Dr. Beth Venit, Chief Veterinary Officer at the American Association of Veterinary State Boards, joins the podcast to discuss veterinary board complaints in the United States and Canada. Dr. Venit explains how board complaints are made, processed and communicated to doctors and technicians. She talks about what to expect at State Board hearings, and what practices are most likely to land someone in one of those meetings. Finally, she gives some simple “best practices” to protect your license if you are a veterinarian or technician.
You can also listen to this episode on Apple Podcasts, Google Podcasts, Amazon Music, Soundcloud, YouTube or wherever you get your podcasts!
LINKS
AAVSB Website: https://aavsb.org/
Dr. Andy Roark Exam Room Communication Tool Box Team Training Course: https://drandyroark.com/on-demand-staff-training/
Dr. Andy Roark Charming the Angry Client Team Training Course: https://drandyroark.com/charming-the-angry-client/
Dr. Andy Roark Swag: drandyroark.com/shop
All Links: linktr.ee/DrAndyRoark
ABOUT OUR GUEST
Dr. Beth Venit VMD is a graduate from the University of Pennsylvania’s School of Veterinary Medicine, Class of 2007. Throughout the area of Washington, DC, she practiced small animal medicine, both ER and GP, as both a full-time associate and a relief veterinarian for the next 12 years. In that time, she earned her Masters of Public Health from the University of Iowa and became a Diplomate in the American College of Veterinary Preventive Medicine. She then worked at the US Department of State, first as a fellow with the American Association for the Advancement of Science, and then as a full-time project manager focused on training foreign partners on biorisk management and the prevention of bioterrorism. In 2022, she joined the American Association for Veterinary State Boards as their first Chief Veterinary Officer.
In her free time, she enjoys hiking in various parts of the world with her husband (past trips include hiking the Grand Canyon Rim to Rim, the Inca Trail to Machu Picchu, several 14ers in Colorado, and a successful summit of Kilimanjaro), and being lazy on the couch with her pittie mix, Eleanor Woofsevelt and maine coon / tiger mix, The Chairman Meow.
EPISODE TRANSCRIPT
Dr. Andy Roark:
Welcome, everybody, to the Cone of Shame Veterinary Podcast. I am your host, Dr. Andy Roark. I am here with my friend, Dr. Beth Venit, today. She is the Chief Veterinary Officer for the AAVSB. Those are the vet state boards. And we talk all about license defense and what happens when there’s a complaint against your license, whether you are a veterinarian or a credentialed technician. And she runs through it, and she makes it less scary, which is good. That was actually what I wanted. I think there’s a lot of unknowns around what it means to have a complaint against your license. And when I met her, I said, “Would you tell me what really happens? Because I’m not sure I really understand and get it.” And anyway, she walks us through the process, what you can expect, what you should know, and most importantly, how to make sure you don’t have complaints against your license. It sounds like some pretty simple advice that was just really reassuring and good to hear.
So anyway, guys, she’s lovely. I pitched to her my Google review system where, if people haven’t been to my practice, their complaints should not be allowed. Kind of like if you haven’t made a purchase, then Google won’t let you write a review. I think we should do that for our vet state boards, but it does not go anywhere. She does don’t agree, and she tells me why. And so anyway, it’s a good episode. I hope you guys will enjoy it. It’s comfort food. All right, let’s get into this episode.
Kelsey Beth Carpenter:
(Singing) This is your show. We’re glad you’re here. We want to help you in your veterinary career. Welcome to The Cone of Shame with Dr. Andy Roark.
Dr. Andy Roark:
Welcome to the podcast, Dr. Beth Venit. Thanks for being here.
Dr. Beth Venit:
Hi. Thanks for having me, Andy.
