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Dr. Coates is a veterinarian based in the other “Sunshine State” – that's Colorado to the rest of you – where she lives and plays with a varied range of animals. She shares her professional and personal experiences, Monday through Friday, here on petMD's blog, the Fully Vetted. Log in for your daily dose of her insight and wisdom.

 

Standard of Care - What Does it Mean?

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September 20, 2012 / (7) comments


Last week I mentioned the term "standard of care" in my post about urinary tract infections (UTI) in dogs. After I submitted it, I got to thinking, “Will everyone know what a standard of care is?” It’s not as straightforward as you might think.

There is no universally accepted definition for "standard of care," but this one is pretty typical:

 

…the standard of care required of and practiced by the average, reasonably prudent, competent veterinarian in the community

 

The Animal Legal and Historical Society cites Dyess v. Caraway, as the origin of that phraseology.

 

When I talk to owners, I get the feeling that most look at "standard of care" as meaning something more akin to "the best care" or "care that is supported by the latest research," and I’m afraid I used this more colloquial definition in last week’s post. But in legalese, the term obviously means something quite different.

To get a feel for what a standard of care is, you would have to ask a large number of veterinarians how they treat a specific condition. Next, you should throw out any whacky answers that fall far outside of the norm and then take the most frequently mentioned response out of those that remain as your answer.

But that’s not the end of it. As Dyess v. Caraway says, a standard of care is community specific. So, if you’re interested in the standard of care in New York City, you have to look at what’s being done in NYC versus what’s normal for Gladstone, MI (no offense to the "yoopers" out there, my husband is one and I can’t help but poke fun).

Determining whether or not a pet has received the standard of care is most important when allegations of malpractice arise. I’ve heard owners complain that their veterinarians failed to maintain an adequate standard of care when they did not recommend what I would consider to be a cutting edge procedure or treatment. While this is unacceptable from a communications point of view (owners should always be aware of all their options), not performing a kidney transplant on a cat in renal failure, for example, does not breach the standard of care in any part of the country.

As my lawyer cousin is fond of stating, from a legal point of view you only have a right to C+ work. Of course, we were talking about home maintenance projects, not veterinary care. I certainly hope that all of you have sought out and found veterinarians who perform A level work. Just know that they are practicing medicine well above the standard of care.

 

 

Dr. Jennifer Coates

 

 

Image: Byelikova Oksana / via Shutterstock

 

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COMMENTS (7)
1
by hwylo on 09/20/2012 09:06am

Interesting that you should mention "malpractice" in this post. As far as I've been able to determine, liability is extremely limited in Veterinary medicine. At least,there is limited financial responsibility in that most states will only require a Vet to pay "replacement" cost of an animal lost trough negligence, incompetence, etc.(Never mind2 that many- perhaps most- people spend many times that amount on an animal in the course of that animal's life.) The primary threat seems to me to be revocation of a license to practice issued by the various state boards. As you mention, all thats required is C+ work, so unless the practitioner is a habitual substance abuser, absolutely inept, or something worse, the chances of that happening seem to me minimal as the licensure boards are operated by other Veterinarians.

2
My dog is not a chair
by Drken on 09/20/2012 10:47am

Gracie's Law is a model law which allows for capped non economic damages when a pet kid is killed through negligence or malice. I believe it is wrong to use the human animal bond to encourage ever increasing sums for veterinary care, yet believe that pets are property when a mistake occurs. I am a veterinarian. Please see Gracie's Law- Pets are Family on Facebook.

by Amanda Soileau on 09/20/2012 08:50pm

Dr. Ken,
Thank you for doing A+ work in your practice of Veterinary Medicine. Vets, MDs... we are all human and capable of error (more than once), but to hear a professional admit that other professionals should make an effort to always do their very best is inspiring, and indicative of how you practice. I know that a line must be drawn between professionalism and emotional investment when dealing with your clients and patients. But to know their is a DVM who understands the love we have for our pets and recognizes their value to our families is awesome. Are you located within 50 miles of Lafayette, Louisiana? Thank you for your contribution to this discussion and to the profession of veterinary medicine!!

