What Determines a Legitimate Veterinarian-Client-Patient-Relationship (VCPR)?
A legitimate VCPR is considered to exist only if medical records of the practice contain sufficient evidence of relevant and timely interaction between the veterinarian, animal owner and animal patients.
These interactions may include, but are not limited to:
- Farm or home visits
- Clinic appointments
- Direct animal examinations (individual or herd/flock)
- Laboratory reports
- Production record reviews, etc.
The VCPR is supported by documented evidence that the veterinarian has undertaken the steps necessary to establish medical needs and consequently prescribes and subsequently dispenses pharmaceuticals.
The VCPR is not a signed contractual agreement but rather a working connection and interaction between veterinarian, client and specific animal patient or group of animals. The VCPR is not in and of itself an entitlement to prescribe and subsequently dispense.
Each provincial and territorial veterinary statutory body has their own definition of VCPR in provincial legislation.
The CVMA's Antimicrobial Prudent Use Guidelines (2008) states that VCPR exists when all of the following conditions have been met:
- The veterinarian has assumed the responsibility for making clinical judgments regarding the health of the animal(s) and the need for medical treatment, and the client has agreed to follow the veterinarian’s instructions.
- The veterinarian has sufficient knowledge of the animal(s) to initiate at least a general or preliminary diagnosis of the medical condition of the animal(s). This means that the veterinarian has recently seen and is personally acquainted with the keeping and care of the animal(s) by virtue of an examination of the animal(s) or by medically appropriate and timely visits to the premises where the animal(s) are kept.
- The veterinarian is readily available for follow-up evaluation, or has arranged for emergency coverage, in the event of adverse reactions or failure of the treatment regimen.
The New Reality for Veterinary Oversight
Upcoming changes to federal policies and regulations will result in the removal of all production claims for antimicrobials in animal feed and water and will require mandatory veterinary oversight in the use of antimicrobials in food-producing animals by the end of 2016.
The existence of a legitimate VCPR will be critical before a veterinarian can prescribe or dispense a medication.
The Canadian Council of Veterinary Registrars and the CVMA’s Veterinary Pharmaceutical Stewardship Advisory Group are developing a pan-Canadian framework for professional standards for veterinarians pertaining to the veterinary oversight of antimicrobial use that will provide a common understanding of objectives and help guide veterinary professionals in their new responsibilities. The draft Framework will include an updated version of the VCPR definition found in CVMA’s Prudent Use Guidelines.