As a veterinary professional, maintaining a positive and professional relationship with clients is crucial. However, there are instances where it becomes necessary to end the VCPR. Whether due to non-compliance, failure to pay, inappropriate behavior, or other valid reasons, terminating a client requires a thoughtful and legally sound approach. A well-crafted termination letter is essential to protect the veterinary practice from liability while ensuring continuity of care for the patient. This article provides a legal perspective on writing a termination letter to a veterinary client by addressing key considerations, identifying essential components, and recommending best practices.
Legal and Ethical Considerations
1. Understanding the VCPR
The VCPR is a core principle of veterinary medicine. According to the American Veterinary Medical Association (AVMA), a VCPR is established when:
- The veterinarian assumes the responsibility for making clinical judgments regarding the health of the patient;
- The client agrees to follow the veterinarian’s instructions;
- The veterinarian has sufficient knowledge of the patient to initiate at least a general or preliminary diagnosis of the medical condition of the patient (i.e., the veterinarian is personally acquainted with the keeping and care of the patient by virtue of a timely examination of the patient by the veterinarian, or medically appropriate and timely visits by the veterinarian to the operation where the patient is managed);
- The veterinarian is readily available or has arranged for follow-up care;
- The veterinarian provides oversight of treatment, compliance, and outcome; and
- Patient records are maintained.
Each state may modify the definition of VCPR. Therefore, while AVMA’s VCPR guidance is helpful (see also 9 C.F.R. § 107.1 (providing federal regulatory guidance about establishing a VCPR)), the controlling authority regarding what constitutes a VCPR will be determined by the state where a veterinarian is licensed if that state’s laws, regulations, or veterinary board defines VCPR differently.
A veterinarian may terminate the VCPR, but that action must be done ethically and in compliance with applicable laws and professional guidelines.
2. Legal Requirements for Termination
Before drafting a termination letter, consider the following legal requirements:
- State Veterinary Board Regulations: Each state may describe where a VCPR arises, and some states have specific requirements regarding VCPR termination. Check with the state veterinary board where the veterinarian is licensed to ensure compliance.
- Adequate Notice: Clients must be given reasonable notice to find alternative care. Availability of veterinary services in proximity to the veterinary practice and the patient’s condition informs how much notice is required. Many states do not specify an adequate duration for notice; 30 days may be considered reasonable in most jurisdictions, but specifics about the practice, client, and patient should be considered in determining a termination date.
- Emergency Situations: If the animal requires immediate care, ensure there is a provision for emergency treatment before the termination takes effect.
- No Discrimination: Termination should not be based on discriminatory reasons, which could expose the practice to legal action.
- Outstanding Balances: While termination can be due to non-payment, veterinarians must still provide emergency care until the notice period expires.
3. Three Ethical Principles Informing Termination
The three foundational principles of the Principles of Veterinary Medical Ethics are:
- Stewardship:the ethical responsibility to act in the patient’s best interests in balance with the interests of the clients, environment, and public.
- Integrity: the ethical responsibility of honesty and truthfulness in all interactions with clients, patients, and the community.
- Respect:the ethical responsibility of respectfulness to patients, clients, and community members.
A termination letter should embody each of these principles by ensuring the patient is not abandoned and can continue to receive care, remaining factual, and maintaining an appropriate tone.
Essential Components of a Termination Letter
A termination letter should be professional, concise, and legally sound. Below are the key components:
1. Date and Client Information
Include the date the letter is issued and the full name and address of the client and client’s pet to ensure proper documentation. The veterinary practice’s information should be included in the body of the letter as well, or at least identified in the letterhead or signature line.
2. Statement of Termination
Clearly state that the veterinary practice is terminating the relationship and the effective date of termination. Express that the letter serves as a “formal notice” that the practice is terminating the VCPR with the client and the client’s pet. Dating the letter and explicitly stating it serves as a “formal notice” establish a timeline of when notice was provided, which is important in determining whether the client had a reasonable timeframe to secure continued care for the patient and transition to a new veterinarian.
3. Reason for Termination (Optional)
Providing a reason is not a necessary component; however, it may help clarify the decision. The language should be professional and factual, stating the reason (e.g., failure to pay) and briefly describing instances or dates supporting the reason.
4. Continued Care and Transition Assistance
To satisfy the ethical obligation to act as a steward and avoid a legal claim of abandoning the patient, provide a reasonable time frame for continued care and assistance in transitioning to a new veterinarian. For example, the letter could provide for continued care for the next 30 days until the Termination Date, which would be previously defined in the letter.
Additionally, it is best practice to explain in the termination letter that emergency care will continue to be provided during the transition period because stating so (a) establishes that the veterinarian is complying with his or her ethical obligation and (b) limits further potentially controversial interactions with the terminated client during the transition period.
5. Medical Records Transfer
Inform the client of their right to obtain their pet’s medical records and provide instructions for requesting them, specifying the veterinary practice office’s contact information (e.g., phone number or email address). To avoid a potential source of controversy, the veterinary practice terminating the VCPR should consider including in the termination letter that it will not charge the former client for the cost of providing the patient records to the succeeding veterinarian.
6. Payment and Financial Obligations
Address any outstanding balances professionally but separately from the termination. A simple statement that outstanding balances must be settled and a final invoice will be provided upon request will suffice.
7. Contact Information for Questions
Provide a way for the client to reach out if they have any concerns or questions about the transition. This may be different contact information than previously provided for the medical records transfer.
8. Closing Statement
The letter should be professional and courteous throughout, and end in that same manner. Wishing the client and their pet well is a polite sentiment that can help maintain an appropriate tone.
Best Practices for Delivering the Termination Letter
- Use Certified Mail: Send the letter via certified mail with return receipt requested to document that the client received it.
- Keep a Copy: Maintain a copy of the letter and any related correspondence in the client’s file for legal protection.
- Communicate Clearly: If possible, inform the client in person or over the phone before sending the letter to avoid misunderstandings.
- Remain Professional: Regardless of the reason for termination, avoid personal or emotional language in the letter.
- Consult Legal Counsel: If the client has a history of litigious behavior or if the termination involves a complex situation, seek legal advice before finalizing the letter.
A Comprehensive Termination Letter Will Smooth the Client’s and Patient’s Transition to Continued Veterinary Care
Ending a veterinary-client-patient relationship is a serious decision that must be handled with professionalism, clarity, and legal awareness. By drafting a well-structured termination letter, veterinarians can ensure they meet ethical and legal obligations while protecting their practice from liability. Following the guidelines outlined above will help facilitate a smooth transition for the client and ensure that the patient continues to receive appropriate veterinary care.
