This guideline outlines the appropriate standard expected of a registered veterinary practitioner in the course of veterinary practice. It should be read in conjunction with other related guidelines.

Context to Guideline 4: Communication between veterinary practitioner and owner or professional peers

Communication relating to the provision of veterinary services takes many forms between individuals. Communications can be targeted, such as in a consultation, veterinary medical record or template form seeking informed consent; or broad, such as public-facing advertisements and social media interactions.

All individuals involved in communications about veterinary services share responsibility to contribute to such exchanges with honesty, respect and openness. The principle of effective communication is shared responsibility of the veterinary practitioner, the owner and professional peers.

As also detailed in Guideline 7 on veterinary medical records, in sharing the responsibility for the wellbeing of the animal receiving veterinary services, an owner should provide accurate information about their animal’s history and wellbeing to a veterinary practitioner. This will assist diagnosis and delivery of appropriate veterinary services and support the accuracy of the medical veterinary record maintained by the veterinary practitioner.

The owner also has a responsibility to seek additional information if they need clarification or require alternative options to a veterinary practitioner’s proposed approach to delivery of veterinary services.

Effective communication skills include active and reflective listening, questioning for clarification, consistent and timely messaging and self-awareness.

Veterinary practitioners are encouraged to develop their skill in navigating difficult conversations and in conflict resolution. A breakdown in communication between a veterinary practitioner and an owner is the trigger for many complaints received by the Board.

While verbal and non-verbal communication may be appropriate and sufficient to ensure understanding in some contexts, the Board encourages the concurrent use of written information where practical. For example, written aftercare information, cost estimates for procedures, instructions for multiple medications or for animal management all assist the owner to understand clearly and help veterinary practitioners to document communications efficiently.

Preferably, informed consent and informed financial consent should be obtained in writing, for example by using a pro forma consent form. This form should include:

1. the name and contact details of the owner (or their delegate), including details of their availability during the treatment period
2. a clear description of the animal
3. the details of the owner’s designated representative, including the representative’s signature
4. a clear description of the treatment/procedure to be undertaken
5. a statement of the risks involved and the owner’s acceptance of these risks
6. an estimate of the costs to deliver the chosen treatment/management plan
7. the owner’s signature.

A veterinary medical emergency presenting in an environment that is time-critical and potentially emotionally charged does not lessen the need for communication to be effective and genuine.

During a consultation, a veterinary practitioner is expected to give an animal’s owner a reasonable range of options for treating or managing the animal, and provide a prognosis, possible complications, consequences and associated costs for each option (Context, Guideline 1).

A veterinary practitioner is expected to take reasonable steps to ensure what they communicate is clear, and that the animal’s owner has understood their communication (Guideline 4.4).

A veterinary practitioner should cover the following information in discussions with an animal's owner:

• the reason for the consultation 
• an appropriate range of options for treating or managing the animal, including:
• any financial constraints affecting the owner’s decisions about their animal's treatment or management (Guideline 7.4)
• the authority of the person presenting the animal to provide consent, and (if the person is authorised) the obtaining of their informed consent to provision of veterinary services and their financial consent to the costs of those services (Guidelines 4.6-4.8)
• instructions to the owner about giving any prescribed veterinary medications to the animal and caring for the animal after giving medication (Guideline 14.1)
• plans for the ongoing care and management of the animal, including what the animal's owner should do if there are any complications or deterioration in the animal’s condition (Guideline 4.10 and 7.4)
  OR
• any decision either by the veterinary practitioner to decline to treat the animal or by the animal's owner to decline treatment of their animal; and any alternative options advised or chosen, e.g.  referring to another veterinary practitioner or seeking a second opinion (Context, Guideline 3)

Discussions should be recorded in the veterinary medical record (Guideline 7).

During a consultation with a veterinary practitioner, an animal's owner should be focussed on the wellbeing of their animal.

They should clearly explain why they have brought the animal to the clinic and answer any questions asked by the veterinary practitioner.

