Shades of fear: Sorting paranoia from truth in a clients story

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Willow Tree Vet Hospital is a busy place. The three doctors, eight technicians and three receptionists are both efficient and compassionate. The facility has been a staple of its small suburban community for the past 40 years, operating under the philosophy that total veterinary care doesn't stop with patients-it's just as important that clients be compliant and assist their pets as a vital part of the healthcare team.

Lisa has brought her miniature poodles to Willow Tree Vet Hospital for 25 years. But with her third dog, Tootsie, things have begun to change. During her office visits she has started talking to the staff excessively about issues with her husband-including how he treats the dog. As the weeks go by Lisa comes to the clinic in an increasingly agitated state. She's convinced that her husband is intentionally mistreating Tootsie. Examinations on multiple occasions show a healthy, well-maintained pet. Soon the staff is spending hours with Lisa and Tootsie every time they come in.

The head technician decides to bring this issue to the attention of Dr. King, the hospital owner. Dr. King calls a meeting to hear team input. It becomes clear that a devoted client's behavior has changed significantly, and the team thinks she's become irrational and unstable. Dr. King says their mission as a compassionate veterinary clinic is to assist both the patient and the pet owner. He emphasizes that they aren't mental healthcare professionals and must be careful about invading a client's privacy. The team decides that Dr. King will meet one-on-one with Lisa to present his observations and see if he can be of any assistance.

Dr. King meets with Lisa in his private office. First he asks about Tootsie. Then he tactfully brings up his concerns about the recent change in Lisa's moods and conversations when she comes to the clinic. She tells Dr. King she has been a client for 25 years and he knows how devoted she is to her dogs. She then tells him about her husband's intentional mistreatment of her and the dog. Dr. King asks if she has sought any outside assistance to help manage the home situation. She replies that when she calls the police and the humane society they do nothing.

Based on this conversation, Dr. King concludes that Lisa is experiencing a significant emotional disorder. At this point, he tells her that in spite of everything Tootsie is doing fine and that in the future she has to call him personally before coming to the clinic. Lisa agrees to this but doesn't understand why nobody wants to help her with her abusive husband's behavior.

Dr. King feels that he has an allegiance to this longtime pet owner and that she deserves his empathy-but he also has a practice to run. He doesn't think it's his place or obligation to intercede further. He has informed Lisa of his availability and reassured her of her pet's well-being, and in his lay judgment he doesn't believe she is a threat to herself or her dog. Some of his staff think he should contact social services as well as her family in an effort to help, but Dr. King finally says, “Enough is enough.”

Do you think Dr. King handled this situation correctly? Let us know at dvm360@ubm.com.

Rosenberg's response

Veterinarians are caregivers. The desire to help pets and their owners has to be tempered with both compassion and reality. I think Dr. King's actions were appropriate. This situation was stressful for both the pet owner and the veterinarian. This, added to the other emotional stresses that clinicians deal with day in and day out, can take a toll on the doctor's ability to function positively in the workplace.

It is important to wear your professional “hat” at all times. Give it your best, have confidence in your decisions, and don't take the stress home with you at the end of the day. This is an excellent formula and philosophy that will allow you to happily help your pet patients for decades to come.

Dr. Marc Rosenberg is director of the Voorhees Veterinary Center in Voorhees, New Jersey. In his private time, he enjoys playing basketball and swing dancing with his wife. Although many of his scenarios in “The Dilemma” are based on real-life events, the veterinary practices, doctors and employees described are fictional.