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Veterinarian Technician March 2007 (Vol 28, No 3) Focus: Emerging Infectious Diseases

A Question of Conscience: "Close to Home"

    You recently overheard the new part-time veterinarian tell a client that she should bring her cat to the other clinic where she works because that clinic is much closer to the client's home. When you are alone in the examination room with the client, she asks you what she should do. How do you respond?

    I would tell the client that geographic proximity should not be the sole reason to choose a veterinarian. The decision should be based on the experiences the owner has with a particular doctor and his or her staff. In a well-run clinic, client and patient comfort should be a priority, as well as cleanliness of the hospital and the overall health of the patient. I would tell the client that I hope our clinic exceeds her expectations and that we strive to meet her needs as well as those of her pet. Then, the practice owner should be made aware that the part-time veterinarian is soliciting business for her other clinic.

    Anonymous

    It is the job of the veterinarian to provide the client with all the options available for treatment of her pet. Even if we assume that the client has financial concerns, we are not supposed to limit the treatment options to the cheapest ones. If the closer clinic provides a service that the original clinic does not, then the client should have the option of choosing the other clinic. Other than that, the veterinarian should not be suggesting that clients go elsewhere.

    Anonymous

    I think it is very unprofessional of the part-time veterinarian to suggest her other clinic unless the client specifically asked. I would tell the client to do as she feels comfortable. If she would prefer to go to the other clinic, I would support that. But I would make sure that the client understands that she does not have to switch clinics if she does not want to.

    Kim, LVT

    I would tell the client, "I cannot tell you what to do, but if it were me, I would ask myself, 'Am I satisfied with the service at this clinic, or do I need more than what this clinic has to offer?'"

    Paula

    If the client was an older person and going to a clinic that is closer to her home would be easier for her, I would support the client going to the other clinic. However, if the part-time veterinarian made the suggestion just to bring more business to her other clinic, I would probably discuss what I overheard with either the head veterinary technician or the office manager.

    Deb

    I would suggest that the client go wherever she feels comfortable. Her decision should be based on what fits her schedule, which specific veterinarian she trusts, and what type of care her pet requires. It shouldn't be about one clinic stealing clients from another clinic.

    At my work, we do send clients to other clinics if it is more convenient for them. If we don't have a particular food they want, we tell them where to get it. We will call prescriptions in to a closer clinic if they want. We will also send clients elsewhere if another clinic has a better ultrasound machine or if we know that one of its veterinarians is an expert in a certain disease or surgical procedure. The clients are very appreciative because they see we are truly concerned with their pets' health, not in making money from their illnesses. I don't think we've ever lost clients because we referred them elsewhere. It's nice to work with this level of professional cooperation rather than competition.

    Katherine, CVT

    Our Ethics Expert Comments

    This scenario raises the issue of how to define the nature of the relationship among professionals in the same field. Are they colleagues or competitors? Evidence suggests that professions have wrestled with this question throughout history. From the Hippocratic Oath1 to modern day codes of conduct, including the Principles of Veterinary Medical Ethics of the AVMA,2 the written histories of all professions contain language regarding the etiquette that allows them to collaborate in the best interests of clients, yet retain their client base.

    Even the law is contradictory on this issue. By granting a license, the state bestows a monopoly to professionals on the delivery of a service to clients, yet enactment of the 1890 Sherman Antitrust Act made it illegal for any business to attempt to restrict free trade.3

    Whether referring a client to a specialist or merely answering the question posed by the client in this scenario, veterinary medicine professionals, as stakeholders, have an obligation to decide where the best interests of the profession lie. Is it in the best interest of a practice to keep a client at all costs, including actively discouraging that client from going elsewhere? Is it possible to discourage the client from taking her business elsewhere without disparaging the other practice, since denigration for no purpose except to influence choice would be unethical? Conversely, by encouraging a client to exercise her legal and moral rights to choose a veterinarian, does the practice not motivate itself to continue to strive for excellence, which will benefit the client, the practice, and the profession as a whole?

    The new veterinarian must also consider her best interests. Her contract may have a noncompete clause that would expressly prohibit her from competing with the practice where this scenario occurs. Is her behavior defined as unethical in breaching that contract, or as defined by the Sherman Antitrust Act, is that clause in her contract illegal?

    Nadine Hackman, MS, VMD, MBE

    (Master's in Bioethics)

    Director, Veterinary Technology Program

    Harcum College, Bryn Mawr, PA

    1. Lammers SE, Verhey, A (eds): On Moral Medicine: Theological Perspective in Medical Ethics, ed 2. Grand Rapids, MI, Eerdmans Publishing Company, 1989, p 72.

    2. AVMA: Principles of Veterinary Medical Ethics of the AVMA. Accessed January 2007 at www.avma.org/issues/policy/ethics.asp.

    3. Wilson JF, Garbe JL: Law and Ethics of the Veterinary Profession. Yardley, PA, Priority Press Ltd, 1993, pp 176-181.

    References »

    NEXT: Bovine Spongiform Encephalopathy Overview

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