Can pandemic rules be broken?

Dr. Jim Geer worked very hard for 16 years to build the Geer Animal Care Center, had a thriving suburban veterinary practice with a state-of-the-art facility, a highly skilled staff, and loyal clientele. Then, COVID-19 hit and all the rules changed. Some mandates were state orders, some were professional recommendations, and others were just plain common sense. In the midst of all the governmental directives, stimulus support options and outright panic, Dr. Geer tried to understand the new rules that would govern his practice of veterinary medicine for the foreseeable future.

One new rule was that veterinarians were considered essential workers, with “essential” functions limited to non-elective care. When Dr. Geer approached his state veterinary organization for a definition of non-elective care, the debate began. He had a meeting with his staff to discuss what was elective and what was not, but the distinction between the two started to become unclear.

Everyone agreed that an animal in pain and distress should be cared for, but what about elective spaying of young animals? Spaying is not a life-or-death situation, but spaying after a certain age can have serious medical consequences. Next were those breeds that become pathologically matted when they are not groomed. And some nail trims are cosmetic while others are clearly medically indicated. Dr. Geer felt that client requests should be evaluated on a case-by-case basis.

As more rules were created, so were more issues. Curbside care was instituted to maintain the health and wellbeing of staff and clients. The rule was that no one except professional staff could set foot inside the clinic. At first, this rule seemed cut and dried, but then a very emotional euthanasia was presented. Participating in the euthanasia via FaceTime or Zoom was unacceptable to the owner, and Dr. Geer decided he was not going to deprive this client of her last moments with her beloved pet. During the procedure, which took place inside the hospital, Dr. Geer, his staff, and the pet owner all wore gown, gloves, and mask.

After this experience, Dr. Geer decided he had had enough. He gathered his staff and told them that while all of the new directives were certainly well intentioned, they were not created by veterinary clinicians. Therefore, his years of practice combined with his staff’s desire to observe all safety measures while caring for patients would guide his decision-making going forward. As far as veterinary care was concerned, the new rules could not be etched in stone.

His team observed all of the core rules. Staff and client safety was the priority. All team members washed their hands frequently, wore masks, and practiced social distancing. But the state’s directives, the veterinary medical association’s directives, and the endless media expert opinions all had to defer to Dr. Geer’s best judgment. He was a hands-on clinician who knew the unique needs of his clientele, and he had the support of his staff. As long as he had the best interests of his patients and staff as a priority, he would ignore the chaos and let his experience be his guide. His state officials and other practice owners may not agree with all of his decisions, but in the end in at his hospital the buck stopped with him. Rules certainly are not made to be broken, but in the world of veterinary medicine and COVID-19, calm assessments and good professional judgment are paramount.

Do you agree with Dr. Geer that veterinary practices should use their own judgment in the care they provide during the COVID-19 pandemic, or do you feel that in times of crisis the experts should be your guide? We would like to know. Email us your thoughts at dvm360news@mmhgroup.com.

Dr. Rosenberg’s response

Dr. Geer, like the rest of us, is in unchartered territory. Veterinarians are being pulled in all directions by well-intentioned pundits. Pandemics are like storms because they are not always predictable and often change course. Every practice has a profile, and nobody knows that profile better than the professionals who work there. If you are meeting the needs of your clients, patients, and staff, you are satisfying your professional ethical obligations. Rules are not made to be broken, but during trying times such as these, they should serve only as guides.

Dr. Rosenberg is director of the Voorhees Veterinary Center in Voorhees, New Jersey. Although many of the scenarios Dr. Rosenberg describes in his column are based on real-life events, the veterinary practices, doctors, and employees described are fictional.