License defense: Are you prepared?

The legal stories I am hearing from my friends and acquaintances have a disturbing sort of similarity.

As a veterinarian and lawyer, I have become accustomed to hearing doctors lament about receiving malpractice threats. At this year's North American Veterinary Conference, a new risk category was being discussed more widely. I am hearing new and unusual legal war stories involving confrontations with state licensing boards. Interestingly enough, I actually had an anecdote from my own recent experience to fire back. Listen to the varied experiences my clients shared in January:

One practitioner told me about an incident in which she treated an emergency case when no one else would see the patient. This Samaritan's empathy ended up placing her squarely in front of her state board.

One late night, this experienced doctor answered an emergency call from a client who regularly went to another practice. The regular veterinarian was simply not available to answer the emergency call that night when the client's dog was seriously injured in a car accident.

During the examination and initial treatment, the owner repeatedly told this veterinarian that money was a critical concern and that spending any more money than absolutely necessary was "out of the question." After three days of intensive care, intravenous fluids and constant medical treatment, the dog recovered and went home wagging its tail. The ecstatic owner thanked the veterinarian and went on her way. She was not heard from again, until six months later.

Months after the treatment, the veterinarian received a notice to appear before the state veterinary board in connection with the case. Apparently, five months after the emergency treatment, the veterinarian who was unavailable to take the emergency was doing a routine spay on the same dog and allegedly identified a small diaphragmatic hernia. He immediately informed the owner. Although there was neither any certainty that the hernia was present at the time of the emergency, nor was there any sign of hernia-related illness at the time the dog was discharged from emergency care, the owner went straight to the professional licensing authority.

You might expect that any allegation of malpractice would have been dismissed either because the doctor did the client a favor by seeing the case at all or because she saved the dog and stayed within the stated budget. Wrong. The case went forward and years later, it is still being pursued by that state.

Technician duties

Another veterinarian described an instance in which she was permitting a licensed veterinary technician to administer vaccines to animals while she was not in the room. Even though the doctor was present elsewhere in/or near the building during the vaccine administration, the technician did in fact administer shots on her own (in full compliance with prevailing state practice law).

Unfortunately, one client was not aware that the person administering the shots was not a licensed veterinarian. A complaint was made to the state veterinary board, and a full hearing ensued. The client claimed that she was not informed that the person "treating" her pet was not a licensed veterinarian and state law never intended for injections to be given by a technician in the physical absence of a licensed veterinarian.

Ignore the fact that the pet had already been examined and deemed healthy by the technician's boss. The client pressed on with the board; legal representation had to be obtained by the veterinarian, and the fees for that representation were paid out-of-pocket.

Fumbled?

Finally, you haven't heard it all until you get a load of what happened to me two nights before I left for the conference.

At midnight, I was treating an ataxic cat and was sitting on the floor of my exam room watching it walk. As I was doing this, another emergency call came in on my cellular phone. I went to answer the call just as the owner plunged back through the door after consulting with her husband on the case.

The door hit my elbow. The flip-phone dropped out of my hand and landed in the closed position on the floor, inadvertently hanging up on the other emergency. Before I could dial back to the emergency caller, she called again. She was incensed and berated me about my unprofessional conduct in hanging up on her!

Although I tried time and again to get a word in edge-wise to explain what happened, the owner just kept talking, yelling and calling me names. I finally had to hang up on her intentionally!

The next morning, there was a message from my receptionist that the woman had called back and was planning to file a claim with the state veterinary board.

Now, as you can see, I can't just assume that I won't actually have to defend my license at a hearing in Albany. It is clear from the first two examples that just because a complaint may seem goofy or unfair, it still could mean a practitioner shells out big bucks in an effort to defend his or her license to practice (as well as his or her good name).

It is very important to remember that the professional malpractice coverage that most veterinarians carry, whether through the AVMA or another private carrier, rarely covers the costs associated with professional license defense.

The moral of this story is: Run, don't walk, to the telephone and call for a license defense rider on your veterinary malpractice policy.

The alternative might be to stop using a flip-phone when seeing emergency cases.

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