Caring for patients and interacting with clients during COVID-19

Updated on May 26, 2020

Case management

During the COVID-19 pandemic, veterinary practices have been considered “essential businesses” where other retail facilities have been asked to close. Our success in remaining open was due to broad recognition of the need for veterinary services to protect animal and public health, in part because of effective advocacy on the part of the AVMA and state and allied veterinary medical associations. However, in an effort to minimize person-to-person contacts and to preserve personal protective equipment (PPE) and supplies , some jurisdictions issued executive orders placing restrictions on performing non-urgent/elective procedures by those delivering healthcare services. In some instances, these restrictions included veterinary practice, whereas in others these restrictions only specifically called out human medicine, but most veterinarians honored the spirit of the restrictions and postponed non-urgent or elective procedures.  

veterinarians have applied careful professional judgement to case management so that needed care for animals continued to be provided while limiting staff and client person-to-person exposure and conserving PPE.  The AVMA has developed a resource that may assist in making such decisions.

In some jurisdictions executive orders have been issued that will directly influence case management decisions), including decisions about appointments and procedures considered to be “routine” or “elective” (see AVMA’s spreadsheet and confirm with your state veterinary medical association and state board of veterinary medicine). Veterinary practices should also be aware that limits on statewide gatherings (e.g., 10 people) could apply to activity in their clinics. In most cases these will not apply to employees in the clinic, but they may apply to clients in waiting rooms. Consultation with state and local health officials is strongly encouraged so that timely and accurate information can guide appropriate responses in each practice. Since the intensity of an outbreak may differ according to geographic location, local health officials will be issuing guidance specific to their communities.

Animals that are sick or injured should receive veterinary attention. Veterinarians should continue to work to conserve personal protective equipment (PPE), including masks, gowns, and gloves (see links to conservation strategies under “Use of personal protective equipment” and “Potential supply chain impacts”). Actively seek to utilize telemedicine. Guidance is available on the AVMA website at avma.org/Telemedicine. Conducting pre-visit triage can help protect you and your staff as you prioritize and determine which patients need to be seen at the clinic. It can also help you manage personnel resources. And, no matter how you interact with your clients and patients, please remember that keeping good medical records is critical.

Clarify client’s medical status with regard to COVID-19. If an animal owner is ill with COVID-19, telemedicine can be used to help assess the animal’s condition and needs. Note that, in the midst of this emergency, some states—not all—have applied regulatory discretion to temporarily not require an in-person examination to establish a veterinarian-client-patient relationship (VCPR). AVMA is aware that emergency provisions and/or direction have been provided by many states. AVMA’s state orders spreadsheet provides more detail and you should check with your state veterinary medical association and state veterinary medical board to confirm and ensure you are familiar with the situation in your particular state. At the federal level, FDA has issued guidance, for immediate implementation, that temporarily suspends enforcement of certain aspects of the federal VCPR requirements that apply to extralabel drug use and VFDs (21 CFR 530 and 21 CFR 558.6). The guidance acknowledges individual state VCPR requirements that may exist, acknowledges current federal VCPR requirements related to in-person animal examinations/premise visits, and indicates suspension of requirements outlined in guidance are temporary measures during the COVID-19 outbreak.  If the animal must be seen in-person, because of existing state requirements or because the case presentation is not appropriate for the use of telemedicine, the ill owner should have a healthy family member or friend bring their sick animal to a veterinary hospital or clinic.

Communicating with clients

Good communication during times of high stress is critical. Use these tools to help your clients understand how COVID-19 might impact their animals. Answer common questions, spread the most up-to-date information on your clinic’s social media pages, and be a trusted source of information for your clients.

To assist you in sharing information with your veterinary team members, AVMA has also developed FAQs for veterinarians and veterinary clinics.

Minimizing COVID-19 exposure flowchart

The AVMA has produced a flow chart to help you manage veterinary cases while minimizing possible exposure to COVID-19.

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