Dear Sir,
While we welcome Dr. Rumney’s enthusiasm for debate on this issue, we disagree with his response (and with that of Dr. Rollin).
To prescribe or dispense prescription medication in this circumstance (without a valid veterinarian/client/patient relationship) is, in addition to being poor practice, illegal, and for good reason. Any experienced practitioner can relate scenarios whereby clients (often reliable, experienced animal owners) have described “symptoms” (and put forth tentative “diagnoses”) over the phone which the practitioner found upon physical exam to be totally erroneous. The consequences of such inappropriate treatment could be severe for both client and patient(s) and the liability would squarely fall on the veterinarian who dispensed the drugs.
We must object to his labelling our responses as “ivory tower.” Both Dr. Dowling and Dr. Kilpatrick have significant private practice experience. In Dr. Dowling’s case, requests from clients to take actions that were clearly illegal, such as the request from the producer in this hypothetical, were a major source of frustration for her in private practice, and an impetus for her to gain further expertise in her specialty areas.
The word “cavalier” does not apply to our responses, which were well-considered, dictated by the principles of good professional practice, and are mandated by the elected regulators of our self-governing profession. The “common sense” response espoused by Drs. Rollin and Rumney is the easy response. Any doubt as to whether this response would have significant potential negative effects on the veterinarian who goes down this road can be simply dealt with by querying any defence lawyer, veterinary registrar, complaints chairperson, discipline chairperson, or professional misconduct/civil liability insurer. (We have suggested that The CVJ seek the response of one or more of the above to be included in The CVJ issue that contains this letter.) The “respect” and “endearment” sought by Dr. Rumney would immediately disappear with the knowledge within the community that a veterinarian who has knowingly breached the veterinarian/client/patient relationship (and the law) has been charged with professional misconduct and/or is the defendant in a civil lawsuit.
The principles of professional practice require that, to appropriately prescribe/dispense prescription medication, the veterinarian/client/patient relationship exist. These principles (and the laws that enforce them) do not change with the time of day or the occurrence of a holiday, even Christmas. If the veterinarian who receives this phone call feels that this is a matter with which she must assist, then there is only one response. She must attend the animals, make a diagnosis, and dispense/prescribe the appropriate medication. She would not expect a physician to prescribe for a patient not seen, or a lawyer to provide advice on a matter with which she was not familiar. The veterinarian in this hypothetical must make a choice. She must either completely address the matter in a professional manner, or inform the caller that she is unable to assist. We stand by our responses.