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Written by Paul
Dr Paul Manktelow is a vet who’s worked for almost 20 years on the front line in some of the UK’s busiest veterinary hospitals. As Chief Vet in the Charity Sector, he leads a team of vets and nurses that treat thousands of pets every year. Paul also appears regularly in the media as a TV and radio presenter, writer, public speaker and podcast producer.
Most owners assume that when their vet recommends tests or treatments, it’s simply the best clinical option. And often it is. But modern veterinary practice is complex, and behind the scenes many vets, especially early in their careers, find themselves navigating pressures that shape the decisions they make.
One of these pressures is defensive medicine: doing more, testing more, or over-investigating out of fear rather than necessity.
It’s a problem well-recognised in human healthcare, and increasingly acknowledged in veterinary medicine too. Understanding why it happens can help owners and vets work together towards clearer conversations, better outcomes, and care that stays truly focused on the animal’s wellbeing.
What Is Defensive Medicine?
In busy, modern practice, vets sometimes feel pressure to be thorough to the point of being cautious. This doesn’t stem from a lack of care. Quite the opposite – vets want to protect animals, protect owners, and protect themselves from misunderstandings. Occasionally, this can lead to a more investigative approach than may be strictly necessary, particularly in complex or uncertain cases.
It can look like:
- Running a wide panel of tests when a focused approach would do
- Repeating diagnostics sooner than needed
- Referring early out of fear rather than clinical necessity
- Offering exhaustive lists of options without clinical prioritisation
It’s important to stress that defensive medicine is not the norm and not a sign of bad practice. Vets are dedicated professionals acting with compassion and integrity. These pressures reflect the wider environment – not a lack of care. The goal of discussing it openly is to strengthen trust, not erode it.
Why Defensive Medicine Happens
There are several reasons vets may lean towards “doing more”:
1. Fear of complaints or litigation
Modern practice is under more scrutiny than ever. Social media, online reviews, and rising complaint rates mean vets often feel exposed. Many vets err on the side of caution because they genuinely want to get things right. Sometimes this means choosing a more comprehensive route to rule out serious issues early.
2. The new graduate confidence gap
New vets enter the profession with excellent theoretical knowledge but limited experience of what “normal” looks like in real clinical settings. Without the pattern recognition that comes with years of practice, they may default to broad diagnostics because it feels safer.
3. Time pressures
Short consults and busy clinics leave little room for extended discussion. It can seem quicker to print a blood form than to explain a staged approach.
4. Practice culture
Some practices emphasise thoroughness as part of their culture, which can shape the way newer vets approach work-ups. This is always done with the intention of giving pets the best chance of a clear diagnosis.
When Defensive Medicine Affects Pets and Owners
Although well-intentioned, over-investigation is not always helpful.
- Stress for the animal: multiple visits, procedures, or sedation can increase anxiety.
- Financial strain for owners: unnecessary tests can cause worry or guilt.
- Loss of trust: when owners feel overwhelmed by options, it can erode clarity.
- Delayed treatment: sometimes the fastest way to help an animal feel better is to start with clinical reasoning rather than a full diagnostic work-up.
Defensive medicine can unintentionally pull focus away from what matters most: improving the welfare of the pet.
Building Confidence and Trust in the Consultation Room
The antidote to defensive medicine isn’t “doing nothing.” It’s confident, thoughtful, collaborative decision-making.
1. Experience and mentorship
Senior clinicians play a vital role in modelling pragmatic, evidence-based decisions. Their confidence helps new graduates recognise what’s necessary – and what isn’t.
2. Clear, honest communication
When vets and owners can talk openly about uncertainty, goals, and constraints, the pressure to “overdo” reduces dramatically. Owners are usually relieved to be offered a sensible, staged plan rather than an exhaustive list.
3. Prioritising welfare over perfection
Good medicine isn’t about chasing every possibility. It’s about identifying the most likely diagnosis and taking steps that improve comfort and health quickly and safely.
4. Reassurance that a staged approach is still high-quality care
When owners understand why a vet is suggesting a simpler path, they gain trust – and vets gain confidence.
A Healthier, More Sustainable Way Forward
Defensive medicine is rarely discussed openly, yet it influences everyday decision-making in practice. Reframing this conversation is essential for the wellbeing of pets, the financial
and emotional wellbeing of owners, and the sustainability of the profession itself.
When vets feel supported – by their teams, clients, and culture – they can rely more on their clinical judgement and less on fear. That’s when veterinary care becomes more balanced, more compassionate, and more effective.
Listen to the Full Conversation
Explore this topic in more depth in our latest episode of The Consult Room:
🎧 When Less Is More: Rethinking Modern Veterinary Care
