Could a Doctor and a Vet Cross Practice?

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benyjets23

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I know this question is absurd, but its out of curiosity. In some god awfull, hypothetical situation that I cannot imagine, where a vet needed to operate on a human being or an MD surgeon operate on an animal, could it be managed? Are animals and humans so compleletly different that it would be impossible?

Sorry for the strange question, it is just one of those wierd things that pop into your mind.

Ben

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Actually veterinarians get that type of question quite a bit.

Basic surgical technique is the same regardless of species and the anatomy of most mammals is similar. But there are enough important differences to matter (including anesthetic techniques) and the legal ramifications, especially for a DVM treating a person are substantial.

I know of veterinarians who’ve sutured minor lacs, usually their self or a colleague, and a few cases where MDs did more major surgery on the own pet, but for the most part it’s a really bad idea.

On the other hand, having an MD specialist scrub in to assist a DVM in a specialized procedure is not rare. Examples are MD cardiovascular surgeons helping repair heart defects, MD neurosurgeons helping with brain/spinal tumors and dentists helping with root canals/crowns in animals.
 
No. If you're a vet and you lay a finger on a human, for purposes of tx or dx, you will lose your license to practice, possibly face criminal charges (practicing med without a license), and you could very well be sued and lose everything. Why risk it? If faced with a life and death situation, don't risk everything because you will not be shielded from liability with "good samaritan" statutes. A DVM might have knowledge, but is not qualified to practice medicine and should NEVER even attempt to. Let EMS workers help.

Likewise, an MD or DO should never try to practice vet med. I'm an MD and although I think I might be able to treat my cat when she's ill, I really don't know her physiology as well as I'd like to and I could miscalculate a dose or something and kill her.

Some MDs help out with primate surgeries, from time-to-time, but this is rare.

While some PhDs in zoology and primatology, etc., might be qualified to operate on an animal, would most vets feel comfortable with this? Probably not.
 
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Interesting thread. I have come across some people who have both an MD and a DVM so I am sure cross practice is possible in this situation. That is of course assuming that the person has gone through an MD residency and has a license to practice both vet and human medicine.
 
I'm sorry but your answer seems totally off the wall. In an emergency most people do what needs to be done to save a life, MD, DVM or lay person. A few summers ago at the SA clinic I work at a construction worker came over and asked us to call 911 because his boss was choking on a ham sandwich. Eddie was partially obstructed, turning blue around the edges, panicked and motioned that he could not cough. What did my boss the vet do? Had 1 tech call 911, started up the O2 and talked to him to help him stay calm; we watched his O2 sat levels rise on one of our monitoring machines. As the paramedics were wheeling Eddie out he fully obstructed and they had to use forceps to pull the offending chunk-o-ham sandwich out. What did the paramedics say? They told us we did a great job and certainly helped in that situation. What did Eddie say? He bought us a big flower arrangement and thanked us for helping to save his life.
On a near miss occasion this spring I was attacked in the clinic by a vicious dog. He already had a muzzle, thank God. It was the most determined and aggressive attack we'd seen at the clinic ever. The 120# dog had me backed into the corner and was going for my throat and belly. We got the dog off of me and I was unharmed (thank you Lord for muzzles). What was my boss thinking of while trying to pull the dog off of me? How many sterile bandages do I have? How quick can I scrub up? Should we switch to the second O2 tank? I have no doubt that if that dog had gotten the muzzle off without some sort of medical attention immediately I would have died.
Should a DVM practice human medicine? No, not in any normal circumstances. Should a person ethically step in when someone's life is truly on the line and the EMT's are not there yet? Absolutely. I know I would not be able to live with myself if someone died in front of me because I didn't have the balls to try to help and I was afraid of the liability. Perhaps I am naive but I also sincerely doubt when it is a true emergency that the person who's dying is going to sue someone who tried to help.




ProZackMI said:
No. If you're a vet and you lay a finger on a human, for purposes of tx or dx, you will lose your license to practice, possibly face criminal charges (practicing med without a license), and you could very well be sued and lose everything. Why risk it? If faced with a life and death situation, don't risk everything because you will not be shielded from liability with "good samaritan" statutes. A DVM might have knowledge, but is not qualified to practice medicine and should NEVER even attempt to. Let EMS workers help.

Likewise, an MD or DO should never try to practice vet med. I'm an MD and although I think I might be able to treat my cat when she's ill, I really don't know her physiology as well as I'd like to and I could miscalculate a dose or something and kill her.

Some MDs help out with primate surgeries, from time-to-time, but this is rare.

While some PhDs in zoology and primatology, etc., might be qualified to operate on an animal, would most vets feel comfortable with this? Probably not.
 
I think the reasons for the different answers is the OP had a general question, and it really depends on the situation. To me, the term "practice" implies doing things on a routine basis, in which case ProZackMi is right -- practicing without a license is ethically, morally and legally wrong.

On the other hand, anyone -- DVM or not -- is expected to provide bystander care in an emergency. This may just involve calling 911. But in other cases, it may be more. To say that a vet who lays a finger on a person to treat them in an emergency will lose their license is incorrect.

