Saturday, June 21, 2014

when the veterinarian crosses the line

Recently I've heard a number of first-hand stories about horse folks having huge and upsetting issues with veterinarians who were on the farm to examine, diagnose, and/or treat a horse. In all scenarios, the veterinarian crossed the line in one way or another. In one case, a horse ended up with injuries to head and legs and the veterinarian who caused the injuries left the farm without even checking to see if the injuries he caused were serious.

This brought up a lot of conversation. What do you do if a veterinarian exhibits incompetence or even malpractice?

Many people felt there was nothing to do but look for a new vet. Others felt that to name the vet was wrong. Others felt everyone deserved to know the name of the vet so they could steer clear.

A couple of things came to my mind immediately.

First, I always hold my horse when the vet comes for anything. Emergency, wellness visit, etc. I do not even have cross-ties in my barn, so there is no tying a horse up and letting the vet approach. I have the horse in question's halter on so that when the vet gets out of the truck I can quickly snap the lead line on and bring the horse out for the exam.

There have been a few times (all when Salina was very old) when she was actually down when the vet arrived. In those instances she was allowed to have her donkeys with her, as it kept her calm, and I approached her with the vet and let her know with my voice what was happening.

One of the best reasons to hold your horse for any health care professional is so that you can walk the horse away if you need to do so. It is so much easier to walk the horse away than to step in and take over if someone starts manhandling your horse. 

It's sad to think we might need to do this, but if something goes wrong, I much prefer to be the one with the lead rope in my hand.

A frightened horse who is tied in cross-ties or straight-tied is much more likely to be hurt than one on the end of a lead rope. 

Secondly, if you experience abusive treatment, incompetent treatment, or what you feel might be or is malpractice, don't just let it go. Report it to your state veterinary board, the one that licenses vets to practice in your state.

In North Carolina, we have the NCVMB. I've copied and pasted the page on making formal complaints below. Making a complaint means the Board will investigate. The thing is, if you don't report, there is no way they will ever know what happened, and there is no pattern of complaint created so that bad vets are dealt with.

Everyone can have a bad day, things can go sideways, and horses are big animals. But we all know there are humane ways to get things done. We all know anger, frustration, and condescension have no place during a difficult moment with a horse. An equine vet who is competent will know when to take a break, walk away, or request more help. An incompetent vet will actually make the horse more afraid and more difficult, so that the next visit will be even harder. 

Don't be afraid to step in if you feel the professional is out of line in any way. Better yet, BEFORE the line is crossed. You are the voice for your horse. It's your job to step in. And remember: you know your horse better than any professional does. He or she should be asking you questions and LISTENING to your insights and answers. 



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The General Statues of North Carolina established the North Carolina Veterinary Medical Board for the purpose of regulating the practice of veterinary medicine and surgery. 

The General Statues, along with the Administrative Code, establish protocols for the review of complaints and set grounds for possible disciplinary action. Complaints are filed against licensees of the Board rather than veterinary practice facilities. The complaint protocol applies to licensed veterinarians, registered veterinary technicians, applicants for examination and faculty certificate holders of this Board. Complaints cannot be accepted anonymously, by fax, e-mail or telephone.

Printer Printer friendly version of Summary of the Complaint Process    

Types of Complaints 
The Board investigates complaints concerning the practice of veterinary medicine and the standard of care provided by licensees of the Board and includes, but not limited to:
    - Incompetence
    - Malpractice
    - Fraud
    - Gross negligence
    - Misrepresentation

Fee Issues
The Veterinary Practice Act does not address the issue of fees. Therefore, the Board has no authority concerning fees or the jurisdiction to settle monetary disputes. Monetary disputes would be handled through civil court.

Contract Disputes
The Veterinary Practice Act does not address contract disputes; therefore, these types of disputes are generally not within the jurisdiction of the Board.

Filing a Complaint
A letter of complaint should be typed and mailed to:
    NC Veterinary Medical Board
    1611 Jones Franklin Rd., Suite 106
    Raleigh, NC 27606

Complaints cannot be accepted anonymously, by fax or telephone. A formal complaint is serious, the process takes time and may require all parties travel to a meeting of the Board and provide testimony under oath.

The letter of complaint needs to include the following information:
(1.) The name(s) of the accused individual(s) whom the complaint is to be file against.  (2.) Name(s) of any veterinarian(s) or veterinary practice(s) that may have more information or medical records concerning the pet.  (3.) Detailed account of the complaint/situation including pet’s name, age and breed.  (4.) Copies of any documentation(s) or information pertaining to the complaint. NOTE: Remember to provide a mailing address and telephone number(s) should the Board need to contact you. 