3
PEOPLE WHO HAVE CATS
by comstockda on 09/20/2012 03:14pm

I REALLY ENJOY YOUR COMMENTS REGARDING HOW TO TAKE CARE OF YOUR ANIMALS NO MATTER WHAT TYPE THEY ARE OR WHAT TYPE OF HEALTH PROBLEMS THEY MIGHT BE HAVING. I HAVE TWO CATS THAT I HAVE RECUSED AT MY APARTMENT. TO ME IT SEEMS THAT THERE ARE WAY TO MANY PEOPLE UNABLE TO CARE FOR THE ANIMALS THEY HAVE SO THEY JUST TURN THEM LOSE HOPPING SOMEONE WILL TAKE THEM IN. THAT'S ME.
I WISH YOU WOULD TALK MORE ABOUT CATS THAN YOU DO. THERE WAS A SURVEY TAKEN NATION WIDE AND I KNOW YOU WILL NOT BELIEVE THIS BUT THERE ARE MORE PEOPLE WHO OWN CATS THAN DOGS. THIS IS A FACT.
KEEP UP THE GOOD WORK YOU DO, WISH YOU WHERE MY VET.

4
Legitimized Malpractice
by Rod Russell on 09/20/2012 06:32pm

Last month the AVMA legitimized nutritional malpractice when its delegates overwhelmingly condemned feeding dogs and cats home-prepared raw food diets. For nutrional purposes, the AVMA's position now is that the standard of care excludes feeding companion animals the best sources of protein and vitamins.

5
A+ Vet Care
by TheOldBroad on 09/20/2012 07:26pm

My critters and I are so very fortunate to have continuing A+ care from our veterinarian.

He's so good that having to change vets has weighed heavily in decisions regarding the possibility of relocation.

We've gotten very spoiled with the exemplary care he provides.

6
Meaningless
by stefanio on 10/16/2012 01:15am

Re:
"To get a feel for what a standard of care is, you would have to ask a large number of veterinarians how they treat a specific condition. Next, you should throw out any whacky answers that fall far outside of the norm and then take the most frequently mentioned response out of those that remain as your answer."

It's evident to me from reading hundreds of veterinary board documents that the vet boards never go through the process you describe to determine whether a vet who's alleged to have violated standard of care did indeed do so.

It seems to me that instead, if they can find any minority of vets in a community, sometimes even one, who would possibly give such lousy care, that becomes within accepted "standard."

Letting an unlicensed, unsupervised, inadequately trained person use a tuberculin syringe to give a dose of insulin, resulting in a giant overdose? Apparently not outside the "standard of care" in my community.

Take a dying cat in multiple organ failure and perform an unnecessary dental procedure on her without owner consent? No violation of standard of care.

Do a complex surgery you've never done before in your life without disclosing this lack of experience in advance to the owner, totally botch it and leave the animal in such a state that it dies of post surgical complications? No violation of standard of care.

Given cattle-strength xylazine to a dog for a neuter procedure with no disclosure of risk, no pre op blood, and no pulse-ox monitoring or intubation? No violation of standard of care.

Completely insane. The phrase "standard of care" will continue to be meaningless until it is defined by a body removed from the community in which the alleged acts have occurred, since within communities, cronyism reigns supreme. Vets also don't piss up the food chain, even if they are on the board. Just try to get a vet board to find against a "big wig" vet in their community that travels around the country giving lectures on some topic and/or is a pseudo celebrity in the profession. Pretty much, no matter what. Doesn't happen.

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About fully vetted

Jennifer Coates, DVM

Photo of Dr Coates

Image credit: Jim Piraino

...graduated with honors from the Virginia-Maryland Regional College of Veterinary Medicine in 1999. In the years since, she has practiced veterinary medicine in Virginia, Wyoming, and Colorado. She is the author of several books about veterinary medicine and animal care, including the Dictionary of Veterinary Terms: Vet-Speak Deciphered for the Non-Veterinarian. Dr. Coates also writes short stories that focus on the strength and importance of the human-animal bond, and freelance articles relating to a variety of animal care and veterinary topics. Dr. Coates lives in Fort Collins, Colorado with her husband, daughter, and various species of pets.

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