With a cup of tea and slice of cake in hand, and between work to support EU Exit plans, devise sampling plans for disease investigations and develop a deployment plan for vaccination, I take a 10 minute break: The policy is changing it seems like we should be specialists on the outside advising in, and on reflection my veterinary degree was perfect training for becoming a policy maker.
Making decisions on available evidence
We are trained at vet school to make decisions based on available evidence, but with the understanding that that evidence is often scant. We come to diagnoses using that limited evidence, perhaps pulling in evidence from other species, or situations that best fit. Similarly, we can prescribe medicines that might not be licenced in that species by making judgements based on our understanding of how that drug works and our primary knowledge of the animals and disease we are applying it to.
Policy making is the same. We never have all the evidence. Ministers need to make decisions on ways forward with incomplete information: policy makers make recommendations based on what is known, what works in other areas and the balance of risk and benefit. The evidence we draw on is diverse: legal, social and economic as well as the more obvious veterinary and scientific evidence.
Policy is only ever evidence-based: a common misunderstanding is that policy should replicate the evidence but of course it can’t. It is and should be a practical implementation of the science and not a scientific study in itself. That is also true for veterinary practice: it’s evidence-based but not all treatments are scientific studies. We’re pragmatists: we learn by doing. Of course we should review our cases and reflect on patient improvement, whether treatment is being administered as we’d hope and the animal patient is recovering as we (and the owner) would like. The exact same evaluation process is needed for policy making.
Was Fluffy taking her pills?
I remember a particular Saturday morning consultation when I was in practice asking an owner if Fluffy the cat had taken her tablets. I was doing a recheck (I forget the exact condition) but Fluffy was not improving and I wanted to understand why. The owner nodded emphatically that the cat had taken her tablets. However behind the owner was the owner’s house keeper. At the same time as the owner nodded vigorously, the house keeper shook her head, with as much vigour and honesty. I had to come to a conclusion on what the owner thought was happening was indeed happening, and if not, why not?
The same “process evaluation” helps us evaluate policy albeit on a much larger scale: are the control measures being implemented as we think they are being, or is the farmer, at the bottom of on often long line of communications from the Department for the Environment, Food and Rural Affairs, to Animal & Plant Health Agency (APHA), to the Veterinary Office and private vet on the ground, not actually doing what we think and hope they are? And, if not, why not?
This latter work crosses over with social research, which is another area vets need to be mindful of (all vet students are reminded that “every animal has an owner attached”).
In addition to making and evaluating policy, I hope that our training enables us to lead teams, cope with flux in workloads and triage our work priorities.
People might not see me as a proper vet anymore, but in my mind I’m still striving to ensure “the health and welfare of animals committed to my care”, just at the national level.
If you are at all interested in coming to shadow a vet in APHA we are always keen to take people in and show them our work. Please do contact us and we’ll do our best to accommodate you.
2 comments
Comment by Allister Compton posted on
How true. There can be a disconnect that is often more to do with cultural and sociological issues than to technical or veterinary instructions that have filtered down through the tiers of responsibility you quote. It is not that there is a conspiracy at work to redirect from a policy or in some anarchic way reinterpretation to resist. Rather what people assimilate from the well intentioned communications they receive is often markedly at variance from that which the source had in mind.
I was interested to see the link you make to veterinary training being applicable to policy development. In my role providing experience to veterinary students in APHA field work it is interesting to note the varying abilities of evidence based decision in respect of disease diagnosis. In fact it is not 'ability', these are straight A multi qualified students all fully capable of analytical thought. What is different is the approach to the data presented. Those that can absorb information and evaluate that against their own observations demonstrate their ordered approach and decision trees leading them to question even the source data they are presented with. Evidence may not be all it is purported to be. Question, question, validate and qualify before coming up with conclusions. These conclusions have far reaching consequences. It's good to know we have vets at the heart of ministerial advice and policy.
Comment by Blog team posted on
Thanks for your comments Allister and glad you enjoyed reading the blog. Ele has indeed explained very well how veterinary training and the approach needed in practice can be of great benefit to a non-field based veterinary role! Do let us know if there's anything you'd like to see on the blog.