Part of the problem, evident in the wording of your blog post, is that individual veterinarian's believe that prosecution of another veterinarian by a client and an animal lawyer is de facto, A BAD THING.

You focus on the concerns of vets about lawyers, because they see lawyers as helping to prosecute vets.

WHY don't your brethren APPLAUD the prosecution of negligent and abusive vets? Rather than cast their lot with them and think, "there but for the grace go I?"

I'd really love to hear from a vet, for once, who is ITCHING to see more veterinary prosecutions because he is FED UP with the stuff he sees OTHER VETS doing that he can't do anything about through the existing systems.

Stefani February 18th, 2009 11:58:16 AM

I thought this post was going to spend a little more time addressing veterinary malpractice. Oh well. Such is life.

Since lawyers are almost always now involved defending accused vets before the vet boards, that would be a type of animal law. And since record numbers of complaints are pouring into the vet boards, I guess I can extrapolate that discussing what one would do concerning a complaint would be on topic.

I have a hypothetical for all of you. For those of you who are vets or techs, etc., for the purposes of this hypothetical.....now, you are no longer a vet or tech, etc.

Play along, please...

Let's say you have a beloved pet. Your beloved pet dies (God forbid) and you believe that your veterinarian was negligent. You proceed to file a very thorough complaint with the state board. The state board then forwards all of your thorough complaint to the accused vet. The accused vet then crafts their reply directly to your thorough complaint and submits it to the board. In their reply, the accused vet is absolutely lying and has changed all of the facts of the complaint. They have effectively rewrote history.

WHAT ARE YOU GOING TO DO?

Greg - Stempy's Story February 18th, 2009 11:58:38 AM

Stefani: I'm really itchy. I just don't want to be involved. That's the most common perspective among us. We all know who they are in our community. And we want them GONE. But we don't want to have our names dragged through the legal process. It's the coward's conundrum.

Dr. Patty Khuly February 18th, 2009 12:01:03 PM

“But your exposure is negligible! All you’re likely to lose is the price of the pet and a day of depositions!"  YEP.  It is a teeny bit funny to me that lawyers would take up arms against other lawyers before DMVs.  Vets just aren't on their radar screen YET.  And, yes, if those on all sides of the issue don't jump in NOW, at the beginning, LOTS of bad law will result and it is indeed the animals who will suffer.  Most law students have incredibly little hard science in their background so they will get it wrong if not helped along the way.  First, get these students at the beginning (while they're in school or as they graduate) and help and encourage them along.  Keep a dialog going and give them your legal business (Vets, you need your wills updated and so do all the pet owners out there; who's set up the trust for their beloved pets in the event the worst happens?  start a running list on your desk and schedule an hour consult every couple of months) which keeps you in contact with them and the conversation going.  It will also keep them in business and thinking about animal issues and Vets and pet owners.  In the beginning, disregard which side the law student/newbie lawyer thinks they're on because that may well change and besides that the best lawyers don't pick a "side" but evaluate each case.  Wouldn't it be wonderful to have a cadre of lawyers out there who are well informed and attempting to advocate for the animals?  OK, that will take another century but ya gotta start somewhere.

I will now try to spend the rest of my day trying not coming back to rant on how there aren't nearly enough lawyers out there (despite public belief to the contrary), practicing in the right areas of law and social reform and how, although medical practice lags 20 years behind research, legal practice is stuck in the era of Socrates!  And that three piddly years in the classroom does not a lawyer make and on and on...

PJBoosinger February 18th, 2009 12:02:56 PM

Dr. K, thank you for admitting. But . . . it's not a good thing. What hope do we have, then?

Stefani February 18th, 2009 12:38:59 PM

Because animals are considered property, if your pet is injured or killed, you must file a lawsuit to recover damages. This is true even if it is your veterinarian who inflicted the harm. Veterinarian malpractice lawsuits are not common, though, because the measure of damages for the loss of a pet in most states is the market value of the pet--i.e., the amount of money someone else would pay for an identical pet of the same age, breed, and condition. A few states allow causes of action for emotional distress and loss of companionship, but awards for an owner's mental suffering are the exception rather than the rule. Veterinary malpractice lawsuits often do not make economic sense because of the limited amount of damages available. The truth is your lawyer's fees may be more than you are able to recover in court. An alterative is to file your lawsuit in small claims court where you will not have the cost of a lawyer. Even then, a lawsuit will unlikely make up for the loss of a treasured animal companion. Dr. Khuly your coward's conundrum is another way of saying you do not truly practice to your full potential. Being admitted to the profession of veterinary medicine, I solemnly swear to use my scientific knowledge and skills for the benefit of society through the protection of animal health, the relief of animal suffering, the conservation of livestock resources, the promotion of public health, and the advancement of medical knowledge. I will practice my profession conscientiously, with dignity, and in keeping with the principles of veterinary medical ethics. I accept as a lifelong obligation the continual improvement of my professional knowledge and competence. Veterinarian's Oath -- Adopted by the AVMA July 1969

Debby February 18th, 2009 01:05:39 PM

I suspect that the reason Dr. K and other vets do not want to speak out (i.e., get caught in the "cowards conundrum") is that they fear being blackballed, isolated, shunned, or even retaliated against WITHIN their own profession. Not necessarily by any vet against whom they might testify, but more generally by their COMMUNITY. Dr. K is this correct?

I have heard such stories -- but I firmly believe that as soon as vets start overcoming this fear and speaking up for reasonable accountability, the community standards will begin to change. The only remain the way they are because vets are speaking out -- it's a viscious cycle. Ye who bow to the "cowards conundrum" perpetuate it.

Stefani February 18th, 2009 02:00:22 PM

At the risk of scaring the Docs but for the benefit of the pet owners...  Most attorneys don't have any accounting or economics background either and do a poor job of calculating damages.  What I have in my dog is 8 years of food and health care (and time) in addition to my cost and she's like real estate, not replaceable with an equivalent; alternately, if she is, then you must include my time or that of a professional trainer to bring her up to the same standard I now enjoy with my dog.  In addition, I'd be inclined to sue for breach of contract and potential deceptive trade practices, especially the latter which often comes with a variety of add on and treble damage provisions, emotional distress, etc.   (That's in ADDITION to a malpractice suit.) In addition, the attorney should make the argument for reimbursement of legal fees (even when the fee agreement is a contingent one since there's a simple formula to calculate that and a client should never be shorted because the attorneys' fees weren't backed out if they too should be an element of damages) AND for the client's time and out of pocket expenses in tending and pursuing the case (especially if a reasonable offer is made for settlement by the client and the court or jury awards more than the offered settlement).