Several months ago, a veterinary anesthesiologist friend of mine performed CPR on a guy in V-fib (as he was instructing someone to call 911). In this capacity he wasn't a DVM, just a bystander -- albeit one that knew more about what he was doing than an average bystander.
 
bubbles525 said:
I'm sorry but your answer seems totally off the wall. In an emergency most people do what needs to be done to save a life, MD, DVM or lay person. A few summers ago at the SA clinic I work at a construction worker came over and asked us to call 911 because his boss was choking on a ham sandwich. Eddie was partially obstructed, turning blue around the edges, panicked and motioned that he could not cough. What did my boss the vet do? Had 1 tech call 911, started up the O2 and talked to him to help him stay calm; we watched his O2 sat levels rise on one of our monitoring machines. As the paramedics were wheeling Eddie out he fully obstructed and they had to use forceps to pull the offending chunk-o-ham sandwich out. What did the paramedics say? They told us we did a great job and certainly helped in that situation. What did Eddie say? He bought us a big flower arrangement and thanked us for helping to save his life.
On a near miss occasion this spring I was attacked in the clinic by a vicious dog. He already had a muzzle, thank God. It was the most determined and aggressive attack we'd seen at the clinic ever. The 120# dog had me backed into the corner and was going for my throat and belly. We got the dog off of me and I was unharmed (thank you Lord for muzzles). What was my boss thinking of while trying to pull the dog off of me? How many sterile bandages do I have? How quick can I scrub up? Should we switch to the second O2 tank? I have no doubt that if that dog had gotten the muzzle off without some sort of medical attention immediately I would have died.
Should a DVM practice human medicine? No, not in any normal circumstances. Should a person ethically step in when someone's life is truly on the line and the EMT's are not there yet? Absolutely. I know I would not be able to live with myself if someone died in front of me because I didn't have the balls to try to help and I was afraid of the liability. Perhaps I am naive but I also sincerely doubt when it is a true emergency that the person who's dying is going to sue someone who tried to help.


I'm a physician and an attorney. Let me say that the examples you gave are exigent circumstances where someone's life is on the life and help is required immediately. I'm not sure how much CPR and medical-first-repsonder type training vets get, but do you really think a vet knows more than an nurse, PA, or EMT in terms of responding to emergency trauma? I don't think so. I know vets know a great deal....of VET MED, but you simply don't know enough human phys and anatomy (and despite Bill's comments, it is quite different from canine/feline anatomy) to render effective emergency medical care.

NOW...if a vet is also an EMT or MFR, then fine...no problem. In the choking situation, the vet wasn't doing anything medical, but was rather acting in a reasonable way to extricte the foreign body from the trachea. If you said the vet performed a trach to establish an airway, I think that vet would need a good lawyer...regardless of whether he saved the guy's life or not. That is going too far and he could have killed him. However, things worked out, so not a big deal.

In the situation where you're a vet at a clinic and you get injured and another vet renders medical care, again, given those circumstances, fixing a laceration, cleaning a wound, etc., is not a major thing. However, I would caution you from doing it to a client. If a dog bit the owner of another animal while on your premises, and the injury was deep, you should give the client some antiseptic, help put pressure on the wound, but either 911 or, if they are well enough, help them get to the local ER. You should never try to "repair" it yourself. If you botch it up, and the client is not a kindly soul, you will have your ass handed to you in court. You could also lose your vet license.

Most states have a "good samaritan" shield in tort/civil law. Essentially, this means that a person who tries to save the life or limb of another, in an emergency situation, is shielded from general negligence liability if he/she screws up and ends up harming the patient further, or causing another injury in the process of rendering assistance. Example, while performing CPR, the helper breaks a rib or causes a diaphragmatic contusion or breaks the sternum, dislocates a shoulder, etc. Things happen -- unforeseen things -- so these people are normally shielded from liability.

HOWEVER, this does not always apply when the person rendering aid acts in a way that is somewhat deceptive or induces trust in others. I know of an ohio case where there was a small commuter plane. A man suffered a severe asthma attack (status asthmaticus) and one of the flight attendants yelled out "Is there a doctor on the plane?" As fate would have it, a vet was on the plane and this ***** yelled "I'm a doctor!" and tried to help the poor guy. He damaged his trachea and esophagus and caused permanent damage. Was the vet shielded from liability? No; instead, he lost his license to practice, was sued for everything he had, and also was charged with practicing med w/o a license. His defense attorney tried his best to offer the good samaritan defense, but the deciding factor here was that no matter how much "medicine" he knew, he should have kept his mouth shut since his knowledge wouldn't amount to jack squat in the circumstances. Same with a dentist, optometrist, pharmacist, etc., who said "I'm a doctor", which caused others to trust the guy and think he knew what he was doing.

Now, what if there was an OB-GYN on the plane, or a GI specialist, who knew very little about respiratory conditions, but offered help? Well, in that case, you have an MD or DO who has been through internships and rotating residencies and has received extra-speciality training in emergency med, etc. While I would rather have an ER nurse or EMT help me, I would feel better with an MD radiologist or ophthalmologist rendering aid to me than a DVM, PharmD, OD, PhD, JD, etc.

I mean no disrespect, but am being honest. In a crisis, while it might bother you to sit idly by while someone is in need of help, you are not a medical doctor, so don't risk it all by thinking you know the same. Assess the situation, see what's going on, and if it's something relatively minor, do what you can until EMS gets there. However, if it's totally outside the scope of your training, shut up and wait for EMS.
 
Bill59 said:
I think the reasons for the different answers is the OP had a general question, and it really depends on the situation. To me, the term "practice" implies doing things on a routine basis, in which case ProZackMi is right -- practicing without a license is ethically, morally and legally wrong.

On the other hand, anyone -- DVM or not -- is expected to provide bystander care in an emergency. This may just involve calling 911. But in other cases, it may be more. To say that a vet who lays a finger on a person to treat them in an emergency will lose their license is incorrect.

Several months ago, a veterinary anesthesiologist friend of mine performed CPR on a guy in V-fib (as he was instructing someone to call 911). In this capacity he wasn't a DVM, just a bystander -- albeit one that knew more about what he was doing than an average bystander.

Actually, it would depend on the facts. In most situations, if a vet tries to help, he/she is just another good samaritan, but if you go around saying "I'm a doctor" or "I'm a vet" (better, but still, don't), you are then changing your status as a mere bystander to an informed medical professional -- don't do that if you're not trained as an EMT. Even if you hold a CPR cert, just shut up and help, don't puff yourself up like in my scenario above "I'm a doctor, I can help!". While you may be a doctor insofar as a DVM is a doctor, in the eyes of the public, "doctor" means MD or DO only, NOT PhD, JD, PharmD, OD, DDS, DVM, DPM, DPT, ScD, etc.

