Q. What is a Veterinarian-Client-Patient Relationship (VCPR)?
A: While there are some differences in what is necessary to establish a valid VCPR for small animal medicine versus large animal medicine, the basic factors are the same: The veterinarian assumes responsibility for making medical judgments regarding the health of the animal based on a current thorough medical knowledge of the animal(s), such knowledge is gained by recently seeing or being personally acquainted with the keeping and care of the animal to the extent necessary to properly make appropriate medical decisions the veterinarian must keep readily accessible, written medical records of his/her knowledge and treatment of the animal with sufficient detail to clearly explain the initial exam and enable another veterinarian to take over treatment of the animal based on such records, the veterinarian must provide for some form of after care in case an emergency occurs after said care is provided; and the veterinarian's actions would conform to applicable federal law and regulations.
Q. What can happen when a valid VCPR doesn't exist?
A:Â Inappropriate prescription medications maybe given for undiagnosed or unrelated conditions;
Inappropriate dosages are given in unapproved locations;
Meat quality assurance guidelines are ignored;
A definitive diagnosis is never made; Evidence-based medicine is not practiced;
A food animal may go to slaughter with drug residue. ( A possible human safety issue caused by drug residue is the reason most, if not all new antibiotics are script drugs).
There are many variables or questions that must be considered or answered when establishing a valid VCPR, such as: Is your client a small animal owner; does the owner have a stocker/feeder cattle operation; or does the owner have a horse or horses for commercial reasons or for recreational use. If any one of the factors listed above is missing then a valid VCPR does not exist. If a veterinarian has any question about whether a valid VCPR exists, err on the side of caution and do not prescribe, dispense or administer drugs until a thorough medical exam is conducted. When dispensing medications for administration by an animal owner/client please be mindful of your client's ability to follow your instructions. The veterinarian must, can, or should weigh the relative risk of the medicine being properly administered to the patient as well as the risk of the medicine being diverted for improper use such as human consumption.
Any veterinarian prescribing, dispensing or administering medication to animals for which a valid VCPR does not exist is in violation of the Oklahoma Veterinary Practice Act.
Q. Why is a VCPR so important?
A: A valid VCPR involves a scientific/biological examination process, knowledge of pharmacology and experienced professional judgment exercised by a duly licensed veterinarian in deciding if, when and how medications are utilized for an animal. If you have a good working relationship with your veterinarian, he or she will be able to help, advise, and guide you in the use appropriate medications for your animal. By establishing this relationship, a veterinarian also gains a better understanding and working knowledge of your animal management practices. Therefore, your veterinarian can help you make medical judgments, assist you with withdrawal times in food animals, your recordkeeping system, and can provide extra label drug use when deemed necessary under special circumstances. (Some medications are dangerous and can compromise the patient's well-being). Seeking and following a qualified veterinarian's advice and supervision is highly recommended regarding drug use for animals, especially in any food animal.
Q. Does the veterinarian have the right to refuse to provide a prescription?
A: Prescribing, dispensing or administering prescription drugs to an animal is generally in the discretion of the treating veterinarian. However, the Board has consistently held that it is unprofessional conduct for a veterinarian to refuse to provide a prescription to a client if deemed medically necessary and the veterinarian would have dispensed the medication for use by the patient from their own clinic. In other words, if the medication is deemed necessary by the veterinarian for treatment of a patient, then said prescription may be either dispensed by the veterinarian or if the client requests a written prescription so that the prescription can be filled by an external pharmacy.Â This does not mean that the veterinarian is compelled to release a requested prescription to an animal owner when there are medical or safety reasons for not releasing it or they would not dispense the medication from their own practice. If the veterinarian dispenses narcotics/controlled substances they must report it to the State's Prescription Monitoring Program (PMP). The PMP reporting process provides continuity of information between practitioners, pharmacies, and state law enforcement to help prevent prescription drug diversion and misuse of drugs in the State. In accordance with the PMP process, controlled dangerous substances must be reported within 5 minutes of dispensing.
Also, an owner and veterinarian should keep in mind that it is considered unprofessional conduct by a veterinarian to prescribe, administer or dispense any veterinary prescription drug to or for an animal solely for training, show or racing purposes and not for a medically sound reason.
The Board's staff is available to address questions concerning a valid VCPR and can be reached at 405-522-8831.