Client Diagnoses
Got a call today from a woman who says, "My cat has crystals and needs some antibiotics. I don't want to pay for an exam, I just want the medication."
Who diagnosed the crystals? Was it me? I pull the chart. Well, no. Seems I've never seen this cat before, and the only time the client has been in was August 2004 for a different cat.
Repeat after me: Federal law prohibits the dispensing of prescription medications without a valid veterinarian/client/PATIENT relationship. That means that the veterinarian MUST HAVE EXAMINED the pet before prescribing medication.
Why is that such a big deal? Clients tell us all the time that they know what the diagnosis is, so why can't they just get the meds? Um, tell me, when did you graduate from vet school again? Right. Didn't think so.
To clear this up for those who don't see what the big deal is, it's only antibiotics, what harm could they cause? Let me explain.
In this scenario, the cat could very well have crystals. Many cats with feline lower urinary tract disease do (FLUTD). Or, the cat could have inflammation of the bladder (idiopathic intersticial cystitis). Can't tell them apart without examining urine under the microscope. Plus, most of these urinary issues in cats are bacteriologically sterile; in other words, they're not an infected, and antibiotics are not usually necessary.
That said, what if the cat is, in fact, obstructed and is not urinating? And I just give the antibiotics on the owners's say so? Then, in a day or two, because the antibiotics were not the correct treatment for the problem, the cat is now dead from uremic poisoning? Who do you think the pet owner is going to blame? Herself, for being too cheap to pay for an exam? Or the vet who gave her the wrong medication for her pet's true ailment?
The vet, of course, that's who. And what is the state board going to say when I explain why I didn't examine the cat to determine it was blocked rather than just having mere crystals?
Whose license and livelihood is on the line? The client's? Or mine?
I'd rather keep practicing, thank you. Which is why the answer to the original question will always be NO.
Who diagnosed the crystals? Was it me? I pull the chart. Well, no. Seems I've never seen this cat before, and the only time the client has been in was August 2004 for a different cat.
Repeat after me: Federal law prohibits the dispensing of prescription medications without a valid veterinarian/client/PATIENT relationship. That means that the veterinarian MUST HAVE EXAMINED the pet before prescribing medication.
Why is that such a big deal? Clients tell us all the time that they know what the diagnosis is, so why can't they just get the meds? Um, tell me, when did you graduate from vet school again? Right. Didn't think so.
To clear this up for those who don't see what the big deal is, it's only antibiotics, what harm could they cause? Let me explain.
In this scenario, the cat could very well have crystals. Many cats with feline lower urinary tract disease do (FLUTD). Or, the cat could have inflammation of the bladder (idiopathic intersticial cystitis). Can't tell them apart without examining urine under the microscope. Plus, most of these urinary issues in cats are bacteriologically sterile; in other words, they're not an infected, and antibiotics are not usually necessary.
That said, what if the cat is, in fact, obstructed and is not urinating? And I just give the antibiotics on the owners's say so? Then, in a day or two, because the antibiotics were not the correct treatment for the problem, the cat is now dead from uremic poisoning? Who do you think the pet owner is going to blame? Herself, for being too cheap to pay for an exam? Or the vet who gave her the wrong medication for her pet's true ailment?
The vet, of course, that's who. And what is the state board going to say when I explain why I didn't examine the cat to determine it was blocked rather than just having mere crystals?
Whose license and livelihood is on the line? The client's? Or mine?
I'd rather keep practicing, thank you. Which is why the answer to the original question will always be NO.
posted by Dr. Snark @ 9:13 AM
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