Using that reasoning, a lawyer, who holds a DOCTOR of Jurisprudence, or a pharmacist with a DOCTOR of Pharmacy or an optometrist (OD) would technically be doctors too, but in reality...not the kind of doctor you'd want or need in that crisis situation, right?

So, yes, acting as a bystander, you'd be okay....but don't assume that as a vet you can help someone in medically exigent circumstances. Don't just sit by, but call 911 and wait for professional help to arrive. I'm an MD, but my speciality is psychiatry. I did an IM residency too, but I've a psychiatrist for a while. Two years ago, I came upon an MVA, late at night, around 2 am, in a rather isolated area. I had just missed the accident by a few minutes. Two teenage boys. One was obviously dead, the other was seriously injured. I assessed the situation and realized I could not get the kid out without possibly hurting him further. I called 911 with my cell and waited until the sheriff's department arrived. In that case, even if I could have gotten to the kid, I didn't have a first aid kid or medical bag. I don't know what I could have done to help. EMS got there within 10 minutes. Nothing I could have done would been helpful in that time period.

So, in situations like that, as vets, you really should assess the situation and ask yourself "is there anything I really can do that would help?" In a true medical emergency, a vet, dentist, pharmacist, optometrist, chiro, etc., would be no more qualified to offer effective asssistance to those in need than a carpenter, farmer, stock brocker, or social worker.
 
ProZackMI said:
I mean no disrespect, but am being honest. In a crisis, while it might bother you to sit idly by while someone is in need of help, you are not a medical doctor, so don't risk it all by thinking you know the same. Assess the situation, see what's going on, and if it's something relatively minor, do what you can until EMS gets there. However, if it's totally outside the scope of your training, shut up and wait for EMS.


Jesus christ. We get it - you're so much better than us.

Firstly, we went to vet school to treat animals, not people - nobody here is disputing that, nor do we want to stomp on your toes by saving sick people. Secondly, your story is pretty far fetched, and i dont quite believe it - nobody is that stupid.

Thanks for coming out though.
 
Thanks for your comments ProZackMI. We mostly agree, and I don't think anyone is saying a DVM is adequately trained to treat human patients, nor should ever claim to be.

That said, the DVM anesthesiologist I referred to runs 2-3 codes a week -- dogs, cats, horses, hawks, -- he's used to different species. If I'm the one that's down I hope there's an EM MD there. But if my choice is him or a social worker, I know who I'm picking.
 
A Vet sewed up my eyebrow when one of my friends hit my forehead with a bottlerocket. I was in high school and my friend's mom was an ER nurse at the local hospital. He took me to his Vet friend because his mom would find out and kick his a$$.
 
ProZackMI said:
HOWEVER, this does not always apply when the person rendering aid acts in a way that is somewhat deceptive or induces trust in others. I know of an ohio case where there was a small commuter plane. A man suffered a severe asthma attack (status asthmaticus) and one of the flight attendants yelled out "Is there a doctor on the plane?" As fate would have it, a vet was on the plane and this ***** yelled "I'm a doctor!" and tried to help the poor guy. He damaged his trachea and esophagus and caused permanent damage. Was the vet shielded from liability? No; instead, he lost his license to practice, was sued for everything he had, and also was charged with practicing med w/o a license. His defense attorney tried his best to offer the good samaritan defense, but the deciding factor here was that no matter how much "medicine" he knew, he should have kept his mouth shut since his knowledge wouldn't amount to jack squat in the circumstances. Same with a dentist, optometrist, pharmacist, etc., who said "I'm a doctor", which caused others to trust the guy and think he knew what he was doing.


Thats interesting. THanks for the legal advice. What if the opposite happend. Say i'm a vet, and a person has a medical emergency and I do nothing. I'm just a bystander. What is my liablility if the family/person tried to sue me for not rendering aid.
 
chemokine said:
Thats interesting. THanks for the legal advice. What if the opposite happend. Say i'm a vet, and a person has a medical emergency and I do nothing. I'm just a bystander. What is my liablility if the family/person tried to sue me for not rendering aid.

If you don't put yourself out there, as a samaritan, how would anyone know who you are in order to sue you? No private citiizen has a legal duty to act on behalf of another. A moral duty is different. Now, if you're a vet and an EMT, that's different...you have a legal duty to act. However, if you're a vet and see something like an auto accident or something to that effect, you have no legal duty to assist. No one can sue you for inaction when there is no legal duty to render aid.

Only police officers, EMS workers, and others who, by virtue of their job, have a LEGAL duty to act, can be found liable for failing to act. Also, some have a legal duty to act per statute or contractual provision. None of these would apply to a vet under normal circumstances.
 
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ProZackMI said:
If you don't put yourself out there, as a samaritan, how would anyone know who you are in order to sue you? No private citiizen has a legal duty to act on behalf of another. A moral duty is different. Now, if you're a vet and an EMT, that's different...you have a legal duty to act. However, if you're a vet and see something like an auto accident or something to that effect, you have no legal duty to assist. No one can sue you for inaction when there is no legal duty to render aid.

Only police officers, EMS workers, and others who, by virtue of their job, have a LEGAL duty to act, can be found liable for failing to act. Also, some have a legal duty to act per statute or contractual provision. None of these would apply to a vet under normal circumstances.

Well assume that you are on a plane or something where they could reasonably get a list of passengers and figure out who you are. What if you are an MD, (but like a psychiatrist or OB-GYN) and not really trained to handle such a situation and you do nothing.Or you do do something but
the person gets hurt badly, could he sue you? But you made no indication that you are medically trained.
 
chemokine said:
Well assume that you are on a plane or something where they could reasonably get a list of passengers and figure out who you are. What if you are an MD, (but like a psychiatrist or OB-GYN) and not really trained to handle such a situation and you do nothing.Or you do do something but
the person gets hurt badly, could he sue you? But you made no indication that you are medically trained.