Attorneys need to be more creative rather than sticking to one single bit of law.  For example, there is a bill pending in Texas which ups the criminal penalty for theft of a pet as opposed to livestock.  Inherent in such a law is the recognition that a pet is not merely property in the same class as livestock (easily replaceable) and that argument should be made.

Docs, it isn't the malpractice claims you should fear.  There's a growing consumer advocacy group of attorneys out there and they are slowly figuring out that professionals are not generally exempt from consumer laws (and good old contract law which, when not specified in detail in writing, consists of a multitude of unspecified terms neither of you may truly be aware of AND which often provides for numerous forms of nebulous forms of damages; pled in alternative to the contract if the provider claims lack of a contract is good old fashioned fraud based in, you the professional failed to specify the contract terms and you're the only one who had sufficient knowledge and understanding to have done so, so, if you didn't, it's fraud).

I don't say any of that to frighten any one.  We have been over a decade when the line for contracts and fraud and etc. have been very blurred.  There is change in the air and there are a lot of fed up people around.  I suspect we will be seeing criminal and civil prosecutions for fraud, deception, and a number of other things that we haven't seen in a very long time.  This will jog attorneys into better thinking.  It would behoove all in business now to "get their s*** together" now.  Devote one day a month to helping your profession oust the worst of the worst to show an internal effort is being made (else a lawyer gets to point out to a jury that it isn't so they should send a big hefty message), do public service and/or pro bono work and DOCUMENT it (including showing discounts on bills), etc., etc.  Despite those enormous student loans, if you ever went to public school or college, you did NOT pay for your own education and you do own the tax paying public who helped pay for your college so resist the feeling that you work hard, pay your student loans and should be entitled to 4 hours a night (weekends, three day weekend trips, etc., etc.) of personal time in addition to sleep time; remember that a couple of generations ago a couple of "me" hours a week was a luxury.

PJBoosinger February 18th, 2009 02:01:42 PM

Debby: Indeed I do not "practice to my full potential" if I doing so means I should lodge complaints against my colleagues where evidence of their misdeeds is generally circumstantial. 

And when I have direct evidence? Reference a past post, where a local poor quality provider of surgical services continues to practice his profession with apparent impunity. Considering the prevailing ethics in the veterinary profession, any action, including letting the client know she had the right to lodge her own complaint (which I eventually did), is considered "poor form," worthy of collegial condemnation. 

But never fear (and this is a response to Stefani, too), times are changing. More veterinarians are willing to testify on the side of the prosecution against a veterinarian (which I have done). More are encouraging their clients to lodge complaints (as in the above example). 

Things ARE changing as veterinary medicine gets more progressive. Trust me, we want some of our colleagues' licenses on a stick, too. But we won't get directly involved if we stand to slaughter our professional reputations in the process. Consider the outspoken veterinarian "working from the inside": in this current climate she has much to lose (and so do her four-legged constituents) if her colleagues believe her cause celebre to be taking other veterinarians to the mat. 

Dr. Patty Khuly February 18th, 2009 02:04:01 PM

Oops...here's the post I referenced above.

Dr. Patty Khuly February 18th, 2009 02:07:57 PM

LOL! I said sabatage was not mentioned!

Stefani February 18th, 2009 03:02:28 PM

I guess nobody wants to play along with my hypothetical. :(

What I was trying to do was present this in a way that affects others, without bringing my personal experience into the equation.

The general response I get from people when I present them with this scenario is this: ..."Well, I will tell the board they are lying!" My response is, "No, you won't." Why, you might ask? Because, in most states, the complainant is NOT ALLOWED to see the accused vet's response.

The complainant SHOULD be allowed to both SEE & RESPOND to the accused vet's reply. This is just one aspect of the unfair complaint processes in place in many states. There is MUCH MORE that is wrong.

Greg - Stempy's Story February 18th, 2009 03:03:32 PM

Greg, The problem I see with your hypothetical is that it has virtually nothing to do with the law since board complaints (even if they are prerequisite to filing suit) are an administrative and/or government matter rather than a legal matter.

PJBoosinger February 18th, 2009 03:09:23 PM

The public has much to do with permitting this: "considered 'poor form,' worthy of collegial condemnation".  We've allowed blue walls of silence and white ones and so on and on.  However, attorneys are most of all at fault.  If attorneys make it more cost effective to do any job/profession right  rather than wrong, do not allow bad actors to be rewarded but ensure a steep penalty; then it becomes poor form not to step in, not to assist.  It won't change until the majority of us establish a higher level of ethical behavior for ALL of us because that slippery ethical slope the professionals slide down started long before professional school and practice.  Personally, I'm fascinated by the "What Would You Do?" series.  When did we become a society where a stranger could take the hand of a child on a playground and walk away with the child while the vast majority of those adults present simply decided they were undecided (or worse, it just wasn't their business/concern) and watched the stranger leave with the child?  I so desperately want to hold attorneys' feet to the fire and often do but I also know the attorneys out there couldn't possibly file all the lawsuits they themselves are entitled to file because society has deteriorated so.

Each of the professions needs to clean up but all members of society need to do so as well.  When was the last time you saw a teen carry an elderly person's groceries?  Have you driven past a wreck instead of stopping and putting yourself on the witness list?  Do you watch the car chase on TV or turn it off, signaling to the criminals you will not give them 2 minutes, let alone 5, of fame?  And it is our individual failings that then become reflected in the media.  Why isn't this (whatever the issue is) on the news?  Because we've all signed up for 700 cable channels and can't be bothered with 30 minutes a day of local or national news because we're vegetating and so even the news broadcasts are filled with mostly nonsense just because it's all we're willing to watch.  I wonder if they even teach a year of Civics (aka ethics and responsibility) and government in Jr. High like I took.  If we want a right and just society, we have to teach our children what is right and just, that they have responsibilities - not just rights.

