Vets Gone Bad

I recently participated in a brief Facebook conversation with some of my colleagues about the highest rated program on National Geographic Wild. I have not seen it, but I have certainly heard and read a lot about it. I may have the name wrong, but it's something like "The Appalling Dr. Pol".

Off stage, Vetography lawyers: "You can't say that! You know it's not called that. We'll get sued!"
Me: "Come on, get real. Nobody reads this blog." 

People appear to love this guy despite the fact that he is manifestly a quack.

Lawyers: "OMG!!"

You would be hard pressed to find a veterinarian who feels otherwise. But I'm not going to talk about the show or the details of his practice. I only mention him because his story is a useful illustration of the weakness of the professional disciplinary process.

One the hats I wear is as Chair of the Peer Review Committee (PRC) of the Manitoba Veterinary Medical Association (MVMA). I've been Chair since 2011 and sat on the PRC as a committee member reviewing complaints for about ten years before then. Veterinary medicine is like most other professions in that it has been accorded the right to self govern and self regulate.The reason professions are permitted to do this is that the government recognizes that only those who actually do the work are in a position to determine what is appropriate and what is not, and which errors are avoidable and which are not. Lay people are also appointed to the PRC to make sure that the public interest is kept in mind and that it doesn't evolve into an "old boys and girls club".

It's an interesting job but it's also a stressful job. Standing in judgment of your peers can feel like an onerous responsibility at times. A more subtle stress though is the knowledge that the worst offenders are getting away with it and that we are only seeing a skewed sample. This is because the process is necessarily complaint driven. Clinics are inspected for equipment, record keeping, sanitation etc, but nobody swoops in and looks over your shoulder to see how you are handling a case. There aren't the resources to do so and it would be pointless as you would be on your best behaviour when observed. The legislation states that for the PRC to investigate a complaint it must receive the complaint in writing. That's it, that's all. So we sit and wait for letters to arrive, our hands otherwise tied.

Think for a moment about your GP. Is he or she "good"? If so, how are you assessing that? Do you know enough about medicine to understand what is proper medical practice and what is not? Honestly? No, more likely, when you say that your doctor is good, you are saying that he or she is nice, and listens to you, and seems to care, and doesn't keep you waiting too long etc.. You have no real idea if the right test has been run and even if it was run, whether it was interpreted correctly. Your doctor could easily be incompetent and it would be very difficult for you to tell. Consequently you probably would not complain about your doctor to the College of Physicians and Surgeons, even if you had a poor health outcome. However, if you encountered a rude doctor with terrible bedside manner and had that same poor outcome, chances are higher that you would complain, even if he or she did everything right and the bad outcome was due to bad luck.

And so it is with veterinary medicine too. In all the complaints I have seen, the great majority have been due to poor communication by the veterinarian rather than poor skills or knowledge. Those of my colleagues who are a little more awkward around people, or perhaps are short tempered, but are objectively quite competent attract far more complaints than those who are charming and charismatic, but are objectively less competent.

The good news though is that given enough time, eventually the charming quacks trip up badly enough or often enough that they are unmasked and professional discipline can take action. As Churchill said regarding democracy, it's the worst system, except for all the others. Dr. Pol has been disciplined, albeit lightly.*




* And another more recent successful disciplinary case against him was reversed by a higher court in a ruling that effectively questioned the scope of authority of regulatory bodies. It doesn't impact us here, but it is interesting/frightening nonetheless.