After the veterinary practitioner explains the range of options for treating or managing the animal; and provides a prognosis; possible complications, consequences and associated costs for each option, the owner should:

1. ask questions about anything they do not understand, including the options provided, recommended treatment plan, and costs
2. based on what they can afford, decide on an option (or options) for their animal from the range of options provided by the veterinary practitioner, and give their informed consent and informed financial consent to the veterinary services to be provided, and
3. ask questions about their role in their animal's treatment or management, e.g., about administering medication, caring for their animal at home, and what to do if there are complications and/or the animal does not respond to treatment.
OR
4. decline the actions recommended by the veterinary practitioner or choose an alternative action (if the animal’s wellbeing will not be negatively impacted). Alternative actions an animal’s owner could decide on include: consulting another veterinary practitioner for a second opinion or asking for a referral to another veterinary practitioner, e.g., a specialist.

Consent is an animal owner’s agreement for a veterinary practitioner to provide veterinary services, including any tests, medicines, treatments or procedures. Consent is informed consent if the animal’s owner has received clear and sufficient information about their choices in relation to their animal’s health and treatment before they give their consent to treatment or a service. Informed consent is successful when the animal’s owner indicates they understand the information they have been given and confirm this verbally or in writing (Definitions, these Guidelines).

Financial consent is an animal owner’s agreement to the cost of veterinary services to be provided by a veterinary practitioner/practice. Financial consent is informed financial consent if the animal’s owner has received clear and sufficient information about the cost of a veterinary service, preferably in writing, before the service is provided. Informed financial consent is successful when the animal’s owner indicates they understand the information they have been given and confirm this verbally or in writing (Definitions, these Guidelines).

Yes, a veterinary practitioner is expected to obtain both informed consent and informed financial consent from an animal’s owner or their designated representative before providing veterinary services to an animal (Guidelines 4.7 and 4.8).

Obtaining consent in writing is preferable though not always possible. Keep signed consent documentation and note any conversations with the animal’s owner in practice records before treatment begins (Guideline 4.8). A consent form should include:

• the name and contact details of the owner (or their delegate), including details of their availability during the treatment period
• a clear description of the animal
• the details of the owner’s designated representative, including the representative’s signature
• a clear description of the treatment/procedure to be undertaken
• a statement of the risks involved and the owner’s acceptance of these risks
• an estimate of the costs to deliver the chosen treatment/management plan
• the owner’s signature.

(Context, Guideline 4)

A veterinary practitioner should provide an animal’s owner with updates on treatment and costs (Guideline 4.9). The veterinary practitioner or their staff should contact the animal’s owner and obtain their consent and financial consent before proceeding with additional treatment.

Before beginning treatment, veterinary practitioners should also consider and discuss the potential need for additional services with an animal’s owner. For example, sometimes emergency procedures may need to be performed during a surgery. Veterinary practitioners should explain this to the animal’s owner, tell them the costs of any additional services and obtain the owner’s consent and financial consent before the treatment. Some practices have consent forms which include the potential need for additional services and their estimated cost. If you have further questions about the content of such forms, consult your indemnity insurer or legal practitioner for advice.

The rules about advertising of veterinary services are in Section 59 of the Veterinary Practice Act 1997. The Act says a person must not advertise a veterinary practice or veterinary services in a manner:

• which is false
• which is misleading
• that is deceptive
• which is intended to be false, misleading or deceptive
• that offers a discount, gift or other inducement to attract persons to a veterinary practitioner or veterinary practice unless the advertisement also sets out the terms and conditions of that offer
• that unfavourably contrasts veterinary services provided by a veterinary practitioner or veterinary practice with services provided by another veterinary practitioner or veterinary practice

As veterinary practitioners provide goods and services, they must also comply with their obligations under the Australian Consumer Law and the Consumer Law and Fair Trading Act 2012 (VIC). More information:

• Advertising and selling, Australian Competition and Consumer Commission (ACCC)
• Avoiding unfair business practices – a guide for businesses and legal practitioners, Commonwealth of Australia

Yes, a veterinary practitioner can use a testimonial to advertise their business. However, as testimonials are a type of advertising, veterinary practitioners should check the content of testimonials against the advertising requirements in the Veterinary Practice Act 1997  (VPA) - see FAQ above. For example, a veterinary practitioner should not publish a testimonial which unfavourably contrasts veterinary services provided by a veterinary practitioner or veterinary practice with services provided by another veterinary practitioner or veterinary practice (section 59(1E) VPA).

A veterinary practice effectively communicates the normal business hours during which it offers veterinary services (Guideline 16.1).

