Updated model practice act goes to HOD
The AVMA House of Delegates this January will vote on an updated version of the AVMA Model Veterinary Practice Act.
Last updated in 2013, the MVPA is a set of guiding principles for regulating the practice of veterinary medicine within the states.
Meeting at AVMA headquarters on Sept. 8 in Schaumburg, Illinois, the AVMA Board of Directors voted to refer this latest iteration of the MVPA to the HOD with a recommendation for approval.
Delegates also may vote on a bylaws amendment sunsetting the Judicial Council, which advises the AVMA on questions of veterinary medical ethics and oversees disciplinary actions involving members.
During the meeting chaired by Dr. Gary Brown, the Board approved a proposal from the Working Group on Volunteer Engagement to replace the Judicial Council with Board-appointed ad hoc entities as needed. "The BOD may rely on the expertise of staff and existing volunteer entities for input on these matters," the working group stated in its proposal, noting that AVMA staff includes four attorneys.
The Board action initiated the process for passage of an AVMA Bylaws amendment that will ultimately be voted on by the HOD.
Regarding the Model Veterinary Practice Act, one of the changes in the document is the expanded definition of the veterinarian-client-patient relationship. The proposed wording states: "Such a relationship can exist only when the veterinarian has seen the patient(s) or is personally acquainted with the keeping and care of the patient(s) by virtue of a physical examination of the patient(s), by medically appropriate and timely visits to the operation where the patient(s) are kept, or both.
"Both the licensed veterinarian and the client have the right to establish or decline a veterinarian-client-patient relationship within the guidelines set forth in the AVMA Principles of Veterinary Medical Ethics.
The AVMA Model Veterinary Practice Act continues to state that a veterinarian-client-patient relationship "cannot be established solely by telephonic or other electronic means," consistent with the prevailing interpretation in most states and the federal government's view in applying the VCPR to prescribing drugs for extralabel use and issuing veterinary feed directives. The MVPA contains language restricting the ability of local governments to prohibit state-sanctioned veterinary procedures within their jurisdiction.
"A licensed veterinarian who in good faith engages in the practice of veterinary medicine by rendering or attempting to render emergency or urgent care to a patient when a client cannot be identified, and a veterinarian-client-patient relationship is not established, should not be subject to penalty based solely on the veterinarian's inability to establish a veterinarian-client-patient relationship."
In addition, "client" has been broadened to include individuals presenting an animal for care who aren't responsible for the animal, as when a good Samaritan brings an injured animal to a veterinary clinic for treatment.
The MVPA continues to state that a VCPR "cannot be established solely by telephonic or other electronic means," consistent with the prevailing interpretation in most states and the federal government's view in applying the VCPR to prescribing drugs for extralabel use and issuing veterinary feed directives. The MVPA contains language restricting the ability of local governments to prohibit state-sanctioned veterinary procedures within their jurisdiction.
Federal definitions of "veterinary feed directive" and "veterinary feed directive drug" are included in the MVPA, which clarifies that veterinarians and nonveterinarians employed by state governments or the federal government are not exempted from following federal law concerning extralabel drug use and VFDs.
The latest revision process began in 2016 as the AVMA Council on Veterinary Service anticipated the mandatory five-year review of the Model Veterinary Practice Act.
By the fall of the following year, a working group of representatives from an array of organizations had assembled and began updating the document.
In early 2018, a draft MVPA was circulated among members of the AVMA Board and House of Delegates; an updated version was subsequently posted online for a 60-day comment period. Nearly 200 comments were received, which the working group reconciled. The group then provided an updated draft for review by the COVS.
The most common comment received was in response to the proposed elimination of the farrier exemption, which did not happen in the final iteration. The next most common were comments on the use of the term "veterinary nurse" and issues related to the practice of massage therapy, according to background materials.
The council approved the proposed MVPA revisions during its spring meeting. After further review by counsel, additional changes were approved by the COVS in June, and an updated draft was sent to the BOD for consideration.
The Board postponed consideration of the MVPA when, in July, the American Association of Veterinary State Boards sent proposed changes to its own Practice Act Model to the AVMA. The AAVSB publication covers a host of issues facing regulatory boards of veterinary medicine, including a new definition of the VCPR, telemedicine, and requirements for medical records. The AAVSB approved changes to its Practice Act Model at its annual meeting in September 2018.
After reviewing the AAVSB document, the COVS sent an updated recommendation to the Board with additional changes. "Throughout the revision process, the two organizations consulted with one another and exchanged views and perspectives, which ultimately helped strengthen both documents," said AVMA President John de Jong.
Related JAVMA content:
AVMA helping veterinarians take on telemedicine (Sept. 15, 2017)
Defining relationships (June 1, 2017)