PJBoosinger February 18th, 2009 03:16:23 PM

"If your conscience is clear, you'll have nothing to fear, when it's time to rest at night. What strength it can give, when we strive to live, according to what is right."

Dr. Carl Osborne, DVM, PhD, Dipl. ACVIM (Stempy's Expert) used this as the preface to his latest article in DVM Newsmagazine. He is a role model for veterinarians everywhere.

Greg - Stempy's Story February 18th, 2009 03:40:31 PM

I'm not concerned with malpractice cases increasing against bad vets who commit actual malpractice/negligence - anyone who's worked in the veterinary industry has witnessed firsthand or heard the actions of "old-school" vets, or vets who have just learned what they can get away with.  However, I am concerned about veterinary malpractice going the way of the human medical field - where surgeons, OBs, and others are in a constant state of being sued just for the chance that damages can be collected.  We may not be on the lawyer's radar yet, but that's because there's very little precedent of emotional damages in our malpractice cases, so there's not much money in it.  I'm not saying I don't support improvements in animal welfare law - I absolutely do - I'm just saying there will be a backlash effect when in comes to our malpractice premiums, without a doubt.  Hopefully the bad vets will be weeded out, but the rest of us will be affected, too, and probably in ways we can't predict yet.  

Not to sound paranoid, but it's never ever a good idea to hop around with the idea that the lawyers are your friends or on your side.  

beth February 18th, 2009 03:58:27 PM

My take on the animal law story was that I'm not sure I like the agendas of the people who are trying to write the laws. Too often it seems the people who go into this field are being driven by zealotry, not common sense. And the end game for many zealots is that animals can only be protected by not existing at all in a domesticated state. But Dr. K your post brings up many important points that I just didn't get to, and I sure appreciate that. However, I do still find that there's a core group of people in the commentors here who really have a very warped view of the veterinary profession, and that disturbs me because of its unfairness. I have worked with so many wonderful veterinarians over the years, both as a pet-owner and as a pet-care journalist. I have known a few bad apples, but that's to be expected in any group. Are there bad vets who need to be struck off? Sure, but they are a very small minority. Veterinarians often work in ways animal-lovers do not see in steering people away from the bad ones. "Closing ranks" in public is not exclusive to the veterinary profession, but to all professions I know. Few of us like to air our dirty laundry in public. One of the most brilliant men I know, veterinary cardiologist Dr. Paul Pion (of VIN, and one of my co-authors and a former but not current boss) is very clear that the practice of medicine (human and veterinary) is still more art than science, and that there's still more that we don't know than there is that we know. Yes, there are bad vets, and good vets who make mistakes. But often I think that many people believe their doctors and veterinarians should be some all-seeing, all-knowing God. And that's just not possible, nor is it reasonable to hold them to a standard you yourself could never attain. Most of us do our best, and I remain convinced that's true of most veterinarian as well. In other words, I'm with Dr. K in her earlier post: The vet-bashing here gets a little thick, and isn't particularly fair to Dr. K, who runs an open and honest forum for us all. That said, we are in the midst of a sea change in how "pets" are valued in the eyes of the law. And that will change the relationship we have with our veterinarians, in ways we cannot yet fully realize.

Gina Spadafori February 18th, 2009 04:06:35 PM

I think you are creating unrealistic worse case scenarios vis a vis malpractice premiums.

I know the bad situation OBs face-- met one recenty who told me her mal insurance was $80-some K. But that's NEVER going to happen in your field.

The court will NEVER award incredible amounts to owners, because there are no future earnings at stake. And any future medical (veterinary) costs are self-limited by the pets' short lifespan. So even under the most generous scenarios, we are not talking 6-digit awards.

As you know, your veterinary malpractice premiums are in the $300-$500 range for a policy with about $1 million in coverage, right?

Christopher Green, in his groundbreaking animal law paper, did an analysis -- with input from AVMA PLIT and other veterinary insurers as basis -- of the likely impact of allowing capped awards in vet mal cases on your insurance costs, and also on your fees to your client (because let's face it, we clients would be paying for any increased insurance cost).

The results? Impact = Negligible.

This tired old canard about skyrocketing malp insurance and concomitant skyrocketing vet costs is just a deliberate con job repeated to you over and over by people who have OTHER REASONS for not wanting to see things change.

Please read Green's paper.

Stefani February 18th, 2009 04:13:19 PM

"Dr. Carl Osborne, DVM, PhD, Dipl. ACVIM (Stempy's Expert) used this as the preface to his latest article in DVM Newsmagazine. He is a role model for veterinarians everywhere."

... and one of my professors :) He is fabulous.

Megan February 18th, 2009 04:15:17 PM

<p>ISAR, ALDF, IDA, just to name a few--large organizations acknowledging veterinary malpractice.  Yes, 

there is a change in the air for veterinary consumers who are fed up with some of Dr. K's incompetent colleagues.

Fotini February 18th, 2009 04:20:00 PM

What a fantastic essay! Though I [slightly] dispute the easy three-category layout for conscience (I mean, where does irrational guilt play into it?), this is a piece everyone should read--regardless of profession.

Dr. Patty Khuly February 18th, 2009 04:29:38 PM

Dr. Osborne is not only a fabulous veterinarian, he is a fabulous human being. He spent hours of his time on the phone with us and we will be forever grateful to him for everything he did for us. He is world class. I only wish Minnesota was a little bit closer to Texas.

Gina - we are all fully aware that there are many great vets out there. One of the problems is that the bad vets look amazingly similar to the good vets. If nothing is being done about these bad vets - and there are a LOT more than you think there are - then countless pets remain AT RISK every single day. Simple as that.

Also, as Dr. K asked, you do not see us posting our stories over and over anymore. Today's post is about Animal Law, which encompasses veterinary malpractice.

Obviously, this must be a topic you would like to keep behind closed doors so that YOU can feel better. What about all of those countless at risk pets? How about them? Do THEY matter?

