BY: SAMANTHA BARTLETT, DVM
Several state legislatures and veterinary medical boards are examining the issue of whether establishing a veterinarian-client-patient relationship (VCPR) must be established through and in-person physical exam or if the VCPR can be established solely through electronic consultation (telehealth). Many veterinarians feel that telehealth has a place, but that it shouldn’t replace in person care particularly for pets that do not have regular veterinary care.
The FDA stance is that a VCPR cannot be established through telemedicine. The District of Columbia and 43 states have followed the stance of the FDA and require in-person examinations to establish the VCPR. Kentucky re-evaluated their VCPR requirement this year and asked the opinion of members of the Kentucky Veterinary Medical Association (KVMA) throughout the state. The overwhelming majority of the KVMA membership that responded to the survey (over 85% of the total membership) agreed a VCPR should be established in person and renewed every 12 months.
Six states changed their veterinary practice acts to allow a VCPR to be established without an in-person examination. These states include Arizona, California, New Jersey, Virginia, Idaho and Vermont. All of these states have stipulations on prescribing and when an in-person examination is required. Arkansas, Florida and Michigan were unsuccessful in passing legislation about virtual VCPR requirements this year.
A recent study conducted by the AVMA entitled, 2023 Pet Owner Attitude Survey, found that pet owners prefer to establish the VCPR in person as opposed to virtually. Pet owners also indicated they prefer their pet’s care be overseen by a veterinarian rather than a licensed non-veterinarian.
The survey was developed to get a better understanding of pet owner’s perceptions and attitudes following the COVID-19 pandemic and veterinary trends stemming from that time period. Notably, the push to eliminate in-person exams to establish a VCPR and the suggestion that a new mid-level employee position be created to take over some of the duties historically relegated to a veterinarian.
The findings are as follows:
• 88% of pet owners feel that a physical exam by a veterinarian and in-person conversation is the best standard of care.
• 79% of pet owners would prefer that a veterinarian lead their pet’s healthcare.
• 76% feel their pet’s health and safety is a priority for veterinary care
• 72% of pet owners want to meet a veterinarian in person before allowing them to care for their pet
• 80% of pet owners feel it would be dangerous for anyone other than a licensed veterinarian to make recommendations about life-or-death decisions for their pets.
The survey was available from September 8-14 and was completed by 1000 pet owners in the United States.
The AVMA is opposed to telemedicine without the presence of an in-person VCPR unless in the case of emergency teletriage. The AVMA has joined over 50 other member organizations to form the Coalition for Connected Veterinary Care (CCVC) to protect the integrity of the VCPR but acknowledge the benefit of telehealth to animal patients.
The CVCC is concerned with many e-commerce conglomerates pushing telemedicine as a platform to sell high-profit pharmaceuticals to pet owners. Many online corporations have already expanded into telehealth such as Chewy and Walmart. Amazon is also considering a move into veterinary telehealth to compete with Walmart. According to Senate disclosure reports, Amazon has spent over $400,000 on lobbying targeting telemedicine and the Food and Drug Administration. Whether these funds were solely for human or pet health, or both, is unknown.
