Establishing Veterinary-Patient Client Relationship through Telemedicine

Jul 30, 2024 | Tennessee Farm Bureau

Key Takeaways

  • States that allow veterinary client patient relationship to be established through telehealth: Arizona, Idaho, New Jersey, Vermont, and Virginia. 
  • Currently in Tennessee establishing a VCPR requires an in-person examination by a veterinary; however, there has been proposed legislation that would allow for a VCPR to be established through telehealth. 
  • Current Tennessee law allows telehealth to be utilized once the VCPR is established, in order for the VCPR to be maintained the in-person exam must happen annually.  
  • states that a veterinarian-client-patient relationship cannot be established or maintained by telephone.  
  • Tennessee Farm Bureau Federation has argued in an animal cruelty court case that an in-person examination of an animal should establish the VCPR in order to prevent the wrong actors from performing telehealth to determine probable cause for cruelty.  

Questions

  1. Do you utilize telehealth for your veterinarian services? 
  2. Do you feel in your community you have reasonable access to a veterinary provider? 
  3. Should the establishment of VCPR require an in-person examination? 

Background

A veterinarian-client-patient relationship (VCPR) is the basis of interactions between a veterinarian, clients, and their patients. This relationship is crucial in allowing the veterinarian to ensure their actions only enhance the life of the patient. Currently in Tennessee establishing a VCPR requires an in-person examination by a veterinary; however, there has been proposed legislation that would allow for a VCPR to be established through telehealth. Current Tennessee law allows telehealth to be utilized once the VCPR is established, in order for the VCPR to be maintained the in-person exam must happen annually.  Proponents say establishing the VCPR through telehealth would make it easier in rural areas with limited access to nearby vet clinics.  Other stakeholders raise concerns it would limit the veterinarian in their professional ability to make calls over a screen, as animals lack the ability to convey their pain like humans; animals cannot say if it is a dull ache or sharp pain thus a vet must use professional judgment to accurately diagnosis animals requires knowledge of its natural state. 

There is no opposition to telehealth being utilized after the initial relationship is established. Telehealth allows clients to have access to veterinary care despite being in a more remote location and allows for consultations with specialists working within certain parameters. However, opponents’ main concern with the legislation is with how limiting it can be to a veterinarian during their initial examination. Tennessee Farm Bureau Federation has argued in an animal cruelty court case that an in-person examination of an animal should establish the VCPR in order to prevent the wrong actors from performing telehealth to determine probable cause for cruelty.   

States that allow VCPR to be established through telehealth: Arizona, Idaho, New Jersey, Vermont, and Virgina. According to the American Veterinary Medical Association (AVMA) , 43 states and the District of Columbia use language that is essentially the same as the Food and Drug Administration (FDA) with respect to establishing a VCPR, and of those states 22 have added additional language to explicitly require an in-person examination. Only two states have no VCPR provisions: Michigan and New York.  

Concerns of establishing VCPR through telehealth include inaccurate diagnoses, concerns of abuse or mistreatment, proper treatment plans, and /or disease outbreaks. Veterinarians use sight, sound, smell, and touch to ensure the patient is diagnosed correctly, the treatment plan is correct and one the owner can follow, and that there is not a potential disease outbreak. Establishing a relationship in person provides a more comprehensive understanding of the patient and their owner including their environmental factors. After the establishment of the VCPR, telehealth is a great tool for those located farther from a veterinarian’s office. 

Read more about AVMA and Telehealth provisions across the country HERE.

Policy

Tennessee Farm Bureau
Veterinary Services (Partial) 

Large animal veterinarians help livestock producers stay abreast of and have access to the latest technology available in large animal care.  

A distinguishing definition of acceptable livestock management practices as opposed to veterinary medical practices is needed to avoid unnecessary conflict between the veterinary community and the farm community. We need and depend on one another. Everyone wins if responsible, proper, safe, cost efficient, Animal care is prioritized. 

 

 

American Farm Bureau
307 / Livestock and Poultry Health 

  1. We support:

10.25. Changing the federal definition of a veterinary-client-patient relationship (VCPR) to allow for the use of telemedicine when making an animal health diagnosis and recommending a course of treatments.  

301 / Animal Care 

  1. We support:

5.2. A farmer’s right, in consultation with their veterinarians, to set appropriate protocol for common animal husbandry practices to be administrated by the farmer or trained employee that are appropriate for their farm.