VCPR: The Veterinarian-Client-Patient Relationship

The veterinarian-client-patient relationship (VCPR) is the basis for interaction among veterinarians, their clients, and their patients and is critical to the health of your animal. 

View a printable form of the VCPR to post in your office.

Establishing a Veterinarian-Client-Patient Relationship

A VCPR is present when all of the following requirements are met:

  1. The veterinarian has assumed the responsibility for making clinical judgments regarding the health of the patient and the client has agreed to follow the veterinarians' instructions.
  2. The veterinarian has sufficient knowledge of the patient to initiate at least a general or preliminary diagnosis of the medical condition of the patient.  This means that the veterinarian is personally acquainted with the keeping and care of  the patient by virtue of a timely examination of the patient by the veterinarian, or medically appropriate and timely visits by the veterinarian to the operation where the patient is managed.
  3. The veterinarian is readily available for follow-up evaluation or has arranged for the following: veterinary emergency coverage, and continuing care and treatment.
  4. The veterinarian provides oversight of treatment, compliance, and outcome.
  5. Patient records are maintained.
The VCPR is defined in Section III of the AVMA’s Principles of Veterinary Medical Ethics. This document also includes a description of how the VCPR may be terminated.
 
The AVMA Model Veterinary Practice Act (Section 2 and Section 2 Commentary) further states the following:
The definition of “veterinarian-client-patient relationship” (VCPR) in subsection 20 was changed in 2012, and is now different from that embodied in federal regulation 21 CFR 530.3(i) relating to extralabel drug use.
 
In 2012, subsection 14 was revised to define “patient” as “an animal or group of animals.” Therefore, the definition of VCPR can be applied to individual animals as well as a group or groups of animals within an operation (production system).
 
The AVMA recognizes that individual states may wish to more clearly define specific terms within the definition of VCPR. For example, a state regulatory board may wish to include a specific time period (eg, no less frequent than 6 or 12 months) to better delineate the term “timely” relating to examinations and visits. The term “timely” should be considered in light of the nature and circumstances of the patient (eg, species, condition or disease, or operation).
 
In 2012, subsections 20-b and 20-c were revised for purposes of clarification. Subsection 20-e was added to state that patient records must be maintained to establish a VCPR.
 
States may also wish to further specify that when establishing a VCPR in the case of large operations, “sufficient knowledge” can be supplemented by means of:
1. examination of health, laboratory, or production records; or
2. consultation with owners, caretakers or supervisory staff regarding a health management program for the patient; or
3. information regarding the local epidemiology of diseases for the appropriate species.
Section 5 (and commentary) of the AVMA Model Veterinary Practice Act states the following:
No person may practice veterinary medicine in the State except within the context of a veterinarian-client-patient relationship.
A veterinarian-client-patient relationship cannot be established solely by telephonic or other electronic means.

COMMENTARY TO SECTION 5—This section, which was added in 2003, emphasizes not only that veterinary medicine must be practiced within the context of a veterinarian-client-patient relationship (VCPR), but also emphasizes that because a VCPR requires the veterinarian to examine the patient, it cannot be adequately established by telephonic or other electronic means (ie, via telemedicine) alone. However, once established, a VCPR may be able to be maintained between medically necessary examinations via telephone or other types of consultations.

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