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Do you have the right to remain silent?

Publication
Article
dvm360dvm360 October 2023
Volume 54
Issue 10
Pages: 82

A case of confidentiality highlights how privacy is managed with patient records

xixinxing / stock.adobe.com

xixinxing / stock.adobe.com

Burke Veterinary Hospital is a busy place in a suburban community. For 25 years, the clinic has been a trusted caretaker of pets in the area. As is the case with long-established veterinary practices, sooner or later, every imaginable circumstance presents itself. Burke Veterinary Hospital recently experienced such a day.

A married couple had been bringing their dog, Sweetie, to the clinic for 2 years. In recent months, the couple had had some marital discord and separated. One of their major issues was custody of Sweetie. Additionally, there was a question of who was allowed access to the dog’s medical records.

The hospital director had encountered situations similar to this one in the past. Any client whose name appeared on the medical record was identified as an owner and entitled to acquire the information. The animal’s owners were responsible for medical decisions and financial obligations.

Unfortunately, the marital discord escalated. Both parties called the clinic and advised the hospital manager that they were in a legal battle for custody of the pet. Additionally, the husband informed the clinic that he had a new residential address and should be contacted concerning the animal using his new information. The hospital manager had no issue assisting because both the husband and the wife were listed as owners on the medical record. Then things started to get a bit sticky.

A week after the hospital received the request, a local police officer visited Burke and asked to speak to the hospital manager. He advised the manager that some police-related issues had arisen concerning the husband. To investigate the matter further, the officer required the husband’s new address. The hospital manager was aware that the state in which the clinic was located considered veterinary record information as privileged. This information could not be shared without the permission of the pet owner in question.

The police officer became a bit aggressive. In response, the hospital manager told him that she would be happy to assist him if he would obtain a subpoena for this information. She explained that she wanted to help but that she had to obey the law as well as prevent the clinic from any legal entanglement. An irritated police officer left. Two days later the authorities returned to the clinic with a subpoena in hand. The hospital manager immediately gave them the information they had requested.

As far as the American Veterinary Medical Association (AVMA) is concerned, medical records are considered privileged and confidential, but this may vary from state to state.1 The AVMA website does have a listing of the confidentiality status of veterinary records by state. Of course, there are exceptions for when imminent danger to pets or people may be involved. If that were the case, the authorities would immediately put the clinic in contact with legal advisers.

The days of veterinary medical informality are past. Now releases must be signed, informed consent must be discussed, and client privacy is a mandate. This ultimately protects the pets, the clients, and the veterinarians. Personally, the office manager wished she could return to the old days when she could just help a pet or client in need without all the red tape, but she also understood the clinic’s legal obligations.

Rosenberg's response

What it comes right down to is veterinary medicine and veterinary medical facilities are big business. Along with the advances in pet health care and the world of corporate veterinary clinics comes the concern for liability. My goal has always been to strike a balance between personal one-on-one client interaction and adherence to the rules and laws of 21st-century veterinary medicine. It can sometimes an be a difficult line to walk. In the end, the primary directive is that the pet always comes first.

Marc Rosenberg, VMD, is director of Voorhees Veterinary Center in Voorhees, New Jersey. Although many of the scenarios Rosenberg describes in his column are based on real-life events, the veterinary practices, doctors, and employees described are fictional.

Reference

1. Confidentiality of veterinary patient records. American Veterinary Medical Association. Updated May 2019. Accessed September 12, 2023. https://www.avma.org/advocacy/state-and-local-advocacy/ confidentiality-veterinary-patient-records

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