Dr. Andy Roark:
It is my pleasure to have you. You and I met in Orlando this year at one of the little functions, the muckety muck things, and I got to talk with you, and it was wonderful. You were such a wonderful sunshiny spot. It is a great event, but it was really, really wonderful just to bump into you and meet you. You and I were having that thing where we were talking, and I said, “Oh, that’s what you do.” And you said, “Yes.” And I was like, “I have many questions.” And you said, “Oh, ask me anything.” And I thought this is great. I said, “I know exactly some things I want to ask you.” And I think it’d be a great podcast. So for those people who don’t know you, you are the chief veterinary officer with the AAVSB, which is the American Association of Veterinary State Boards. Why don’t you talk a little bit… Oh, and you’re also a veterinarian, and you’re a Penn graduate. So why don’t you talk a little bit about what the AAVSB just does as a high level in the US and Canada and kind of how it comes into the lives of unfortunate veterinarians, many not unfortunate veterinarians. For me, it’s a scary… If you called me, I’d be like oh no. Tell me about the AAVSB.
Dr. Beth Venit:
So, Andy, at the end of this, I’d love to have you not fear the process so much and actually perhaps have a little bit of appreciation for the state boards and might, I don’t know, dare I say they love them.
Dr. Andy Roark:
I appreciate the state boards. I do. I believe that they’re run by good people who are doing an important service. I just don’t want to hear from them at all, ever.
Dr. Beth Venit:
That’s true. That’s true. That’s true. Well, so let me tell you about AAVSB first. The AAVSB is a 501(c)(3) nonprofit, and we are the bridge between our member jurisdictions in the United States and Canada and the licensees to strengthen the regulatory process. We create programs that make licensure process more efficient and user-friendly, with the ultimate goal of public protection. So we work with our member jurisdictions to provide them expertise and data management solutions, and we work with licensees to give them tools to maintain compliance and manage the requirements of being a licensee. And this applies to both veterinarians and veterinary technicians. And we also work with students. We like to educate them on licensure and the regulatory process, because it is so confusing as a student on what to expect after graduation. So we like to give them ideas about how AAVSB can help them through the life of their license.
Dr. Andy Roark:
Okay. That’s a lot. That sounds like, I call it corporate speak.
Dr. Beth Venit:
It is.
Dr. Andy Roark:
Okay. Tell me, just you and me… Like I’m nine years old. Tell me… I’m a nine-year-old veterinarian. Tell me what the AAVSB does, just in the most simplistic terms. Like efficiency of licensing and things, I’m like, okay, what does that mean?
Dr. Beth Venit:
Well, first of all, congratulations on being a nine-year-old veterinarian.
Dr. Andy Roark:
Thanks. I am very precocious.
Dr. Beth Venit:
A Doogie Howser. So we make it easy to manage the requirements. We simplify the process. We make it easier to manage the requirements for both licensure and regulation so that everybody can forget about those requirements and then do their jobs.
Dr. Andy Roark:
Gotcha. Good. That’s what I like to hear. All right, great. Cool. When we started talking, I was asking you about what it means to have a complaint filed against your license with a vet state board. And so I have seen this a number of times in my career. To me, it’s still kind of this black box process where you get a letter possibly delivered by a raven. It has black smoke when you open the envelope that comes out, and it says, “You have been summoned to defend yourself,” which is not what it says, but that’s what I imagine it saying. And on the day of the event, a carriage drawn by large black stallions pulls up outside your hospital, and you have to get into it, and then you go. And hooded figures weigh judgment upon you and whether or not you get to continue to practice the profession you love or whether you are exiled from the community to live in the wilderness by yourself and forage for food. And that’s kind of how the process is in my mind. And so if it’s different from that, we can just sort of start there and sort of start to unpack what the process, how it is actually different from that and what I might actually expect.
Dr. Beth Venit:
Yeah. And actually, Andy, you have it pretty correct, except you forgot to mention the red burning eyes.
Dr. Andy Roark:
The red burning eyes. Yeah, I blocked this out.
Dr. Beth Venit:
And the letter kind of explodes when you open it. So I think the process is scary. I’m going to a admit, as a practitioner, I was scared about the process. Every day I was scared that something that I would do would get me in front of the board. But I’m here to alleviate some concerns. It is a scary process, but it’s not as bad as you think it is. So the board follows something called due process, just like we do in our court system. And what the due process is is meant to look at the complaint as a whole and see if there’s actually a violation. So the very first step… And everything I’m going to say here has a caveat of in most cases.
Dr. Andy Roark:
Sure.