No. Besides, plane tickets (at least the ones I've purchased), NEVER say MD after my name. No one would know. How would the passenger compel the airline to release names of all passengers? That would not be evidence that would be discoverable normally. Besides, all cruise ships and airplanes have medical-first-responder trained flight attendants, etc.
 
ProZackMI said:
No. Besides, plane tickets (at least the ones I've purchased), NEVER say MD after my name. No one would know. How would the passenger compel the airline to release names of all passengers?
OK, I can't resist jumping in with a better example, because I'm actually curious about the answer... Say I'm a vet, and a client has a heart attack in my office. Or even more likely, an allergic asthma attack. A tech gets attacked by a dog (as described earlier). A client gets attacked by somebody else's dog. A workman you've hired chokes on his lunch (as described earlier). A vet student goes anaphylactic from the hay/dust in a barn (know someone who did this). An accident happens at the corner, and somebody sees the "Veterinary Hospital" sign on your building. Vet practices get a lot of traffic, some of the people coming through are bound to have medical problems. And... They're almost all there because they *already* know you're a vet. ;)

I'm not harrassing you, ProZack, given all this conversation I just wonder what's too much... Offering a client a band-aid or an ice pack? A handful of gauze and some pressure to stop bleeding? Giving supplemental oxygen to the guy who was choking? Epinephrine shot for the anaphylactic student out in the country far from any EMS station? Does it make a difference if the person in distress is your employee or your student vs. a client or some guy walking down the street?

Seems like a practicing vet would be wise to get *human* first aid and CPR training and keep it current for themselves and their staff. That would actually let you do quite a lot in an emergency (if EMS actually got the chunk out with forceps, the ham-sandwich guy might have benefitted more from a Heimlich than an oxygen mask), and might cover human-specific issues that wouldn't transfer well from vet med. Then again, it might just increase your liability...
 
ProZackMI said:
So, in situations like that, as vets, you really should assess the situation and ask yourself "is there anything I really can do that would help?" In a true medical emergency, a vet, dentist, pharmacist, optometrist, chiro, etc., would be no more qualified to offer effective asssistance to those in need than a carpenter, farmer, stock brocker, or social worker.

You're a dick. Pull your head out of your ass.
 
BrushGoodDar said:
You're a dick. Pull your head out of your ass.

Why am I a dick? Because I'm clarifying a question from a legal perspective? Forget the fact that I'm an MD. I DO NOT look down on vets at all. Why would I? Maybe if I had gone to vet school instead of medical school, I would have stayed in my profession of choice rather than leaving it for law. I do not look down on vet med at all. If my posts have come across that way, maybe YOU should look inside yourself and see what's going on in there. I suspect some underyling "inferiority" complex.

No vet has a reason to feel inferior to ANY MD or DO. Our training is similar, but different. Given the original question posed, I answered in terms of legal fact and reality. One of my best friend's father is a vet who's been in practice as long as I've been alive. He's a great guy and like a second father to me. However, I have heard his wife, and even him, say things like he's is a "doctor" and I've seen him give meds at his clinic to his own family for purposes of tx (UTI, URI, etc.). While he may know what he's doing, to some extent, I really think behaviour like that is somewhat cavalier and risky.

That is why I replied to this post. So, if anyone out there who reads this gets all defensive, NO...I'm not being condescending or denigrating the vet med profession. I'm answering the originally posted question about cross-practicing within a legal context.

If you think I'm full of sh|t, that's fine, but I would still caution you from doing anything that would induce the public, or someone in distress, from thinking you're an MD or DO or possess knowledge equivalent to such professionals. In terms of treating humans, a DVM does NOT possess such knowledge and has NO experience treating human patients...period. Why would this even be questioned? How would you vets feel if I started performing OHEs on my cat and my friends' animals? I could do it. I went to medical school and rotated through OB-GYN and did an IM residency. Why wouldn't I be qualified to provide basic tx to another mammalian species?

Simple answer: I never went to vet school and even though I may think I know enough, I might actually do more harm than good. Emgergencies are always different given the circumstances. That's why if this poster didn't suffer from microcephaly, he would have realized that given an exigent situation, the prudent vet would assess the situation, determine if she/he would competently be able to provide some assistance without doing further damage, and then do what he/she can to help.

If that advice was too complicated for you to understand, I suggest you apply to chiropractic school. You might excel in that profession. You'll never make it into med or vet med with your piss poor reading comprehension, poor information processing skills, and repugnant bedside manner.
 
ProZackMI said:
lots of stuff.

I think that you have given good advice and been really helpful to this conversation. I am going to be a vet (we start in just a couple of days). I would never want to do something that would really hurt my career or get me sued and ruin my life. With how sue happy people are in this day and age we need to know our boundries. A vet is a highly trained health care professional and I don't think he was trying to denigrate that. What he is saying is that our scope of training limits us to practice on animals. Just as an MD is limited to only people, and would get into trouble for trying to treat an animal. If there was an emergency I would try and help any way I could, but I have to know some of the law and what my limitations are for the above mentioned reasons.
 
kate_g said:
OK, I can't resist jumping in with a better example, because I'm actually curious about the answer... Say I'm a vet, and a client has a heart attack in my office. Or even more likely, an allergic asthma attack. A tech gets attacked by a dog (as described earlier). A client gets attacked by somebody else's dog. A workman you've hired chokes on his lunch (as described earlier). A vet student goes anaphylactic from the hay/dust in a barn (know someone who did this). An accident happens at the corner, and somebody sees the "Veterinary Hospital" sign on your building. Vet practices get a lot of traffic, some of the people coming through are bound to have medical problems. And... They're almost all there because they *already* know you're a vet. ;)

I'm not harrassing you, ProZack, given all this conversation I just wonder what's too much... Offering a client a band-aid or an ice pack? A handful of gauze and some pressure to stop bleeding? Giving supplemental oxygen to the guy who was choking? Epinephrine shot for the anaphylactic student out in the country far from any EMS station? Does it make a difference if the person in distress is your employee or your student vs. a client or some guy walking down the street?

