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Potentially morally injurious events (PMIE)
The VDA has previously written an article about moral injuries in veterinarians. In the last four years, moral injury in veterinarians as a concept has developed into potentially morally injurious events (PMIE) as seen in new published research.
Euthanasia- A triple-edged sword
A recently published article, ‘I’m a vet, but I can’t face putting down another healthy animal,’ written by Tom Rhind-Tutt, has revealed an eye-opening truth (18 November 2024 on www.telegraph.co.uk).
Resilience - Finding your Confidence as a Vet (Article 528)
Resilience has recently become a buzzword in many areas, including veterinary practice. Finding the strength to keep going during trials and tribulations is a trait that some people seem to ooze, whilst others continually struggle to overcome setbacks.
Things You Should Learn About In Veterinary School (Article 505/6)
After seven or so years of veterinary school, many feel that they now know all they need to know in order to be a successful veterinarian.
Euthanasia Gone Wrong - Guest article by Dr A (Article 525)
Dr A has written an article for the VDA on a topic that she feels very strongly about. She wishes to pass the message on to others. We agree with her thinking: depression and suicide are always most important and should always be at the forefront of our thoughts when listening to those who are ‘having a tough day’.
Hot off the bad press
Social media is a hot topic as are the negative consequences that keep it company, such as constant screen time and addiction spirals, desensitization after repeated exposure to inappropriate content, expected immediate response times, and the ability to bully others from the safety of your couch.
Neurospice
ADHD, Autism, on the spectrum, dyslexia, dyspraxia, dyscalcula, sensory processing, OCD and all the other terminology being thrown around of late when referring to neurodivergence. Most vets are choosing to ignore this as something that couldn’t possibly include them - until they are staring it in the face.
The Value of a Post Mortem
(Article 480- Previously published on 2017-08-30)
A post mortem should be offered in every case of unexpected death. The post mortem should ideally be performed by an independent specialist pathologist. If no specialist pathologist is available or the owner refuses to pay for this, then a colleague, rather than you, should perform the post mortem.
Rabies and export issues
It has come to the VDAs attention that vets need to think more carefully about consultations where rabies vaccines are given.
Trying to Please Everyone is Not Advised!
BnB issue 219 (Comment on the last B ‘n B news article - When things just don’t go as planned!)
One of our members wrote to discuss their recent experience with the VDA’s handling of a case he was involved in, in the light of the opinions expressed in the above-named article.
Debating Locum Cover
Each and every veterinarian that provides veterinary services needs to have their own professional indemnity and professional protection in the form of a dedicated veterinary defense organization.
When things just don’t go as planned!
(Article 489 previously published on 2017-11-08)
Have you ever done your utmost to treat a case to the best of your ability and yet everything that the textbooks say should happen, doesn’t? We are sure that every veterinarian has been met with this scenario – known as an “adverse outcome”.
Did the Owner Consent?
(Previously published on 2016-11-23 as Article 439)
Mrs X’s pony developed signs of colic in the morning, but she delayed in calling Dr A until 16h45. Mrs X’s first request was that Dr A dispense Finadyne in order for Mrs X to administer the medication.
Alternative Dispute Resolution
The VDA is unique in the fact that we perform ADR (Alternative Dispute Resolution). This is what makes us a "Defence organisation" which is different from an ordinary insurance provider.
Banning the Bullies
There has always been a stigma surrounding bully-breed dogs and unfortunately it just takes one picture of a sweet little girl in pigtails with stitches across her cheek and the headline “Attacked by beloved pet Pit Bull” to spark a national outcry against bully-breed dogs.
How to Handle a Scheming Client
(An update on Article 409- Previously Published on 2016-05-18)
Although it is only January, the VDA has already received calls from two members, complaining about clients who have not treated them with integrity.
All for nothing!
Previously published on 2015-10-13 as Article 373.
After Mrs X’s dog was euthanized, Mrs X asked Dr A’s veterinary practice to have her dog’s body cremated and the ashes returned to her. Mrs X called in to collect the ashes on the scheduled day, but when she arrived at the clinic she was informed that her dog’s ashes were not there. Dr A undertook to find out what had happened to them. Mrs X seemed disappointed but pragmatic.
