As the disciplinary case against Dr. Margaret Ferrell enters final stages, controversy surrounding low-cost, high-volume spay/neuter clinics is heading to the legislative arena.
Officials with the Alabama Veterinary Medical Association (ALVMA) voted last week to explore crafting a bill to amend the practice act to excuse 501(c)(3) clinics from the state’s veterinarian-owner requirement. Instead, leaders suggest tightening oversight and restricting services of spay/neuter nonprofits with that tax code designation.
The bill's development is in preliminary stages.
As the ALVMA considers allowances for spay/neuter nonprofits, state regulators are prosecuting a veterinarian who works in one. The Alabama State Board of Veterinary Medical Examiners (ASBVME) has accused Ferrell, who performs high-volume sterilizations at the nonprofit Alabama Spay/Neuter Clinic in Birmingham, of gross negligence, incompetence and/or malpractice, among other charges.
Attorneys for both sides have until today to submit post-hearing motions to Administrative Law Judge Jerry James Wood, who is expected make a recommendation to the ASBVME concerning Ferrell's case.
Ferrell's disciplinary hearing in Montgomery ended Oct. 7, resulting in the dismissal of some allegations brought by the ASBVME.
One of two dogs she allegedly injured was never her patient.
It also was determined that Dr. Robert Pitman, former ASBVME president, filed the complaints against Ferrell after perusing the medical records of an emergency practice that had received some Alabama Spay/Neuter Clinic patients.
“Dr. Pitman was the sole complainant that initiated the investigation against Dr. Ferrell, and he was president of the board while he did that,” said Christopher Waller, Ferrell's attorney.
Pitman, whose second term on the regulatory board expired in early October, did not return calls left on his cell phone or at the small animal practice he owns in Athens.
He remains, however, a leading voice in a campaign to shut down high-volume spay/neuter nonprofits in Alabama based on the position that surgeries performed at such practices do not meet standards of care in the state.
Critics also argue that nonprofits unfairly compete with private clinics because they are exempt from paying income taxes and often provide services to all pet owners, not just those who are needy.
Ferrell, who says she’s performed more than 22,000 spay/neuter surgeries since joining the Alabama Spay/Neuter Clinic in 2010, declined to comment about the ongoing case. In a commentary Ferrell authored for the Veterinary Information Network (VIN), a private online community for the profession, she said her ability to perform 40 sterilization surgeries in a day is due to repetition and time-saving techniques taught by groups committed to curbing pet overpopulation.
“If a cat spay can be safely performed in five or six minutes or a dog spay in six to 12 minutes, why not do it?” Ferrell mused. “Surgery is never rushed. Speed comes with repetition and perfect practice. There is no compromise to quality.”
The assertion that pet sterilization can be performed that quickly and carefully has sparked heated debate among veterinarians on VIN, generating concern from practitioners that speed-surgery might give way to medical shortcuts or impinge on the quality of care.
As a regulator, Pitman is known for initiating the case against Ferrell’s boss, Dr. William Weber, who on June 11 was fined $5,000 and had his license suspended for a year. The board determined that Weber fraudulently obtained a permit for the Alabama Spay/Neuter Clinic given that he did not own the nonprofit’s building or equipment.
Weber, who owns a private veterinary hospital in nearby Irondale, is appealing to the Circuit Court of Montgomery County and has a March 2015 court date. The Alabama/Spay Neuter Clinic will remain open during the appeals process.
According to regulators, Weber’s status as a veterinarian was needed to keep Alabama Spay/Neuter Clinic in operation because the state requires all practices to be owned by licensed veterinarians — a stipulation that could change given the ALVMA's anticipated legislation.
Veterinarian or not, no one person or group can own a company that is tax-exempt under Internal Revenue Code section 501(c)(3). Rather, a board of directors typically controls the organization, which belongs to the public at-large.
The potential bid to create allowances for spay/neuter clinics has deepened conflict between the ALVMA, which supports high-volume spay-neuter, and the Alabama Veterinary Practice Owners Association (AVPOA), a professional group Pitman helped form in 2012.
Additionally, Pitman is suing the ALVMA and its executive director, Dr. Charles Franz, because the association made its membership a requirement of ASBVME nominations. The ALVMA nominates candidates for the regulatory board, which is comprised of six veterinarians, a layperson and licensed veterinary technician. The governor’s office makes the ultimate decision on appointments.
Filed in June 2013, the lawsuit accused the association of engaging in “conduct not in the interest of its members.” Depositions are being taken in the case.
Franz declined to speak about the case.
In an Oct. 15 letter, AVPOA officials urged veterinarians to lobby against the ALVMA’s efforts to open the practice act to make ownership allowances for nonprofits, imploring readers to “walk over to a mirror and look very carefully into it. You are looking at the person who is key to solving this issue.”
The letter is signed by Pitman and Drs. Ronnie Welch and Sam Eidt, two private practitioners who also have served on the regulatory board. Eidt is the board's current president. They maintain that legislation isn’t needed because the Alabama Veterinary Practice Act does not preclude veterinarians from setting up a low-cost spay/neuter clinic. “… Therefore there is no reason to open that act up and make changes to it.”
“Anyone who wants to do this is doing so at the peril of altering the standards of care for our entire profession, and opening up the gates for so much more harmful legislation in the future,” the letter said.
It went on to allege that the “leadership paradigm” of the ALVMA has been corrupted.
ALVMA President Dr. John Hammons, who owns a practice in the same small town as Pitman, did not return a phone call seeking his perspective on the letter.
Meanwhile, Ferrell took her seat on the regulatory board Oct. 10, appointed by Alabama Gov. Robert J. Bentley to replace Pitman as his term ended.
The governor’s office rejected the notion that it might be a conflict to have a seated board member accused of regulatory infractions. Waller, Ferrell’s attorney, said his client will recuse herself from any dealings with her case.