Prepare for the inevitable: Reduce liability from human-animal bond - DVM
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Prepare for the inevitable: Reduce liability from human-animal bond


DVM360 MAGAZINE

The human-animal bond is clearly leading to a new burden of risk and potential litigation for veterinary hospitals.

It is highly probable that the nation will follow Rhode Island and California's lead in terms of pet classification as something more than chattel property. Even though the most recent attempt in Colorado was defeated, it is just a matter of time. When this legal reclassification happens, the incidence of lawsuits will increase dramatically as pet owners sue for the emotional distress of pet loss.

Empathetic juries may offer significant monetary awards reflecting the value of pets as companions, rather than the inherently and relatively low values associated with animals simply considered to be chattel property.

We recommend that you consider implementing new procedures and improve existing protocols to continually move the practice toward increased risk mitigation. Lag behind, and you may unwittingly incur the cost of defense, a small price when compared to potential devastation of bad publicity, staff turnover and sleepless nights.

Risk strategies

Here are some ideas to consider:

* Hospital employees must stay on their game. Increasingly, you will be challenged to assure documented continuing education at all levels of practice, which maintains the knowledge and skills of veterinarians, technicians, receptionists and kennel personnel. Assure every individual regularly spends time away from the practice in formal education as well as through required in-house seminars and auto-tutorial regimens.

* Periodic in-house veterinary meetings should establish current protocols and procedures for dealing with pet care issues. Vaccination frequency or lowest level laboratory workup for specified medical conditions should become standard operating procedures. Documented procedures and staff training lead to clear understanding by each employee as to what should be communicated to the client in a particular case type and at what point a doctor's consultation must be obtained in clarifying points of confusion or where the client desires less than the optimal case management because of monetary constraints.

* Keep abreast of professional standards of care. Know the level of animal continual supervision required in your state and jurisdiction for your practice type. Doctors and staff should know their limitations and seek second opinions or offer specialist care where appropriate.

Lawsuits and claims often result not from error or omission, but because of a breakdown in communication with the client. Client communication issues must be continually refined and improved.

Informed consent

Informed consent is the keystone of client communication. Written estimates and sign-off by the client prior to treatment or surgery are essential. Documentation requires the institution of multiple pre-surgery, pre-anesthesia, pre-dental and pre-medical treatment forms.

Veterinarians and technicians must take the time to provide the client with adequate information regarding a proposed treatment plan. Ideally, that information would be provided in a written format and supplemented verbally to assure the client has a complete understanding prior to authorization.

Signed consent forms must be archived. Explore technology that can improve efficiency for information gathering and secure storage while decreasing space requirements. High-speed scanners, compact disks, or DVD backups will become increasingly more common.

Other electronic alternatives are available now and can be implemented as you move forward with strategic plans for overall practice database computer system changes and new software integration.

For example, new tablet PCs will allow full mobility for veterinarians. Practice forms, such as consent forms and check-in histories, can be loaded electronically. Client signatures may be scribed directly on the tablet PC and then saved electronically through burning to CDs or backup on the practice network server.

Enough insurance?

Re-evaluate insurance coverage. Veterinary malpractice insurance is inexpensive. It will probably not continue to be so, as lawsuits increase in this area of emotional distress, as state laws change. Malpractice insurance should be obtained at the highest attainable level for the hospital as a whole and for doctor personal coverages. Associate veterinarians must also be covered.

In the event your practice general liability insurance policy also provides malpractice coverage, make sure that each veterinarian is listed on the business-owners policy as a named insured.

The alternative or supplemental approach would be insurance through the AVMA Professional Liability Insurance Trust (PLIT) for every employee and contract veterinarian. The PLIT, being focused on veterinarians exclusively, provides legal counsel that may be several notches above which could be provided by a business-owners policy.

Contact the AVMA to receive information about professional license defense endorsement. This low-cost premium provides coverage for defense in the event of a complaint with the state licensing board by a client.

For boarding of healthy pets as well as housing those that are sick, make sure the claim allowance of the insurance policy is high enough for high-value animals that might be lost while being walked outside, or hang themselves in runs, or incur some other terrible injury while under your control.

We all hope that no unfortunate events occur, but the nature of veterinary practice is such that accidental injury and death to animals while in the care of a veterinarian is always a potential risk. Make sure you continue to improve the procedures, protocols and insurance coverage that mitigate the loss of sleep and anxiety that each practice owner inevitably experiences when the worst imaginable does happen.

Look out for legislation

Watch proposed legislation and dialogue in your city, state and nationwide. Already, various jurisdictions are attributing anthropomorphic characteristics to pets. The veterinary profession has worked hard to ensure that the human-animal bond would be engrained in the fabric of the world and American society. These efforts have been so successful that the inevitable has occurred. Some individuals will find legislative recognition of the bond as a ripe opportunity for lawsuit.

The mere fact that a practitioner has not committed malpractice is no cause to relax. With higher stakes for awards, greater probability exists that animal owners will wrongfully accuse in hopes of gaining settlement. When awards are low, the probability of suit or an individual taking the time to bully a veterinarian into settlement are nominal.

With the advent of attribution of rights and the potential for loss of a pet when its status is much more than just chattel property, the potential for lawsuits increases substantially, either through the courts or pressure on insurance carriers to settle.

Please make sure you continue to evolve practice procedures and standards to mitigate the risk as the full ramifications of the human-animal bond unfold in the legal arena.

Assure you maintain adequate malpractice coverage. Establish training programs and protocols. Document them. Demonstrate that every practice employee who is licensed or certified has satisfied more than the minimum legally required level of skill in accord with standards for the region and particular area of practice expertise.

Judiciously raise your fees on a regular and proactive basis. The cost of insurance, training, recordkeeping and documentation, and informed consent procedures will increase over time. Make sure the practice's fee schedule reflects the risks you take in providing veterinary care to your community.

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Source: DVM360 MAGAZINE,
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