About a week after calving, a few of Smith’s cows were behaving oddly, wandering around in circles and appearing not well. The cows’ milk production was poor and their calves looked malnourished. Smith phoned his vet, who had not been to his farm for about a year, and described what he was seeing and that, to him, it looked like ketosis that his vet diagnosed during last-year’s calving season.
“What do you think, Doc?” asked Smith. “Can I treat them the same way we did last year?” The vet told Smith he could not say for sure it was ketosis or give him a diagnosis without visiting his farm and examining the cows.
“Good grief,” Smith thought, “I’ll be stuck paying him for a farm visit. Why can’t he tell me on the phone what’s wrong and how to treat it?”
In actuality, when such situations happen, your vet is not trying to increase his or her bill. Rather, he or she is complying with Missouri and federal laws and professional ethical obligations which requires that veterinarians examine affected animals before rendering a diagnosis and recommending treatment.
Specifically, the Missouri Veterinary Practice Act requires veterinarians to have a valid “veterinarian-client-patient relationship” before they can treat an animal, what veterinarians call a VCPR. That means, among other things, “the veterinarian has recently seen, and is personally acquainted with the keeping and care of the animal by virtue of an examination or by medically appropriate and timely visits to the premises where the animal is kept.” R.S Mo. § 340.200(23).
Succinctly, the VCPR is the basis for the interaction between a veterinarian, his or her client, and the respective animal patients.
Besides the veterinary practice acts, Missouri and federal drug laws and regulations as well as veterinary board professional conduct rules prohibit veterinarians from dispensing or prescribing any off-label/extra label medication, prescription drug or controlled substance without having a valid VCPR. In other words, if the veterinarian has not recently seen the animal(s), he or she cannot give a diagnosis or advise treatment over the phone or by other electronic means.
Not only is this a legal requirement, it is also ethically mandated by the American Veterinary Medical Association’s Principles of Veterinary Medical Ethics.
Veterinarians who don't comply, run the risk of various disciplinary sanctions up-to-and-including losing their license to practice.
The VCPR applies also to any situation where a veterinarian diagnoses, recommends, suggests, treats, changes, alleviates, rectifies, cures or prevents any animal disease, deformity, defect, injury or other physical or mental condition or renders any service or recommendations with regard to any such matters.
The necessity of a valid VCPR cannot be circumvented by any of the veterinarian’s lay employees or veterinary technicians visiting your farm and then speaking or texting on a phone with the veterinarian what they see.
It was a good thing Smith’s vet did not diagnosis ketosis (a metabolic, non-contagious disease) over the phone because, when the vet arrived at the farm and examined the cows, it turned out to be Leptospirosis (an infectious, contagious disease) that has a markedly different treatment from ketosis.
Gregory M. Dennis is Legal Counsel for the Missouri and Kansas veterinary medical associations. He practices law at Kent T. Perry & Co., L.C., Overland Park, Kan.