Seems like a practicing vet would be wise to get *human* first aid and CPR training and keep it current for themselves and their staff. That would actually let you do quite a lot in an emergency (if EMS actually got the chunk out with forceps, the ham-sandwich guy might have benefitted more from a Heimlich than an oxygen mask), and might cover human-specific issues that wouldn't transfer well from vet med. Then again, it might just increase your liability...

ANY business owner should have a fairly comprehensive first aid kit around in the event that a customer or employee becomes injured. As a business owner, you have a LEGAL duty to assist an employee or customer who becomes injured on your property or within the sphere of your business operations (such as the grounds, etc.). This is in striking contrast to the vet on the plane or coming upon an accident who has no LEGAL duty to do squat. Under normal circumstances, this duty means that a business owner must call 911 or obtain EMS assistance as quickly as possible in the event of a significant trauma.

If the injury is something minor, then the owner of the business should provide water, first aid supplies, a telephone, a place to sit, or whatever is needed until the customer or employee can leave on his/her own, safely.

Let's go through your hypotheticals individually. You're a vet and you own a clinic. You have a client in your office who has brought his dog Frisky in for a routine check-up. Your client suffers a heart attack in your office. The most important question is: do you hold a CPR certification? If yes, and it's up-to-date, the first thing you should do is call 911 and then administer CPR to the best of your ability. You're immune under general good samaritan statutes if you make a mistake and cause an injury negligently.

What if you do not have any CPR training? Given the facts, are you, as a DVM, any better trained to offer assistance than your other clients or your staff? No. Without CPR training, or medical first responder training, your training in vet med would not be helpful to this adult human being suffering a myocardial infarction. Call 911. You won't be that far from a police cruiser (all cops are medical first responders) or fire dept. What else can you do? Perform a CABG? Do a PTCA with stenting? Administer an EKG? An Echocardiogram? There's nothing medically you can do.

Okay, now what if a client or employee or student has an asthma attack? For employees or students, given the nature of your work with animals (who are primary or secondary allergens to many), and the possibility of injury, you should always ask your employees or students some basic medical questions: (1) Any known drug allergies; (2) any significant medical impairments that might be triggered here at work (and specify, allergies, asthma, COPD, IDDM, NIDDM (hypoglycemia vs. DKA), haemophilia, DVT on anticoag tx (e.g., Coumadin), etc. This may seem intrusive, it's also necessary given your work conditions. If an employee or student has severe asthma, one thing you could do is ask: where do you keep your inhalers in case of an emergency? If the employee or student has meds that they take routinely, where does he/she keep the meds in case of an emergency?

Now, don't, as a routine, ask these questions on an employment application, but it's okay to ask the employee about these things, CONFIDENTIALLY, after being hired. You're doing it to help the employee and to mitigate your liability.

If you have a student or employee who goes anaphylactic on you, and you are far from the police or EMS, and you have access to Epi and know how to administer it, you should be okay. The employee and student has a duty to inform you of potential emergencies (medical) and you have a duty to provide some form of competent assistance given the facts. Obviously, if you don't have access to Epi, or in the case of cardiac problems, atropine, the ONLY thing you can do is make the patient comfortable and wait for EMS.

If it's a client, you have no way of knowing a medical hx, so if the client is with a spouse or child, ask that person some basic questions AFTER you call EMS/911. See if there are any meds that can be given or special allergies. You might be the only reasonable person to communicate with EMS when they get there.

If an employee or client gets attacked by an animal, there should be no problem cleaning a wound, placing gauze or a bandage over a wound, etc. That is not medical tx, but first aid tx. If it's a deep laceration, clean the wound thoroughly, and apply pressure. If the patient seems weak or light-headed, call EMS and wait. If they are not light-headed, offer to drive them to a local urgent care or ER, or call a family member or friend to pick them up. Offer to board their animal over night, etc., if necessary.

If someone walks into your clinic seeking medical attention, explain your clinic is a veterinary clinic and then find what's going on. Again, call EMS or 911 and get help. If you try to provide medical assistance, you might become infected with something (e.g., Hep C, HIV, etc.), expose your clients and employees to something, or expose yourself to liability. These people are not clients or employees, you owe them no duty. Inform them or those asking that you're a vet, not a physician, and that you can't help but will call 911. To do otherwise is to take a significant risk.
 
chemokine said:
I think that you have given good advice and been really helpful to this conversation. I am going to be a vet (we start in just a couple of days). I would never want to do something that would really hurt my career or get me sued and ruin my life. With how sue happy people are in this day and age we need to know our boundries. A vet is a highly trained health care professional and I don't think he was trying to denigrate that. What he is saying is that our scope of training limits us to practice on animals. Just as an MD is limited to only people, and would get into trouble for trying to treat an animal. If there was an emergency I would try and help any way I could, but I have to know some of the law and what my limitations are for the above mentioned reasons.

Do you get any kind of basic legal training in vet school? Is there a course on vet ethics and professional responsiblity? If not, but there are electives, I suggest you take a few. Also, take a few business classes if possible; it will help you in private practice.

In general, the common sense thing to do, in any profession, is to act within the scope of your training and within the scope of your practice. With MDs, it's different, even if we are trained in one speciality, it's presumed that we are trained in medicine in general due to our rotating internships and residency training after med school.

But for vets, psychologists, optometrists, pharmacists, dentists, etc., who have a great deal of medical knowledge, but don't have comprehensive medical training, it would be prudent to avoid situations that might expose you to unncessary liability.

Essentially, some good advice:

1) Always be honest and upfront. Tell people you're a vet, not a physician. Never say things like "I'm a doctor!" While you wouldn't be lying, per se, the average idiot on the street thinks "doctor" means MD or DO, not DVM, PHD, PharmD, JD, etc. Some folks, like chiros, love to deceive others into believing they are physicians or possess the knowledge of physicians. Most vets are honest, hard-working, exceptionally intelligent people who would never do that. So, avoid confusion by saying "i'm a vet". Be proud of who you are and what you do. Most people have a profound respect for vets.

