Tips to preventing malpractice pitfalls

PLEASANT HILL, CALIF. — Increasingly vulnerable to lawsuits and state board complaints, veterinarians remain on the lookout for liability concerns in their practices, and graduates should be aware of the dangers of not working in a legally sound environment.

To aid new practitioners in their transition to clinics, Duane Flemming, DVM, JD, offers several how-to tips to surviving litigation. Good record keeping is a hallmark, he says.

"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 reveals ways new graduates can create sound legal safety nets for themselves and their practices:

Document, document, document

Diligence with record keeping is the best way practitioners can protect themselves from liability claims. All veterinarians know they must record the 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, a 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.

Ways to avoid malpractice claims

Any conversation and 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 scheduled procedure and the person performing it. Release forms should show the doctor has discussed alternatives and intended risk and the client has no additional questions and hereby consents to the procedure.

Flemming recommends that you take any form you generate and run it by an attorney in your state.

Keep a clean hospital

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

Don't run from clients

Veterinarians, by their very nature, are introverts and don't generally like confrontation. When things start getting dicey, DVMs tend to run, and clients interpret that in a negative way. Instead of getting a positive outcome from expressing their, they're magnified. Veterinarians need to deal with problems quickly and honestly and communicate with the client. Don't shove these problems onto staff, he adds.

Practice good medicine

Don't take shortcuts. Issues arise because veterinarians take shortcuts to make it convenient for a client or save them money. Veterinarians are not the protectors of clients' pocketbooks. It's their job to practice good medicine. Failing to perform a blood workup before anesthesia to save the client money isn't right, and a lot of problems stem from 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. Lots of cases come from clients asking, "Why wasn't I referred sooner?"

Communicate

Maintain good protocols during drop offs because it's easy to make mistakes. For example, an animal is admitted for a dental and instead it gets neutered. Unauthorized surgical procedures are more common than you think. 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 you.