Vet Stress One thing this veterinary hospital didn’t learn in kindergarten

April 19th, 2008  

Add Comment17 Comments

If it were my dog I'd want to know. And I think a letter would be appropriate.

Cassandra April 19th, 2008 10:20:00 AM

I think you should have a discussion with your client about this, from the standpoint of the potential impact on her pets health and the need for care coordination.

Stefani April 19th, 2008 10:48:00 AM

Not only would I send a letter to this practice, but I would check with your clients when they come in for visits whether the animals had received any treatement while boarding the last year. You can just ask if they have, and if the answer is yes, follow up with a questions whether any vaccines or meds were issued.

If your patients are curious, you can just say that you'e come across a couple of cases where this was done and you didn't receive the records and you want to be extra careful to make sure that vaccines aren't being duplicated. And you can toss in a statement that should never let a kennel give these shots, etc.

That way you don't have to name the facility, you educate your customers and you avoid the liability that would end up on your plate if you were to give vaccines on top of the ones they were given by these bad vets.

And of course if they mention they use this vet for boarding you can always warn them about the vaccine problem or just gently tell them that you are now recommending facility X as your preferred boarder.

2CatMom April 19th, 2008 11:14:00 AM

I agree with the above posters--this is still your client, and if it were me, I would definitely want to know since there is a chance the dog's health could be compromised. It seems to me more important to talk to the client than to write the letter to the offending facility (though you might very well do both!). I think the client PROBABLY should have know that it isn't a good idea to be getting treatment from two different vets unless those two vets are closely conferring--but she may have assumed that was happening.

Arlene April 19th, 2008 01:17:00 PM

Old advice but good.....write the letter, then put it in a desk drawer for a week. Take it back out and read it again. Then decide if you want to send it, revise it, or shred it.

Larry April 19th, 2008 02:33:00 PM

If I was your client I would want to know. Who knows "what they told her", you need to correct that.

Elizabeth April 19th, 2008 05:11:00 PM

I have found *many* vet hospitals that give yearly vaccines and perform unnecessary tests. The only explanation I can give is that they are trying to boost their bottom line. You should definitely tell your client. When I inform adoptors of the 3-year vaccine protocol, and their vet is still giving them yearly, they are astonished and usually switch vet hospitals. Your client would want to know.

Tara April 19th, 2008 05:58:00 PM

I agree with all above posters. If you were my vet, I would expect you to tell me that my dog had been overmedicated and how to keep that from happening in the future.

I had a related experience with my dog at a boarding facility within a vet clinic over 15 years ago, and I'm still ticked about it. We had to travel unexpectedly and couldn't take our dogs. Our normal kennel was full. I don't recall how we chose this place.

When I picked up our dogs, they presented me with a computer printout of a list of recommendations -- food change, further diagnostics, semi-annual exams, I don't know what-all. Turns out they had done an "Older Dog" exam on my dog without my permission and -- obviously -- without me present. I don't recall whether they gave him any meds. Poor pup. He didn't know any of these people, and he didn't like exams. He didn't deserve to have that done to him at all, to say nothing of in the absense of someone he trusted by his side.

I was extremely upset about this (mis)treatment and never used them for kennelling again -- or anything. I let them know what I thought, but they acted as if they had done me a favor. So, every friend and client of mine who had pets learned that this clinic had poked and prodded my dog (and took blood, as I recall!) without my permission.

Interestingly, the vet sold the practice and moved. I moved too, later on, and recently found that he's practicing nearby. Oh goody -- a whole new opportunity to educate my local friends and clients -- and the humane society also.

M April 19th, 2008 06:03:00 PM

Wowee Dr. Khuly, Scammed & betrayed within your own profession.Should I restrain myself, or let it all out? I certainly feel stressed enough to go full blast.

I think a curt letter to the vet/boarding facility is in order, since you have referred past clients to utilize the facilities (no appreciation for that obviously!!). Of course you could formally register a complaint of AVMA guidelines with your state association too----since you have pretty much stated exactly what the written ethical guidelines are (I've read them too!).

Will you sound petty to the client? It would not appear that way to me, but is the client kind of a dim bulb? Sorry for lack of better description. I only say this, because it would occur to me immediately that something "not right" was up with all these "included tests" for a boarding stay. The vaccine issue, I would mention your position on the issue (that is now backed up by all research, including the AVMA)

Lately, I have been pondering the cruel "referral scam" that Pocket and I were subjected to. And it is my belief that not only was I scammed, but the referral hospital was scammed also. This does not in any way excuse any of the unethical, cruel, and fraudulent vets involved from what they did. Every individual is responsible for their own actions, including the "silent support staff "

Hmmm, I believe the above sounds pretty restrained, since I truly am in a "simmering & stewing mode" , since my old gal's peaceful and humane death that flies in my face to remind me of the incredibly cruel one I'll never forget. This blog is about ethics----

For the readers, I have learned that federal guidelines for all states Attorney General Dept. are mandating "transparency in government" and easier access to FOI (freedom of information). A search on the "new website" here in NH (and you have to use multiple searches to find the buried info) has disclosed "some" of the complaints filed starting in '06---no details except the name of the clinics (I'll be updating my web site hopefully this week)

Barbara A. Albright/New Hampshire April 19th, 2008 08:25:00 PM

Brabara: You'll be pleased to know that the State of Florida is moving towards publishing more visibly (via Google, how much more visible than that?) the license status of all licensed professionals in the state. Though this information is already public record, the move (thanks to our Governor) will become more easily obtained. Some professionals are steamed. I think all consumers should be gratified.

