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A Professional's Responsibility

People get mad at me sometimes. They usually take it out on my staff. I’m a people pleaser by nature, and I like nothing better than to say “Yes!” Unfortunately, that mean ol’ gub’mint won’t let me.

It started when I became a veterinarian. Mere years of training and a doctoral degree aren’t enough: the gub’mint made me get a license before it let me care for animals. A license to practice is a privilege, not a right, and it comes with a long, long list of responsibilities. In order to be allowed to do things, the law requires me to do them correctly, and that applies to even the simplest things. It’s so annoying.

It starts like this: Noah Dia calls my office to complain that his dog UnCorky is unable to do his business. “UnCorky just keeps straining and straining,” Noah tells my technician, “and nothing comes out. Can the doctor prescribe some laxative for him?”

My technician passes the request on to me and the law requires me to say “No.” I have to examine UnCorky before I can make a prescription.

But Noah doesn’t like it. “Well, why not?” he demands of my poor technician. “Doesn’t the doctor care that UnCorky is UnComfortable? He just wants to charge me more money!” Pity my poor technicians as they try to explain that the law doesn’t allow me to hand out prescriptions like political leaflets. Some people will argue about this kind of thing for hours, not that it does them any good. It certainly doesn’t help my technicians.

And it’s all the gub’mint’s fault: When they made me a licensed professional, they saddled me with all kinds of laws and responsibilities and obligations. It’s so annoying.

What Noah is seeing is called “tenesmus,” a clinical sign in which the patient perceives a constant need to pass stools. In fact, most animals with tenesmus have no stool to pass. We usually see tenesmus as a result of colitis or diarrhea, both of which may be life threatening.

The problem is rooted in the fact that people do not call and describe what they SEE: they describe their INTERPRETATION of what they see. An experienced doctor knows better than to take these reports at face value.

Now, if Noah’s ‘knowledgeable’ neighbor, Edie Ott provides him with medication (“This worked great on my old horse ThunderBat, just before he died!”) to fix UnCorky’s ‘constipation,’ all heck will break loose. It’s even possible that electrolyte depletion caused by diarrhea (and made worse by medication) will result in UnCorky’s death. If the worse should happen, Noah has no one to blame but himself. Noah, not the neighbor, is responsible for his decision to rely upon advice and inappropriate medication obtained from an Edie Ott.

The law holds professionals to a higher standard. When we give advice, we are legally responsible for the outcome. The law doesn’t require we be perfect in our judgments, but in all cases to exercise a superior level of care when making recommendations, particularly when it comes to dispensing prescription medication. These drugs can be dangerous. It doesn’t matter that UnCorky has taken the medication before or that your previous veterinarian prescribed it or that it’s just a refill or he’s been taking it for years.

If a licensed veterinarian makes a prescription because he accepted unreliable information (such as Noah’s assurance), that’s negligence. If an ineffective or adverse response occurs and the animal is injured or dies, it’s malpractice. Noah will have been legally and financially injured and the professional is responsible for damages - and subject to professional discipline.

What’s the worst that could happen? Professional discipline can result in suspension or loss of the veterinarian’s license to practice: complete and permanent loss of their ability to make a living, pay their rent, and feed their family.

The State of California recently tightened its regulations, making it illegal for a veterinarian’s prescription to remain valid for more than one year. To refill such a prescription, some sort of examination is required by law. This law exists for Noah and UnCorky’s protection. It’s so annoying, but it’s NOT negotiable.

We explained all this to Noah, and he gets it. Now if only we could get through to Stu Pidazo…

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