Dr. Beth Venit:
So in the United States, we have 52 different jurisdictions. And as you can imagine, there’s 52 different ways of doing things, slightly different. So this is a generality.
Dr. Andy Roark:
Sure.
Dr. Beth Venit:
In most cases, so a complaint comes in from member of the public, a coworker, concerned citizen, whatever. It is the board’s job for public protection to review every single complaint. So they have to look at every single complaint that comes in and determine is this jurisdictional? Is this within our jurisdiction? Or is this non-jurisdictional? And non-jurisdictionals are the things that we hate when they get in front of the board. So that includes things like complaints about fees, complaints about wait times, complaints about bedside manner, your business practices, debt collection. All of those are non-jurisdictional, and what that means is with none of those complaints was there actually a violation of a rule or regulation. So those are immediately dismissed in most cases. Okay?
Dr. Andy Roark:
So when you say immediately dismissed, is that like the veterinarian doesn’t hear that they have happened? Or is that We still go through the process, and when we get to that point of, “Hey, Dr. Roark, today’s the day,” and then we look at it and go, oh yeah, “People thought that your T-shirt was too tight and was inappropriate, and that’s why you’re here. And so we threw that out.”
Dr. Beth Venit:
That’s a great question. That’s a great question. So in most cases, most cases, the veterinarian doesn’t know about those complaints. The horses have not been hitched up. The raven has not been summoned, okay?
Dr. Andy Roark:
Okay, good.
Dr. Beth Venit:
So in most cases, but the board still has to review them.
Dr. Andy Roark:
Sure.
Dr. Beth Venit:
So if they look at a complaint and they determine that there is jurisdiction, so there is the potential for a violation, or at least it falls within the rules or regulations of that jurisdiction, then they look at the actual complaint. And they review the complaint, and they say, they may say, “Oh, there hasn’t been a violation here. It’s dismissed.” Okay?
Dr. Andy Roark:
Gotcha.
Dr. Beth Venit:
They may look at the complaint and say, “You know what? We can’t tell from the complaint if there’s actually been a violation.” So then what they’ll do is they’ll gather more information, they’ll assign an investigator from the state board, and they’ll research the complaint. And that includes looking at the medical records, looking at a statement from the licensee, looking at a statement from the complainant, if that was available. So they’ll look at all of that information. From there, and usually at this point, the licensee knows that there’s a complaint, because they’re [inaudible 00:10:53] a statement.
Dr. Andy Roark:
Yeah, I would imagine when they start looking at medical records-
Dr. Beth Venit:
Right. [inaudible 00:10:56] You’re going to know something’s up.
Dr. Andy Roark:
[inaudible 00:10:57] your hand. Yeah.
Dr. Beth Venit:
So from there, there may be a potential for something called a consent order. And what a consent order is is an agreement between the investigating member of the board and the licensee. And the consent order usually is, “Hey, I realize that I was deficient in my medical record-keeping. I agree to a fine and this education, the X number of CE hours, to help me improve my medical record-keeping,” or, “Hey, you’re right, I did not keep up to date with my CE. I’m going to pay fine and have to make up the CE and do extra CE on top of it.” So consent order is basically, usually it’s a one-time offense. It’s a minor offense, and you work with the member of the board and the licensee to present this option to the rest of the board, and they have the decision to accept or reject it. Okay?
Now, if in the information gathering process they determine that there is a major violation, or if the board rejects the consent order, then we’ll go into a hearing. And that’s the nightmare situation that we all worry about and we fear. And this is where the licensee is called in front of the board. There might be a judge involved. There are lawyers involved. There might be a subject matter expert. So they will have the hearing like Law & Order. A CE’s hearing’s probably less dramatic with less dramatic music. And there will be a decision based on all of that. Again, was there a violation? Or was there not a violation? And then from that violation, they’ll determine what the proper course of action is. So it could be still education and paying a fee or a fine. And in very rare cases, there’s a suspension of license or the license is revoked. So things that may get you a violation for the board, because I talked about the things that are non-jurisdictional. So let’s talk about things that may be a violation of the board’s rules or regs.
Dr. Andy Roark:
Okay.
