Malpractice prevention begins with awareness

PLEASANT HILL, CALIF. — Veterinarians vulnerable to lawsuits and state board complaints must remain vigilant when it comes to liability in their practices, and graduates equally should beware the dangers of working in an unsound legal environment.

To aid new practitioners in their transition from the classroom to the clinic, Duane Flemming, DVM, JD, a California practitioner, offers suggestions on surviving in a litigious environment.

"Before suing veterinarians and complaining to state boards became a national pastime, veterinarians were immune," he says. "We can't take chances anymore. Right now our profession is riding high in the realm of credibility and stature. But if we keep playing these games and not doing what's right, we'll lose that status."

The following advice shows how new graduates can create legal safety nets.

Document, document, document.

Good record keeping is the best way practitioners can protect themselves from liability claims. All veterinarians know they must record procedures they do, but most don't include the procedures they don't do. For example, every time a client cancels or fails to show up for a scheduled appointment, that notation should be in the medical record. If the receptionist called and left a message on the answering machine, it should be in the record. These notations in a case of negligence can protect the practitioner by showing that the client failed to return for a recheck.

Any conversation, anything that's done to the animal should be recorded even if you're just providing the client with a vaccine pamphlet. Without documentation, all you have is the veterinarian's word or comment.

Don't rely on release forms

You can't wave away your negligence with a release form; they're not airtight and usually are a waste of time. Release forms are only useful if they document informed consent. What a lot of veterinarians do is throw out this blanket release that says, "I give XYZ Veterinary Hospital release from all claims and all liabilities." That's worthless and won't hold up in a court of law, according to Flemming.

Release forms should show that you've provided the client with the information necessary and, after receiving that information, they consent to the procedure. Make sure the form identifies the client and animal specifically by name, the procedure to be done and the person performing the procedure. Release forms should show the doctor has discussed alternatives and risks, the client has no additional questions and consents to the procedure. Flemming recommends that practitioners run the forms they generate by an attorney in their respective states.

Keep a clean hospital

Start in the parking lot and continue through the waiting and exam rooms. Keep the back of the hospital clean and be careful about what goes on behind closed doors. Staff members can generate a substantial number of lawsuits or state board claims.

Don't run from clients

Veterinarians by their very nature often are introverts and don't generally like confrontation. When things start going south, practitioners tend to run, and clients interpret that in a negative way. Instead of getting a positive outcome for their concerns, they're magnified. Veterinarians need to deal with problems quickly and honestly and communicate with clients. Don't shove confrontational issues onto staff members.

Practice good medicine

Don't take shortcuts. Issues often arise because veterinarians try to make tasks convenient for a client or save them money. Veterinarians are not the protectors of their clients' pocketbooks. It's their job to practice good medicine. Not doing a blood workup before anesthesia to save the client money isn't right, and a lot of problems arise because of this.

Recognize your limitations

Refer early and often. New doctors need to grow thick skins, let go of their egos and honestly evaluate their capabilities. They have to ask the question, "Can we really do what needs to be done for this animal?" If not, the veterinarian has an obligation and duty to refer it. Many lawsuits stem from clients asking, "Why wasn't I referred sooner?"

Communicate

Beware of the drop off. An animal comes in for a dental exam and mistakenly gets neutered. These unauthorized surgical procedures actually happen. Veterinarians who allow this often are trying to save time for their clients by letting them leave their animals without good communication.

The harder you try to do people favors, the worse it will come back to bite you. These clients will be the first ones to sue.