Case study: Falling short of professional standards

background a dog was taken to a veterinary clinic with symptoms including pain, bloating and diarrhoea the dog’s owner told the veterinarian that it had a history of pancreatitis and asked for a test to be done, as the symptoms were similar to previous occasions following an x ray, where only a lateral view was captured, the dog was admitted to hospital over the weekend and placed on a drip the veterinarian thought the dog had gorged itself on the monday, a different veterinarian at the clinic performed a blood test and confirmed a tentative diagnosis of pancreatitis the dog was discharged later that week, and its owner took it to a different clinic there, an ultrasound was performed which confirmed pancreatitis and the dog was hospitalised again for intensive treatment the complaint the dog’s owner made a complaint to the vet council about the first veterinarian that saw the dog, which was sent to the complaints assessment committee (cac) the cac is a preliminary screening body that decides what should happen next with a complaint the cac can conduct a formal investigation and decide what steps, if any, need to be taken to ensure the veterinarian is fit to practise and public interest is protected the owner complained about the standard of the veterinarian’s clinical record keeping there were no hospital charts, record of the dog’s condition, weight or temperature, and no record of any medications being administered over the weekend the owner also complained that the veterinarian did not perform any diagnostics, aside from the one radiograph, and no pain relief was provided what do the professional standards say? the code requires all veterinarians to keep clear and accurate clinical records the clinical records must contain enough detail so that another veterinarian could take over a case at any time the guiding principle of the veterinary services part of the code is that veterinarians must deliver evidence based veterinary services of a high standard the services must meet the needs of their clients and the welfare of animals under their care they must also ensure their clients’ animals have access to emergency care competency standard 7 https //hub vetcouncil org nz/competency standards and performance indicators for veterinarians deals with effective communication and says veterinarians must provide clear and accurate explanations of findings, treatment options and likely outcomes in easily understood language, and also confirm the client understands the information provided how it was managed when reviewing a complaint, the cac measures the veterinarian’s conduct against the standard that is expected in similar circumstances and refers to professional standards in this case, the cac felt the clinical records did not meet the expected standards as there was not enough information for another veterinarian to take over the case the veterinarian could not provide any record of medication being administered, although the client was invoiced for it the cac considered that if there was a suspicion of pancreatitis, this approach would fall short of expected standards the cac also considered that the quality of care provided was of a poor standard no blood or diagnostic testing was performed over the weekend, even though this was requested by the client the cac was concerned about this, especially as the owner reported the dog had a history of pancreatitis the radiograph taken by the veterinarian was of poor quality, and only a lateral view was captured the cac felt it was unacceptable to make a definitive clinical judgment on only one view the radiograph also had no identification, date, or time recorded on it the cac recommended that the vet council conduct a competency assessment on the veterinarian what is a competency assessment? a competency assessment is carried out by a small team, including two veterinarians and a layperson it normally includes a day long visit to the veterinarian’s place of work, where the team can gather information the aim of the assessment is to evaluate the veterinarian’s competence to determine if they are practising at the required standard it is wide ranging and looks more generally into a veterinarian’s practise, rather than just the issues raised in the complaint the council and the veterinarian agree on terms of reference for the assessment before it begins the process is not disciplinary in nature and is designed to be evaluative, educational, and rehabilitative learnings for the profession it is essential for all veterinarians to ensure their record keeping is of a standard where another veterinarian could take over the case if needed it is also critical to understand an animal’s vital information, any medication that has been administered, and diagnostics veterinarians must also consider the history of a patient when developing a diagnosis more information about professional standards and the code of professional conduct can be found on the hub https //hub vetcouncil org nz/