2) Never assume you know more than you do by virtue of your training. I'm a psychiatrist with internal med training. While I have a basic understanding of ocular physiology, anatomy, and pathology, I would be a fool to even attempt to perform any form of ophthalmological surgery. I also never assume that by virtue of my MD, I know everything there is to medicine. I've known clinical pharmacists, PAs, NPs, and others who know far more specialized medicine than me. You know what you practice and what you've learned. You may have learned something in vet school, but if you don't use it, you lose it. Example, if you're a small animal vet and you attempt to operate on a horse, without large animal experience, would you really know what you're doing?

3) Never let anyone, including clients or pompous MDs, tell you that you're somehow inferior to a physician. It takes a great deal of work, intelligence, and dedication to become a vet, just like it does to become a doctor, pharmacist, attorney, etc. If someone tells you that you must not have been accepted into medical school, laugh and tell them how much work vet school was. Don't let people make you feel inferior. Be proud of who you are and what you do. Don't be arrogant, but dont ever feel that you're less because you work on animals, not people. Also, money isn't everything in life. Most vets seem to be very happy with their career choice and love their work. How many doctors and dentists can say this?

Good luck!
 
ProZackMI said:
more stuff

I believe we have to take a course in veterinary medical ethics in 2nd year.

In regards to training a vet is trained very much like a doctor and vet school curriculum covers similar basic science(Gross anatomy, histology, micro, pharmacology etc...) and then goes into clinical rotations much like an MD or DO student in the 3rd and 4th year. I think the key difference lies in the fact that in order to get a license you don't have to do a residency. You can go right to work. However, I am sure there is a steep learning curve after you graduate. THe vet I worked for told me you actually learn everything when you get your first job so you work for someone who is older and more experienced (or go through an internship and residency).

Also it is alot easier to get into MD or DO school then veterinary school. At the school I am going to (MSU) there were 1000 applicants for 100 seats this past year with similar stats at other schools (there are only 28 vet schools in the entire USA).I'm also sorry to say this but usually clients that give us guff are MDs that think they know better than the vet (nurses are bad sometimes too).The general public also has limited knowledge of the extent of our education and sometimes thinks it's akin to trade school. This is why alot of vets/vet students get on the defensive when they feel challenged about their credentials. I don't really care what anyone thinks and I believe most people are well meaning. They just are not educated about veterinary medicine.
 
ProZack, check the ego at the door, we're not impressed. :sleep:
 
BackTalk said:
ProZack, check the ego at the door, we're not impressed. :sleep:

You're a chiroquackter...er...chiropractor, I'm sure you're used to people being not impressed. Go crack some backs and sell some subluxations and call me in the morning. No one is impressed with you doctor-wannabes with your 2.0 GPAs, no undergrad degrees, and laughable DC degrees. :)
 
chemokine said:
I believe we have to take a course in veterinary medical ethics in 2nd year.

In regards to training a vet is trained very much like a doctor and vet school curriculum covers similar basic science(Gross anatomy, histology, micro, pharmacology etc...) and then goes into clinical rotations much like an MD or DO student in the 3rd and 4th year. I think the key difference lies in the fact that in order to get a license you don't have to do a residency. You can go right to work. However, I am sure there is a steep learning curve after you graduate. THe vet I worked for told me you actually learn everything when you get your first job so you work for someone who is older and more experienced (or go through an internship and residency).

Also it is alot easier to get into MD or DO school then veterinary school. At the school I am going to (MSU) there were 1000 applicants for 100 seats this past year with similar stats at other schools (there are only 28 vet schools in the entire USA).I'm also sorry to say this but usually clients that give us guff are MDs that think they know better than the vet (nurses are bad sometimes too).The general public also has limited knowledge of the extent of our education and sometimes thinks it's akin to trade school. This is why alot of vets/vet students get on the defensive when they feel challenged about their credentials. I don't really care what anyone thinks and I believe most people are well meaning. They just are not educated about veterinary medicine.

I went to MSU CHM and really enjoyed my 4 years in East Lansing. MSU is one of the best vet schools in the country. Congrats on getting in and I wish you the best. We took a lot of our basic science classes alongside DO and DVM students. :)
 
ProZackMI,

I think you've given us all some excellent advice. If someone in my exam room had a cardiac arrest, at most I would call 911 and attempt CPR - now I took a human CPR course a LONG time ago (my mom is a CPR instructor), so it wouldn't be *good* CPR, but it would be worth something. If someone had an anaphylactic reaction, I really would not feel safe administering any kind of medication other than O2 via face mask (unless they carried an epi-pen in their pocket!). I just think there're too many potential liability problems there.
 
OK, I'll go crack some backs if you go out and shrink some more heads. My undergrad degree is worth more than your flunky law degree. Talk about a quack! Go pump some Prozac....um....yes....yezzzzzz
 
Hey,

I'am sorry the discussion has flamed up a bit. I did not intend my question as a provocation. I appreciate everyones answers. Thankyou.

I may have not have phrased my question correctly, but my question was driving at potentiality as opposed to "legality". How different is a similiar operation on a Dog and a Human for example? Would a Vet be able to diagnose illness in a human?

Ben
 
birdvet2006 said:
ProZackMI,

I think you've given us all some excellent advice. If someone in my exam room had a cardiac arrest, at most I would call 911 and attempt CPR - now I took a human CPR course a LONG time ago (my mom is a CPR instructor), so it wouldn't be *good* CPR, but it would be worth something. If someone had an anaphylactic reaction, I really would not feel safe administering any kind of medication other than O2 via face mask (unless they carried an epi-pen in their pocket!). I just think there're too many potential liability problems there.