Procedure for Investigation/Review of Complaints
1.) A copy of the letter of complaint is forwarded by certified mail to the accused individual for a response. They are given twenty (20) days from the time they receive the letter of complaint to respond in writing.

2.) A copy of the accused’s written response is then forwarded to the complainant. They also are given twenty (20) days from receipt of letter to reply. Should the complainant not reply to the accused individual’s response, the Committee on Investigation (the “Committee”) could dismiss the complaint.

3.) When the complainant’s response is received, a copy is forwarded to the accused party and a date is set for the complaint to be reviewed by the Committee.  

4.) After the complaint is reviewed, the Committee relays its findings at the next meeting of the full Board.  The attorney for the Board prepares all letters that summarize the findings of the Committee and mailed to all parties.

NOTE: A complaint may need to be continued until the next meeting of the Committee: all parties are informed of this continuation by the Board in writing.

Possible Actions by the Board
    - Issue a Letter of Dismissal 
    - Issue a Letter of Caution
    - Issue a Letter of Reprimand
    - Suspension of licensee to practice veterinary medicine in North Carolina

Dismissed Complaints
The Committee on Investigations can dismiss a complaint when it:
    1.) Determines that no probable cause exists
    2.) Lacks the jurisdiction to proceed
    3.) Lacks a response from the person who initiated the complaint

Letter of Caution
A Letter of Caution may be issued when no probable cause is found but it is determined by the Committee on Investigations that the conduct of the accused individual is not in accordance with accepted professional practice.

Letter of Reprimand
When probable cause is found, but it is determined that a disciplinary administrative hearing is not warranted, the Committee on Investigations can issue a Letter of Reprimand. The Letter of Reprimand is prepared by the Board’s attorney and mailed to all parties.

Acceptance of Reprimand: If the Letter of Reprimand is accepted by the accused individual, a record of the Letter of Reprimand shall be maintained at the Board office.

Refusal of Reprimand: The accused individual has fifteen (15) days to refuse the Letter of Reprimand from the date received. A written refusal and request for a hearing should be addressed to the Committee on Investigations and filed with the Executive Director of the Board. This is pursuant to Chapter 150B of the North Carolina General Statutes, Title 21, Chapter 66 of the North Carolina Administrative Code. Legal counsel for the Board shall prepare and file such Notice of Hearing.

Administrative Hearing
When disciplinary action is refused by the licensee and probable cause was found, the attorney for the Board will file a Notice of Hearing. All parties involved in the complaint are informed and must travel to a meeting of the Board to provide testimony under oath. Hearing procedures are similar to a court of law.

Method of Notice: The Board shall give notice to all parties of a Notice of Hearing in person or by certified mail. In the event that the notice is accomplished by certified mail, the delivery date on the return receipt shall be the date served.

Notification Deadline: The Board shall give the party or parties in a contested case a Notice of Hearing no less than fifteen (15) days before the hearing.

Suspension of License/Registration
If the Board determines that public health, safety or welfare requires such action, the Board may issue an order suspending a license or registration. The Board’s attorney will prepare the order requiring the licensee or registrant to immediately cease the practice veterinary medicine in North Carolina.

Ownership of Veterinary Practices 

Only a North Carolina licensed veterinarian can own and operate a veterinary practice facility and deliver services to the public. Welfare groups, humane societies or other entities cannot operate, and are not able to own veterinary practice facilities in North Carolina. Any advertising or promotions suggesting that someone or entity owns a veterinary practice other than a North Carolina licensed veterinarian, would be considered in violation of the Veterinary Practice Act.

Welfare groups, humane societies, or other entities are not authorized by law to engage in the delivery of veterinary medical services to the public.


Claire said...

couldn't agree more. don't think anyone over this side of the pond would not formally complain in such a circumstance! (mind, i'm not aware of anyone over here having cross ties, either! not a UK thing.....)

billie said...

I was surprised that some people really thought they had no recourse at all.

There is no assurance the NCVMB will be able to do anything, of course, but if you file a complaint, the vet will have to deal with it, the Board starts a file on said vet, and you have helped create (or add to) a pattern of behavior. If the vet just had a Very Bad Day, and it never happens again, great. But I suspect vets who would walk away and leave an animal injured due to their own mishandling are vets who cross the line regularly and in other ways as well.

Calm, Forward, Straight said...

I would imagine word of mouth will play into those situations you described too. Enough "bad days" and the practices' bottom line will be affected. I definitely hold the lead rope for any and all treatments to Val.

Fortunately - a recent unhappy interaction with my farrier resulted in opening up a dialogue, and encouraged me to take over responsibility for the trimming, under his supervision. Win, win.

billie said...

One hopes, wrt word of mouth.