How Low Can 'Standard of Care' Go?
It’s no secret that not all veterinary clinics are created equal, and not all veterinarians practice the same medicine. Let’s be clear from the outset that I agree this is the case.
As veterinarians, we all struggle to help clients figure out what is in the best interest of their clients and pets; those who don’t think of this as their primary directive shouldn’t be someone you trust with your pet.
The problem is this: What is defined as “best interests?” That is where standard of care comes in.
When people talk about the standard of care for a patient, it refers to the level of care at which the average, prudent practitioner in the community would provide. This can vary from community to community, or state to state. It doesn’t mean “the best you can provide at any cost,” it means “the level below which you are being negligent.”
Sometimes it’s easy. If a pet comes in and has fleas, the standard of care pretty much everywhere is “remove the fleas.” It doesn’t matter where you practice or what your client base is like, everyone is capable of doing this.
Sometimes it’s a little trickier. If a pet has a broken leg, how should it be fixed? If you are the only vet in the county and you are not a surgical specialist, you are going to be held to a different standard than if you are a general practitioner in a major city practicing a mile away from a board certified orthopedic surgeon to which you can refer.
And sometimes it’s a big old ball of “I don’t know,” as is the case with many veterinary cancer cases. There are so many variables: the health of the pet, the finances of the owner, and their willingness to go as far as medicine will allow in the pursuit of treatment.
It’s not always cut and dried. In fact, most of the time it’s clear as mud. But if you have a pet with a brain tumor and do not elect to go for the $10,000 treatment option, few people would argue that you are being a negligent owner.
I lay all of this out to you to explain why there is so much angst in the veterinary community surrounding Dr. Pol, the star of a very popular show on the Nat Geo channel.
To those who have sufficient knowledge of the workings of a typical veterinary hospital, so much of what we see makes us cringe: surgery without gloves, anesthetized pets without intubation, pets treated without pain medication.
Dr. Pol’s response is somewhere along the lines of, “these city vets just don’t get what it’s like to be in the country,” along with a side of, “I make care affordable for people who couldn’t get care otherwise.”
And while he’s correct that the average practice out in the country may do things a little different than one in a city, he’s trying to make it sound as though the complaints levied against him are somehow unreasonable.
This is not a matter of a specialist dumping on a country boy for not doing all those highfalutin fancy things. Some things are below the standard of care no matter where you are.
If you bring a dog to a vet with fleas, would it ever be okay to send them home with no treatment whatsoever?
If you bring a dog in for an amputation, would it ever be okay to skip pain meds?
If you bring a pet in for a surgical procedure, would it ever be okay to skip gloves?
We’re not talking hundreds of dollars; tens or ones of dollars, maybe.
I’ve gone to third world countries and performed surgery in areas with no electricity and STILL managed to accomplish parasite treatment, pain meds, and gloves.
There are some standards of care that apply no matter where you live. The bar for some of this stuff is pretty low, and Dr. Pol still manages to slide under it. That’s why I can’t watch the show. Do you?
Dr. Jessica Vogelsang
Image: Kachalkina Veronika / Shutterstock