House considers changes required to meet profession’s future needs

Technology an opportunity and challenge veterinarians are eager to explore in practice and elsewhere

Updated June 26, 2024

A veterinarian’s expertise is key. This applies when deciding what duties to delegate to veterinary technicians and veterinary assistants or whether to use artificial intelligence to help interpret a radiograph.

The AVMA is working diligently on preserving practitioners’ ability to exercise their professional judgement and prepare for the future. In addition to professional liability (see story), AVMA leaders on June 20 discussed the Association’s Model Veterinary Practice Act (MVPA) and the use of technology during the AVMA House of Delegates’ (HOD) Veterinary Information Forum (VIF).

Model Veterinary Practice Act

The MVPA is undergoing review by the Council on Veterinary Service (CoVS) and its Expanded Working Group. Dr. Lindy O’Neal, Arkansas delegate, said the CoVS anticipates opening comments on a draft updated MVPA later this year or early next with the hopes of having an updated MVPA presented to the AVMA Board of Directors (BOD) for consideration in 2025 and to the HOD by summer 2025.

Dr. Lindy O’Neal, Arkansas delegate, says veterinarians should have ultimate authority to delegate duties and tasks to their staff members.
Dr. Lindy O’Neal, Arkansas delegate, says veterinarians should have ultimate authority to delegate duties and tasks to their staff members. (Photo by R. Scott Nolen)

The MVPA is intended as a set of guiding principles for those revising a veterinary practice act under the law and codes of a particular state. Notable provisions in the document include the following:

  • Creates a board of veterinary medicine that oversees the practice of veterinary medicine (and veterinary technology) in the state and sets its powers.
  • Creates requirements for licensing or registration and establishes procedures for dealing with complaints and discipline of licensees and registrants.
  • Defines the veterinarian-client-patient relationship (VCPR) and sets requirements around the practice of veterinary medicine that hinge on the VCPR.

During the VIF, one topic of interest was whether and how to identify duties and supervision of veterinary technicians, veterinary technologists, and veterinary technician specialists.

Dr. Tiffany Healey, Wyoming delegate, said she would like to see additions to the MVPA describing duties that veterinary technicians can perform to give veterinarians a better and consistent understanding of what they can do.

Dr. Hunter Lang, American Association of Bovine Practitioners (AABP) delegate, pointed out that his organization has put together a list of duties credentialed veterinary technicians can do, as have other organizations, such as the American Association of Equine Veterinary Technicians and Assistants (AAEVT) and the American Animal Hospital Association (AAHA). The AVMA Committee on Veterinary Technician Education and Activities has created an essential skills list that describes competencies required of new graduates of accredited schools of veterinary technology.

Dr. Kristen Clark, Iowa VMA president, said in a reference committee meeting after the VIF that her organization just finished reviewing its veterinary practice act, which included defining tasks of veterinary technicians.

“It went well overall, but one of the more challenging things was that some things applicable to more urban practices were struggles for staff in rural areas, especially when it came to licensed veterinary technicians,” Dr. Clark said. “In rural areas, they have a harder time hiring and need veterinary assistants to do more things.”

They resolved this by allowing veterinary assistants to do more activities, such as administering medication, but under direct supervision.

Dr. Don Ferrill, Texas VMA president, said what really matters in a veterinary practice act is a good definition of what veterinary medicine is and what it isn’t.

“In Texas, it is prescribing, diagnosing, and treating and some exclusions,” he said, including treating your own animal, castrating farm animals, and dehorning. “All of this discussion about tasks for this level and that level—it’s just an attempt to create a midlevel practitioner. You’re opening the door with these exclusions. Guess what? Every time your legislature meets, there will be another push to add more to that list (of exemptions).”

License portability

License portability was another often-discussed topic brought up at the VIF. 

Delegates for the American Association of Industry Veterinarians and American Association of Avian Practitioners both noted that many of their members transfer between states due to the nature of their work and would like to see more reasonable application processes for people who have licenses in good standing in another state.

The MVPA allows for licensure by endorsement, which is when a veterinarian who is licensed in one or more states in good standing can become licensed in an additional state under a streamlined process. But for this to happen, the veterinarian must have a letter of endorsement from every state they are licensed in or have had a license to prove they do not have actions taken against their license in these other states.

The American Association of Veterinary State Boards (AAVSB) has its Veterinary Application for Uniform Licensure Transfer (VAULT) program, which is a license verification process that connects state databases with the AAVSB’s license information database to transfer professional information to the state and update the AAVSB database once a new license is issued.

However, Dr. Beth Venit, AAVSB’s chief veterinary officer, said it doesn’t necessarily speed up the process of getting licensed in another state because compiling the information takes up just as much time, if not more, than submitting the material.

“VAULT’s premium program collects letters of good standing, test scores, and everything else and then sends to the target jurisdiction,” she said “What slows it down is getting letter of good standing from wherever you’ve practiced, and most have an expiration date, usually 30 days. After that, you have to start process all over again.”

The AAVSB is now working on creating a national database for licensees similar to the National Practitioner Data Bank for physicians or the National Nursing Database. The Veterinary Information Verifying Agency (VIVA) database would have the AAVSB provide score and credential transfer information to its member boards.

“So, if we get all the jurisdictions signed on, this should eliminate need of a letter of good standing,” Dr. Venit said.

The MVPA mentions programs such as VAULT and encourages the creation of electronic databases like VIVA to make the process more seamless and quicker. But ultimately, it’s up to the states whether to allow licensees in good standing in other states an easier time getting licensed in their state.

Technology in the veterinary profession

Finally, delegates were asked ahead of the VIF to share their experience and thoughts about technologies they use in practice or ones they are considering adopting.

Many indicated that they use electronic medical records, practice information management systems (PIMS), and scribe services, as well as artificial intelligence-supported diagnostic tools, mostly for radiology and cytology—and biomarker technology.

Dr. Sherilynn Burkman, Idaho alternate delegate, said her clinic recently moved to an AI-based medical record system that captures audio from appointments and dictation in real time.

“I’ve saved 12 hours from typing notes. In clinical practice, I recommend exploring this option. I’ve seen significant improvements in quality of life for myself and my colleagues,” she said.

Dr. Bill Williams, Iowa delegate, said he would like guidance on client consent when it comes to technology.

“I’ve seen mixed opinions from legal [authorities] on best practices, which will vary from jurisdiction to jurisdiction, but it would be nice to have guidelines for practitioners to be aware of,” he said.

So far, the AVMA has created a Task Force on Emerging Technologies and Innovation that is charged with identifying needs and strategies to support AVMA members in the practical and responsible use of clinical- and business-augmenting technologies.

Delegates suggested during the VIF that the Association for Veterinary Informatics be engaged with the task force and that the task force also seek information from the American Medical Association, particularly regarding the use of AI in creating medical records. Other ideas were for the AVMA to create a forum where members can communicate with each other on their experiences with emerging technologies and to develop guidelines on how to best choose and implement these new technologies.

Learning to live with AI

Dr. Susan Chadima, Maine alternate delegate, says artificial intelligence (AI) is here to stay, so veterinarians should learn how to best use it to their advantage.

“(AI) has impacts for the MVPA, especially for questions about liability, and it has the potential to improve our skills as diagnosticians and care providers. It also comes with a downside if we don’t understand it and don’t regulate it. It’s a challenge we need to explore,” she says. (Video by Matt Zingale)