At its heart, veterinary medicine is a customer-focused business. Animals can’t drive themselves to the veterinary clinic for care; therefore, we must appeal to their owners to ensure that our patients receive the level of care that they need. 

In the name of client service, all members of the veterinary team are expected to tolerate a wide variety of client requests and behaviors. Sometimes, however, these requests or behaviors cross the line from merely annoying to downright hostile or abusive. 

What options does a veterinarian have in that case? Is it actually possible to fire a client?

Fortunately, it is!

Firing a client is a very rare occurrence, but it is an option in extreme cases.

The Veterinarian-Client-Patient Relationship

The basis of veterinary medicine is the veterinarian-client-patient relationship (VCPR).

While each state has its own guidelines regarding what constitutes a valid VCPR, the AVMA offers the following general guidelines that are applicable in most states:

1. The veterinarian has assumed clinical responsibility for the patient and the client has agreed to follow the veterinarian’s recommendations.
2. The veterinarian has sufficient knowledge of the patient to make recommendations, based on either a current physical exam or site visits. 
3. The veterinarian is available for follow-up and emergency care, or has arranged for another veterinarian to provide these services.
4. The veterinarian oversees treatment and outcomes.
5. Accurate patient records are maintained. ¹

The VCPR is a two-way street. It requires collaboration between the veterinarian and the client, in order to ensure the best possible medical outcomes for the patient. 

Can the VCPR be Terminated?

The VCPR can be terminated by either the client or the veterinarian. In most cases, the client terminates a VCPR and elects to transfer the care of their pet to a new veterinarian. In rare cases, however, a veterinarian must terminate the VCPR to protect themself, the veterinary team, and/or other clients within the practice. This is not a decision to be taken lightly.

The veterinarian’s ability to terminate the VCPR is supported by the AVMA’s Principles of Veterinary Medical Ethics, which state “veterinarians may terminate a VCPR under certain conditions, and they have an ethical obligation to use courtesy and tact in doing so.” ² 

Why Would a Veterinarian Terminate the VCPR?

Some clients cause significant hardship for the veterinarian, the veterinary team, and the other clients within the practice. These abusive behaviors may constitute grounds for termination of the VCPR. 

Client behaviors that may lead to termination of the VCPR include:

• Physical violence (or threats of violence)
• Verbal abuse, including vulgar language
• Discriminatory language or hate speech
• Continued or repeated unreasonable requests
• Threats if demands are not met
• Consistently negatively impacting the experience of other clients in the clinic

While all clients may have an occasional “off day,” clients who exhibit consistently hostile behavior should be terminated. Continuing to serve them will negatively impact the well-being of team members, which can also decrease the quality of care that is offered to other patients and clients.

Terminating the VCPR

In addition to providing permission to terminate the VCPR, the AVMA Guidelines also provide guidance on how to terminate the VCPR. ² The procedure differs, depending on the patient’s health status. 

If the patient is not currently receiving ongoing care for a medical issue (for example, a healthy pet whose owner lost his or her temper at a wellness visit), termination of the VCPR is simple. All you have to do is notify the client that you no longer wish to serve that client and patient. This notice is typically provided via a written letter, which is often sent to the client with a printed copy of the patient’s medical records. This allows the client to select a new veterinarian at their convenience.

If the patient has a medical condition that requires ongoing care, the procedure is a bit more complicated. In that scenario, you must refer the patient to another veterinarian that can provide care for the patient’s condition before you can remove yourself from the case. Fortunately, transferring the pet to another veterinarian is usually pretty easy. In many cases, you can simply ask the client “where would you like me to send your records?” You are required to continue caring for the patient until a new veterinarian takes over, however, so take this into account if the patient is hospitalized or receiving ongoing care! 

Reality Check

While all of this information is helpful to know, you will probably find yourself working as an associate, not an owner. Therefore, you may not be in a position to fire clients, even if they behave in extremely abusive ways. In most practices, firing clients is a privilege reserved for the owner or practice manager. 

Still, understanding the considerations that go into terminating the VCPR can help you participate in these conversations. Additionally, they can give you an idea of what to look for when selecting your first job; is the practice willing to fire abusive clients or do they tolerate poor behavior? 

Finally, being able to think through these decisions now, as you enter practice and begin to encounter difficult clients, will give you a chance to think through these scenarios and be better -prepared if you do elect to own your own practice in the future.

References

1. AVMA. The veterinarian-client-patient relationship (VCPR). Retrieved from https://www.avma.org/resources-tools/pet-owners/petcare/veterinarian-client-patient-relationship-vcpr
2. AVMA. Principles of Veterinary Medical Ethics. Retrieved from https://www.avma.org/sites/default/files/resources/2014S_Resolution8_Attch1.pdf