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10 ways to avoid a lawsuit

April 1, 2006
Amanda Bertholf

Making sure you're on the same page with clients is the best way to avoid malpractice claims. Use these strategies to refine your approach and avoid potential trouble spots.

"Malpractice" May Be The Scariest word in your vocabulary. Of course, you can't let fear keep you from providing the best service and care possible. But you can take steps to protect yourself. The best option: solid communication skills. Good communication bridges the gap between you and the client—and reduces your risk of a malpractice claim. Great communication with clients also makes your job more enjoyable, says Dr. Rodney Johnson, a trust representative with the AVMA PLIT. And building strong relationships with horse owners is good for business, too.

Ready to start digging your moat? Take these 10 steps to hold off trouble:

1. Don't promise a cure

Avoid making promises about medical outcomes. Being open and honest with the client about the reality of the situation minimizes stress and heads off the possibility of a malpractice claim if things don't go as planned.

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2. Keep all parties informed

Often there are several people involved when you examine a horse. For example, let's say you're evaluating a horse for sale. In this case, you must maintain consistent communication among you, the buyer, and the seller. "Equine veterinarians often deal with an absentee owner, too," Dr. Johnson says. In these cases, are you sure the agent speaks for the owner? "Make sure that whoever you deal with is authorized to make medical decisions for the horse," he says.

3. Explain treatment options thoroughly

Horse owners need clarity, says Dr. Johnson. "So be direct when you need to. And if it's noisy, make sure you speak up or move to a quieter location to talk." He suggests asking the owner or agent to repeat information back to you. "The fact that the client nodded isn't good enough evidence in a malpractice case," he says.

"You need to deliver the information in a way the client understands," he says. "And keep in mind, clients may not always say so when they don't know the terms you're using."

4. Be clear about the limitations of pre-purchase exams

"Claims regarding purchase examinations account for a significant percentage of malpractice claims overall," says Dr. Dennis Meagher, MS, Ph.D, Dipl. ACVS, and professor emeritus at the University of California-Davis School of Veterinary Medicine. He reviewed 128 equine malpractice claims that he has participated in as an expert over the last 35 years. One key lesson: "Buyers must understand that a pre-purchase exam isn't a warranty," he says.

5. Stick to your protocols

If you must diverge from your normal practices during a purchase exam, make note of the circumstances, says Dr. Meagher. It is ideal if you follow your standard procedure, especially if you don't have all the information you need, like diagnostic-quality radiographs. "You should also avoid situations where you feel pressured to reach a decision," he says.

6. If you don't know, say so

It's OK to admit you don't have an answer. After all, you don't want to be put in the position of making a shaky decision and just hoping everything works out. So, if you're not sure what to do, Dr. Meagher recommends suggesting a second opinion. Be sure to note your recommendation in the record, he says.

7. Keep complete records

Most people think of communication in terms of verbal exchanges, but written communication is just as important. Your files should be thorough and organized, and radiographs and charts must be clearly labeled. If a client files a claim against you, your records are your greatest allies.

Legibility is also critical; after all, what good are records if you can't read them? Consider using a computerized system to keep your records neat.

8. Follow up with the client

For example, purchase exams and discussions about novel, controversial, or potentially risky surgeries or therapies warrant a letter to the client at the minimum, says Gregg Scoggins, a veterinarian and attorney who serves as the National Director of Regulatory Affairs for the Magna Entertainment Corp., an owner and operator of horse racetracks. The letter gives you the chance to reiterate treatment options and repeat other information you may have discussed.

9. Keep your team in the loop

"At haul-in practices, the practice manager or doctor should sit down with the scheduler, receptionist, technicians, office manager, and anyone else who works with clients," says Scoggins. "It's important to explain how other parts of the business function." Seamless understanding at all levels creates better customer response, he says. Cross-training, or even the opportunity to observe co-workers, also gives team members better understanding so they can answer clients' questions and address their concerns with confidence.

Ambulatory practices face different communication issues. "These doctors spend a lot of time behind the wheel, and they don't always have access to complete records," says Scoggins. Technology like BlackBerrys and laptop computers with wireless technology or network connections help ambulatory veterinarians stay connected to the office. These tools improve efficiency and let you communicate with the office right away rather than hours after an exam, he says.

10. Create a client-focused culture

Dr. Johnson advises spending some time working with communication experts and providing training to your staff. "It's important for your whole team to develop strong skills so everyone is prepared to address clients' questions and concerns at check in, checkout, and during any follow-up discussions," he says.

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