A Veterinarian's Oath — Dr. Hartfield

When I became a veterinarian, I agreed, in fact took an oath, to abide by a standard of ethical principles created to ensure veterinarians provide the best and safest care for the animals we’ve spent years learning to treat.

I take these principles very seriously, not just because I want to be a good veterinarian, but because I want to continue practicing veterinary medicine and not adhering to these ethical principles would put my license in jeopardy.

Occasionally, I have a client make a request that goes against these ethical standards and I have to explain why I can’t honor their request, but how we can follow the correct protocol and get to the same result. With an explanation, most every client understands and is agreeable.

However, and unfortunately, that’s not always the case.

Recently, a regular client, we’ll call him Mr. Cow-Man, came into the clinic and was greeted by one of our fabulous technicians. We’ve seen Mr. Cow-Man’s dogs, cats and even horses. Most of his animals were brought in for routine things, like vaccinations and flea/tick pills. But on this particular visit, Mr. Cow-Man wanted some antibiotics to keep on hand just in case his calves get sick. This sounds very reasonable.

Can anyone spot the problem?

Even though Mr. Cow-Man is not a stranger to the clinic, neither veterinarian on staff has examined his cattle. While there may be a client-veterinarian relationship, there’s no veterinarian-patient relationship.

The following is from the American Veterinary Medical Association:

According to the AVMA Principles of Veterinary Medical Ethics, it is unethical for a veterinarian to write a prescription or dispense a prescription drug, or provide other veterinary treatment, outside a Veterinarian-Client-Patient Relationship (VCPR). The AVMA Principles state that the VCPR is the basis for interaction among veterinarians, their clients, and their patients and requires all of the following for a VCPR to exist:

The veterinarian has assumed the responsibility for making clinical judgments regarding the health of the patient and the client has agreed to follow the veterinarians' instructions.
The veterinarian has sufficient knowledge of the patient to initiate at least a general or preliminary diagnosis of the medical condition of the patient. This means that the veterinarian is personally acquainted with the keeping and care of the patient by virtue of a timely examination of the patient by the veterinarian, or medically appropriate and timely visits by the veterinarian to the operation where the patient is managed.
The veterinarian provides oversight of treatment, compliance, and outcome.
Patient records are maintained.

As the veterinarian on site that day, I politely explained to him that I would love to give him what he needed, but I have to examine his cattle and get more information about his herd to establish the Veterinary-Patient-Client-Relationship required for me to prescribe medication. Once we have that relationship it would be no problem to get him the medication he needs for his herd.

It was clear that was not what Mr. Cow-Man wanted to hear, but he seemed to understand.

Unfortunately, Mr. Cow-Man didn’t understand and did not care to establish a Veterinary-Patient-Client-Relationship. Instead, he turned it into a very negative situation denouncing our clinic as a place just trying to get more money out of our clients.

Now I know what other people say about me is none of my business, but I’m sharing this story because A.) I want clients to know we really are only trying to work in the best interest of your animals and B.) to let aspiring veterinarians know this happens, but it should never stop them from following the ethical code.

It’s easy as a young veterinarian to get upset and angry with clients because of situations like this.

While his words about me to others were hurtful, this situation actually makes me really sad. I love helping my clients and helping them get what they need to correctly and responsibly take care of their animals. I offered a very simple solution to Mr. Cow-Man’s problem, but it wasn’t what he wanted to hear. Despite what Mr. Cow-Man and others may think, we aren’t withholding medication or treatment because we want to take your money or we think you don’t know what you are doing, it is actually because it is the law. Believe me, I know most of the cattlemen and cattlewomen know way more about herd management than I do!

It’s the same principle any medical professional follows – an ethical doctor would never prescribe medication to a patient they’ve never seen. If I choose not to abide by these rules/guidelines/laws I earn the risk of losing my license that took me many years to obtain. What also makes me sad is that someone would want to put me in that position.

One thing that I love to do is teach. I like to explain to my clients why I am running blood work or why I need those x-rays. To me, this helps to validate what their animal needs, helps me get a diagnosis and makes the client feel comfortable about what we are doing. Explaining “why” we are doing what we are doing is very important to me. Most of the time people/clients just don’t know “why” we are telling them “no” to something. If you take the time to explain the “why,” you will usually have a much better outcome.

Unfortunately, I will have more Mr. Cow-Mans that choose to not care about the “why”, but at least I know that I did the right thing. The Oklahoma Board of Veterinary medicine will also be proud of me. :)

A few pointers for aspiring veterinarians or new veterinarians:

Don’t let the Mr. Cow-Mans get to you.
Be nice.
Explain why you need to see their animals or why you are prescribing something, etc.
Be proud of yourself for not caving into a client’s peer pressure.
It’s law. Don’t give in and risk losing what you worked so hard to obtain.

A few pointers for the Mr. Cow-Mans:

Veterinarians are just doing their jobs.
Most veterinarians want to do whatever they can legally to help you.
Be nice. :)
Take a moment to listen to the “whys” before getting upset.
We know that most of you are very knowledgeable, but we still have to build that relationship.