There but for the grace of God - Veterinary Practice
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There but for the grace of God

PERISCOPE continues the series of reflections on issues of current concern

MOST of us have probably at some time read the results of one or other RCVS disciplinary committee hearing and thought, “There but for the grace of God….”

Such a thought came into my mind when reading the report of the most recent disciplinary hearing involving Mr Munhuwepasi Chikosi, a Zimbabwean vet who was working for Vets Now when the incident which precipitated the hearing occurred.

Mr Chikosi’s name was removed from the register as a result of being found guilty of disgraceful conduct in a professional respect. I urge all of you out there to read the details of the case and the disciplinary committee’s comments on the matter.

The main thrust of the College’s dissatisfaction was that it took Mr Chikosi almost an hour-and-a-half to perform a house visit “out of hours” to a severely injured dog. And, that he advised the owners to transport it on a blanket to the surgery which the College considered “was completely wrong as the animal may have had an injured back”.

Having read the full report, it seems that Mr Chikosi did not help himself as well as he might. It appears that not only did he not attend the hearing but he didn’t even pay the College the courtesy of informing them of, and the reasons behind, his non-attendance.

However, “snubbing” the College should not be a reason to have one’s name removed from the register and one hopes that this failure on his part did not play a substantive part in the College’s decision-making process.

Reading the report also suggests to me that Mr Chikosi could have perhaps handled things a little better and in particular could have been more understanding and compassionate in his dealings with the dog’s owner over the phone. One could, however, argue that one’s telephone manner is more to do with public relations than relieving animal suffering and should not necessarily be a matter for the RCVS disciplinary committee. The public are free to choose not to use a particular vet if they do not like his or her “bedside manner”.

Consider also the following statement that is to be found in the report: “The Committee considers that the profession should be reminded that providers of emergency out-ofhours services should have in place at all times adequate staff to comply with the requirements of the Guide.”

And very laudable a sentiment it is too. But, come on, is that really practical? “At all times?” Is this not a gold-plated requirement that is totally impractical and economically unviable?

Have no members of the committee ever sat in a hospital A and E waiting room on a Saturday night and, after a four-hour wait (if you’re lucky) just to lay claim to a hospital trolley, mused that one-and-a-half hours to get a vet out at night to attend to an injured dog is actually pretty impressive?

Have they not heard the reports of people waiting for hours for an ambulance to arrive, and often being in considerable pain during the process, and mused that one-and-ahalf hours to get a vet out at night to attend to an injured dog is actually pretty impressive? Have they not read the reports of people dying of neglect in hospitals and mused that one-and-a-half hours…? Well you know the rest and we are yet to see any heads roll as a result of those human deaths.

Let us assume that Mr Chikosi had visited the injured dog immediately when asked to do so. Let us for the sake of argument also say that five minutes after he left the 24-hour emergency clinic that a dog was rushed in bleeding profusely from a puncture wound in the axilla that had partially severed an artery.

And that in spite of the veterinary nurse’s best efforts to apply pressure to the wound, the animal had, over a 15-minute period, bled to death because there was no veterinary surgeon on site. If the RCVS had then received a complaint from the owner of the haemorrhaging dog concerning the failure of Mr Chikosi to be in attendance, would Mr Chikosi have been struck off by the disciplinary committee for abandoning his post when he was the only vet on duty?

A not unreasonable decision

We will never know the answer to that question, of course, but the benefit of hindsight and the ability to reason things through in the cold light of day in the unpressured environment experienced by those sitting in judgment at a disciplinary committee hearing, should not be used to excessively punish someone who made what many of us might consider a not unreasonable decision given the circumstances.

Which brings us to the disciplinary committee’s comment concerning the advice of Mr Chikosi to transport the dog using a blanket. Clearly, in an ideal world there would be an expert at hand within minutes to attend to all suspected head, neck and back injuries, preferably with one of those little rescue “carts” that you see deployed in the big rugby games these days.

However, we live and work in the real world and I suspect that a goodly proportion of us have at some time or another advised an owner to use a blanket as a “stretcher” to transport a recumbent animal to the surgery via the owner’s car.

I have no doubt that there have been cases when the animal’s injuries have been made worse by such advice but I also have no doubt that many more animals’ lives will have been saved and their pain controlled more expediently through the process.

We don’t have an NHS for animals (and I have already indicated some of the shortcomings of that service), and we do not have paravets and flying vets with helicopters ready to attend any RTA and whisk the injured animal to hospital in a neck brace. What we do have is a huge number of highly dedicated individuals who for whatever reason sometimes make decisions that turn out to be wrong as judged by their peers.

However, in order to bring some sort of perspective to the whole issue, I suggest that those sitting in judgment would do well to repeat the adage, “There but for the grace of God go I”, before commencing the disciplinary process and at frequent intervals throughout the proceedings thereafter.

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