Q I have a philosophical question for you, and it is prompted by an experience I had with my veterinarian. Without going into detail, my veterinarian missed a diagnosis, which resulted in the death of my dog.
Their insurance agreed and paid for the bill. I can understand that no one is perfect and that he was doing his best, but what bugs me is that he has never admitted he was wrong and apologized. I am an educated professional and I am not overstating when I say he was at fault. It was a painfully obvious error. So how do you handle it when you screw up? Do you admit it or take the fifth?
A: As a senior in veterinary school at the University of Illinois in 1994, I (Henri Bianucci) had a discussion with a professor on this topic. His advice, and it seemed to be the prevailing thought, was not to admit guilt.
He advised that when a problem arises, turn the matter over to your professional liability provider, let them make a determination as to whether, and what, they would pay, but do not admit fault. “This only invites a lawsuit,” he said.
He reasoned that that was why you had a liability provider and it would not be fair to them for one to admit fault and create a liability, thus obliging them to pay, where one may possibly be avoided. He never advocated lying or falsifying records, but he felt that in only the most obvious of cases should one admit to a mistake.
Being a veterinarian is as much a description of who one is, as it is of what one does. Because your actions can have such a direct and often profound effect on the health and well-being of someone’s beloved family member, mistakes can be devastating to all concerned parties.
If through your actions you have caused harm to one whose health had been entrusted to you, what does that say about you? Are you not then a bad doctor? And since this profession and your identity are so intertwined, is there something wrong with you? Is your thinking, reasoning, surgical skill or medical knowledge defective?
Believe me, when a mistake is made by a veterinarian, we are that hard on ourselves. It is that personal. For this reason, I believe that the fear of litigation or censure by the medical board are only part of a veterinarian’s reluctance to admit fault.
Ours has always been an open and honest approach. In our practice, we err on the side of accepting responsibility for a problem, even in cases that could be judged either way.
Why? I guess it’s because I know when a case is not going well, when all anticipation was that it would, the client, at least in part, may feel that something was not done the way it should have been. If I know that nothing was done improperly, I will not say that it was, but I will accept some or all of the cost in getting the case back on track.
Ultimately, I would rather be seen as someone whose primary goal is the best possible outcome for the patient than as someone who lets short-term concerns about image or money dominate. We should be seen as a partner, never an adversary, throughout the course of treatment.
In almost 15 years of practice, I have never faced a lawsuit and have had just one complaint to the veterinary board, which was immediately dismissed as frivolous.
Does this mean I have never made a mistake? Absolutely not. But each and every time that I believed I could have done something better or made a mistake, I immediately admitted it to my client and, if necessary, covered all costs incurred as a result.
It is such an awesome level of trust that the client bestows on us to care for their pets. To not be honest and forthright in return is an absolute betrayal of that trust. The client asks that we do our best. We can make a mistake and still say we did our best, but we cannot mislead or cover up and still say we deserve to be trusted.
A 2010 study at the University of Michigan confirmed what I and others at my practice have always believed. They found that admitting mistakes and offering to provide compensation for resultant damages in a timely fashion did not increase the odds that the patient would file a malpractice lawsuit. In fact, this honest approach has reduced the incidence of medical malpractice complaints, reduced liability costs, led to faster resolution of cases.
So, it appears that honesty really is the best policy and that we can do good while doing right.
Dr. Henri Bianucci and Dr. Perry Jameson are with Veterinary Specialty Care LLC. Send questions to firstname.lastname@example.org.