Greg - February 18th, 2009 04:44:58 PM

Pocket's Story from New Hampshire"

Barbara February 18th, 2009 05:30:30 PM

Calling it like I see it, Gina, just like you, "...commentors (sic)here who really have a very warped view of the veterinary profession, and that disturbs me because of its unfairness..."

Give me a break.

Fair? I'm biting my tongue here.....but WOW.

Greg - Stempy's Story February 18th, 2009 05:42:56 PM

Gina: Again, as I have said "countless times", there are MANY good veterinarians, there are good ones that make a mistake. But I would suggest to you to read BadVetDaily: badvetdaily.blogspot.com and inform yourself of the countless cases that "made it to public record" of repeated inexcusable abuses that have no meaningful accountabilty at all! Yes, I was once one of those "dummies" that had no clue for 30+ years, not anymore. What you may term as "bashing", in fact is addressing (sometimes to heatedly) points and issues, which simply are not true facts. Here's one of them: less than 10% of complaints ---in some states can be less than 5% are addressed in any way at all, even when the pet has DIED.

Hobson: I would venture a guess that more MD's, DMD's, and nurses have indeed lost their license to practice, multi-fold over the DVM's, or at least felt some retribution for carelessness or fraud.

Barb Albright/NH

Barb A./NH February 18th, 2009 05:48:08 PM

Anna,

The thing is..if the veterinary boards would do their jobs and actually hold the bad vets accountable, and give penalties that actually serve as a deterrent, I don't think you would see clients suing their vets for malpractice very often at all. I know that for many of us who are aggrieved, this has nothing to do about money.

An interesting approach in the human medical field that I believe could be useful in the veterinary field as well, is the Sorry Works! Coalition. Check them out.

Greg February 18th, 2009 06:06:08 PM

Greg- our 2009 state veterinary convention had a whole lecture devoted to apologizing for mistakes (as soon as they happen, not ages after the fact) and being upfront with clients. I wasn't able to attend, but I heard it was great. I can't say we talk about this in school often, although I haven't reached my ethics course yet...

Megan February 18th, 2009 07:23:12 PM

Megan, your last statement about the position articulated at the 2009 convention is very reassuring. Thanks for letting us know that. I hope that this approach takes hold soon and becomes commonplace because it makes more sense than the denial route from every perspective.

Natalie Kramer February 18th, 2009 07:45:41 PM

Megan: That is terrific and real progressive teaching. The "old school" adheres to the belief that :never admit a mistake or lie to cover up a mistake, it is such a wrong way to think. You stand to gain so much more respect & credibility, and then loyalty and satisfaction being honest. You are going to a good school & will be successful.

Barb A./NH February 18th, 2009 07:51:44 PM

Hobson: Actually, I do believe that greater legal scrutiny helps. No, there may not be fewer "bad" vets but the "bad" vets may well change their behavior to reflect prevailing norms. That's worth working towards.

If we had no speeding laws would there be less speeders? No. But you would have a lot more of these speed-demons working harder to keep their foot off the pedal lest they get another ticket. 

Dr. Patty Khuly February 18th, 2009 08:45:27 PM

I think a big part of the "never admit a mistake" thing is the idea that, if you apologize for a mistake before contacting PLIT (or whatever insurance/liability company you use), you aren't covered for liability since you essentially admitted that it was your fault. The lecturer said that not all companies punish you for apologizing immediately, and many have "apology clauses" that allow you to be covered for liability even if you apologize. He suggested checking with your boss or company to see what your policy says, but I thought it was really heartening to hear that some of the roadblocks to giving a sincere apology are starting to disappear.

Megan February 18th, 2009 09:01:50 PM

Megan, That's where these statements go askew...veterinary malpractice insurance is virtually unused! And it is not because of malpractice! It is because there are few to no attorneys willing to "waste" their time AND/OR clients ability to afford legal recourse....meaning "payoff" is paltry and pales in comparison to expenses incurred. Here is the gross injustice and double standard. Human med negligence/malpractice, etc. is mostly taken on contingency percentage, not upfront $$$ retainers/hourly fees.

And since this is so widely known within the profession (including little to no sanctions from governmental authorities, which BTW, the AVMA guidelines discuss ethics & responsibility of "members" in these positions), I often wonder why there is such a thing as vet mal. ins.

But Joe Q. Public has no clue, is not informed, and makes assumptions that protective measures are in place, hence believe that no harm would ever be deliberate. Oh sure, maybe an extra charge every now & then, a few booboos, but surely NEVER abuse.

Pocket's Story from New Hampshire

Barbara A. Albright February 18th, 2009 09:53:38 PM

For the record, I'm totally, absolutely committed to the admit-your-mistakes camp. I FEEL every clients' loss personally--because I'm committed to the health/safety of the pet. Why wouldn't I express my regrets, things I feel I should've done differently, confess when I feel culpable...?

My humanity is what bonds me to my clients, to my patients. Apologizing, even when I don't really need to (because, truth be told, I'm an irrational guilt-harborer), is the expression of the honest me. 

But it's not in every person's personality to express their failings/true feelings. I think this flaw is responsible for many misunderstandings/obfuscations. After all, we're all flawed...we're only human.

Dr. Patty Khuly February 18th, 2009 10:03:11 PM

The word here is accountability. A bad vet needs to be held accountable. (just like a bad doctor, a bad parent, a bad dentist and the list goes on..)

many years ago I had an incident in which my cat was misdiagnosed. To compound a bad diagnosis was the administration of a harmful antibiotic.

IF I had not known in my gut that something was wrong, marched into my "former" vet's office and removed my cat from his care, she would have died.

His accountablilty was my stop payment on a $400.00 check. I wasn't interested in suing, I was interested in him admitting he was wrong, which he didn't do, and I was more interested in saving my cat, which I did do, simply by removing her from his minstrations.

We don't need more legal suits, we don't need money which doesn't undo the poor care, we need a "red letter day" we need more old fashion punishment where embarassment plays a factor, because EVERYONE knows what "you" did....

we need people to be honest and forthcoming and own up to what they do, but that's never going to happen, so I opt for public humiliation. A well worded editorial full of liable sidestepping in the local newspaper is my personal favorite.

