The cross hairs of complaints

SACRAMENTO, CALIF. — Invite Dr. Wade Himes to shed light on the inner-workings of state regulatory agencies and he pauses, then laughs and asks, "Do you want me to lose my license?"

The small-animal doctor who now practices on Minnesota's Canadian border once sat on the state's board of veterinary medicine. Dissatisfied, he refused a second term. The agency's "unbridled power" over licensees was too much, he says. Appointment is political. Despite the board's mission to protect the public, personal opinion runs rampant and accountability is almost non-existent, he contends.

Not everyone shares his views. State board officials vehemently rebuff such claims. Executive Director Dr. Jeff King insists that regulators operate with integrity. Himes admits he's "a little sour," yet his criticism hangs on a belief that veterinarians are more vulnerable than ever to regulatory rebuke. It's a theory that's substantiated by the nation's growing number of state-board claims. From California to Florida, a DVM Newsmagazine survey confirms that complaints are climbing (see related story). Whether state board power cultivates those numbers is a matter of personal opinion. Some experts insist more complaints reflect lax practitioners, the demise of client relationships and an Internet savvy consumer population. Others surmise the regulatory spotlight is a product of tertiary care driven by the emotional value owners place on pets. Whatever the source, the general consensus is this: Consumers and the profession demand more accountability from veterinarians. The result is complaints are up, as regulators consider specialization, higher client expectations and a bevy of new questions regarding care standards.

It's a system that operates at the expense of DVMs, Himes contends.

"Every grievance from every irate person that's lodged with the board is investigated. You have to prove yourself innocent even if it's some cuckoo filing the complaint," he says.

On the receiving end

That's the position Dr. William Powell takes. The Oregon veterinarian who once operated a low-cost spay/neuter clinic was forced to close in July when his licensed was revoked. He now awaits a hearing to appeal the Oregon Veterinary Medical Examining Board's decision.

The charges reflect what regulators insist was a serious danger to public health and safety that included "unacceptable patient care." Among the allegations is a lack of drugs for pain management — a new frontier for veterinary regulators (see related story).

Board authorities insist there's more to the charges. Court documents reveal allegations of improper record- keeping, shoddy surgical practices, misdiagnosed patients and animals with infectious diseases not isolated.

Powell refutes every allegation and insists his discounted services made him a target in a profession increasingly concerned with revenue standards. "It's a real eye-opener," he says.

Himes is more concerned about new regulatory notions regarding pain management.

"There's an awful lot of personal opinion when it come to protocols for pain. This scares me," he says. "The vast majority of clinics would not meet standards that are now being enforced by some so-called experts within regulatory boards. Practitioners don't even know what the criteria are."

Numbers game

If veterinarians are being blindsided by emerging pain protocols, it's too early to tell, says Dr. Matt Huddleston, executive secretary of the Mississippi Board of Veterinary Medicine. He counters allegations that regulators have an agenda outside public protection and advancing the veterinary profession.

The surge in complaint numbers has Huddleston scratching his head. Nine years on the board, and the state regulator says he's never witnessed such a rise in grievances. Since 2005, filings against DVM licensees more than doubled to total 27 this year, records show. While most involve client allegations of malpractice and negligence, some stem from veterinarians filing against other veterinarians. With just 1,100 licenses issued in the state, it's a trend that has board members paying attention.

Huddleston theorizes that competition, higher client expectations and urbanization have altered the profession's climate at a fundamental level. The once-symbiotic relationship between client and veterinarian is cooling. Public attitudes toward practitioners have changed, he says.

"I don't know if there's actually more gross negligence or more gross malpractice or if people are just more apt to make claims. What I do know is we've definitely had more actions against veterinarians," he says. "It seems like we're practicing in a different time. I'm concerned about what's happening."

Hard numbers

So is Gina Bayless, enforcement program manager for the California Veterinary Medical Board whose office investigates complaints and coordinates random, routine inspections of the state's 7,000-plus licensed resident veterinarians.

The complaints come in daily, with 453 of the 651 grievances filed already in 2007 against veterinarians alleging negligence, Bayless says. The state used to receive around 400 reports annually. Now anything less than 600 is considered a light year. Total citations and fines also are up, with 135 issued as of June for minor practice act violations. Anything that requires formal discipline goes to the attorney general's office. While Bayless can't put her finger on what's driving complaint numbers, the ebb and flow appears to follow publicity surrounding high-profile cases.

"It raises the level of awareness that there are regulatory boards, someone to complain to," she says. Nearly all grievances involve a gap in communication, she adds.

"Consumers are expecting more from the veterinary profession. They want a higher level of care because of the increased importance of pets."

Complaint numbers also reflect eroding collegiality and morals in the profession, Huddleston says.

"I think it really comes down to treating others well, with respect and good medicine. The basic rule of veterinary ethics is the same as the Golden Rule. If we ever get to that point, we'll have a decrease in claims," he says.