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Making Disclosure A Reality For Healthcare Organizations 

Disclosure Going to the Dogs (Literally)

image1A veterinarian friend recently sent me a moving article about a fatal misdiagnosis caused by a vet not double-checking a lab report...the key data was right there but the vet never saw it and the dog eventually died. The vet in question ignored the insurance company's advice to clam up, and did the right thing. She met with the owner, apologized, they cried together, and the owner forgave the vet. The vet did everything possible to save the dog over the next few months, but the damage was ultimately fatal. Again, the owner forgave and brought a new puppy to the vet for care. The owner also gave to the vet a collage of pictures of the dog who died, and the vet has hung the collage on her office wall as a reminder to always double-check lab results. Powerful story of reconciliation, healing, and learning from mistakes -- to read more click here. I've done some rewarding work on disclosure with veterinarians and vet schools, but a cynic might counter the liability exposure is dramatically lower with animals and the dynamics of a vet practice are completely different from human medicine. To be fair, there are differences, but, especially today, the emotional impact of adverse events with animals is not much different (if at all) from humans. Moreover, many vet practices drum up the emotional bond with animals to increase business, so post-event, it's kinda hard to say Fido was just a dog, so, please, get over it. Such an attitude will lead to acts of revenge, including bad publicity, complaints to the licensure board, and yes, litigation. Animals teach us so much, and now include disclosure of adverse events to the list. Again, read the story listed above -- it's a great example of the power of disclosure --- and consider my story below.

This past week we brought home our second dog. Gabbi, a feisty and incredibly cute three-month old Wire Hair Fox Terrier is now frolicking with her big brother, Sparky, a 16-month old Wire Hair Fox Terrier, who thankfully has all four paws following a misdiagnosis.

Sparky is my running buddy. We run 20+ miles per week, four to five miles per day in all types of weather. Sparky especially likes cold and even wet running conditions. However, one morning back in April I noticed Sparky had a slight limp when I let him out of his cage. When my wife came downstairs for breakfast, I asked her if she saw the limp, but she could not. Moreover, as the day progressed, Sparky was fine (no limp). However, the next morning, the limp returned and was more pronounced, and my wife saw it this time. Sparky's left front-paw looked different, even a little cracked, so I went to the local Pet superstore and purchased an antibiotic pad cream. I also called our vet who said the cream would be fine, but, as a rule, paws take a long time to heal. Over the next two days I religiously applied the cream according to the manufacturer's instructions, and the limp was at times better, sometimes the same (no improvement). So, out of an abundance of caution, I took Sparky to the vet. In retrospect, I should have just kept applying the cream and not seen the vet.

The vet examined Sparky, took an x-ray, and declared that an "old break" in one of the toes had been re-injured. The vet said the "old break" probably occurred when Sparky was a puppy in the litter, the re-injured bone would take a least a month to heal, and to stop the antibiotic cream immediately because touching the pad in any manner risked further injury.

I wondered how the vet knew it was an "old break" (versus a new break), but, I listened, stopped the antibiotic cream, and didn't mess with the paw in any manner (didn't even look at it). Unfortunately, over the next few days, Sparky's limp became progressively worse to the point he hobbled around on three paws throughout the day. My running buddy was out of commission, but we had faith that in four weeks all would be better. Thankfully, however, a concerned neighbor pushed us to get a second opinion. The new vet took several sets of x-rays and found no break (new or old), but she did find a massive infection. Sparky's paw had been punctured, and swelling from the infection had doubled the size of the pad that had been punctured. It took two rounds of antibiotics to cure the infection, and Sparky is again at my side on the running trails. If, however, we had stayed faithful to the original diagnosis, Sparky would have lost the paw (or worse).

I called the first vet to tell him what happened, and express my frustration. He was dismissive, saying it was a difficult diagnosis, and he still thought there was an old break that had been re-injured. The vet did NOT say sorry, did NOT express any empathy, did NOT show an interest in learning about the infection, and did NOT offer to pay our additional vet bills fixing Sparky's infected paw. Big, fat zero. Thankfully, I had charged the $185 visit to the first vet on my credit card, and the credit card company reversed the charge for me. I will never return to that first vet.....we are very happy with the second vet who saved Sparky's paw.

So, no matter what type of animal is being treated -- canine or homo sapiens -- the emotional wreckage of adverse events must be met head-on with empathy and pro-active behavior. It's called disclosure, and dogs and humans both deserve it.

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