Advocate for your pets...if you try and know everything there is to know, then at least the chance of stupid goes down...if it doesn't seem right..question it, get a merck manual and a medical dictionary...everything you read on the web isn't correct, but hey, either is everything the so called experts say either...

I good vet is worth every penny...a bad one should be tarred and feathered.

LorriM February 19th, 2009 12:05:56 AM

"never admit a mistake"  This is IMO a part of the attorneys' unwritten "Full Employment Act".  First, it prays on your fears that admission is worse than denial which may be entirely incorrect for several reasons.  Most certainly find out what the provisions for your insurance are and, if required, speak with them/their attorney before making the admission but give them a very short deadline (call me within the hour, otherwise, I'm doing this on my own).  Insurance companies pay lawyers, lots of lawyers and the lawyers like these regular hourly billables.  There's the first group of attorneys with a vested interest in seeing you speak to an attorney before making an admission.  Yes, the admission might affect the case but it also ensure the attorney a payday.  Then you're pressured into denying and told all the horrific things that might happen if you admit while the consequences of a wrongful denial are downplayed if mentioned at all.  If it goes to a board complaint or court, you'll probably have an attorney from the insurance carrier and you may well hire another to represent you (since you're not entirely sure the insurance carrier's attorney is really doing so and you should be suspect on this one).  The opposition may well have an attorney.  Then you get to court and the judge will send you to mediators (another attorney) and, of course, there's the judge (an attorney) getting paid too.  How many attorneys are getting paid now???  TALK to each other!  Don't give attorneys easy money, they can (and should) work for it.

Medicine is more art than science however that is not the public perception.  In an effort to be distinguished (rightly so) from snake oil salesmen, the medical professions have emphasized science.  It would do the medical professions well to point out that there is also a great deal of art involved; the art being based upon science when possible but art nonetheless.  With science expanding so rapidly, it is almost impossible for the public to understand that it's still a drop in the bucket; to resist thinking doctors have or can get all the answers quickly.  Doctors have some amount of insecurity in admitting these limitations for a variety of reasons but they need to get over them.

Add to this gloss of omnipotent knowledge the denials and "not wanting to air dirty laundry" in public and you have professionals behind a wall over which the client cannot see and has no way to determine what should reasonably be expected nor distinguish what should reasonably be expected v. what is hidden laundry.  Swallow hard and toss it all out in the light.

"My take on the animal law story was that I'm not sure I like the agendas of the people who are trying to write the laws."  Me too.  I'm equally concerned there is a gathering polarized group in opposition to them that is taking an equally untenable stance (no laws at all).  Every time I encounter this, I encourage people to get involved and find the middle ground consensus from all concerned parties/professions and then help the lawyers/legislators write laws we can all actually live with instead of jumping on either end of that pendulum.

Fear of it "going the way of the human medical field - where surgeons, OBs, and others are in a constant state of being sued"... IMO, HOOEY.  Don't believe the hype on this one.  Not that many doctors got sued.  Not that many got large judgments against them (and, when they did, it often wasn't covered by insurance because it wasn't malpractice but another form of tort).  This was primarily a media campaign by the insurance companies, promoted by their attorneys, to justify increases in premiums which was then bootstrapped into tort limitation laws to protect their (insurance company) profits from those increased premiums (which don't come back down despite the new tort reforms).  Now we all have less ability to hold doctors accountable AND higher medical bills (because we're all paying for those increased premiums the docs pay).  Take a look at the insurance companies out there.  No matter how lousy the economy is, except for the insurance companies that took their profits and invested them in the mortgage loan industry trying to make even bigger profits, they're quite fat and happy; not leading the "bail us out" crew.  In addition to that, even my creative accounting skills will never result in a damage calculation even close to what can be added up for harm to a newborn child.  The fear that Vets feel on this one is just mostly irrational and that needs to go away.

PJBoosinger February 19th, 2009 03:25:34 AM

Thanks, BJB for resurrecting Gina's excellent point...one whose discussion I was looking forward to after this post:

"My take on the animal law story was that I'm not sure I like the agendas of the people who are trying to write the laws."

Ditto. And veterinarians are likely to be caught in the maelstrom should some laws become commonplace.

Think:

Breed specific legislation, mandatory spay/neuter laws,pet guardianship proposals, etc.

If veterinarians don't start paying attention to how this affects all of us and the care our patients receive, we'll be missing the bus bigtime. It's to our benefit to understand that the legal side of our profession is not just for the lawyers.

Dr. Patty Khuly February 19th, 2009 05:29:54 AM

"veterinary malpractice insurance is virtually unused!"

I might not be using terms correctly, but I don't think I'm referring to malpractice insurance... I'm talking about liability, where you make an honest mistake that ends up being expensive to fix. Like, say, a routine cystocentesis results in a bladder leakage that requires surgery to repair. It's a known complication of the procedure, although rare, and clinics could choose between charging the client for the surgery, taking the payment for the surgery from the clinic itself, or sending it to the liability insurance and having them settle things with the client.

At least, that was my understanding... Having not entered practice (or clinics) yet, I haven't had much need to look into insurance yet...

Dr. Kuhly- I emailed the state representative that was pushing BSL in Minnesota last summer. I told him that, as a graduate of our state's vet school, I would find it a violation of the veterinary oath to be made responsibile for euthanizing perfectly healthy, well-adjusted animals as part of the law he was proposing (there was no grandfather clause, so all rotties/pitties/etc that were currently in the state would have to be moved out or euthanized). I also told him I would take my heavily-subsidized state education to another state if he were successful in passing his legislation. The bill never made it out of deliberations. I never did get a reply from him, the weenie.

Megan February 19th, 2009 06:13:45 AM

Great thread.

Re Meghan: "I think a big part of the "never admit a mistake" thing is the idea that, if you apologize for a mistake before contacting PLIT (or whatever insurance/liability company you use), you aren't covered for liability since you essentially admitted that it was your fault"

I don't know about such clauses in vet malp, but in human malp, insurance companies are modifying this. The website Greg posted a link to, SorryWorks, is at the forefront of the "disclosure and apology" movement in human medicine, and they have compelling evidence that if doctors and hospitals:

a) fully admit what happened (I mean fully)

b) Accept responsibility (i.e., not engage in that doublespeak where they blame passive instruments etc. or the patient)

c) Apologize -- with acceptance of responsibility, not the "I'm sorry this happened to you," but "We are sorry that the unintentional error the doctor made resulted in or caused . . . "

d) Offer reasonable compensation up-front, without having to be sued (as in, cost of medical care to address the problem caused to the patient, time away from work for the family, nursing care or whatever else is needed as a sequelae of the incident: and finally

d) tell the family EXACTLY what measures the hospital is taking to reduce such errors in the future . . . .

