When a colleague's expectation crosses the line

Dr. Lee Grant owned a three-doctor practice in a resort area of South Carolina. He had thrived during the last 15 years by reaching out to local pet owners while also welcoming vacationers with open arms. He was proud to be a veterinarian and had been an officer in his local and state veterinary associations for more than a decade.

Dr. Bill Rader retired from practicing veterinary medicine two years ago. He sold his busy small animal practice and moved from the frigid northern part of the country to spend his retirement years in beautiful South Carolina. Dr. Rader had always had a Labrador retriever as a pet. He loved the breed and had been spending more and more time with his dog since he retired. In recent days, he had noticed that his dog had become a bit lethargic. He observed paleness in the pet's gums and knew that medical assistance was needed, so he called Dr. Grant and scheduled an appointment.

Upon arrival, Dr. Rader introduced himself as a recently retired veterinarian. In light of this background, he asked Dr. Grant if he could participate in the care of his pet. Being the collegial person he was, Dr. Grant consented to Dr. Rader's request. A complete workup was done, including an abdominal ultrasound. It became clear that the Labrador had a splenic mass. Both doctors agreed that surgery was necessary. Dr. Rader then requested to scrub in on the surgery.

At this point Dr. Grant started to feel uncomfortable. His retired colleague did not hold a license to practice in South Carolina. In addition, he could prove to be a distraction in the operating room, impacting the health and well-being of the patient. Dr. Grant shared his feelings with Dr. Rader, who reluctantly complied with Dr. Grant's decision. Fortunately, the surgery went very well. The dog recovered uneventfully, and Dr. Rader removed his pet's sutures himself 10 days later. Dr. Grant sent his retired colleague a bill for his services with a 15 percent discount as a professional courtesy.

Dr. Grant soon received a check in the mail accompanied by a letter. Dr. Rader reported that the pet was doing well but that he was as disappointed both in Dr. Grant's refusal to honor his request to participate in the surgery and the minimal monetary courtesy that had been applied to his bill for professional services.

Dr. Grant was flabbergasted. He felt he had treated his fellow veterinarian very generously, but then he remembered that no good deed goes unpunished. Do you think these doctors acted and reacted appropriately?

Rosenberg's response

Most veterinarians attempt to extend professional courtesy and respect to their colleagues, as Dr. Grant attempted to do with Dr. Rader. But a clinician must also keep in mind the regulations that he or she is bound by when issued a state license. It is true that a license is not required for an owner to humanely administer care to his own pet. But Dr. Grant took on his colleague's pet as a patient and at that point had to meet the standard of care mandated by his licensure.

If Dr. Grant had allowed Dr. Rader to participate in the surgery and order certain medical protocols for his pet, he could have placed himself in a gray area of adherence. In this case, Dr. Grant acted ethically and courteously, while Dr. Rader was out of line. There was no requirement that a discounted bill be issued, and it was inappropriate for Dr. Rader to object to the amount of the courtesy. Hopefully this will not deter Dr. Grant from offering colleagues courtesies in the future.

As for Dr. Rader, retirement was an excellent decision.