Blurred lines: Would you risk insulting a veterinary client over a safety concern?

Lisa Lone was a 53-year-old pet lover with three dogs, two cats and a squeaky guinea pig named Myrtle. She had been a client at Dr. Hay's veterinary clinic for 11 years-in fact, she was the ideal client. She diligently came in with her pets twice yearly for checkups, listened to all veterinary recommendations and was very proud to recommend Dr. Hay to all who would listen.

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Occasionally Ms. Lone would call Dr. Hay after hours and relay anecdotal tales about her beloved pets. Dr. Hay sometimes noticed her speech was a little slurred. When this occurred, he politely got off the phone, telling her he would speak to her again when she was feeling better. Dr. Hay felt this was an unspoken code he shared with the client informing her of the fact that he didn't want her to call when she was intoxicated.

At 6 p.m. on a December evening, Ms. Lone called and said that her Cockapoo, Pepper, was limping on her right front leg. She insisted on having the dog cared for immediately. Dr. Hay asked her to come right over. About 20 minutes later, Ms. Lone appeared with her limping dog and her 7-year-old granddaughter, Susan. It seemed Ms. Lone had been babysitting her granddaughter when the youngster accidentally dropped the dog. All three were visibly beside themselves.

Dr. Hay thoroughly examined the pet and found the problem to be a soft tissue injury. No fractures or dislocations were present. Needless to say, everyone was relieved. However, when Ms. Lone had helped hold Pepper during Dr. Hay's evaluation, the doctor detected a smell of alcohol on the woman's breath. He didn't think she was acting impaired-her balance was good and her speech and observations were sharp. It was possible that she'd been having an evening cocktail at the time the incident occurred. He thought to himself, "Many people often relax at the end of the day with a cocktail."

Dr. Hay had a dilemma on his hands. A very good client had the smell of alcohol on her breath and had driven to the clinic with a 7-year-old child. The dog was fine and could go home after the exam, but could he in good conscience allow the client, child and dog to be put at risk during the car ride home?

He decided to tactfully ask Ms. Lone if she would like a staff member to drive everyone home. He commented that it seemed she may have had a cocktail when this emergency arose, and it might be safer for all concerned if the clinic provided a designated driver as a courtesy. Ms. Lone thanked her beloved Dr. Hay but insisted that she was quite all right and that she would drive.

It was at this point that Dr. Hay made a judgment call. He felt that his client was steady and alert. She was offered a ride and declined. In his mind, he had evaluated the situation to the best of his ability and determined that she wasn't obviously impaired. He said nothing as his client, her granddaughter and the dog left to return home.

Rosenberg's response

Dr. Hay knew his client had an issue with alcohol from previous conversations with her. Although he felt she wasn't impaired at the time of her visit, the alcohol on her breath was apparent. The elephant in the room was the fact that she was a good client who generated income and referrals for the practice.

If I had been in Dr. Hay's position, I wouldn't have called the police when she left, but I would've been more emphatic and insistent about providing a designated driver for her and her family. It's the veterinarian's obligation to do what's necessary to provide for the safety of pets and the children attached to them. One can only imagine how he would have felt-and the repercussions he would have suffered-if they'd had a serious car accident on the way home from his practice.

Dr. Marc Rosenberg is director of the Voorhees Veterinary Center in Voorhees, N.J. He is a member of the New Jersey Board of Veterinary Medical Examiners. Although many of his scenarios in "The Dilemma" are based on real-life events, the veterinary practices, doctors and employees described are fictional.