Dr. Beth Venit:
Would include things like negligence, substandard care, malpractice, unprofessional conduct, illegal activity, drug diversion. All of those are actively bad things.
Dr. Andy Roark:
Like really obviously bad things. Yeah.
Dr. Beth Venit:
Obviously bad things, but it also can include controlled drug errors, so if you’re doing something wonky with your [inaudible 00:13:47] license or another person’s CE license and you’re not aware that you’re doing something wrong, or you just don’t know how to do it correctly or you don’t know how to store your controlled drugs correctly. So that’s a violation. CE deficiencies are a violation, and medical record-keeping is a violation. Also, in some jurisdictions impairment, so chemical impairment could be a violation as well.
Dr. Andy Roark:
If you dream of doing team training with your team, getting your people together, getting them on the same page, talking about how you guys work together in your practice, I’d love to help you. You can check out drandyroark.com, and check out our store. I have two different team training courses. These are courses for teams to do together to get on the same page and to talk about how you do things. I have my angry clients course, and I have my exam room toolkit course. And they are both available and there to come out. All right, guys, let’s get back into this episode.
So a couple of quick questions.
Dr. Beth Venit:
Sure.
Dr. Andy Roark:
So what percentage… And I know this differs wildly between states, but what percentage of complaints actually end up going to a hearing? Are we talking about 10%? Are we talking about 50%? We’re talking about 1%. Kind of what percentage of complaints… If I get a thing that says, “Hey, there’s been a complaint. We’re going to investigate,” what’s the probability that that’s going to end up in hearing? Just kind of big picture.
Dr. Beth Venit:
Yeah. It’s a low percent. I can’t say exact percents because it varies by the year and by the jurisdiction-
Dr. Andy Roark:
Of course.
Dr. Beth Venit:
But it is a low percent. And part of that is because the public doesn’t understand due process. So a lot of the complaints, the large portion of them are non-jurisdictional. So you have to think about that whole process, but it is a very small number that actually make it all the way through.
Dr. Andy Roark:
Okay. So yeah, it’s funny about the public not understanding due process. When you and I met, I had my own idea, and I was like, “You know how if you write a one star rug review on Google, but you haven’t actually been a customer of the business, Google will just remove that review?”
Dr. Beth Venit:
Yeah.
Dr. Andy Roark:
“Because it stops people from showing up on the internet and bashing you?”
Dr. Beth Venit:
Yeah.
Dr. Andy Roark:
I was like, “I think the state board should have that policy,” which means if you have not actually been to the clinic, you are not allowed to file a board complaint. And you did not agree with that and told me that that was not how it’s done. Can you touch on that, on the reason why that’s the case?
Dr. Beth Venit:
Well, it’s part of the process. I don’t know if that’s exactly what I would say now. It’s part of the due process for the board to investigate whether or not this complaint is reasonable or not.
Dr. Andy Roark:
Gotcha.
Dr. Beth Venit:
So if a complaint is anonymous, they have no way of verifying if the person complaining ever had experience, right?
Dr. Andy Roark:
Gotcha.
Dr. Beth Venit:
But I do want to emphasize there is due process. So in complete opposition to Google or Yelp reviews or Yahoo, whatever, there is somebody and a multiple number of people who are reviewing the complaint for is this worthwhile? Does this make sense? And personally, for me, if I was a veterinarian, I would much prefer a complaint to go to the state board than to have it end up on social media or Google or Yelp.
Dr. Andy Roark:
Oh, that’s interesting. Yeah, I have to process that a little bit. I see where you’re coming from, because it’ll be handled. You’ll get a fair hearing, which is not the case on-
Dr. Beth Venit:
It’s not the-
Dr. Andy Roark:
On the social medias. Yeah, I see that.
Dr. Beth Venit:
And the problem with social media is that everything kind of snowballs and goes downhill, and it never ends. If it’s on Facebook, if it’s on Twitter or TikTok or whatever the kids use these days, it never ends. But the process with the board, once you get to the decision, it’s over. And if they find there’s no violation, then there’s no public record. So if there’s no violation done, then nobody knows that anything happened, right?