If all these things are done, lawsuit filings GO DOWN. Not up.

Of course the human factor is: It dissipates the ANGER the family feels when the doctor and hospital take these steps. And lawsuits, while often driven by the need to get money to care for the injured party, also are about anger. IMHO, if there is lying, denying, and trying to stick a family with the financial aftermath of a preventible error or "blame the victim," the anger is ENTIRELY justified and understandable. But when health care providers do the right thing, the anger begins to seep away. Frankly, it seems like a no brainer to me.

Stefani February 19th, 2009 08:08:47 AM

It strikes me that people seem to have a genuine belief in our legal system, which I find frightening. The more people do not stay active in holding their government representaion, supervisory boards, and professional boards accountable, the more we will need to rely on attorneys. Attorneys have had tremendous time in this country to refine and manipulate a system for maximum profit (that's not to say good, ethical attorneys no not exist, that is NOT what I'm saying at all. But in terms of litigation, it is emotional and murky). Putting Vets in their cross hairs will have a trickle down effect into not only the quality of care medically speaking, but also intangibly. It will effect cost of care as well, and it seems Vets are on the tightrope of keeping costs down (poor people keep pets as well as rich people) while providing maximum care (Dr. K has written about this at length).
I think a point that is sometimes lost in many of Stefani and Barabara's posts is that they are setting an example and TRYING to hold these government boards & professionals boards responsible and make them do a job that is not currently being done. Perhaps that point is lost at times, but it's there. But when citizens putting up the fight are exhausted, attorneys will eventually be there to take over. I'm not sure if this is good or bad, but I can't help but think the only people to profit will be the lawyers. Not the profession, the animals or the owners.

CreatureofHabit February 19th, 2009 08:43:16 AM

"I don't know about such clauses in vet malp, but in human malp, insurance companies are modifying this."

Yes, that's what I was referring to in the second part of that post- there are "apology clauses" showing up now  in liability insurance plans that protect doctors who apologize rather than punish them for "admitting fault". Definitely a move in the right direction.

Megan February 19th, 2009 08:53:30 AM

Creature, thanks. I have to just speak for myself when I say I would FAR prefer Vet Boards do the job rather than have to see it go to the courts. Few owners I've talked to who either believed or knew their pets had been harmed by a vet wanted MONEY. They really wanted some kind of disciplinary action strong enough to act as a deterrant, and also for someone to say that what was done was wrong/negligent, what have you. I think its a general rule that people turn to the courts when the other avenues are not working, and that's the case here.

Stefani February 19th, 2009 08:55:48 AM

Yes, that's the heart of the matter. If people stop being an advocate for their own actions & results, the lawyers will happily do it for you.... for a fee.

Many professions are going this way it seems, and I can't help but fear the long-term consequences. Most professions will need to start having degree/continuing education requirements in law/legal matters. Sigh. If I'd wanted that I would've gone to law school.

CreatureofHabit February 19th, 2009 01:06:14 PM

Creature, In law school my history of law professor told us of the Roman jurisconsults.  IMO, these were the first true lawyers and virtually the last of the professional lawyers.  "Jurisconsults were wealthy amateurs who dabbled in law as an intellectual hobby; they did not make their primary living from it."  IMO, they were anything but amateurs because they had a vested interest in the knowledge and the time to learn with fewer conflicts than modern lawyers who, of necessity, must work for a fee which builds a rather significant conflict into every transaction.  Nearly all professionals, again of necessity, must charge fees and, as business becomes more complex and more emphasis is put on the business than ethics (which is a vicious circle), more professions are merely businesses.  A true professional, IMO, has to set their own "stuff" aside (profit/loss, feelings, guilt, etc.) while giving their professional opinion/services.  Those other "stuff" issues must be entirely separate issues or it lessens the professionalism.  If more professionals would concentrate on the human factor and basic common sense, we'd all be better served because the technical requirements of law can usually be reduced to mere checklists.

http://en.wikipedia.org/wiki/Legal_profession

http://en.wikipedia.org/wiki/Profession#cite_note-0

PJBoosinger February 19th, 2009 02:45:37 PM

CreatureoH: I thank you too for your comment--that is what we are desperately trying to convey: that the system in place for "protection, accountability" is non-existent. Nobody is looking to "run to lawyers and file suit". Unfortunately, all over the country, that is what people are FORCED to do, if not with attorney representation, then perhaps "small claims". That is why this type of abuse does NOT stop. Just as Dr. K. mentioned, if you get a few $500 speeding tickets, are you going to change? Most would, some would continue until they lost their driver's license.

LorriM: Amen, a GOOD vet is worth "gold"! Unfortunately the bad ones aren't getting "tar & feathered", nor put into the stocks in the public square to be jeered. Here again, most media sources will NOT touch your story, unless it is somehow "public record". And even then, depending on the "media bias" in some small states, they will do everything to ignore it, hide it, to stay in the "favorable light" of government (AG office)...since it could possibly be tightly woven (I can't think of the word that means "blood-related" bigwigs---rats!).

At the risk of repetition: When an "important long-standing law" has been violated, and all it deserves is a "phone call investigation by a former employer" and then you meet in person with an AG lawyer who sneers "that no one would believe you", and you finally wake up and realize that "everyone believes you & not one 'outside' person denies the fact"---you say someone must work hard & STOP this. And I would give every last cent I have, for it NEVER to have been me or my dog, and to sit on the sidelines offering someone ELSE moral support.

