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Barks 'n Bytes No. 110

Lately, there has been much hype and reporting on Dr Pol who is a mixed animal practitioner in central Michigan and who also stars in a National Geographic Channel reality television series. 

Dr Pol was recently disciplined by the Michigan Board of Veterinary Medicine and was placed on probation for up to a year, levied a $500 fine and ordered to complete continuing education courses in the fields of documentation and record keeping, small animal reproduction and ultrasound techniques and interpretation.

The complaint was the first to be filed against Dr Pol in Michigan who has practiced there for 41 years and is presently 70 years of age.

Despite board discipline, Dr Pol has asserted his innocence on all charges, claiming that he was not negligent and did not act incompetently in a case involving a litter of stillborn puppies.  An associate of Dr Pol’s who was involved in the same case was also placed on probation until she completes continuing-education training on the same subjects.

Dr Pol claims that he and his associate made no mistakes in dealing with the case, other than not having recorded all of their conversations with the owner.  He claims to have only agreed to the disciplinary action on the advice of his lawyer, in order to lay the complaint to rest.  Dr Pol says that the complaint against him can be confined to inadequate record-keeping and is not connected to negligence or incompetence.

The case occurred in 2010, just over a year before the premiere of “The Incredible Dr Pol” which is a reality show, following Dr Pol through his work days with rural mixed animals.

The complainant in this case sings a completely different tune to Dr Pol’s. According to the owner of the dog, the bitch was mated on January 30th and her due date had been calculated as April 3rd.  The owner called Dr Pol’s clinic three times between April 3d and April 8th to report that her dog had not delivered any puppies yet.  The owner was informed that it was not necessary to take the dog to Dr Pol’s clinic but to let nature take its course. She was requested to call the facility again on April 9th if the dog had still not given birth.  None of the telephone calls were documented by Dr Pol or any of his staff.

According to the owner, her husband called Dr Pol on April 9th and informed him that the dog had a brownish-green mucus discharge and he was told that the dog might be beginning labour.  The owners were instructed to keep the dog in a quiet place and to call back in the afternoon if still no delivery.

By early evening, the bitch had still not delivered and the owners took the dog to Dr Pol’s practice.  One of Dr Pol’s associates examined the dog and stated that she was not dilated and was likely to give birth in the next day or two.

The owners called again the following day, claiming that the dog’s belly looked skinny and was hanging low and were again informed by a veterinarian at Dr Pol’s practice to let nature take its course.

On April 12th the owners took the dog back to Dr Pol’s clinic where a veterinarian performed an ultrasound, claimed to have detected movement  and said that the owners had calculated the dog’s due date incorrectly and sent her home again.

The owners took the dog to a different veterinarian where an ultrasound revealed no movement and a caesarian section was immediately performed.  The doctor found 10 dead puppies in the dog’s womb covered in a brownish-green mucus and the veterinarian believed that the puppies had been dead for at least 3 to 4 days.

Dr Pol claims that the veterinarian that was consulted for a second opinion had once worked for him and they had parted on bad terms. He stated that the veterinarian had probably botched the caesarian and  tried to frame Dr Pol.

The news of Dr Pol’s disciplinary action has been met with mixed reviews in the veterinary world. One veterinarian has started an online petition to have Dr Pol’s reality show removed, citing that the show “promotes substandard medicine to the public.”

Many other veterinarians have voiced their opinions on the VIN news service, most of them negative.

Dr Pol’s response to the criticism he has received is “We are living in Michigan where the economy is bad, and I help animals to the best of my ability and to the best of what people can afford. That’s the way I see it. ... To me, the owner of the animal has the last say. You cannot shame an owner into doing things he cannot afford.”

Discussion:

1.  Is there a place for lower standard practice in communities that cannot afford better standard of care?   

In this case, cost was not claimed as an issue. The owner requested care but the veterinarians apparently refused or neglected to provide the care sought by the owner.  Veterinarians are professionals whose conduct must meet the minimum standard of professional practice. It can never be a defence to an allegation of unprofessional conduct that the owner consented to a procedure that did not meet the minimum standards of professional practice. If owners do request an option that is too cheap to meet minimum standards, rather refer them to a welfare organisation.

2.  Had Dr Pol sought proper veterinary defence, instead of using a local attorney, could the outcome of the disciplinary proceedings have been in his favour?

Even a new graduate should be able to recognize the turning point in this case – the presence of the brownish-green liquid. This dark green liquid is lochia and is the substance between the placenta and uterus wall. Lochia is released when the placenta detaches from the uterus and this lochia discharges from the vagina. The presence of lochia in a bitch before any puppies are delivered is a sign of foetal distress because the puppies do not have an oxygen supply, and is an indication for an emergency caesarean.  Many specialist theriogenoligists recommend assessing the size of the cervix using a vaginoscope to determine dilation and thereby the correct timing of parturition and medical or surgical intervention.

Based on these two facts, it appears that the defence was weak, which no amount of legal assistance could rectify. However, the Rules of Natural Justice dictate that the board would have to prove that the respondent had a legal obligation to act in a certain manner and that his conduct varied substantially from that obligation. In this case there may have been room to argue that there is no certainty about the particulars of the case such as the exact identity of the animal that forms the subject of this complaint.  The animal that was presented to the veterinarian that performed the caesarean may not have been the same animal that Dr Pol’s assistant examined.  A competent board would establish whether the conduct of the veterinarian met or fell below the minimum standard. A competent board would also establish corroborating evidence and would not rely merely on the owner’s version of events.