:)
 
BackTalk said:
OK, I'll go crack some backs if you go out and shrink some more heads. My undergrad degree is worth more than your flunky law degree. Talk about a quack! Go pump some Prozac....um....yes....yezzzzzz


Let's see here, to get into ANY chiropractic college, like Life University or Palmer, you need:

1) About 60-90 undergraduate credits in any major (no degree is required);
2) NO admission test;
3) And a cumulative GPA of what, 2.0 to 2.5?

To matriculate with a DC degree, you need 3.5 years of cracking backs, quasi-scientific classes taught by DCs (not MDs, PhDs, etc.), and a pathetic "clinical" experience where you have to recruit "patients" from the local community and convince them they need adjustments and tx without an objective SOAP exam. After graduation, you have a pathetically easy licensing exam and then you can peddle your wares at malls, strip malls, and shoppling centers all over the country.

A great many of chiros default on their student loans. Many have no undergrad degree to fall back on. Most were "C" students who could not handle the intellectual rigours of med school, vet school, optometry school, dental school, or yes, law school. Many chiros leave the "cult" of chriopractic and seek "lesser" employment as school teachers, nurses, or techs. Most find that their DC degree does not qualify them to teach in any field other than chiropractic.

Now, to get into law school, what does it take?

1) A completed undergrad degree (note, a BA/BS is an undergrad degree, not an associate's degree);
2) A cumulative GPA of at least 3.0-3.5, usually 3.5+;
3) Good scores on the LSAT (note, there is nothing comparable for chiroquackters).

Then, law school is about 3 - 3.5 years of full-time study beyond the BA/BS (not just 90 credits of college needed to get into chiro school with a "C"). Law is not simply memorization of facts, like medical school (which I equate to undergraduate education), but actual critical thinking and application of facts to a body of knowledge. My law degree was more intellectually demanding than my medical degree insofar as it taught me how to think, critically analyze facts, apply those facts to a specific body of law, and how to write/speak effectively.

After graduation, the newly-minted JD must pass a very rigourous bar exam. Even though the Michigan Bar exam was not as demanding as USMLE I and II, it was a huge endeavour and very difficult; it's two days of pure hell. Not only the bar exam, the Multistate Professional Rules of Ethics (MPRE) exam must be passed, a very thorough and scrutinizing "character and fitness" investigation must also be completed before one can be licensed as an attorney. Many lawyers then go through a 1-3 year clerkship that is similar to many residencies. There are also post JD fellowships.

Most JDs are from credible universities, you know, like University of Michigan, Harvard, Michigan State University, Univ of Cal Berk, Yale, Stanford, etc. Chiro schools: Life University, National Chiro College, Palmer Chiro College, etc. Yeah, I can see the comparison!

I'm not saying medical school was easy. Far from it. However, medical school was mostly memorization and regurgitation of facts, not application. It wasn't until my PGY residency years that I actually learned how to apply that knowledge and think like a doctor. Medical school was hard, but it was not as "intellectual" as law school. At least in my opinion.

Now, given the facts, can you really say my JD from Michigan State University College of Law is inferior to your undergrad degree or your DC degree? I suggest you do some research and see what it takes to be a lawyer in the US; it's not a cakewalk, unlike your back-cracking cracker jack degree.

And, while many lawyers change careers, most stay with law. A law degree is equivalent to a PHD in academia and a JD can teach a wide range of undergraduate and graduate classes in business, business law, political science, criminal justice, human resources/labor-industrial relations, journalism, and a few other fields. This is, of course, in addition to JDs who teach in law schools. Some JDs find tenured positions in medical schools, schools of public health, etc., teaching medical ethics, law and medicine, and public health courses. A JD is also useful in many administrative jobs, whereas a DC degree is absolutely useless outside your field of back-cracking.

Yes, I know a few DCs who teach at community college, in bio courses, etc., but you'd never find a DC on the faculty of a four-year college or university that was not connected with chiro education. NEVER.

So, you were saying?
 
Interesting discussion all...

***Reminder please!*** SDN policy does not allow the flaming and harassing of members which has been showing up in this thread! Please try to refrain from these behaviors and stick to the vet-related conversations.

Thank you!

Deanna
SDN Veterinary Forums Moderator
 
Prozack, I'll be more than happy to continue this dicussion privately or as a new topic, I am not going to hijack this thread and turn into a chiropractic bashing thread which is where you are taking it.
 
ProZackMI said:
So, in situations like that, as vets, you really should assess the situation and ask yourself "is there anything I really can do that would help?" In a true medical emergency, a vet, dentist, pharmacist, optometrist, chiro, etc., would be no more qualified to offer effective asssistance to those in need than a carpenter, farmer, stock brocker, or social worker.

"Help, someone please! There's been a terrible car accident up the road!"

Carpenter: "I've got my saw in the back of my truck here, I'll go into the woods, cut up some trees and make some splints just in case anybody needs one"

Farmer: "Well I'm used to pitching hey and driving tractors so if you need someone for heavy lifting or driving the ambulance, you've got your man!"

Stock Broker: "I'm already on my phone, the people in the accident are probably going to need some funds to fix up their automobiles after this whole thing is over."

Social Worker: "I'll gather everyone who's been in the accident around my car here and have a discussion about the whole incident. It's far better to vocalize fears and anxieties after an accident than to keep them bottled up inside."

Veterinarian: "Uh... someone better call a doctor, none of these animals have fur."
 
benyjets23 said:
How different is a similiar operation on a Dog and a Human for example? Would a Vet be able to diagnose illness in a human?
Well, mammals are pretty similar as far as the internal organs. A mouse spleen looks a lot like a human spleen, and they're in generally the same place. Some of the wackier small structures like the thyroid and parathyroid are configured differently, but if you had an MD slice open a dog (or a vet slice open a human) they'd probably recognize everything.

