NUTRO is under investigation on the basis of this FOIA denial. Confirmation from an anonymous agency official was also reported.
Screening of veterinary-specific lists for news of confirmation or denial of this investigation did not make things any clearer. When questioned by a veterinary news service, a representative from the Center for Veterinary Medicine (CVM) division of FDA confirmed that NUTRO is not under investigation. This information is repeated in this eFoodAlert post. But a direct announcement from the FDA was not found. Apparently, the FDA is not stepping up to deny the investigation themselves publicly. Instead, FDA is denying it to NUTRO and other sources, allowing those parties to reply to ConsumerAffairs report and CNN Headline News coverage. Perhaps, FDA did not think a ConsumerAffairs article warranted a direct response?
As of today, there is still no explanation for the denial of ConsumerAffairs FOIA request. It is possible the FOIA denial is related to the "Menu Food Recall" of 2007 or other subsequent recalls. Why not tell us that and dispel this probe rumor?
So is NUTRO Pet Food safe? Probably. With the many pet food options available, you need to decide whether "probably safe" is good enough for your pets. We will update as more information is available. Hopefully, the information will be more from the (FDA) source than rumors and second-hand denial / confirmation.
As a reminder, diet changes should be made gradually over a course of 5 to 7 days, longer if your pet is more sensitive to changes. Even with "safe" diets, sudden changes may cause vomiting, diarrhea and intestinal discomfort.
Tell your family veterinarian if you suspect your pet's illness is food related. Bring a sample of the food in a freezer bag, labeled with the product's name and lot numbers. If your veterinarian agrees the diet is implicated, he/she can contact the company and FDA with the diet information.
Update 04/27/2009 CNN corrected their Nutro story, confirming that FDA is not investigating Nutro Pet Foods.
Update 04/27/2009 - 2 pm Additional reporting from VIN News Service includes interview with freelance journalist Lisa Wade McCormick and Nutro spokeswoman Monica Barrett.
"Swine Flu" and political news will likely dominate the airwaves, keeping this ConsumerAffairs article from much airplay or coverage. The article reports of an FDA investigation on NUTRO Pet Food brought on by a series of unexplained illnesses and deaths. ConsumerAffairs noted that consumers (their readers) have been complaining for more than two years about illnesses believed to be linked to NUTRO Pet Food.
ConsumersAffairs followed up with an article on NUTRO's denial of the investigation. ConsumerAffairs remained steadfast on the existence of an FDA probe, evident by FDA's denial to ConsumerAffairs' request for a list of all complaints and lab results collected on NUTRO in the past two years. The request was filed under the Freedom of Information Act (FOIA) and was denied since:
"The document(s) constitute record(s) compiled for law enforcement purposes, the disclosure of which could reasonably be expected to interfere with enforcement proceedings."
ConsumerAffairs concluded NUTRO is under investigation on the basis of this FOIA denial. Confirmation from an anonymous agency official was also reported.
Screening of veterinary-specific lists for news of confirmation or denial of this investigation did not make things any clearer. When questioned by a veterinary news service, a representative from the Center for Veterinary Medicine (CVM) division of FDA confirmed that NUTRO is not under investigation. This information is repeated in this eFoodAlert post. But a direct announcement from the FDA was not found. Apparently, the FDA is not stepping up to deny the investigation themselves publicly. Instead, FDA is denying it to NUTRO and other sources, allowing those parties to reply to ConsumerAffairs report and CNN Headline News coverage. Perhaps, FDA did not think a ConsumerAffairs article warranted a direct response?
As of today, there is still no explanation for the denial of ConsumerAffairs FOIA request. It is possible the FOIA denial is related to the "Menu Food Recall" of 2007 or other subsequent recalls. Why not tell us that and dispel this probe rumor?
So is NUTRO Pet Food safe? Probably. With the many pet food options available, you need to decide whether "probably safe" is good enough for your pets. We will update as more information is available. Hopefully, the information will be more from the (FDA) source than rumors and second-hand denial / confirmation.
As a reminder, diet changes should be made gradually over a course of 5 to 7 days, longer if your pet is more sensitive to changes. Even with "safe" diets, sudden changes may cause vomiting, diarrhea and intestinal discomfort.
Tell your family veterinarian if you suspect your pet's illness is food related. Bring a sample of the food in a freezer bag, labeled with the product's name and lot numbers. If your veterinarian agrees the diet is implicated, he/she can contact the company and FDA with the diet information.
Saturday, April 18, 2009
Sites We Like....L.A. Times Animal Blog
Los Angeles Times' animal related blog, L.A. Unleashed, is a great read for animal lovers that want to stay informed. L.A. Times does a great job of posting everything from the trivial (what Newt Gingrich thinks of Obama's new dog), to the wacky (goat enters a Carl's Jr. Riverside), to the serious (animal cruelty case updates). L.A. Times unleashed is here.
Events....The Orange County Pet Expo
Billed as "the world's largest pet expo," Orange County's Pet Expo is this weekend, April 17-19th.
The Pet Expo has demonstrations, pet products, and of course, lots of rescued animals for adoptions. The Pet Expo is located at the Orange County Fairgrounds. For discount tickets and more information, visit their website.
Long Beach Animal Care Services' Microchip Day May 3rd
If you have ever considered microchipping your pet, Long Beach Animal Care Services will be having a low-cost microchip day Sunday May 3rd. For just $10, your pet will be microchipped with an AVID microchip, as well as registration. This is a fantastic deal, as AVID registration normally costs about $15 alone. No appointment is required for this event. For more information, contact Long Beach Animal Care Services at 562-570-7387.
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