California recently updated its website providing answers to “Frequently Asked Questions Regarding Veterinarian-Client-Patient Relationship (VCPR)” pursuant to California Code of Regulations (CCR), Title 16, Sections 2032.1, 2032.15, and 2032.25.
Answers to the first four questions posed, clarify when a VCPR is required, but the answer to the last question may require specific examples to clarify when a VCPR is not required. Consider the answer to Question No. 5:
Question No. 5:
Can a veterinarian do laboratory tests on an animal patient where no VCPR is established?
Answer to Question No. 5:
Yes; a VCPR is required only if the veterinarian is administering, prescribing, dispensing or furnishing a drug, medicine, appliance, or treatment to the animal patient (except for wild or unowned animals). Part of establishing the VCPR is obtaining sufficient knowledge of the animal(s), which includes through laboratory testing, to initiate at least a general or preliminary diagnosis of the medical condition. (CCR, tit. 16, § 2032.1, subs. (a), (b)(2).).
If the client requests treatment for the animal patient after the laboratory test results are returned, a VCPR, which includes a physical exam, must be established. (CCR, tit. 16, § 2032.1, subs. (a), (b).)
If, as a result of laboratory test results, the client requests treatment, it is understandable, legally and otherwise, that a VCPR is required before treatment is provided.
However, the question that arises based on the initial response, is whether a veterinary technician or other employee working under the supervision of a veterinarian, can obtain the samples from the patient and submit them to a laboratory for such laboratory testing? Would a veterinarian have to order such testing and if so, wouldn’t that require the establishment of a VCPR in order to determine testing was indicated?
If not, could a veterinarian establish a service which provides for testing requested by the owner, and performed by staff under the veterinarian’s supervision?
The duties of the supervising veterinarian set forth in 16 CA ADC § 2035 (California Code of Regulation) states,
The supervising veterinarian shall have examined the animal patient prior to the delegation of any animal health care task to a R.V.T. [Registered Veterinary Technician], permit holder or veterinary assistant. The examination of the animal patient shall be conducted as such time as good veterinary medical practice requires consistent with the particular delegated animal health care task.
So, while the answer to FAQ No. 5 appears to permit laboratory testing before a VCPR exists, when considering other regulatory requirements, it is not clear when such testing would actually occur.
Perhaps the California Veterinary Medical Board could provide examples of when a situation would arise in which testing occurs without the preliminary veterinary exam.