Missing rule-outs spell trouble
Sometimes there's a tendency, especially among experienced practitioners, to itemize only a short rule-out list in the medical
records. While other causes of the presenting problem might be in the back of a veterinarian's mind, it's sometimes easier
to mention only the most likely causes of a medical problem while awaiting blood work and other diagnostics.
The absence of a complete or fully brainstormed initial rule-out list implies to later record readers that consideration of
the case was incomplete or superficial. While the thought of anyone critically reviewing a doctor's work may seem unfair,
it's important to recall that malpractice trials are about obtaining money damages, not about objective analysis of a veterinarian's
It's not the client's responsilbility
I just got two identical certified letters from my dermatologist. He wants me back to check for more pre-cancerous spots on
my shoulder like the one he removed last fall. Now does he just want to scare me into coming in so he can bill Blue Cross
for a recheck? Maybe. But it's more likely that he wants his records to show how he made the existence of future risk abundantly
clear and that he fulfilled any possible existing duty to inform me.
With that in mind, you might want to ask yourself: Do we remind pet owners to refill chronically used medication or to come
in for follow-up glucose curves? If your medical records don't reflect that you reached out to clients in these regards, how
could you rebut later client testimony that nobody ever made it clear, for example, that medical treatment for hyperthyroidism
is an ongoing therapy? If nothing else, well-kept records are a way of protecting you and your practice.
Dr. Allen is president of the Associates in Veterinary Law P.C., which provides legal and consulting services to veterinarians. Call
(607) 754-1510 or email firstname.lastname@example.org
For a complete list of articles by Dr. Allen, visit