Maple leaves.

ACCOUNTABILITY IN VETERINARY MEDICINE

When poor outcomes happen in any form of healthcare, including veterinary medicine,  it doesn't automatically mean someone is to blame. The nature of the underlying disease, the general state and age of the animal in question and other issues are usually the most important factors in determining how well a particular patient will do. Even so mistakes still can occur and even then that doesn't mean someone has been negligent. None of us are perfect and a train of circumstances can lead to a less than optimal outcome for an animal. What I believe most owners hope and expect will happen for their pets, when they attend a veterinarian, is that they will be cared for in a compassionate and diligent manner that at least meets the expected standard of care available in their local region. They also expect to be provided with enough information so that any decision they themselves make regarding their animal's care will be informed and will truly be in what they determine is their pet's best interest. 

What options however does a pet owner have when seeking answers to what may have happened to their pet when there is a poor outcome? What accountability may a veterinarian face if they fail to provide informed consent to a client before a test or procedure is done? What penalties could they face if they fail to provide less than the standard of care expected of them? Let us look at the options available for the pet owner to pursue.

1/ Do nothing except complain to whoever will listen.

It is understandable for an owner to be upset, if following care from a veterinarian, their animal dies or is seriously damaged. Numerous authorities have reported on the significance for an owner when their beloved pet dies. However, as I said earlier, a negative outcome doesn't mean anyone is to blame. It takes some emotional maturity however to realize this, on the part of the pet owner, and not every owner has that maturity. That doesn't excuse the behaviour of an owner if they insist on telling everyone they subsequently meet about how lousy the vet was who looked after their dog or cat. This is especially so when they haven't even bothered to talk with the veterinarian in question to get their side of what may have happened. 

2/ They can talk with the veterinarian and the clinic to see what happened. 

This is the first step preferred by veterinarians and the Veterinary Regulatory bodies. I also agree with this approach. It is not easy however, for a pet owner to have these type of conversations when they may be angry with the veterinarian and the clinic, where their animal died. These conversations are also not easy for the veterinarian or the clinic involved. Despite this, both sides should listen to each other respectfully and clients should not be classified as whiners and have their issues dismissed out of hand, even if the clinic believes the complaints have no foundation. In many of these situations the owner, whether it is realized or not, is simply looking for an opportunity to vent their anger at the person they believe has caused the pain they are feeling. Owners therefore should not be fired from a clinic just because they have voiced complaints about the service they have received. These difficult conversations however, can give both the veterinarian and the clinic an opportunity to explain their side of things; they may also offer condolences or even an apology for how things worked out if they deem it appropriate to do so. They must ensure however that the owner realizes that an apology is not an admission of guilt or of negligence on their part. In many cases, even though there may be nothing to suggest that the veterinarian or the clinic did anything wrong, by giving a pet owner an opportunity to properly understand that, the clinic and the veterinarian concerned, can go a long way with helping an owner deal with their grief appropriately and also in preventing a complaint from escalating.

 

 

3/  They can complain to the Provincial Veterinary Regulatory Body. 

Most complaints that the self regulatory veterinary bodies receive from the public are in the form of emails or phone calls. Generally no record is kept of these communications and the complainant in these situations is encouraged to contact the veterinarian directly to deal with the issue in question. It is only when written formal letters of complaint are received by the Regulatory Body that records are kept and that a formal file is opened. In Alberta, two thirds of those formal complaints are dismissed without being forwarded to a Hearing. Of the remaining one third, 66% are settled between the Provincial Body and the Veterinarian, without any input from the complainant. These settlements are called Consent Agreements and the complainant only sees them when they have been completed and signed off on by both the veterinarian and the Regulatory Body. The remaining one third may go to a Hearing. In Alberta for instance, around 25-30 formal complaints are received each year about either veterinarians or RVTs. Of these perhaps 2-4 may end up in a formal Hearing. The complaint process can take a year or significantly longer to complete. If a complainant is unhappy with the decision they can appeal to the council of the ABVMA, or afterwards to the Ombudsman. This process of making a complaint to the Regulatory bodies overseeing Veterinarians is stressful for all parties involved, including the veterinarian accused of any wrong doing. The penalties a veterinarian can face, if found in breach of their professional obligations range from loss of their ability to practice veterinary medicine (rarely occurs), to requirements to take on line courses regarding such things as their record keeping. If a veterinarian wants to appeal a decision made by their regulatory body regarding the care they have provided, they can appeal that all the way to their Provincial Court of Appeal.   

4/ Initiate a Lawsuit.

It is exceedingly rare for a veterinarian to end up in court because of alleged negligence provided to a client. In Canada, in the twenty year period from 1995-2015, there were 3 such cases recorded in the legal database Canlii. The reasons for this are many and they will be explored in the section, "What's your pet worth under the Law?"

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