As far as diagnosis, there are loads of very "human" ailments that other animals get - diabetes, kidney failure, liver failure, hyperthyroidism, cancers of all types, inflammatory bowel disease, allergies, arthritis... just to name a few off the top of my head that I've seen shadowing in the past few weeks. Not to mention broken bones, collapsed lungs, and other traumatic injuries. In many cases, the symptoms are exactly the same in animals and in humans, and bloodwork that gets done on animals is often looking for exactly the same things (liver enzymes, electrolyte balance, white cell count, whatever). So if the vet did a "H&P" and labs on the human (not that they should legally...) they may have a very good chance of diagnosing correctly. However... There are also diseases that present very differently in animals and people - and between species of animals, for that matter.

As far as treatment, some of the above conditions are treated *exactly* the way they are for humans, with exactly the same drugs just in proportionally smaller doses. In some cases, differences in metabolism mean that you need much more or much less than you would proportionally give a human, or that the human drug is toxic to the animal. (And of course these same differences can exist between the different species you might see as a vet.)

I guess that means the answer to your question is... "maybe". :)
 
Also the basics of good surgical technique are very similar regardless of species: asepsis, gentle tissue handling, hemostasis, suturing. That's why MD surgeons often lean/practice new techniques on animals first.

And why with all the animal rights problems, veterinary students have had to switch to practicing on humans.
 
Prozac emphatically declares:


"but you'd never find a DC on the faculty of a four-year college or university that was not connected with chiro education. NEVER. "



Oh really now?
You either have no knowledge of what you are claiming, or are intentionally proferring ridiculous nonsense.

This DC happens to be faculty at Brown Medical school.

http://www.brown.edu/Divisions/Medical_School/andera/profile.php?id=1100924820

And now, I will join Backtalk, in respecting the original vet posters. I will not address your other inaccurate/preposterous(intentional or not) DC assertions here.
 
....To matriculate with a DC degree, you need 3.5 years of cracking backs, quasi-scientific classes taught by DCs (not MDs, PhDs, etc.), and a pathetic "clinical" experience where you have to recruit "patients" from the local community and convince them they need adjustments and tx without an objective SOAP exam. After graduation, you have a pathetically easy licensing exam and then you can peddle your wares at malls, strip malls, and shoppling centers all over the country....

So, you were saying?

Sounds like you have first-hand knowledge of DC school. Remind me again which chiro school you attended?

Nobody's comparison is valid unless they actually attended both schools, otherwise you're just flappin' your gums and blowing hot air. At least you avoided the usual justifications like "My brother is a chiro and he says..." or "everyone knows that chiros...."
 
this is a very interesting topic...

on a more hypothetical situation...suppose a veterinarian who got stuck in a battlefield (insert any convenient natural disaster) and many civilians and soldiers are wounded, there is only 1 doctor and he cant handle the amount of casualties, many of whom require surgery or they will die...in this situation, the vet is the ONLY other person who has any medical and surgical knowledge should he/she come forward and render assistance? By that i mean should the vet be operating on a human? Will he be liable for any future law suit?
 
there is only 1 doctor and he cant handle the amount of casualties, many of whom require surgery or they will die...in this situation, the vet is the ONLY other person who has any medical and surgical knowledge should he/she come forward and render assistance?
In the hypothetical battlefield I happened to envision (which seems realistic to me, but who's to say...), for all the major injuries requiring surgery, there are many many more people with minor/non-surgical injuries. In a situation that bad, some people are going to die. If the vet and the doc both concentrate on the people who are already mostly dead, then there will be loads of people who lose limbs or fade away in the corner from shock or whatever. I think the vet would ultimately save more lives if he grabbed all the supplies he could carry, ran out into the crowd and stopped bleeding, irrigated wounds, gave IV fluids (if your lone battlefield doc is so well equipped as to have that on hand), splinted limbs, and all kinds of other basic stuff that was well within the region of overlap between human and animal medicine and that hardly anyone would think to sue him for. Kind of a reverse triage. If you save the life of one gravely injured person, but in the same time three other people bleed out or die of shock, was it worthwhile?

Anyway, that's just my battlefield. And of course I didn't actually answer your question...
 
The basic point is if you are not licensed to provide anything more than basic emergency techniques to a human being you should not do so. DUH! I would not put a catheter in a person, or give them medications...that is bordering on a medical diagnosis. I would go by the ABC chart for people and call 911. Giving O2 is never a bad thing.

But LOL....hugely different anatomical differences between dogs, cats, and human....sorry, not at all dissimilar there. Humans, cows/ruminants and reptiles/amphibians however.....you would have me there. However....since I AM human....don't you think I know my own anatomical structure just based on the fact I studied anatomy in other creatures do you really believe I thought to myself...nah I don't care about my OWN anatomy?

I know what everyone is thinking, you want to help how you can. It's like a fire. Sure I know you throw water on a fire to put it out......but If I see a 20 foot building on fire...I'm calling a firefighter! That's the job he was trained for and has the responses to handle.
 
I broke my thumb about a year ago. A friend of mine is a vet. I didn't even go to an MD. Obviously, there are differences. But I really don't think it is that huge. MD's study one animal, while Vet's have to study many.

Yah, there are some differences, but there not that huge. Your question wasn't ridiculous.

ProZack...I recommend getting back on your meds immediately, and this time stay on them.

I have also included a link for you.


http://www.drphil.com/plugger/respond/?plugID=10473
 
If you don't put yourself out there, as a samaritan, how would anyone know who you are in order to sue you? No private citiizen has a legal duty to act on behalf of another. A moral duty is different. Now, if you're a vet and an EMT, that's different...you have a legal duty to act. However, if you're a vet and see something like an auto accident or something to that effect, you have no legal duty to assist. No one can sue you for inaction when there is no legal duty to render aid.

Only police officers, EMS workers, and others who, by virtue of their job, have a LEGAL duty to act, can be found liable for failing to act. Also, some have a legal duty to act per statute or contractual provision. None of these would apply to a vet under normal circumstances.

This law varies from state to state. In California I have no legal duty to act if I'm off duty but if I do act then I am protected under the good samaritan law.
 
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