Question 1: What is the most important determinant in your decision to advise referral of a patient for overnight care?
1. The medical condition of the patient.
2. The clients' degree of advocacy for their pet.
3. My opinion of the care at the emergency clinic.
4. The clients' ability to pay the additional fees.
5. Availability/distance to the overnight hospital.
6. My personal/financial relationship with the emergency clinic.
Commentary by Kathy Yerger, hospital administrator, Animal Care Center of Sonoma, Rohnert Park, Calif., a large 24-hourreferral
What the client is expecting for their pet during the overnight care should be what is considered. I think that if most clients
knew that their pet was left alone in a clinic overnight without supervision they would prefer to be referred to a hospital
that has staffing throughout the night.
Most clinics have signs informing clients that no one is on site, but I don't think emotional clients notice them or truly
understand that their pet will be unattended when the doctor goes home.
Question 2: What is the most important factor involved in your decision to refer a patient to a specialist?
1. The medical condition of the pet.
2. The patient is likely to die if I don't refer.
3. Do I have the time to care for the patient properly?
4. The client's level of advocacy
5. The client's ability to pay
6. My personal relationship with the client.
7. My personal relationship with the specialist.
Commentary by Kathy Yerger, hospital administrator, Animal Care Center of Sonoma, in Rohnert Park, Calif.
What is in the best interest of the patient is the question that should be answered. And most family veterinarians refer for
that reason. Historically veterinarians have been preoccupied by the financial aspect and let that interfere with referring
the patient. They tend to decide for their client. They believe that their client will decline referral because of the expense
and that is simply not my experience. Many families want that level of care and expertise and are very willing to pay for
it, especially when the option to finance the services is available.
One of the ways to enhance the referral relationship is to have a trusting relationship with a specialist. It is important
that the family veterinarian is kept informed about the patient and is able to reassure their client that their pet is getting
the care it needs.
Veterinarians have long been able to minimize the costs of professional liability as the law has seen pets as little more
than property. Lately, this is changing as numerous jurisdictions have changed the legal status of pet owners to "guardians",
and emotional damages have been awarded for negligence to pet animals. Despite our profession's support of the human-animal
bond, there has been a collective outcry over the specter of pets as having emotional value.
Question 3: Does your apprehension regarding this issue arise from: Importance ranking
1. Concern for rising liability expenses.
2. Anticipated costs to my clients for practicing defensive medicine.
3. Financial repercussions if I were found liable for my actions.
4. The need for improved medical records and client consent strategies.
5. The potential need to refer more cases to specialists.
Commentary by Robert Newman, attorney; Irvine, Calif., who represents pet owners pursuing claims against veterinarians.