Based on my knowledge of my own skill and experience with this type of problem, would I consent to the proposed diagnostic
and therapeutic plan if I were in this patient's situation?
What diagnostic and/or therapeutic goals are likely to be achieved?
If I follow the proposed plan of action, in all probability will the overall benefits of this plan of action justify the associated
risks and costs?
Would my clients maintain their confidence in me if they could match my words with my thoughts and actions?
Have I ever misrepresented the probable course of events of a patient's illness to my clients?
Do I have a tendency to overstate the benefits of therapy while minimizing the risks? Would my clients maintain their confidence
in me if they knew I had concealed information about serious side effects associated with the proposed diagnosis or therapy?
Do I routinely explain the differences between specific, supportive and symptomatic therapy?
Do I consistently inform my clients when I am recommending the extra-label use of a drug?
Do I encourage incorporation of my clients' preferences in decision-making?
Do I give them the opportunity to understand the benefits and risks of various types of diagnostic and therapeutic options
with the goal of assisting them in making informed decisions?
Would my clients maintain their confidence in me if they knew my philosophy about referrals?
Am I realistic in conveying my level of competency when dealing with difficult medical problems?
Would my clients find that I value the viewpoints, judgment and experiences of others, or would they find that I have misled
them by indicating an ability to manage a patient's illness that is beyond the my expertise or the capability of my hospital?
Won't you agree that treating our patients as we would want to be treated encompasses patient referrals? However, do we have
a tendency to avoid referrals by rationalizing that when we inform our clients that needed care is beyond our expertise they
will lose confidence in us and go elsewhere?
Ironically, this philosophy could result in our clients being first to recognize the need for a referral. When a dissatisfied
client initiates the request for a referral, the receiving veterinarian may face a difficult task in restoring the client's
confidence in us (the primary care veterinarian).
In this circumstance, it is not unusual for clients to state that they have no intention of returning to the primary-care
practice. If that occurs, the primary-care veterinarian may wrongly assume that the referral veterinarian is "stealing" clients.
The primary-care veterinarian may believe that his/her "prophecy" of loss of clients by referral has been fulfilled.
Now switch to a scenario in which the primary-care veterinarian initiates the option of referral in a timely fashion. In this
setting, the client's trust and confidence in the primary care veterinarian often is enhanced. Why? Because the clients gain
firsthand knowledge that the referring veterinarian places the patient's and client's interest and welfare above his/her own
financial or egoistic gain.
When referrals are timely, the receiving specialist is in the optimal position to reinforce the altruistic motive of the referring
veterinarian to the client, who then is more likely to be motivated to return to the primary-care veterinarian for continued
Won't you agree that iatrogenic disorders are at times caused by most, if not all, who practice veterinary medicine including
highly trained and skilled specialists?
In that context, would my clients maintain their confidence in me if they knew how I respond to my errors in diagnosis and
Is my response to others about my mistakes governed by a heartfelt desire to be honest?
Do I recognize, admit and accept responsibility and accountability for my mistakes, or do I intentionally try to hide them
or shift the blame?
Do I take corrective action to minimize repeating the mistake?
If I were to make a mistake that results in the need for additional diagnostics, treatment and/or hospitalization, would my
clients maintain confidence in me if they knew my motive behind determining who should assume responsibility for the additional