The only side comment to above : veterinary costs in my locale have "tripled" in the last few years, it has become "unaffordable" to most. Pocket's Story from New Hampshire

Barbara A. Albright February 19th, 2009 04:59:27 PM

PJB, I'm not sure what your point is. But I think you are agreeing with me? It's been a long, professional day. ;)

CreatureofHabit February 19th, 2009 05:04:31 PM

Barbara...I don't know how to email directly, so I'll respond here...

you don't need a newspaper to touch the story....if you live in a small or medium sized town that has a local paper, simply write a letter to the editor full of inuendo and implication that anyone with a brain bigger than a pea can figure out. 99% of the time, a little to the editor WILL get published and you'd be surprised how many people read them.

I'm in the process of packing to move, but if I can lay my hands on that aformentioned editorial, I'll be happy to send you a copy...

you can email me at ldmccolgan@comcast.net

LorriM February 19th, 2009 05:43:08 PM

Creature, yep, agreeing with you. :)

PJBoosinger February 19th, 2009 07:18:21 PM

Lol, I thought so.... but what a day I had! I usually only read The Do in the mornings. My mind is mush by the end of the day.

CreatureofHabit February 20th, 2009 06:39:56 AM

Ok normally I keep my mouth shut, but something just made me want to speak up. First off I have seen both great vets and vets that honestly I wish would die. I personally think vets should be under more scrutiny, a lot are very lax and are more concerned with the dollar than with the well being of a pet. Two prime examples. I rescued a cat over 2 years ago and took him to the vet, they ran their usual test or so I thought and prescribed treament for worms. The next day I took the cat back because I noticed that it had ear mites, and guess what it did. Thats not the worse part the worst part is that days later I take him in again because of a fever. They keep him overnight and I think great they are going to get to the bottom of this, I call frequently to get updates on his condition, hoping for the best, the fever subsides and I am told to pick him up. I ask to speak to the vet to see what caused it, his response: "I dunno, it happens sometimes" Now I, personally would think, one would investigate the cause of the fever. Long story short I noticed two days later that he wasn't going to the bathroom at all and on the second day when I awoke, I noticed he had a hole on his side from an abscess. I take him to the vet immediately speeding all the way there, hoping they can do something. I get there and another vet see's him, says its an abscess they are going to surgically remove it, drain it and he'll be ok. What happens? The main vet, the one who owns the clinic, which is the one I have been seeing says nope the surgery will wait till tomorrow because he doesn't want to come in today. They keep him overnight, with NO OVERNIGHT care even though they CLEARLY advertise overnight care, but as it turns out that care only exists when someone is available. I go in the next morning to be there for his surgery and it turns out he was dying. They didn't administer warming fluids or do all that they could to stabalize his condition. All they did was pump heat into his cold pen and then call in a very cold fashion to say, "your cat died, what do you want us to do with the remains? We have some good funeral plans that start in the X range" This isn't the first incident with a vet, don't get me started on Banfield that place is something I wish I could drag down into the bowels of hell myself.

Are all vets horrible sorry excuses for life? No, there are some great ones. I am thankful for those. I truly am. They genuinely gave it their all when one of our pets was diagnosed with cancer. I was thankful for having found them and for how much they cared and made it a point to give it their best shot. Even though Sweetie passed away not long after I can honestly say that they did all they could and treated her as a living being instead of an income source.

In closing while I am sure many vets hate lawyers because of client complaints, those complaints are not always without merit and let's be honest just like regular medical doctors, there are vets out there who don't give a rats ass. I for one am thankful for those lawyers and hope that they make the lives of vets that deserve it a living hell.

William February 26th, 2009 07:19:40 AM

As a licensed Professional Engineer, I have the same licensing and standard of practice requirements, malpractice Ins.(Errors and Omissions for us)and have basically the same level, if not more so, responsiblities to the public. I have successfully negotiated numerous contract claims, and have a better than average (So say I :))understanding of statutory, and civil law. That being said, I am very interested in the groups thoughts on the value of damages, should the result of veterinary malpractice not result in death, but rather permanent disfigurement, and financial costs stemming from numerous unnecessary surgical procedures. If the cost of my dog, as property, is less than the accrued costs of willfully negligent and unnecessary surgeries, what is the limit of damages in this case? I cannot imagine that the limit of liability for a terrible vet, could possibly be limited by the value of the pet. I would accept no amount of money for my best friend, as he is irreplaceable.

David February 26th, 2009 03:17:43 PM

Wow, where have you been guys? Two, great and thought-provoking posts, and a LOT of us thank you for taking the time to do so!

I agree completely, sometimes you would think the public is reaching for "pie-in-the sky hopes that all one can, should, and wants to expect is a professional doing their job to the best of their ability for a fee.

Just like everyone else. Simple: there is no place for fraud, abuse, and gross negligence.

Pocket's Story from New Hampshire

Barbara A. Albright/NH advocate for ethical veterinary care February 26th, 2009 06:07:41 PM

William: "I for one am thankful for those lawyers and hope that they make the lives of vets that deserve it a living hell."

D I T T O!

Asproolee’s Story

Fotini February 26th, 2009 07:03:58 PM

Thanks William and David. David, I can't give you an across-the-board answer to your question about a vet's liability in the event that the pet doesn't die but instead sustains severe, expensive injuries. The laws that would govern this liability are established at the state level, so it varies by state. I believe in "general" -- with a few exceptions that include Florida and Oregon - you are limited to "economic" damages, which theoretically could allow you to recover the cost of surgeries if the dog lived, but if the dog died, you would be limited to recovering the "market value" of the dog. You can thank the vet lobbyists for keeping that "market value" clause in place. What's the resale value of a beloved 12 year old friend who was adopted at a shelter and now has chronic medical conditions? Not much, but you probably love him more than ever.

In some states, like my state of Maryland, the situation is WORSE. At the time my cat suffered devastating injuries thanks to his vet, there was a State Cap in place in Maryland limiting damage recovery to $5,000. So, even if you proved negligence in court, the maximum you could recover was $5k. It doesn't matter how much the subsequent cost of care was to you, nor whether the vet was demonstrated to be responsible. So, in the hypothetical case you pose, if you had a dog requiring multiple surgeries to fix what a vet did to him, in Maryland, even if those surgeries cost you $25,000 (or more . . . ) in a court of law you would have been limited to recovery of $5,000. This limit has now been raised to $7,500, but it is irrespective of the market value of the pet and irrespective of the actual economic loss -- it's a cap.

