Case study on meeting an agreement to provide veterinary services
Published in the August 2016 issue of Vetboard Victoria's newsletter
The following case study provides an opportunity for general reflection. The case study is based on a complaint about an individual set of circumstances at a particular time. As veterinary knowledge and professional and community standards and expectations change over time, readers should not assume that the Vet Board would make the same decision when presented with a similar complaint.
Having noticed that a cow agisted on the property was ill, the property owner informed the cow’s owner, a neighbour, of the situation and, as the neighbour was profoundly deaf, contacted Dr W on their behalf.
Dr W advised that they would only attend the property if specified conditions were met:
- that the owner was available to provide consent
- that payment was required at the time of service, and
- that the sick cow was isolated from a bull in the same paddock.
The property owner undertook to meet these conditions and it was agreed that there would be further contact the following day. During this conversation there was discussion of the possible diagnosis and treatment of the illness affecting the cow.
The property owner contacted Dr W the following morning and left a message. Dr W failed to return the phone call and the property owner phoned again some hours later, at which stage Dr W advised that they would not be attending the property and suggested that contact another veterinary practitioner be contacted. The cow died before another veterinary practitioner could attend. The property owner alleged that the reason Dr W offered for not attending the property was that they were only attending their own clients and the distance was too far. Dr W stated that the reason for not attending was due to the safety and payment policies not being met.
After a preliminary investigation, the matter was referred to an informal hearing into the professional conduct of Dr W. It was alleged that Dr W refused to provide veterinary services without an adequate reason.
Dr W was found to have engaged in unprofessional conduct, and the informal hearing panel determined that Dr W be counselled.
Counselling is one of the determinations that may be made following a finding of unprofessional conduct. It is a formal process during which the veterinary practitioner is informed of how their conduct failed to meet the minimum required standard and how that standard might be met in future. The Panel may counsel in any way it sees fit. The counselling may be oral, written, given immediately or within 28 days of the determination. It becomes a matter of permanent record on the veterinary practitioner’s file and may be referred to in any future Hearing or action taken by the Board.
The informal hearing panel made its finding based upon the following reasons:
The panel determined that Dr W failed to attend the property to treat the ill cow, without adequate reason. Upon the first communication with the property owner, Dr W imposed specific conditions: that the owner was available to provide consent, that payment was required at the time of service, and that the sick cow was isolated from a bull in the same paddock. The Panel considered that the conditions imposed by Dr W in regard to owner authority, payment and occupational health and safety provisions were all reasonable.
In a statement to the Board, Dr W stated: 'At no stage during the conversation…did I suggest that I was going to attend the property without…meeting our safety and payment policies'. The panel was of the opinion that this statement indicates that it had been communicated to the property owner that Dr W would attend the property if the conditions were met, and Dr W conceded that this inference was implied. The panel questioned Dr W’s subsequent refusal to attend the property despite the conditions being met. Dr W informed the panel that in speaking with the property owner they were unable to ascertain with certainty that the bull had been isolated from the cow, and informed the property owner that they were busy and would not be attending. Dr W referred the property owner to another veterinary clinic.
The panel was concerned with several aspects of this case. During the first communication with the property owner, Dr W was informed that the cow had been down for three days. The panel considered that this information was adequate for Dr W to conclude that the cow’s condition was serious and warranting of timely veterinary care. Dr W was unavailable when the property owner phoned the following day and left a message for Dr W to attend the property. Dr W informed the panel that they heard the message from the property owner approximately thirty minutes after it was recorded, but did not return the call. The property owner phoned Dr W again three hours later. When asked by the panel why they did not return the property owner’s call upon hearing the message, Dr W stated that they had decided to finish the tasks they were performing before phoning back. Dr W further informed the panel that the tasks they were undertaking at the time were not urgent. The panel considered that given Dr W was aware of the cow’s condition, including the fact that the cow had been down for over three days, they should have returned the property owner’s call in a timely manner and as a matter of priority. Dr W conceded that they erred in not returning the property owner’s call as a matter of priority.
The panel was also concerned that Dr W did not refer the property owner to another veterinary clinic at initial contact or earlier in the day if their intention was not to attend. It was the opinion of the panel that if Dr W was indeed too busy to attend they should have phoned the property owner soon after receiving the message, advised of this fact and referred to another veterinary clinic. Had the property owner been informed earlier of Dr W’s decision not to attend, they may have been able to access veterinary care for the cow from elsewhere, and before the cow died.
As the cow was not treated and no diagnosis was made, the panel was unable to determine if her death may have been preventable had treatment been instigated.
Relevant guidelines