5 types of potentially litigious veterinary clients

Throughout my career as a practice owner, I have been hesitant to suggest that clients look elsewhere for veterinary services. Particularly in my early years, I never wanted to give up a client, and this policy usually served me well. However, now that I'm a little older and wiser, I've learned that there are certain instances in which clients need to be fired — or politely asked to seek veterinary care elsewhere.

When I say this, I don't in any way mean that you, as the practice owner, should give in to every entreaty by an associate or staff member to "Tell that $#%@! to go somewhere else!" All of us want to fire pain-in-the-neck clients from time to time. Most practice annoyances from clients must be tolerated, particularly in the current economy. And while we know that a small percentage of clients create the largest percentage of management problems, we usually put up with a certain number of clunkers.

But this article isn't about clients who are merely irritating. No, some clients are lawsuits waiting to happen. Following are important signs to watch for to be on your guard against troublesome clients who may be more likely to become potential litigants. If you encounter a client exhibiting one or more of these danger signs, I suggest taking an objective look at your relationship with that client and deciding if that relationship is worth continuing.

Sour on specialties

Be concerned when taking on advanced or sophisticated treatments on behalf of clients who express serious dissatisfaction with their previous experience with a specialty practice or university teaching hospital. That is a telling sign of a serious disconnect between client expectations and the reality of medical science.

I'm not talking about unhappiness with the cost or outcome of a procedure at a referral facility. We always hear from clients about how the local veterinary college "was able to put on a new wing after my last visit there" or they "spent $5,000 at the Animal Medical Center and ended up with a dead cat."

No, the clients to worry about are those who, while perhaps unhappy about the cost of a previous referral experience, have specific and pointed issues with the quality of care or treatment rendered to their pets. Be cautious if clients claim that some previous referral visit resulted in a misdiagnosis or the use of an outdated or inappropriate treatment modality or neglect or a deviation from the treatment they read about or saw on the Internet.

Stuck on the details

Be concerned when a client asks you to repeat, with annoying specificity, the medications, surgical techniques or treatment approaches you intend to employ or have employed in working up a case. That often implies that this client is acting out that old chestnut, "A little knowledge is a dangerous thing." This saying is true and a little knowledge can be dangerous for your reputation and your practice when litigation or state board claims later ensue, initiated by some self-appointed specialist/client. I have found that later legal problems are more likely to develop when clients become deeply involved in the intricacies of the medicine or procedure performed on their pets. If the outcome isn't perfect and the decision of how to treat was open to any subjective opinion whatsoever, something magical happens: The client knew from everything he or she had read that the doctor should have gone the other way on that medication/dosage/protocol/technique. It's not long before that certainty unfolds into legal action.

Seeing a nonexistent pattern

Be concerned when owners are convinced that previous treatments or surgeries at another veterinary clinic are the cause of some new problem that is presented to your hospital. Clients of mine have convinced themselves absolutely that the bilaterally symmetric lick granulomas on their dogs were originally initiated by incompetently performed heartworm test phlebotomy. And, of course, there is that obese dog that has "never really walked right since Dr. Last removed that big lipoma from Porker's thigh."

Standing as the last resort

Be concerned when you're the only veterinarian in a multidoctor practice whom a specific client is willing to see. When undying dedication and accolades are bestowed on a single health professional, something else frequently tags along: unrealistic expectations. If you're a perfect veterinarian in the eyes of a client, you can expect some serious problems when your skills fail to match up to expectations of magic.

It's tough to ask clients who look at you with stars in their eyes to see others at your practice or go elsewhere, but it can be a good idea.

Sweet on just one

There's another side to clients picking their favorite doctors.

Be concerned when scheduling surgeries or major procedures for needy clients on a day when their favorite doctor isn't present. If your hospital knows that Mrs. Tude only wants appointments with you, it is wise not to allow any surgery to be performed when you're not there. If someone else operates on a Tude animal and something goes wrong, watch out. Mrs. Tude will raise holy hell with the doctor who does the work, and you both may end up the target of a lawsuit and an investigation by the licensing board. If you're a boarded surgeon, ophthalmologist or neurologist in specialty, the risk of this is even greater.

When a needy client develops a close relationship with a doctor, that favored veterinarian should be the one who works on the pet. If hospital custom and practice make this impossible, such a client should probably find another practice.

Sending a message

Be concerned when clients mention that they're undertaking litigation or administrative action against a health professional.

It's amazing how much personal information clients will share in the exam room. Reluctantly or under protest, I have learned details about clients' personal marital problems, painful career crises, uncomfortable medical procedures and unusual prostheses. Clients are also happy to share information about how they're angry at a local internist, pediatrician or podiatrist and are suing. This kind of talk sets off my alarm bells.

One special note, however: I don't get too worried when I hear people in the exam room tell me they're planning to sue their lawyer. When I see the delays and stalling some of my colleagues put their clients through, I'm surprised more law practices don't end up in legal trouble.

Dr. Allen is president of the Associates in Veterinary Law P.C., which provides legal and consulting services to veterinarians. Call (607) 754-1510 or email him at info@veterinarylaw.com.

For a complete list of articles by Dr. Allen, visit dvm360.com/law