Posted Dec. 15, 2011
What is the definition of the veterinarian-client-patient relationship if the patient is a population of animals? A newly formed
working group seeks to refine the description of the VCPR in the AVMA Model Veterinary Practice Act.
A task force has presented a revised version of the AVMA Model Veterinary Practice Act, although the definition of the veterinarian-patient-client relationship in the document is under review.
Dr. John R. Scamahorn, chair of the task force, said the model practice act provides the states with "a model of what AVMA feels is the best way to protect the health, safety, and welfare of people and animals" in the regulation of veterinary practice.
The task force submitted the revised model practice act to the AVMA Executive Board in November, and the board voted to forward the document to the House of Delegates for consideration in early January.
Model practice act
The HOD first adopted a model practice act in 1964. The board approved the most recent major revisions in 2003 and approved minor revisions in 2007. In 2010, the board established a task force to conduct a comprehensive review of the document.
The revision process began in January 2011 with a 30-day comment period, garnering about a thousand comments from veterinarians and the general public. In June, the task force released a first draft of potential revisions to the model practice act (see JAVMA, July 15, 2011).
Some of the key revisions in the first draft addressed the credentialing of veterinary technicians and confidentiality of patient records, Dr. Scamahorn said.
The task force solicited input from various AVMA entities—including the HOD, councils, and committees—on the first draft of the new version of the model practice act. Among other comments, AVMA entities expressed divergent views on the definition of the VCPR in the document.
According to the existing model practice act, no person may practice veterinary medicine except within the context of a VCPR. The document describes the VCPR mostly in terms of a veterinarian having knowledge of an individual animal. A number of AVMA entities noted that many veterinarians work with animals as groups or populations, Dr. Scamahorn said.
"How do we define the act of treating an individual animal versus a small group of animals versus a population of animals?" he asked.
The task force decided to submit the revised model practice act without any modifications relevant to the VCPR and to recommend the formation of a working group to examine the definition of the VCPR. The board approved the working group, which was to meet in December.
Input from AVMA entities also led to various revisions after the first draft of the new version of the model practice act. The revisions included the following changes:
- A more descriptive definition of "animal" as meaning "any living organism, except humans, having sensation and the power of voluntary movement and requiring for its existence oxygen and organic nutrients."
- A new definition of "complementary, alternative, and integrative therapies" as meaning "a heterogeneous group of preventive, diagnostic, and therapeutic philosophies and practices that are not considered part of conventional (Western) medicine as practiced by most veterinarians and veterinary technicians," replacing a definition referring to the therapies as differing from current scientific knowledge or instruction at veterinary colleges.
- Commentary that veterinarians should document owner consent in the medical record and obtain the client's signature whenever possible.
- Commentary that, while the model practice act provides for veterinarians to request assistance from nonveterinary animal health professionals, the provision does not preclude states from requiring that nonveterinary animal health professionals be subject to veterinary oversight such as supervision or referral by a veterinarian.
- New subsections to clarify the circumstances under which veterinarians may disclose patient information for purposes of treatment, payment, or research.
The board forwarded the revised model practice act to the HOD as a resolution, with a recommendation for approval.
Other policy changes
The board forwarded two other items to the HOD as resolutions, with recommendations for approval.
One item is a proposal for a new AVMA policy on exemptions from rabies vaccinations.
The AVMA Council on Public Health and Regulatory Veterinary Medicine proposed a policy and an accompanying waiver form to provide for exemptions from rabies vaccinations for the rare animals that have contraindications. The council otherwise still supports rabies vaccinations for all dogs, cats, and ferrets per the recommendation from the National Association of State Public Health Veterinarians.
According to the pending policy, "All rabies vaccination waivers should be reconsidered at least yearly and, if appropriate, may be renewed on an annual basis following a reassessment of the animal's condition."
The other item that the board forwarded to the HOD is a proposal for revisions to an AVMA policy on animal abuse and neglect.
According to the existing policy, veterinarians should report animal abuse or neglect to appropriate authorities, regardless of whether they are mandated to do so by law. The AVMA Animal Welfare Committee proposed revisions to add that reporting should be timely.
The board submitted the three resolutions to the HOD after the 60-day deadline for prior notice, and a two-thirds vote of the HOD will be necessary to waive the notice requirement.