Individually, a veterinary practitioner effectively communicates to an owner the hours they provide veterinary services, whether or not there is an established veterinary practitioner-owner-animal (VOA) relationship (Guideline 16.3).

The Board also expects that at the time a VOA relationship is established, the practitioner clearly communicates the availability and extent of veterinary services they provide outside of business hours (Context of Guideline 16). A veterinary practitioner is expected to provide information on where and how to obtain veterinary services outside normal business hours (Guideline 16.2).

Sometimes a veterinary practice will not have a suitably qualified veterinary practitioner, or any vet at all, at their practice at all the times it advertises the availability of services.

If a veterinary practice is unable to deliver veterinary services during advertised hours (including business hours), it would be appropriate to communicate any changed circumstances to animal owners.

Ways to communicate any changes to the veterinary services normally delivered include:

• contacting existing clients to advise a veterinary practitioner's changed services and/or hours
• changing signage on doors and inside the workplace
• changing online messaging on the practice’s website and social media pages, and
• changing the practice’s phone/hold messages.

Communications to animal owners could include:

• the availability and extent of services that can be provided by a veterinary practitioner
• any changes to hours during which veterinary services are available
• which services cannot be provided or may no longer be able to be provided by a veterinary practitioner
• encouraging the animal’s owner to plan for their animal’s care when a veterinary practitioner cannot deliver veterinary services. Offer them reasonable assistance to make those plans. Plans can include caring for an animal at home and/or in an emergency, or referring to another veterinary practitioner. Before any referral, it may be useful to check the hours and capacity of other veterinary services in the area. If they are closed at the same times or cannot take referrals it may not be appropriate to refer to them.
• if a practice provides emergency veterinary services, any limitations or conditions to the emergency veterinary services you offer, so animal owners understand the scope or availability of services (Guideline 17.3). It may not be appropriate to advertise emergency veterinary services if they cannot be provided (Guideline 17.1).

For their part, animal owners have a responsibility to:

• know the normal business hours of the veterinary practice/s they routinely attend
• know the conditions under which veterinary services would be available outside of normal business hours, and
• plan for providing or obtaining care for their animal outside of normal business hours. This may include caring for their animal at home where referral to another veterinary facility and/or hospitalisation is not an option. More information: planning for pets in emergencies, Agriculture Victoria.
  (Context, Guideline 16)

Adverse events may occur when an animal is under a veterinary practitioner’s care. These events may range from an adverse reaction to medication, an injury to (or release of) an animal while in the clinic, complications after treatment including surgery, or the unexpected death of an animal. Sometimes a veterinary practitioner themselves can be injured when providing veterinary services.

Adverse events can be challenging and stressful for both the animal’s owner and the treating veterinary practitioner and their team, so clear and effective communication is crucial at these times. The owner and veterinary practitioner share responsibility to communicate with honesty, respect and openness (Context, Guideline 4). The focus of interactions should be on collaborating to resolve any issues rather than on any perceived shortcomings in the animal’s care or treatment (Context, Guideline 18).

A veterinary practitioner should also consider communicating with their professional insurance provider who may offer additional advice and support in these circumstances. It should be noted that the Board does not consider a veterinary practitioner's offer of sympathy or sorrow (e.g, saying “I’m sorry”) to be an admission of unprofessional conduct or liability.

Under Guideline 4.12, when an unexpected adverse event occurs during the provision of veterinary services, a veterinary practitioner should tell the owner:

1. what happened
2. any actions taken to rectify the event when it occurred
3. the likely short- and long-term consequences of the event
4. the availability of post-mortem examination
5. the relevant authority of an adverse event involving the use, supply or administration of medicines.
   As an example, the relevant authority could be the Australian Pesticides & Veterinary Medicines Authority (Adverse Experience Reporting Program)

If a veterinary practitioner is injured while providing veterinary services to an animal, they should seek treatment following their workplace’s health and safety protocols and report any reportable incident to appropriate agencies, e.g., dangerous dogs can be reported to the local council.

If a complaint is made to the Board about the event and there is an investigation, the veterinary practitioner should also provide the facts of the adverse event and actions following the event (Guideline 4.12).

In relation to post-mortem examination, if an animal dies unexpectedly it is appropriate for the veterinary practitioner to tell an animal’s owner that a post-mortem examination/necropsy can be performed to try to find out why the animal died. The results of a necropsy can help to provide transparency for an animal’s owner, the veterinary practitioner who treated the animal, and the Board (if a complaint is lodged about a matter).

