NEW Client Notes Fall 2021


(fall 2021 update)

The situation regarding business openings and safe exposure continues to be fluid and recommendations changing often as new infection surges come and go. The facility where we practice (Eye Care for Animals) has not been allowing the public to enter and, with humans infected and spreading virus without showing clinical signs and new, concerning emergent varients like “Delta,” we simply still cannot safely use our “regular” practice model of meeting in person with pet owners and pet(s) for an extended appointment in the same small exam room breathing the same unfiltered air. For now, we will be still only meeting new cases briefly “in person” in the open-air cul de sac or driveway in front of the doctor’s home office in Carmel Valley (just east of Del Mar) ideally driving down immediately after the rest of the appointment is first done via telemedicine. Legally, all licensed veterinary doctors (including specialists like Dr. Melese) must establish a Veterinarian/Client/Patient (VCPR) legal relationship during an “examination” of the patient (“in person”) and actually meeting the pet owner in order to provide any veterinary services including establishing a diagnosis, treatment plan, prescribing medications, etc. Due to ongoing exposure concerns, we will establish this VCPR by “seeing” the patient/pet parents in person outside with a “curbside meeting” in Carmel Valley using appropriate “social distancing” and masks. Before this very brief (usually less than 10 minutes) “in person” part of the visit occurs, we will convene at the initial appointment time using “video chat” option such as Zoom (Zoom or Google Meet are free and ideal since audio & visual but on phone call possible as well if no other choice) with pet parent safely at their home with the pet and at their computer (or tablet or cell phone if they prefer) using telemedicine/video chat with the specialist doctor who is still working remotely from his home office. Although we could also do the “ curbside exam” first followed by the video-chat, it is usually better to plan for after the telemedicine consultation so that, potentially, training aids and/or medications, etc. may be able to be dispensed by the doctor after the telemedicine portion of the appointment. FOR CLIENTS COMING FROM SOME DISTANCE, WE HIGHLY RECOMMEND AN AFTERNOON NEW PATIENT APPOINTMENT since the “team” will have more “breathing room” for the pet parent to drive down to Carmel Valley home office after the Zoom appointment compared to trying to “squeeze” this in between end of new AM telemedicine consultation and the doctor starting with the afternoon appointments! We are sorry for the challenging nature of meeting the legal needs of establishing the legal VCPR after the initial appointment via telemedicine for both clients and our doctor, but this is the present reality and we would not offer this arrangement if we had not found that we can still provide very effective help using telemedicine followed by handouts sent later via e-mail. Follow-up/recheck appointments can all be simply via phone or videochat for up to 12 months after we have actually seen the pet “in person.” For those that must come a great distance for this brief “check in,” we apologize for the necessary challenge and will work with you as best we can to accommodate your travel/timing needs but cannot legally provide any treatment or diagnosis until we get to meet the pet “in person.” We have now done hundreds of new cases using this Covid 19 model since March 2020 (as have the majority of our N American colleagues) and the progress and results so far are comparable to when we were able to see each new patient “in person” at an clinic exam room during the entire appointment. We also have an online pharmacy partner integrated into our practice so can provide any needed refill medications or other veterinary products that will be shipped to you as needed using that resource “contact free.”

Please check our website for future updates or inquire with our office (e-mail best since little time to “chat” on phone these days but leaving voicemail can work) if you have remaining questions about your upcoming appointment not found on FAQ on website or in e-mails we have sent you. As with all Telemedicine appointments, payment will be taken at the end of the appointment (see P.S. below).

We are sorry for any disruption in our “normal” specialty practice services and our clients’ schedule with these steps but they are for all of our health and it is vital for us all to work together to make it through this difficult time until robust (likely 90% of population with virus immune protection needed for “Delta Varient”) population (herd) immunity can be achieved with vaccines (safely and effectively or, alternatively, hopefully surviving infections and without “long Covid” ongoing symptoms lasting months to possibly years ) and virtually all of our clinic clients are vaccinated for Covid. When we do start seeing patients again at the clinic or by housecall “in person,” we will only be offering this option to clients with proof of completed vaccinations including any boosters following national and local public health guidelines. As always, as a private specialty practice, we reserve the right to refuse services to anyone not following our practice policies.

We hope you and yours stay safe during this time.

P.S. Please note that due to credit card processor changes and increased costs of providing the option of paying by credit card, in order to be fair to all clients, those that choose to pay by credit or debit card (we accept Visa, Mastercard or Discover) will pay a 4% convenience fee (also be sure to let doctor know this ASAP when we start to allow sufficient time to check out via credit card as it takes longer). To avoid this additional modest convenience fee, simply pay using VENMO, Google Pay or Zelle and we are now also again accepting checks & cash at “curbside exams” done AFTER the consultation if you prefer.

“We strive to confirm appointments as a courtesy; it is still your responsibility to stay aware of the time and date of your appointment or cancel/reschedule with sufficient (48 business hours) notice to avoid incurring late cancellation fees.”

Patrick Melese DVM, MA, DACVB and staff
Board Certified Veterinary Behaviorist