As a practicing equine veterinarian, you should be able to answer several important questions: How can I protect my veterinary license? What is veterinary license defense coverage? And do I really need it? (Spoiler alert: You do!)
Today more than ever, it is essential to create a bubble of protection around your ability to practice and maintain your veterinary license. Veterinary license complaints have risen sharply over the last few years, driven by a number of factors.
Owners’ expectations have changed regarding communication, quality of care and the value they place on pets and horses. This has led to an increase in dissatisfaction and complaints. In fact, the most common reasons for board complaints as compiled by the AVMA Trust are failed expectations or a bad outcome. Other commonly cited reasons include lack of communication regarding lab results, failure to obtain owner consent, vaccine reactions and aftercare.
At the same time, most state licensing boards have transitioned to an online complaint submission format, making it easier than ever for an upset owner to file a complaint against a veterinarian’s license. The result: The AVMA Trust has seen a dramatic increase in veterinary license defense claims over the last five years.
How can you protect yourself—and your license—in this environment? One effective strategy is to secure veterinary license defense (VLD) coverage.
What Is Veterinary License Defense Coverage?
VLD coverage is generally available as an endorsement to a malpractice insurance policy. It’s also available with a professional liability policy available through the AVMA Trust’s PLIT program. It is triggered when a client makes a formal complaint against a veterinarian’s license to a state licensing board.
When triggered, the VLD policy entitles the veterinarian to legal counsel and provides coverage for legal expenses (up to the endorsement limits) incurred in defending the veterinarian’s license. Such legal costs are not covered by a professional liability policy. Without VLD coverage, the veterinarian is left to find an attorney and pay all legal fees on their own.
The quality of legal defense is also an important factor. Attorneys assigned to license defense cases should be versed in administrative and regulatory law. They also should be familiar with the licensing agency’s process and be experienced in protecting veterinary licenses. They are there to help respond to the state licensing board’s request for information and to answer any questions the veterinarian might have.
The Importance of Recordkeeping
Thorough, well-maintained medical records are another important defense against a license complaint. Appropriate documentation will demonstrate that a veterinarian met the standard of care and can protect against false allegations of negligence. Right or wrong, the quality of a veterinarian’s care will often be judged on the quality of his or her medical records.
It is also important to note that during a complaint investigation, the state licensing board gains access to the veterinarian’s medical records. It can issue fines for lack of appropriate documentation, even if a client’s complaint is ultimately deemed frivolous. In fact, the most common fine issued by licensing boards is for poor recordkeeping. Therefore, it is essential to maintain medical records in compliance with the state Veterinary Practice Act.
The purpose of medical records is to document the patient’s condition and all aspects of the medical care planned and provided. These records also substantiate the veterinarian’s standard of care and play an essential role in continuity of care for the next provider. A good rule to follow is that any veterinarian who reads another’s records should be able to understand the animal’s condition and pick up where the first veterinarian left off with treatment.
Medical Record Guidelines
Items that should be included in medical records are written consent forms, anesthesia logs, surgery reports, physical exam findings, diagnostics recommended and declined by the client, lab results, estimate sheets and all communications including texts, e-mails, voice messages and verbal conversations. Consult your state’s Veterinary Practice Act for specifics on what needs to be included in the medical record. And remember, that list is a minimum requirement.
In addition, records should be accurate, legible and timely—meaning entries should be made on the same day or within 24-48 hours. It can be very difficult to maintain records in a busy ambulatory practice, and it can be challenging to slow down long enough to make medical record entries. But the longer you wait to document exams and findings, the more likely you are to forget items or details.
Also, the optics of completing medical records after a complaint has been communicated by a client can be bad and might even lessen their value in defending against a complaint. Conversely, documentation entered at or near the time of treatment can provide strong evidence should a board complaint be filed.
For example, in one case an upset owner filed a complaint against an insured veterinarian’s license, alleging that the veterinarian wrote in the medical record after the owner accused them of not recommending a treatment. The record was time-stamped, clearly showing that it had been completed at the time of the visit. The investigator threw the claim out based on the time-stamped record.
One final note: The practice owns all medical records, including original radiographs. The client is entitled to copies of the records upon request within a reasonable time period. Again, consult your state’s Veterinary Practice Act for more information and to remain in compliance.
What If I Receive a Complaint?
First, familiarize yourself with the process before you are contacted by the state licensing board. Many states explain the investigative process online. Review these websites periodically to ensure you understand your board’s investigative process and your state’s Veterinary Practice Act so you are prepared if you receive a board complaint. Understanding the basics might be helpful in case your board contacts you.
The investigative process varies from state to state. Your state’s laws govern what information your board will provide at the start of an investigation and how the board will conduct the investigation. Some jurisdictions will mail or email you a copy of the complaint and ask that you provide the board with a copy of your medical records and a written response. Some will send you only a summary of the complaint. Other jurisdictions will not provide you with the complaint or even a summary. A small number of jurisdictions might simply send an investigator to your office to request records and to interview you.
Do not ignore written correspondence from your board.
Your time to respond will be limited. In many jurisdictions, the time in which you must respond is set by law.
Almost every complaint made to the regulatory agency leads to some level of investigative activity. Still, few investigations result in a “formal complaint” being filed against the veterinarian. A formal complaint is a public document or pleading that lists specific charges against the veterinarian’s conduct and seeks to discipline the veterinarian’s license. Disciplines can range from reprimand to revocation.
What If the Client’s Complaint Has No Merit?
Remember, your state’s veterinary licensing board is a regulatory agency whose job is to protect the public. They are obligated to investigate every complaint—including frivolous ones.
As the subject of a complaint, a veterinarian might face a demand for medical records, an investigative interview or a facility inspection. If you are on the receiving end of a board complaint—no matter how frivolous—and you have veterinary license defense coverage, contact your insurance carrier immediately.
Many license complaints are ultimately closed after finding that the veterinarian’s conduct did not violate applicable state law governing the practice of veterinary medicine. These closures are largely due to the complaint’s lack of merit. The quality of a veterinarian’s legal representation also can affect the outcome of a complaint.
Be Prepared. Be Protected.
Your veterinary license is essential to maintain your ability to practice. Now more than ever, it is essential to protect it. Having appropriate VLD coverage and practicing good medical recordkeeping is crucial to defending your license and maintaining your peace of mind.
If you do not have VLD coverage, you should consider adding it to your bubble of protection. And if you do have it, you might want to review your coverage limits to ensure they are adequate for present circumstances. States with pandemic-driven backlogs are taking longer to process complaints, leading to increased legal fees. Don’t get caught without the protection you need.