Navigating a Resolution with an Unhappy Client
Encountering unhappy clients is an inevitable part of owning or running a veterinary practice. No matter how dedicated you are to providing exceptional services, there will always be instances where clients may feel disgruntled. The key to success in resolving grievances lies in the way you deal with these sticky situations. We believe that Alternate Dispute Resolution (ADR) is a brilliant tool to resolve grievances. And, with the VDA, ADR is free!
The VDA is your Team in Need
Our readers studied and took some of the most rigorous courses at university to become veterinarians, treat patients and save animal lives. By following the VDA protocols, members safeguard themselves from becoming the target of unnecessary board complaints and civil lawsuits.
Completing Pet Insurers’ Claim Forms
Our members are often faced with a difficult situation when the pet owner wants the vet to complete their pet insurance claim form. Most vets are reluctant to sign the pet insurer’s document because they are faced with anomalies that make it difficult to answer the questions.
A Quick Buck?
Dr A has kindly shared his frustrations with a broken system and greedy pet owners.
[Changes have been made to ensure the anonymity of the people involved – Ed.].
Mentoring – How and Who to Mentor
There have recently been circulars inviting – perhaps begging would be a better description – veterinarians to “host” and mentor and share their knowledge with people who have para-veterinary qualifications such as Animal Health Technologists. But this is not a new request – one veterinary board has, for many years, asked veterinarians to train and examine and certify that a lay person is competent to perform animal welfare assistant work.
Monkey Business
What should you do when a client or even another vet asks you to organize for scheduled medication to be sent to other countries? What happens when you are requested to assist with the export of animals?
Dr A shares her struggles
Dr A has kindly shared her story with the VDA after the previous Barks 'n Bytes article: Burnout. This is a hot topic at the moment with many vets reporting that they are going through tough times, and some saying that they are not coping.
Burnout - A Vicious Cycle
According to Dr Ivan Zak, burnout is becoming more prominent in the veterinary industry. The VDA, too, is noticing that not only is burnout increasing, but that this trend is having catastrophic roll-over effects on the rest of the veterinary workforce.
Champagne Treatment for Mere Pennies
Fluffy, an estimated 17-year-old, Male, desexed crossbreed was presented on the morning of 2nd February for further investigation into breathing difficulties. Mrs X (the pet owner) had already consulted Doctor Google and was convinced that Fluffy had toxoplasmosis.
A Rock and a Hard Place
The Shameful Situation of new graduates doing CCS
For some time, our members have been telling us about the shameful situation that new graduates face when doing their required community service year. The bright-eyed new graduates who are so eager to put their new skills to task, are sorely disappointed in a failed system which is underfunded, understaffed and under-resourced.
The Stress Scale
Our VDA members around the world are reporting a new epidemic that is not Covid - stress! The reasons for this outbreak vary, from family issues, to pressures of running a practice, to being short staffed and having to pick up the slack, financial issues, previous traumatic events, and abusive clients, amongst other factors.
“You Murdered my Baby!”
Mental instability in pet owners is a common occurrence in cases the VDA has worked on through the years. Recently a VDA member asked for advice on a mentally unstable client who claimed her dog had been murdered by Dr A.
When Veterinary Boards are a Menace to the Health of the Profession (again)
Many veterinary boards are a menace to the health, prosperity and best interests of the profession and the public, as illustrated in the following case history.
Resilience
“As a profession, is it possible to strive for perfection, but to accept and embrace failure transparently when it occurs?”
Compassion Fatigue
While helping animals is a job that many consider a dream, when one considers the high suicide rates in the veterinary profession, it’s clearly not all rainbows and unicorns. One factor that is unique to the Helping Professions category (which includes veterinarians) is compassion fatigue.
Refunding Clients
The VDA is seeing a rising trend where aggrieved pet owners demand that the cost of prior veterinary treatment be refunded so that they can afford to have further treatment carried out. Pet owners allege that if previous treatment did not cure a condition, then the fees charged are not legitimate. This skewed logic can be fueled by vets experiencing feelings of defensiveness and guilt for the wrong reasons. Veterinarians need to remember that when you do not draw a line between what is your responsibility versus reasonable expectations and the owner's responsibility, it impinges enormously on your liability.
A Lesson in Trauma, PTSD and Coping Skills
Trauma is an emotional response to a terrible event such as an accident, death or natural disaster. Such an event is perceived to have threatened your sense of security that causes physical, emotional, spiritual, and/or psychological harm - rendering you feeling helpless. Trauma includes those situations that leave us feeling overwhelmed and isolated. It is important to note that trauma is a subjective emotional experience and will be different for each individual, based on past experiences and current mental health.
