Risks associated with clients seeing multiple veterinarians

 

Guild Insurance regularly undertakes reviews of veterinary claims. It has been found that there is a significant trend in claims involving treatment being provided by at least two (2) veterinarians. This finding led Guild to explore why a client seeing more than one veterinarian may lead to a claim arising and what can be done to prevent this from occurring.

 

Reasons for seeing a second veterinarian

There are a few reasons why a client may choose to see a second veterinarian. Sometimes it isn’t entirely by choice such as if their regular veterinarian has referred them to a specialist. It may also be a necessity if they require emergency afterhours treatment and they therefore go to an emergency centre.

 

There will be occasions when a client requires a follow up appointment and isn’t able to make an appointment to see their usual veterinarian at a time which is convenient for them. Rather than waiting for an appointment they choose to go elsewhere.

 

The situations which are most concerning in terms of possible claims are the occasions when a client is unhappy with the treatment their animal has received and they choose to go elsewhere for a second opinion or follow up treatment.

 

Case examples

Not all cases where more than one veterinarian is involved in the treatment of an animal will lead to issues arising or claims developing. However it’s important veterinarians understand that on occasions the involvement of other

veterinarians can lead to issues.

The following cases highlight the types of claims which can occur following the involvement of a second veterinarian. 

1. An owner had taken her dog to her regular veterinarian due to her dog seeming weak and unable to walk normally. As there was little noticeable improvement following treatment for arthritis the owner decided to take the dog elsewhere for a second opinion and the dog was diagnosed with a tumour. The owner requested a refund of all fees paid to the first veterinarian.

 

2. Surgery was performed on a dog which resulted in a large wound. The owner was unhappy with the outcome, even though the treating veterinarian was able to explain the reasons for the outcome, and went to see someone else. The second veterinarian criticised the work of the first veterinarian. The owner requested a refund of part of the fees paid to the first veterinarian.

3. Surgery on a dog’s broken leg resulted in complications and the client was referred to a specialist for further surgery. The client then claimed that the first veterinarian should have referred him to a specialist in the beginning, rather than perform the surgery himself. The client was therefore claiming a refund of the fees paid to the first veterinarian.

4. Surgery was performed to remove a lump on a dog’s elbow; however the wound didn’t heal correctly. The owner claims that after many attempts to correct the issue, he then went to see a specialist who recommended another form of treatment. The owner claimed this treatment should have been offered at the beginning. He threatened to make a complaint to the Veterinary Surgeons Board and sought compensation for treatment, medication as well as a dog trainer.

Ethical considerations

Some veterinarians believe there is an increase within the industry of veterinarians criticising the work of others.  Guild’s claims suggest that this can be one of the triggers for a client making a claim or complaint against a veterinarian.  This behaviour is considered unprofessional and reflects poorly on the entire profession.  

It’s possible that the second veterinarian seeing the animal doesn’t have all the information needed to make this judgement.  Quite often when incidents occur, they are not simple matters.  Determining who, if anyone, is at fault and why is not always obvious.  Therefore making the judgement that a veterinarian has performed below an expected standard without there being an investigation is unfair and inappropriate.  Whilst clients may tell you what they believe has taken place, they could quite possibly be inadvertently giving you incorrect information.  They may have trouble remembering, understanding and explaining the clinical elements of what has previously taken place, particularly if it was some time ago.  They may also be upset and emotional due to their animal being unwell which may affect their objectivity in the matter.  It’s also important to remember that when a veterinarian sees an animal which has previously been treated by someone else, it’s possible that the symptoms have changed so the two veterinarians have not seen the exact same scenario.   

Making even what you see as a small or insignificant comment to a client regarding the quality of treatment provided by another veterinarian could be enough to encourage that client to consider making a complaint or a demand for compensation.  It should therefore always be avoided.

Behaving professionally

Managing client expectations from the outset is vital. The client should be made aware of what to expect; they don’t want surprises. The more they understand the less likely they are to be dissatisfied with the treatment and then go elsewhere for further treatment.

 

Building relationships with clients is an important element in running any successful business. Get to know your clients and their animals. Give them a reason to trust you and come back to you.

 

Provide your clients with written information to take away with them. Sometimes not all information will be taken
in and understood during an appointment; giving them something to take away and read in their own time will assist with their understanding. This could include information about the procedure, why it was done, what to expect during the recovery process, what signs to look for to know if there has been a complication and who to contact in case of an emergency.

 

If a follow up appointment is needed, don’t simply tell the client to come back in three days for example. This can easily be forgotten leading to the appointment being missed. Make this follow up appointment with them before they leave the clinic and provide them with an appointment card.

 

Have your nursing staff phone clients the day after surgery or with cases you are uncertain about to check how the patient is recovering, that the owners understand the post-operative instructions and that they are managing the administration of any medications.

 

Clients can often become frustrated with the ongoing costs of treatment. Where possible, bundle the costs of multiple
appointments or treatments together. For example, if a particular treatment will always require a follow up appointment,
incorporate the cost of this follow up appointment into the cost of the treatment. They are more likely to attend when it has already been paid for.

 

Avoid offering refunds or free treatments in the event of a poor outcome. This may be seen by the client as an admission of responsibility or liability. It’s then possible that the requests for discounted or free treatments will continue. Always speak to Guild Insurance before offering any form of compensation to a client.

 

Document everything! The key to dealing with a dissatisfied client who is considering making a claim or complaint against you is your accurate clinical records. If your work is being questioned by a client or another veterinarian, you will need evidence of what you did and why. If a client is claiming they were not made aware of the possible negative side effects of treatment or the need for a follow up appointment, your records need to be able to prove you informed them. This documentation includes all communication with veterinarians, other staff and the clients, particularly telephone conversations.

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