Dr. Patty Khuly April 20th, 2008 08:54:00 AM

Absolutely talk with the client. Any hospital that does not consult animal records, that administers duplicate medication is, in my opinion, committing malpractice. Prior to my coming to you, I was told by a supermarket pet hospital chain that my dog needed unnecessary surgery, meds, etc. This hospital boasts about lower costs while still delivering excellent pet care. And, while it seemed cost effective-- there were charges for unnecessary medications, services and even surgeries.

I think this is a moral issue. Take the "you" out of the situation and deal with it from afar as though it had happenned to another vet or pet owner. Then make your decision. To me, this is an ethical situation.

They suck!

Janet April 20th, 2008 02:07:00 PM

Dr. Khuly, I truly believe to my very soul that taking the moral & ethical "high ground" in any business practice will have its rewards in the end. Sure, it may be a hard and rough, and long road in the beginning financially, emotionally, and intellectually ---but the payoff with referrals, loyalty, and reputation will bring about the "retirement" security.

People are just plain FED UP with scams, blatant incompetance, deception, disrespectfulness everywhere they go. Legal reform is taking place, government reform, accountabilty, because the public is demanding it! The majority of Joe Q. Public is reasonable, expects mistakes to happen, looks for the courteous and ethical transactions----but can no longer accept the mentality pervading the business/service world. Changes are coming! Bad business will fall and fail, as it should be.

Barbara A. Albright/New Hampshire April 20th, 2008 03:00:00 PM

Dr. Khuly, I would like to echo Barbara's remarks thanking you for taking the high ground on this issue. And, more generally, that the best way to ensure the success, health and trust in the vet profession is for vets to behave above board, have transparent practice, etc. And most importantly, stand up on behalf of quality and ethics standards in their own profession. This is of course, true of every profession.

As for your announcement taht "the State of Florida is moving towards publishing more visibly " -- this is good news. Earlier this year I wrote a public records request to every state in the country requesting disciplinary records for the veterinary board for 2007. I didn't hear from Florida -- until just this past week, and the letter was sent in late January. They said my request was mis-routed. I don't disbelieve them, but now must write them again to get the information I originally requested, since they say so much time has elapsed that they aren't sure I still want the information.

Many states make the records of veterinarians as well as other health professionals available on their websites. I don't believe Florida does. My state of Maryland does not either. However, Virginia, Colorado, Connecticut, and a whole bunch of other states have.

It is incredibly expensive to fulfill public records requests when this is not done. I have been informed by several states in the country that it will cost me hundreds, and in some cases, thousands of dollars to obtain the public records associate with veterinary discipline for 2007. Clearly, this is exhorbitant. Some states charge 25-50 cents per page (NOT inclusive of staff time, for copies alone), when the Kinkos right down the street from their office charges only 8 cents per copy. From a consumer standpoint, this seems like an attempt to withhold public records in spirit. Technically, it's available. Practically, its unaffordable in SOME cases.

Also, how much less expensive must it be in the long run for the state to simply do what Virginia has done, and make the decisions readily accessible online? No staff time is involved. True, it's an up front investement to build the database and website, but after that -- no more copying costs, no more research time costs, it all goes away.

Anyway, it's good news about Florida, and I wish they would hurry up and implement.

Stefani April 20th, 2008 05:55:00 PM

I'd outline your points in a letter put a copy in her file and send a copy both to the hospital and also the client. That way you have covered your butt, kept your client informed and hopefully enlightened them both.

Jules April 21st, 2008 11:41:00 AM

Dr. Khuly, have you seen the AAHA referral guidelines? It is a newer document intended to help alleviate confusion from all parties in veterinary medicine (general practioners, referral practices, and pet owners). You should have a conversation with the hospital's medical director about this case.

http://www.aahanet.org/PublicDocuments/AAHAReferra...

Jason April 21st, 2008 01:13:00 PM

Thanks Jason! Just the info I needed!

Dr. Patty Khuly April 23rd, 2008 12:05:00 PM

I would write your client a letter so she knows that you did not "not" diagnose the "problem" and that you are no longer referring clients to that boarding place because of their aggressive tactics. Then a quick 2 sentences about the dangers of over-vaccination and how you are very congnizant of her cat's situation with that. Had it happened to me, I would appreciate a letter like that from my vet.
THen I would write a letter to that boarding place and tell them they broke the "code" between referred to and reffered by, and you do not appreciate their aggressive money-hungry tactics, and you will not be referring anyone to them again. I would also add a sentence saying something such as "last year I made 127 boarding room references" so you think about the long-term financial impact of your short-term financial aggressiveness. OK OK, I'm not saying exactly what I mean, but I think you get the main point... Love your blog!

Jacqueline Rodriguez April 23rd, 2008 02:29:00 PM

Add Commment

Your Name:

CAPTCHA Verification