Exit Strategy
A VDA member brought to our attention the matter of exiting the veterinary profession and the complexities that may arise therefrom. His recent conversation with a friend, who is a human gynecologist, revealed a problem that may potentially affect veterinarians.
Letting a time bomb through the door…
The question of when to fire a client is one that most vets face more than once during their careers. Sometimes there is a clear indication as to when to terminate a relationship, and other times this is a difficult decision for a vet, who is often filled with guilt and concern for the animal in question. The difficulty here is not the animal, but the client (pet owner) who may make the life of a vet unnecessarily complicated.
No Sees and No Shows
Mrs X’s cat was presented showing signs of Feline Lower Urinary Tract Disease. At the outset Mrs X was warned that urinary blockages can occur, that they are very serious; and can lead to permanent organ damage and death. On this occasion the cat was treated medically and responded well.
Beware Pet Medical Aids
Dr A has approached the VDA with a complaint regarding pet medical aids. It appears that the policies of some of these companies are creating a problematic relationship between clients and their vets more and more often these days.
Social media overshare?
Online presence is a concern in the business world today and the big question is always: how much should professional people share with members of the public? Recently a VDA member enquired about sharing veterinary treatment videos on social media and in the public domain.
Article 543: Post Covid Psychological Crisis
The sudden impact of COVID-19 on the veterinary profession has had far-reaching effects with most practices adopting a new normal to ensure patients continue to receive essential veterinary care while staff and clients are protected.
Article 542: Moral Injury
Research into mental health in the veterinary profession has recently unearthed the fact that there are connections between veterinarians’ mental health and the damage caused by Moral Injury.
Article 541: Veterinarian Suicide Crisis
Recently there was an episode of Insight on ABC in Australia regarding issues of mental health, stress, and suicide in the veterinary profession, which is receiving great feedback from the general public (https://www.sbs.com.au/news/insight/tvepisode/veterinary-care). This enlightening snippet, coupled with numerous worrying news headlines about the current worldwide Covid-19 pandemic, the tanking economy, and other related stresses, has prompted the VDA to once again explore the data regarding suicide in veterinarians.
Article 540: Don't get caught with your pants down!
Some practice owners make the error of employing assistant veterinarians, locums and relief veterinarians as well as nurses and techs without making it conditional that they are fully paid-up VDA members in good standing before they set foot in the practice.
Article 539: Covid 19 - Dilemmas
With thousands already dead, the airports closed and the streets empty, Covid- 19 is proving to be an underestimated pandemic. Unfortunately no one is an exception to the rule in these unique times with every country being affected by the infected. The VDA is here to support members in any way that we can. With so much news circulating, please bear with us and read through the following.
Article 538: Dysfunctional Vets and Dysfunctional Boards
It is a very disturbing experience to have one’s employer (the person who should be your protector and mentor) turn against you. More so when your employer ‘throws you under the bus’ by lying under oath to the veterinary board, in order to save themselves. It is even more distressing when you discover that the veterinary board is so dysfunctional that it cannot even get the most basic part of the disciplinary process right.
Article 537: Latest Developments Regarding Telemedicine
Following Barks ‘n Bytes article Issue 173 (Telemedicine: Are Virtual Vets Really The Future?), published on 23 August 2019, there is an update to Telemedicine Regulations from the California Code of Regulations (CCR) which effectively makes Telemedicine illegal from 1 January 2020 in California.
Article 536: Ivermectin Toxicity - A Cautionary Tale
It is practice policy in Dr A’s practice to deworm pregnant bitches prior to whelping. Dr A is experienced in breeding and is located in an area renowned for its resistant worm population. Dr A’s experience is that doramectin is an effective dewormer, and that the health benefits (in treating morbidity and in preventing mortality from verminosis) outweighs the risks of side-effects.
Article 535: Pet Abandonment
Pets being abandoned at a veterinary practice is a common problem. The veterinarian gets stuck with an animal at their practice, taking up space and resources, all the while not being paid. Presenting a pet for treatment and then refusing to pay is fraudulent and places veterinarians in an invidious and unenviable position, since they are naturally empathetic to the animal’s plight but still have to maintain a businesslike approach.
