Veterinary team safety—or client’s preference—first?

Veterinary team safety—or client’s preference—first?

Would you expect team members to treat an unvaccinated and sometimes feisty feline that has potentially been exposed to wildlife?
Dec 01, 2014

Getty Images/Elena ButinovaLeah Ness has a 5-year-old cat named Tuffy. She loves her cat and tolerates his lovable but inconsistent behavior. She adopted him at age 2 from a less-than-caring environment. Most of the time he is loving. Occasionally he is anything but loving and may scratch or bite. Ms. Ness leads a holistic lifestyle consisting of natural foods, natural remedies and always healthy choices. The same applies for her beloved cat Tuffy. Dr. Summer cares for Tuffy and sees the feisty feline on a regular basis. Ms. Ness will not allow vaccinations but opts for titers instead. She does not allow pesticides for parasite control, and she only feeds this pampered feline organic food. 

Dr. Summer has recently spoken with his team members concerning some wildlife rabies that has been discovered in their county. Many team members were immunized against rabies, as is recommended for animal care workers with increased exposure risk. In addition their clinic implemented a policy allowing employees the option of not working with pet patients that aren’t properly immunized against rabies.

Dr. Summer receives a call from Ms. Ness on a Friday morning. Ms. Ness explains Tuffy snuck out of the house and returned early this morning with a large laceration on his back. Of course Dr. Summer tells Ms. Ness to bring Tuffy in to the practice immediately. 

This poses a problem for Tuffy the cat. He is unvaccinated and has a wound of unknown origin and could be fractious. That being said Ms. Ness is an excellent client and this cat is in need of medical assistance. Three of the veterinary technicians on duty respectively decline to work with the cat. They note that the owner has declined immunizations, and knowing Tuffy they choose not to assume the exposure risk. Dr. Summer and another team member elect to work with Tuffy. They use gloves and proper sedation. Fortunately all goes well and Tuffy is discharged without incident.

Ms. Ness is advised that some team members would not care for Tuffy because he did not have his shots, yet she still refuses immunizations. Dr. Summer feels on the surface that his employees exercised their legitimate choice not to work with this cat. Nevertheless he harbors a bit of resentment with their decision because it impeded the care of a good client’s pet. 

After the chaos of the moment passed and when cooler heads prevail, Dr. Summer calls Ms. Ness. He tells her as Tuffy’s caregiver and her veterinarian she must respect his request to vaccinate the cat against rabies. It is the law and the right thing to do. In addition, it isn’t fair to his team nor to Tuffy to maintain an unnecessary serious health risk. Ms. Ness reluctantly agrees and Tuffy receives his rabies vaccination.

Rosenberg’s response:

No one will argue the fact that pet owners ultimately have the right to select their pet’s vaccination protocol. Of course they should do this in consultation with the veterinarian and with a complete assessment of the animal's risk profile.

On the other hand, the veterinarian as an employer must first maintain the health and well-being of his team members. Knowingly compelling a team member to take unnecessary risks and then making judgments based on the employee’s response is unprofessional.

Dr. Summer ultimately did the right thing. He advised his employees of their right to decline treatment of an unvaccinated animal, and he became assertive with a client who was displaying poor judgment. Good for Dr. Summer!

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Dr. Marc Rosenberg is director of the Voorhees Veterinary Center in Voorhees, New Jersey. He is a member of the New Jersey Board of Veterinary Medical Examiners. Although many of his scenarios in “The Dilemma” are based on real-life events, the veterinary practices, doctors and employees described are fictional.

Wrong Dilemma

To me, there's absolutely no dilemma here. Rabies vaccination is the law, and the client does not get to choose, particularly if she's expecting people to handle it and treat it. What I would like to see addressed and discussed is how to proceed when we're talking about vaccines other than rabies, and the client is an anti-vaxxer.

vaccine dillema with Taffy

What if unvaccinated-for-rabies Taffy gets loose in your clinic and bites another pet? Now you are in a world of hurt! Although the safety of you and your staff should come first, common sense should be just as important, especially if it can prevent a nasty lawsuit. The other client's pet could have to be quarantined for 6 months if unvaccinated (even if it were a puppy or kitten too young to vaccinate) and Taffy as well. Guess who might end up keeping both cats for 6 months! In quarantine! Maybe even treat the wound on the bitten animal at your cost. Maybe lose both clients, or more as word spread....The doctor did the right thing but only after many opportunities for the above scenario to have happened. Well, it's a tough place to be in with a client, and now that it has been brought to everyone's attention, it helps the rest of us to think things through more thoroughly before an accident happens.

Client's choice

I don't agree with the comment that owner's ultimately have the final choice on vaccinating their pets when it comes to rabies vaccines. This isn't an owner choice, it's the law. Pets must be vaccinated for rabies, period. I think clinics should be allowed to decline all care to unvaccinated animals just like my pediatrician declines care to parents who won't vaccinate their children. I also think veterinarians should be obligated to report any non rabies vaccinated animals to dog control.