THE BUSINESS OF PRACTICE: MANAGING PRACTICE CHALLENGES AND OPPORTUNITIES


mate sheets or medical treatment plans, and all communication including texts, e-mails, voice mes- sages, social media communications, and verbal con- versations. Pictures and videos from smartphones can provide compelling information, especially for absentee clients. The quality of care will be judged on the records. The practice owns the records, in- cluding original radiographs. The client of the re- cords is entitled to copies upon request within a reasonable time period. Equine practice, especially in the field, can be additionally challenging. Find- ing a suitable environment and the time to write in the record and obtaining history and consent from absentee clients are a few of the challenges (claim example will be discussed/intensive care unit [ICU] impaction colic/pre-purchase exam [PPE] to illus- trate how to prevent claims with complete medical records).


7. Keep Clients Safe


Human injury claims are less common but can be the most costly and difficult to defend in court. Claimants’ attorneys may argue that a veterinarian is considered the expert in animal behavior and should be aware that animals can react suddenly when injured or frightened. Unlike small animal practice, patient restraint by clients is more accept- able in the equine industry, which opens the veter- inarian to additional exposure for human injury claims. Once the veterinary exam has begun, it is the veterinarian’s responsibility to assure the safety of everyone in the immediate area. The risk of human and patient injuries is higher in equine prac- tice because of the size of the patients, the “flight” nature of the patients and inexperienced, non- employee handlers restraining patients. Practitio- ners should consider using chemical restraint when- ever possible to reduce injuries to both patients and humans (employees and clients). Practicing sound medicine by making intelligent, safe restraint deci- sions prior to treatment will help reduce human and patient injuries (example of human injury malprac- tice claim).


8. Professional Extension (Animal Bailee)


Animal bailee covers damage to animals in your care, custody, and control resulting from an outside source and not related to a veterinary incident. Typically, this includes losses resulting from fire, theft, escape, flood, catastrophic weather, injuries in stalls, paddocks, pastures, in addition to many other perils not related to treatment. This is an impor- tant coverage for practice owners if their practice


hospitalizes boards and/or transports animals. A practice owner could be held accountable for inju- ries to or death of patients while in their care. Practice owners should check their policies for cov- erage of patient injuries not related to a veterinary incident. Practitioners that are completely mobile and do not keep or transport patients in their care, custody, or control do not need this coverage (specific claim fractured humerus/expensive foal). An important exclusion often found in profes-


sional liability policies is that any loss of semen and embryos while in storage or transit is not covered. Veterinarians can ask their insurance provider about securing an endorsement to cover losses while in storage or transit by the insured veterinarian (not third party transit/UPS/Fed X), (examples of semen/ embryo claims).


9. Discussion


In summary, equine practice poses additional risks of claims when compared to small-animal practice. The higher monetary value of patients prompts cli- ents to seek economic losses by filing a malpractice claim when an adverse event occurs. The special veterinarian-client-patient relationship, the chal- lenging recordkeeping environment in the field and the increased risks of human and patient injury all add to the potential exposures of equine practice. Know the perceived monetary value of your equine patients and secure policy limits in line with their value.


Acknowledgments


Declaration of Ethics The Author has adhered to the Principles of Veter- inary Medical Ethics of the AVMA.


Conflict of Interest The Author has no conflicts of interest.


References


1. Taake v. WHGK, Inc., 228 Ill. App. 3d 692, 708, 170 Ill. Dec. 479, 592 N.E.2d 1159 (1992), Advincula v. United Blood Ser- vices, 176 Ill. 2d. 1 (1996).


2. O’Connell D, Bonvicini KA. Addressing disappointment in veterinary practice. In: Cornell KK, Brandt JC, Bonvicini KA, eds. Veterinary clinics of North America small animal practice. Philadelphia, PA: Saunders; 2007;37(1):135–149.


3. AVMA PLIT. Professional liability. 2013;32(3). 4. Bonvicini KA, O’Connell D, Cornell KK. Disclosing medical error: Restoring client trust. Compend Contin Educ Vet 2008: 31:572–576.


5. Scoggins GA. Legal considerations concerning patient medi- cal records, in Proceedings. Am Assoc Equine Pract 2005;51: 516.


AAEP PROCEEDINGS  Vol. 65  2019 115


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