Article 534: Developing Coping Skills
This article is a follow on from the previous article “Mental health concern- when should we worry?” Veterinary medicine is an incredibly stressful occupation, where professional people have to face more than their fair share of traumatic events. With recent revelations of high suicide rates in veterinarians, we need to address possible preventative methods.
Article 533: Mental Health Concern- When should we worry?
Nowadays, mental health issues are being addressed more tenaciously. The VDA has been focussed on mental health in veterinarians, as well as in the mental health of veterinary clients, for many years, long before this became a “trend”. We, as veterinarians, need to take special heed, since we are more at risk than most other professions, of suffering mental health concerns. Poor mental health is closely associated with the stresses of professional life, such as excessive work hours, poor work-life balance and student/other debt. Practice owners and chief veterinarians need to look out, not only for themselves, but for staff members as well.
Article 532: Vets Treating Stolen Property
Dr A, a VDA member and practitioner in a small town, contacted the VDA for advice and guidance regarding a sticky situation in which one of her clients, Mrs X – acting as the local rescue group - had “saved” an injured dog by taking it to Dr A. Dr A was uncertain as to who was responsible for the dog and its well-being and who should act for it.
Article 531: Resilience: Finding Your Confidence as a Vet
Resilience has recently become a buzzword in many areas, including veterinary practice. Finding the strength to keep going during trials and tribulations is a trait that some people seem to ooze, whilst others continually struggle to overcome setbacks.
Article 530: Telemedicine: Are Virtual Vets really the future?
Many veterinarians are hesitant to give veterinary advice over the phone, never mind utilizing more modern techniques such as Skype to give a consultation. The hesitations are understandable but the veterinary world needs to keep up, so where do we draw the line with telemedicine?
Article 529: Euthanasia Gone Wrong - Guest Article by Dr A
Dr A has written an article for the VDA on a topic that she feels very strongly about. She wishes to pass the message on to others. We agree: depression and suicide are always most important and should always be at the forefront of our thoughts when listening to those who are ‘having a tough day’.
Article 528: Every Click You Make, Every View You Take
Every click, every view and every sign-up on the internet is recorded somewhere. Depending on your view, this is either very creepy or fantastically interesting. There are many advantages and disadvantages of social media and the internet, for both individuals and businesses. The veterinary world is not exempt from this, specifically veterinarians being the subject of online abuse.
Article 527: Addiction - Substance Abuse Part Two
Substance abuse is problematic for veterinarians because clients (pet owners) have quickly figured out that veterinary practices are, potentially, a stable source of mind-altering drugs. Veterinarians frequently prescribe medication for pain management in pets; however, pet owners battling addiction may abuse those prescription drugs intended for their pets.
Article 526: Addiction - Substance Abuse
Part One: Addiction in VeterinariansSubstance dependency is an equal-opportunity disease, affecting the dependent individual and all who surround him or her - and the veterinary profession hasn’t escaped. Society tends to view addiction as a defect of people with compromised morals; however, it is more fairly compared to having a disease.
Article 525: Setting Boundaries
Not setting boundaries is a common issue for many VDA members and veterinarians worldwide. Feelings of anger and guilt are a direct consequence, and these feelings lead to mental and emotional stress, and then burnout, possibly followed by self-harm and suicidal thoughts.
Article 524: Controlling Your Clinical Notes
This article relates to a VDA member, Dr A, who sought advice from the VDA regarding a client’s request for the clinical history of her puppy.
Article 523: Mrs X's Board Complaint Exonerates the Veterinarian... (yet the board continues with prosecution)
This case happens to be in South Africa, but could apply equally to veterinary boards in the USA, Canada, Australia and Hong Kong.
Article 522: Pet Bites Vet!
A recent dog bite has left more than just physical wounds for a VDA member. The trauma associated with an injury in the workplace, and specifically the trauma of an injury caused by an animal, can have detrimental effects on the mental well being of the affected person.
Article 521: The Right To Terminate Your Relationship With A Client (Without interference from the SAVC)
Mrs X presented her dog to Drs A and B’s practice with multiple concerns, including excessive aggression. However, Mrs X’s own aggressive behavior towards the consulting vet and lay staff during the consultation was so unacceptable – this was the first consult, remember - that the practice decided they could not continue the relationship with her and requested that she take her animal elsewhere.
Article 520: Comment On Letter From The SAVC Regarding The VDA'S Last Barks 'n Bytes
Although this article relates to the South African Veterinary Council, the issues discussed here are just as valid for almost every other veterinary board in the world.
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