The price of pain

The price of pain

How a veterinarian facing license revocation exposes an unwritten mandate to treat animal pain
Oct 01, 2007

Painful realization: Charges of substandard pain control threaten Seemann's future in practice. "My clients don't give a damn what anyone says about me. They know this isn't true," he says.
MINNEAPOLIS — For 59 years, Dr. Carl Seemann practiced as northern Minnesota's surgical "spine man," a solo generalist who, at age 84, saw three clients a day until Christmas last year.

Yet the sudden end of Seemann's long career was no retirement gift. It arrived via mail on Minnesota Board of Veterinary Medicine (MBVM) letterhead. On the stationary were the words "license suspension."

"They called me a threat to others," recalls Seemann, now perched in his Colo-rado mountaintop cabin with his wife, dog and pride at bay. At press time, an administrative-law judge was expected to issue a final verdict on the nearly yearlong battle regarding Seemann's case.

The board's complaint, while initially centered on allegations of an orthopedic procedure gone bad, has narrowed to one aspect of veterinary care: the postoperative management of pain.

Onward bound: Retreating to the mountains of Colorado, 84-year-old Dr. Carl Seemann says he's building a new life but promises to continue his fight to practice.
Dig past Seemann's lack of board credentials and malpractice accusations, and what's revealed, experts say, is the nation's first test case regarding pain management in veterinary medicine.

Just a decade ago, pain management was the exception, not the rule, in most pockets of the profession. But combine new research with elevated public attitudes regarding pets, and an older veterinarian failing to adopt new thinking on pain management grabs headlines.

Such standards often aren't tangible. They develop over time, slowly simmering until a general consensus is established. Peer review, continuing education and majority practice can push the evolution. But a single event often brings new standards to a head.

Last month, the American Association of Feline Practitioners (AAFP) and the American Animal Hospital Association (AAHA) released the nation's first guidelines for managing pain in companion animals (see related story). While the tide has clearly turned, veterinarians serving rural outposts might view such change as unfair.

To beat the rap, Seemann has gone to trial, hired expert witnesses and spent $85,000 defending his reputation and his standards of practice.

"City people," Seemann argues, live in a different world than rural America, where pain-management drug costs often are considered impractical. While he acknow-ledges the public's increasing tendency to anthropomorphize animals and demand a higher grade of services, he still doesn't use analgesics following spays.

"I am absolutely shocked this case has gone this far," Seemann says. "I just was trusting that this crazy thing couldn't be happening to me. I've always been a very dedicated veterinarian."

The defense

During a three-day trial in August, the Minnesota attorney general's lawyers and experts argued against that. Defense attorney Zenas Baer, who now sifts through 650-plus pages of transcripts while awaiting the judge's verdict, claims he's never witnessed a case where authorities have lambasted a licensee based on such "flimsy" regulatory evidence. The lawyer, who once sat on the Minnesota Board of Medical Practice and represents Seemann, says he's unaware of any human doctor who has ever been disciplined for inadequate pain-control measures.

So when it comes to his veterinarian client, Baer's argument is two-fold: Veterinary regulators fail to provide any published documents linking emerging pain-control protocols to standards of care, thus creating a basis for making such guidelines voluntary. What's more, animals still are considered property in all jurisdictions in the United States.