Dr. Andy Roark:
Okay. That makes sense to me. Talk to me a little bit about the similarities and differences between the states. So you said there’s 52… You pulled a face. There’s 52 different ways to do things. I guess what I’m looking for here is just like are there areas that are wildly different? I guess this is my own curiosity.
Dr. Beth Venit:
Oh gosh.
Dr. Andy Roark:
Are there certain things that you go, well, this is an issue on which states seem to vary widely? I guess, in my mind, the more mundane things, probably some people say it takes two weeks, and some people say it makes six weeks, or kind of basic things like that. But I’m just curious if there are topics or areas where you say some states are very aggressive in this way, and some states are not so much. I’m just interested in what those topics or those areas of divergence would be.
Dr. Beth Venit:
The areas of divergence are endless. So the thing that is similar is public protection. The way that they go about that is different from every jurisdiction. Due process is similar between one jurisdiction and another, but there’s going to be minor differences. The makeup of the board and how that office operates varies from jurisdiction to jurisdiction. Sometimes in some of the larger states, they have staff members and staff members and staff members. And in other jurisdictions where it’s smaller, it might just be the executive director or the ED. There’s usually the ED. There’s usually some sort of legal representative. It could be someone who is directly on that staff, or it could be the attorney general or the assistant attorney general. And there’s always board members, and the board members are veterinarians and veterinary technicians if they license veterinary technicians. And then there’s always a public member, a member of the public who’s just Joe Schmo, says, “I want to be on the vet board,” and they get appointed.
Dr. Andy Roark:
Like, “Yeah, I have Thursdays free. I’ll be on the board.” Yeah, I get it.
Dr. Beth Venit:
Well, you could be on the board, Andy. It’s a volunteer position, and most boards, they love their veterinarians because you provide subject matter expertise, and you help with this complaint process. So if this is something that keeps you awake at night, you could volunteer.
Dr. Andy Roark:
Okay, I’ll be on the board. Well, it’s always good to know what my options are, but yeah, all right, I like it. So, no, that totally makes sense. And that does make it a bit less scary. I like that. What are the sort of general suspension and revocation of licenses? When we talked about it, you were saying it’s really rare to get-
Dr. Beth Venit:
It is rare.
Dr. Andy Roark:
To this point. So can you color in the lines a little bit of what… Oh, actually, I guess how about this? Let’s start to look together at how cases kind of break down that generally show up for the AAVSB. So if you had to put them into categories, just big categories of what shows up, where complaints come from, could you do a pie graph for me as kind of like this type of complaint tends to be about 30%. And I know you don’t have numbers in front of you or anything like that, and I know they’d be sloppy categories, but are there big categories that come in? And kind of how does that break down? And then of those categories, where do we see suspensions or revocations, things like that?
Dr. Beth Venit:
Yeah. Again, revocations, extremely rare. I think a board is more likely to suspend and try to remediate than to revoke, okay? The biggest category is failures in communication and medical record-keeping. So that is something, because everything else is kind of active wrongdoing. You’re selling drugs, you’re performing malpractice, you’re doing illegal activities through your veterinary office. So the very most common thing is failures in communication and medical record-keeping. And if you think about it from why does this happen, if you think about it, who would be submitting the complaint, it’s a member of the public. So what does the public care about? They care about communication. So for anybody listening, if you’re saying how can I avoid a complaint to the board, I would give you couple different answers. And this will help with the majority of cases. First of all, don’t do anything illegal.
Dr. Andy Roark:
Yep. Good starting point.
Dr. Beth Venit:
Good starting point. General rule of thumb for life, don’t do anything illegal. So putting on my AAVSB hat, I would say, first of all, very first thing you should do if you don’t want to have a complaint against you for the board, know your jurisdiction’s practice act. Know your jurisdiction’s regulations, because they vary, especially if you’re new to that state or that jurisdiction. Read the regulations. I know it is not the most thrilling information you can get out there. It’s not a Tom Clancy novel, but you should read them and understand them, okay? So that’s the first thing. The second thing is stay up to date on your CE. CE violations or failure to complete your CE is so common, and it is something that you can do very easily. And then the third important thing would be your medical record-keeping and then your controlled drugs. So handle those correctly. All right? Now, if I took off my AAVSB hat and put on my Beth hat, I would tell you the key is good communication with your client and compassion towards your client.