As for non-economic value, there is no precedent for recognizing that AT ALL in MD, although there is in some states (FL being one).

I am not sure how many states have caps like Maryland's. My thoughts on this are, of course, that it's a travesty. If someone is responsible for injuring your pet, and you incur substantial costs related to that, they ought to pay it. The law in Maryland bars that when the amount exceeds $7,500. The vets of course, are also to thank for this cap, having successfully fought to defeat its elimination.

Stefani February 27th, 2009 04:43:27 AM

Stefani, I agree that that is a travesty. I read an interesting article concerning use of the Unfair and Deceptive Trade Practices Act in FL for medical malpractice. It is little used, but is one avenue. It still limits damages, but does include as it's basic premise, that the Plantiff should be "made whole" on his losses. My dog cost me $850, but I'm up to $5,300 in unnecessary surgical procedures, and still have to fund an amputation due to the infection caused by the said surgeries. I think I'm becoming an advocate for reform of oversight of this industry. On a side note, my 2d vet is TREMENDOUS, and is willing to help in any way possible.

David February 27th, 2009 07:14:24 AM

David, the problem is that in the eyes of the law and many others a pet is a piece of property. It is not considered a living being, a companion, or a family member. It is actually very difficult to get any Justice. In my case I wanted to take Banfield to court and I called many lawyers and their response was that it would cost me 10 times more than I would get. I didn't want anything except that place shut-down or those involved terminated, but the cost of these cases sometimes can even bankrupt a person. If you've already spent hundreds or thousands caring for your beloved friend and then have to take on the financial burden of lawyers fees and court costs you could easily be looking at a second mortgage. Aside from this obstacle you have to also consider that vets will back each other up even with wrong doing. <a href="http://veterinarynews.dvm360.com/dvm/Veterinary+business/Remove-malpractice-risk-from-anesthetic-risk/ArticleStandard/Article/detail/99207">Take a look at this article</a> The enitre article is really an eye opener and is very disturbing. Personally the closing statement really irks me. "And don't forget to charge the client an extended office visit for the time you took giving your professional risk evaluation."

Personally I think many laws need to be restructed to protect competent vets and clients with cases that have serious merit. As the laws are now, the ones that benefit are the vets that really shouldn't be vets and the clients who are just looking for cash because their pet that they barely saw died and it cost them money. There also needs to be full disclosure, if a vet has been found guilty of any vilations any and all clients both present and future need to be informed.

Stefani, these caps are a huge problem and they serve to protect the criminal which is something that makes no sense to me. If your error cost me 25,000 of my hard earned money then why can't I recover the full amount? Why only a portion, what gives the criminal the right to get away with most of my money? In the end these laws only serve to aggrevate the client and vet, they only difference is he drives off in his new mercedes benz, while you are in debt and grieving over the loss of someone you loved. Thats the problem with the justice system, it removes humanity from the equation and replaces it with protect the ones with the biggest pockets.

William February 27th, 2009 07:56:36 AM

David, so very happy that you have a great vet now. I agree with you and William -- good vets they are gold, and much to be cherished and appreciated.

William, re:

"these laws only serve to aggrevate the client and vet"

Sad to say, I don't think they aggravate the vet. The vets are the ones putting these laws in place and capping economic damages -- to limit their liability. In my state, horse racing/horses are a big deal. I can't help but wonder if the history of the economic damage cap here (which doesn't exist in a lot of states) has to do with limiting liability with respect to loss or injury of horses. Of course, it affects everyone who "owns" any kind of animal.

If you want to network on this issue, give me a holler through my site, The Toonces Project.

Stefani February 27th, 2009 08:38:35 AM

William, I agree completely, but that was the beauty of the legal argument behind using the FUDTPA, as it does allow for the plaintiff to become whole, and in FL, there have been cases of consequential damages, which is what I'm experiencing. Also, unsucessful defendants are responsible for the plaintiffs legal costs. It seems logical that the risk of a win on a slam dunk case of veterinarian malpractice would possibly entice more lawyers into taking the more egrariuos (SP?) cases of malpractice, knowing that the lawyers payoff is based on input effort, rather than size of settlement. And it is specifically written for "property"! The level of risk associated with the cost of prosecution of a claim of this type would be the limiting factor, based on ones own financial standing. http://www.thefreelibrary.com/Physician+deceptive+and+unfair+business+practices-a019608956 I found it rather offensive that the animal cruelty laws in FL are based on "dumb" animals, yet the police use canines, search and rescue dogs save lives, cadaver dogs give closure to loved ones, tracking dogs find lost kids, and the navy uses dolphins more than is publicly known, yet they're all in a neat little envelope of "dumb" animals. My friends german shepard looks smarter than most of my colleagues!! The FL statutes seem to me to have been originally written for herd animals and livestock, and companion pets have not reached a level of standing that is satisfactory to me, and most of you all reading my rant. Thanks for all the input, this is a lively intelligent site I have stumbled upon! If it makes anyone feel better, my wife and I are discussing just writing off the costs ($7600 +/- as of today), and making complaints to all boards of our previous vet, just hoping that maybe it won't happen again.

David February 27th, 2009 01:44:51 PM

David & William, Our biggest "beef" as companion advocates is the lack of enforcement of laws in place; including the complaint process with the state Boards. I am not suggesting not to do so, but be prepared for little to NO acknowledgement or recourse.

As far as legal proceedings, that too, varies from state to state. In some, fraud under a consumer protection law, allows "treble damages" and attorney fees incurred.

The best bet is to do homework, perhaps contact an attorney that specializes in this type of issue.

Should you be looking for referrals, perhaps someone could help with experience. I would contact one of our published sites or Companion Animal Protection Alliance

Barbara A. Albright/NH February 27th, 2009 03:16:29 PM

William, David: Because the law considers our companion animals "mere property" and because the boards dismiss 95 percent of all complaints, the only avenue of closure for a grieving guardian is LITIGATION. My motive is not to collect the thousands of dollars I spent in 3 weeks for my companion, but to expose the veterinarians' unethical and sloppy handling of my dog's health problems and his resulting horrible but avoidable death!

Asproolee’s Story

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