Veterinary practitioners should offer to arrange for referral to another veterinary practitioner to undertake the necropsy. Ideally the other veterinary practitioner would be independent from the current practice. If an independent veterinary practitioner cannot be found to undertake a necropsy, the animal’s owner would need to give their informed consent to any necropsy being undertaken by the treating veterinary practitioner.

It is also important to communicate the costs of a necropsy to an animal’s owner. They would be expected to give their informed financial consent to a necropsy before it was undertaken.

It is an offence to abandon a dog or cat (section 33, Domestic Animals Act 1994).

If an owner does not collect their animal from a veterinary practice after veterinary services have been delivered, the practice should take all reasonable steps to contact the owner, e.g., by mail, email and phone.

If the owner does not respond within a reasonable amount of time, the veterinary practice must deliver the animal to a local council officer/pound/shelter or to a person or body which has an agreement with the local council to keep or re-home animals (s84D, Prevention of Cruelty to Animals (POCTA) Act 1986). The council animal shelter or pound must accept surrendered animals (s33A, POCTA Act).

Information about responding to complaints is widely available.

A business should have a complaints handling policy. Some of the principles in that policy might include self awareness, respectful treatment, good communication, taking ownership, responsiveness, timeliness, transparency, handling of information and accessibility.

A business should have a complaint handling procedure. Often complaints can be resolved immediately; some after investigation. All complaint resolution involves some or all of the following steps:

• Recognise and log the complaint. Recording all complaints in the same place means you can identify recurring and systemic issues.
• Acknowledge receipt of the complaint and, if it cannot be resolved immediately, schedule some time to address the concern, and give the animal's owner a timeframe for the response.
• Assess and triage – What’s the core issue? Who should handle the complaint?
• Investigate – What is the animal owner's preferred resolution (ask, don't assume). Who’s involved? Get all the facts. You might need extra veterinary technical or regulatory information. Put it all together in order so you can reflect on it.
• Reflect on the complaint and develop a potential resolution. What is fair and reasonable in the circumstances?
• Discuss the complaint with the animal’s owner – in person, over the phone or in writing. Where possible and safe, an in-person discussion is preferable to allow for transparency, accountability and trust building. Allow the animal's owner to describe their experience, recognising the importance of active, reflective listening. Check your understanding by summarising the owner's issues of concern and the emotions they are experiencing. For example, 'I hear that you're feeling (very sad) because (you've lost your best friend), you're (frustrated) because (you don't understand why Buster died) and you're (questioning) whether anything could have been done differently to change this sad outcome). Have I understood correctly?' Use this information to guide your suggestions and actions.
• Offer any explanations or possible resolutions, and provide reasons for your proposed resolution(s).
• Consider the animal owner’s thoughts and reactions to your response and proposal. If you’re speaking to them, listen to their comments carefully. Is what they are saying fair and reasonable? Be prepared to change your proposed resolution based on information the owner provides.
• Reach a resolution or outcome, either by mutual agreement, by escalating to someone else then reaching agreement, or without reaching agreement.
• Implement the resolution or outcome. Act quickly and keep promises.
• Document the resolution or outcome. Follow up in writing to the animal’s owner (making sure to include any actions if they have agreed to do). Summarise discussions and the outcome in the veterinary medical record
• Provide feedback to the practice or act on any systemic issues.

Veterinary practitioners should remember that complaints provide a helpful opportunity for reflection, learning and growth for everyone involved. Responding constructively to complaints and concerns is an important part of being professional.

More information:

• Complaint handling, Consumer Affairs Victoria
• Tips to help you resolve a dispute before mediation, Small business and family enterprise ombudsman
• Thrive (if you or your employer has access to this Australian Veterinary Association initiative it includes a resource on managing conflict)

Managing behaviours

It is natural for people to be upset when their pet has been ill or has died, so an animal’s owner may express strong emotions when raising or discussing a complaint. Veterinary practitioners obtain the competencies to respond to such behaviours while training for their veterinary qualification and through continuous professional development activities.

Veterinary practitioners and team members may also be emotionally affected by aspects of their work, for example if they experience an unwanted outcome or are the subject of a complaint. Subsequent communications and resolution of complaints can be assisted by self-awareness, social and emotional intelligence and supportive work systems.