Dr. Andy Roark:
Gotcha.
Dr. Beth Venit:
And those are two things that are going to keep the client and you as a partner and not as them wanting to file a complaint against you.
Dr. Andy Roark:
Gotcha. No, that totally makes sense. I’ll be honest here and say I probably read the state regulations for South Carolina when I applied to get licensed in the state of South Carolina 10 plus years ago. Is there a portal where it’s like, “Here’s all of the state regulations”? Or is it just a go through your licensing body where you say this is where I have to keep up my CE? So in South Carolina, it’s like that LLRC something body and all that. I know all the regulatory stuff is there. Is there another place to go and find those things? Or do you just individually seek it out in your state? And then when we say read the regulations, what exactly should I hunt down to be the most efficient where I go, okay, I got what I need to get?
Dr. Beth Venit:
Well, I don’t know about efficiency because I’m still learning that myself, but I can tell you if you go to our website, aavsb.org, we have a link to all of the jurisdictions, and from there you can find your practice acts and your regulations. So-
Dr. Andy Roark:
Perfect.
Dr. Beth Venit:
That’s an easy way. But I will tell you also, as public agencies, everything is public knowledge. So you should be able to go to your board’s website, and you should be able to access the regulations, the practice act, any guidance documents. All of that would be on the website, and it is public knowledge.
Dr. Andy Roark:
Gotcha. Okay. All right. Sweet. I will link that in the show notes so everyone can find it for sure. But yeah, that totally makes sense. All right, this sounds very doable. I’m going to need to draw this podcast to a close so I can go check my CE hours and make sure… I think the licensing period is closing up here before long, and I’m like I know I’m good, but now I feel compelled to go and look one more time just to make sure that I’m still good. So I am going to do that. It’s good to hear that suspension and revocation is rare. I like to hear that. Is there a ceremony for that? I imagine in the old war movies when the soldiers would have the stripes ripped off their shoulder, is there something like that? Or do you just get another raven-delivered letter, no ceremony?
Dr. Beth Venit:
I wish I could tell you, Andy. I don’t know.
Dr. Andy Roark:
Okay. Well, it’s probably a secret ceremony, I suspect, that’s-
Dr. Beth Venit:
It might be.
Dr. Andy Roark:
Probably held at midnight, and that’s why you’re not there. So I’m going to still hold onto that, that it’s a secret ceremony at midnight, and that’s why Beth hasn’t been invited. And anyway, so let’s hope that we never find out if that’s true or not. Guys, thanks so much for being here. Dr. Beth Venit, thank you so much for your time and expertise. Are there any final resources, links, words of wisdom, anything that you want to put out for people before you go?
Dr. Beth Venit:
Yeah, happy to. So if you go to our website, aavsb.org, like I said, you can see the board links to the websites and the statutes, but then you can also check out some of our programs that we have for licensees. So we have our RACEtrack program so you can track your CE and stay in compliance. We have our VAULT program and VAULT Premium, which is the secret weapon for anyone who wants to transfer from one jurisdiction to another. If you’re moving, definitely check it out. And then we also have links for our VTNE program, or a test for technicians who want to become credentialed. And then we have a PAVE Vets and PAVE Veterinary Technician program for foreign-trained veterinarians and veterinary technicians who want to work in the United States. So you could check those out as well.
Dr. Andy Roark:
That’s fantastic. Thanks again for being here.
Dr. Beth Venit:
Yeah.
Dr. Andy Roark:
All right, everybody, take care of yourselves. Have a wonderful rest of your day.
Dr. Beth Venit:
Thanks, Andy.
Dr. Andy Roark:
And that is our show. That’s what I got. Guys, I put some links to the aavsb.org down in the show notes. Thanks a lot for being here. Thanks for Beth coming in and talking with me. She’s amazing. But, guys, take care of yourselves. Write up your records. Do you CE. Communicate with your clients. Those are my takeaways. And I’m going to go check and make sure I have all my CE done for this year. All right, take care, everybody. I’ll see you later.
