In the dilemma discussed in the November/December issue of In Practice, Andrew Knight describes a case where a woman asks for your advice about her dog Forbes, a seven-year-old schnoodle suffering from vomiting and diarrhoea (IP, November/December 2017, vol 39, pp 478-479). Forbes has been diagnosed with pancreatitis and been prescribed metronidazole, but the drugs do not arrive until tomorrow. The problem is that the client is Sasha in Oklahoma, who has asked you on social media. You are based in the UK and have never met Sasha and never examined Forbes the schnoodle.
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KNIGHT describes the problem surrounding giving veterinary advice to Sasha. Professional veterinary regulators, including the RCVS, require the establishment of a valid veterinary-client-patient relationship for diagnosis and treatment to legitimately take place. There is no such relationship with Sasha in Oklahoma and Forbes the schnoodle. Hence, Knight recommends expressing sympathy with the client but cautions against anything that could be construed as advice specific to Forbes.
Despite this caution, Knight goes on to discuss ‘generalised advice’. Indeed, the RCVS Code of Conduct Supporting guidance states explicitly in the section on Veterinary care (2.28) that ‘General advice may be given in response to an enquiry’. However, specific advice should only be given ‘to the extent appropriate without a physical examination of the animal’ (RCVS 2017). Given the scenario described by Knight, a lot would seem to reside on precisely what advice Sasha has asked.
Consider if Sasha communicated that Forbes has deteriorated and asks whether Forbes can wait until the morning. In this case, since you are in no position to examine Forbes and cannot give good professional advice to answer that question. In contrast, if Sasha has advised you that Forbes is doing well and asks about diet, it would arguably be advice of a general nature to communicate that dogs with pancreatitis should be fed a low-fat diet.
The distinction between specific and general advice, and the grey area in between, probably accounts for the poll results. In the poll, 62 per cent of respondents in a similar scenario would offer some advice but also recommend a visit to the local vets. The remaining 38 per cent of vets would decline to offer advice if they had not examined the patient and the owner was not a client.
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