The focus of complaint resolution should be on collaborating to resolve any issues rather than on any perceived shortcomings in the animal’s care or treatment (Context Guideline 18). Both the veterinary practitioner and the animal’s owner share responsibility to communicate with honesty, respect and openness (Context Guideline 1).

To perform at their best, including being able to learn from and resolve conflict, veterinary teams need a physically and psychologically safe work environment (context VPRBV Guideline 8). Sometimes, an animal owner's behaviour can be vexatious, unreasonable or dangerous. Any assault or attempted assault should be reported to the police. The following guides may help a veterinary practitioner to handle vexatious or unreasonable behaviour:

• Managing complex complainant behaviour, Victorian Ombudsman
• Managing conflict, Australian Veterinary Association

Veterinary practitioners can decide to terminate a veterinary practitioner-owner-animal (VOA) relationship and stop providing veterinary services.

Think before acting

Because a decision to terminate a VOA relationship may affect the wellbeing of an animal, it may help to wait before making the decision and carefully consider the circumstances and possible alternatives to termination.

Factors to consider include:

• Was the behaviour soon after a complaint event? Do you want to terminate the VOA relationship because the animal's owner has questioned the treatment of their animal or made a complaint to you?
• Was the behaviour one-off or is it regular?
• Who was the behaviour directed at? Were there any unrelated factors that might have influenced the way the behaviour was received by the person to whom it was directed?
• Have you explained to the owner the effect of their behaviour on you or clinic staff? Have you asked them to stop the behaviour? Have you told them you are thinking of terminating the relationship with them if the behaviour does not stop?
• Were clinic staff very afraid or assaulted during the event? A veterinary practice should activate its security protocols when events of this type occur, and the event should be reported to the police.

While the Board has no expectations, the following alternatives to terminating the VOA relationship may be appropriate to consider, depending on the context:

• Could you provide training and support in managing and redirecting difficult behaviour to the person in your team who experienced the behaviours?
  More information:
• Managing complex complainant behaviour, Victorian Ombudsman
• Thrive (if you or your employer has access to this Australian Veterinary Association initiative it includes a resource on managing conflict)
• Could another team member sign the animal’s owner into the clinic or treat the animal?
• Could the animal be treated outside the clinic or by itself in the clinic without the owner being present?
• Would you treat the animal if there was an agreement for the owner’s designated representative to bring the animal to consultations instead of the owner?
• If the animal owner cannot pay their bill immediately, would you agree to payment through a payment plan if the animal’s owner provided a trusted guarantor?

Written notice required

If after considering all factors and alternatives to termination, a veterinary practitioner decides they still want to terminate the VOA relationship, they should inform the owner in writing that the relationship is terminated. The veterinary practitioner should keep a written record that they will no longer be providing veterinary services to the owner (Guideline 1.5). The veterinary practice should check it has removed the animal’s owner from reminders and marketing lists: it would be confusing for a person to receive vaccination reminders and other communications after receiving a termination notice.

A veterinary practitioner does not have to provide a reason for terminating a VOA relationship in a written termination notice. If a reason is provided, it is advisable to consider the effect of any statement on the animal’s owner. Veterinary practitioners may wish to consult their indemnity insurer, legal practitioner or the Australian Veterinary Association about the content of a letter terminating a VOA relationship.

This material is current only at the time of publication and may be changed from time to time. The Board reviews and updates the Guidelines on a continuous basis to reflect changes in the science and knowledge base underpinning contemporary veterinary practice. The Board will take reasonable steps to inform the veterinary profession when such updates are released but it remains the responsibility of the individual veterinary practitioner to ensure that their knowledge and application of these Guidelines to their own practice is current.

While the Board has made every effort to ensure that the material in these Guidelines is correct in law, it shall not be liable to any veterinary practitioner or any other person or entity in relation to any claim, action or proceeding whatsoever (whether in contract, negligence or other tort or in proceedings seeking any other form of legal or equitable remedy or relief) for any inadequacy, error or mistake, or for any deficiency in the whole or any part of this document (including any updates incorporated in the document from time to time). A veterinary practitioner or any other person or entity acting upon the contents of this document acknowledges and accepts that this is the basis upon which the Board has produced these Guidelines and made them available to such person or entity.