When things go wrong
Julie had been covering for a colleague all morning and was about to finish her run of consults 10 minutes late. No time for that lovely chocolate croissant until the giant Dogue de Bordeaux in the waiting room was seen. The owner was an old client for the practice and started by noticing that Julie was new. She gently nodded and explained she was covering for a colleague that wasn’t feeling well, proceeding to examine the gentle giant. After a chit chat and a thorough examination of the not so bouncy dog, Julie explained her concerns that, among other things, her patient could have ingested foreign material that was now stuck and causing an obstruction. Highlighting the fact that such might need surgical correction, Julie got consent to admit the patient and go ahead with some investigations. She said goodbye to the owner, promising a phone call when she had some answers.
With some persuasion, ginger giant was brought through the back and it didn’t take long for Julie to confirm her fears – something large seemed to be looming inside her patient’s tummy on the x-ray and gave her enough evidence to want to do surgery. Missing her croissant, she called the owner explaining what she had found and that she recommended surgery to remove whatever ginger giant had ingested. The owner agreed and off Julie went to start surgery. A surgery that turned out to be quite long (there goes her lunch salad now…) but resulted in a lovely disgusting pile of material that was reminiscent of a dog toy. Or something made of plastic. Julie finished surgery and started afternoon appointments while ginger giant recovered under the watchful eye of the duty nurse.
Ginger boy, however, was slow to wake up, so when the owner came down to pick him up in the evening, he was a bit surprised to see his gentle giant so flat. But Julie had noticed the slow recovery and she had arranged for their local OOH provider to look after ginger giant overnight, explaining to the owner that, since he had recovered so slowly from surgery, she would prefer that he was monitored overnight. Seemingly upset for now having to travel with a very sleepy ginger giant to the other practice, the owner managed to put his much-beloved dog in the back seat of his car (clearly not large enough for ginger giant), nonetheless needing the help of a large trolley and three nurses. Off to the big hospital he went. Some consults and calls to catch up after, Julie also finished her shift and grabbed a bit of her missed lunch salad.
It was much to her surprise that she received a call first thing in the morning the following day from the OOH hospital. They were calling her to say that gentle giant had arrived collapsed and, despite their efforts, had passed away shortly after. And the owner was not impressed.
Well, believe it or not, Julie is in a bit of trouble if this owner decided to complain (even though they are fictional characters). Julie failed to explain this owner the potential risks, implications and expectations of the surgery. The owner might not have felt that he gave informed consent for such procedure. And he might also have felt that his dog was not in good condition for transport. And, of course, if the animal is not fit for transport, then he should not be transported. A decision, though, that Julie did not take.
This is one of millions of possible scenarios, where teeny tiny things that we as vets omit or fail to explain or fail to record that we did, that can bring headaches and stress to our already high-pressure daily life. Sometimes, they are meaningless and clearly a problem in the communication. Other times, however, they are severe enough that vets are investigated and may be liable for compensating the owner.
This is why professional indemnity insurance for Veterinary Surgeons is a must. This type of insurance “will compensate the client for a negligent act or omission by the professional”, as stated in the RCVS code of conduct, and also applies to veterinary nurses. What happens in most places that you work is that the practice will have insurance that might cover all practising members in the premises. Most of the times it’s part of the package. However, you should always ask about professional indemnity insurance during a job interview. If they don’t provide it, you should get it yourself!
There are other situations, for instance, if you are a locum vet, in which you might be protected against something that happens in the practice, but you might not be covered if a concern or complaint is raised against your person (for instance, if someone accuses you of being disrespectful or aggressive). In a case like this, especially if you do a lot of locum work, you probably want to get your own cover.
VDS, The Veterinary Defence Society, is one of the most common providers for this cover as they have a lot of veterinary backup (it’s not just like another bank that provides insurance). They provide cover for practices, members of the practice, but also for “businesses”, like locum vets that are set up as sole traders or limited companies, and even individuals. They offer advice and support in cases where a client has threatened to file a complaint and, quite frankly, provide a lot of support to vets that do need to go through the process of being investigated and against whom complaints have been raised. And they have newsletters with cases similar to the one that I made up that they try really hard to make interesting for us to read so that we better understand the benefits of this type of cover. The implications of not having such cover could be particularly significant if the client ends up having the right for compensation – the vet would then need to pay for that compensation, which, if substantial, could pretty much ruin the personal finances of said vet! So, when you start working, you should definitely make sure that you have some sort of professional indemnity insurance or, if you are a locum, you should get it yourself and claim it as a business/professional expense.