But the interview process has to be really important, too. People are hiring technicians without a working interview. Whether
you're a new graduate or a veteran a working interview is a really important thing.
A lot of this comes back to each of us understanding our role on the team and being responsible for it. How do we educate
veterinarians? How do we educate technicians? How do we educate the public?
Dr. Johnson: Physicians' assistants in California have a formal agreement that goes in their files, called delegation-of-services agreements.
It says that I, as an MD, won't give you a job path that I don't think you're competent in doing. And you won't accept any
job path that you don't feel comfortable and trained to do.
I would love to see something similar developed in the veterinary profession.
Dr. Ostrich: There are other implications. For example, in large-animal practice in Pennsylvania, we'll go out and bleed a herd of cows
to test for brucellosis. It's the person's job to bleed the cows, identify them and not mix up the samples. It's a complicated
procedure in a lot of ways.
One of the highest-paid malpractice lawsuits recorded was on a herd of cows where a brucellosis sample got mixed up. In this
case, the farmer bled the cow and gave it to the veterinarian, who then shipped it to the lab. It came back negative, but
the cow actually was positive. Obviously, the farmer was the culprit here. He bled the wrong bull, whether purposely or not.
The bull consequently went to Texas or Florida, and it did have brucellosis. It infected not only the herd he brought it to,
but also the next-door neighbor's herd, etc.
These can be highly legal, highly expensive matters when you're dealing with such regulatory work. On the other hand, if your
technician is licensed, has worked with you for a while and you really feel that technician has competence, consider the following:
In an emergency situation, the technician is in the hospital but the doctor's out to lunch. The technician feels competent
putting an IV into that animal, and getting it started on fluids without any supervision, because the doctor's not there.
But the dog dies. Was that an illegal thing that she or he did?
I don't see how a judge would define it that way, but technically it may have been illegal. Is that right for the profession
or the animals they treat? I don't think so.
Mr. Dennis: Some states have included a regulation or, in the practice act, an emergency exception to address that. But in the absence
of such a provision, it would be an illegal, unlawful act of veterinary medicine. Practice acts and regulations would have
to carve out emergency exceptions.
Dr. Johnson: Something the RN who works for me is teaching me is that they've been through all these steps on the human side. One thing
they have developed that we're just starting to develop is protocol. So if I'm not immediately in the room and an emergency
comes in, the technician is given permission in our practice to start an IV line, to start fluids, to do some basic care.
If the technicians can't find me, there is a specific protocol set up to tell them this is how far they can go. They've found
over time that they can expand these protocols and give more opportunities for the nurses to take care of some of these emergencies.