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Vet visit, then meds Ask the Vet
A monthly column By Daniel H Grove, DVM by daniel h. grove, dvm H
ere is a question that can be a point of contention between many veteri- narians and their clients:
“Why does my veterinarian need to see that
before I get medication? This is a simple prob- lem, and I just need the medication.” Let us take a look at why it is necessary for
a patient to first be seen before dispensing or prescribing medication. I will start with the client’s point of view. The client may be a very experienced horse person who has been doing this for 30-plus years. They have a minor cut on the horse that they are comfortable cleaning and wrapping to allow it to heal. They have had the veterinarian out for 10 of these in the past and the treatment is always the same: put them on some antibiotics, give them some bute and give a tetanus shot. Why can’t they just pick up some antibiotics and treat the horse without the expense of the veteri- narian seeing the horse? The first reason that the veterinarian needs to see the animal before prescribing anything is we need to choose what is most appropriate for the situation. In our exam- ple above, is this just a simple wound involv- ing the skin? Does it fully penetrate the skin? If this is near a joint, did it penetrate the joint? Answers to these questions will dictate if antibiotics are even needed and how aggressive you will need to be with your antibiotic choice. Another example is we really need to
know the history of your horse. If your horse has had kidney issues in the past, we might not choose an antibiotic that causes the
ROPE SORT
SPIN TURN BEND
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kidneys to work to eliminate it. Along those same lines, we may not use bute because it also is hard on the kidneys. These are all decisions we need to make before giving you that medication. All of these questions need to be investigated and answered before making these choices. This is what your veterinarian went to school for and has been educated for. The next reason is that it is the law. Every
state has a veterinary practice act. Each one might be worded differently, but it is the laws by which a veterinarian must practice. Here is California’s version: 2032.1. Veterinarian-Client-Patient
Relationship. (a) It is unprofessional conduct for a vet- erinarian to administer, prescribe, dispense or furnish a drug, medicine, appliance, or treatment of whatever nature for the preven- tion, cure, or relief of a wound, fracture or bodily injury or disease of an animal without having first established a veterinarian-cli- ent-patient relationship with the animal patient or patients and the client, except where the patient is a wild animal or the owner is unknown. (b) A veterinarian-client-patient relation- ship shall be established by the following: (1) The client has authorized the veteri- narian to assume responsibility for making medical judgments regarding the health of the animal, including the need for medical treatment, (2) The veterinarian has sufficient knowl-
edge of the animal(s) to initiate at least a general or preliminary diagnosis of the med- ical condition of the animal(s). This means
that the veterinarian is personally acquaint- ed with the care of the animal(s) by virtue of an examination of the animal or by medical- ly appropriate and timely visits to the prem- ises where the animals are kept, and (3) The veterinarian has assumed respon-
sibility for making medical judgments regarding the health of the animal and has communicated with the client a course of treatment appropriate to the circumstance. (c) A drug shall not be prescribed for a
duration inconsistent with the medical con- dition of the animal(s) or type of drug pre- scribed. The veterinarian shall not prescribe a drug for a duration longer than one year from the date the veterinarian examined the animal(s) and prescribed the drug. (d) As used herein, “drug” shall mean any
controlled substance, as defined by Section 4021 of Business and Professions code, and any dangerous drug, as defined by Section 4022 of Business and Professions code. This is just an excerpt. I know it is a bunch
of legal jargon, but it lays out what meets the veterinary client patient relationship. If we do not follow this, we are jeopardizing our license and ability to practice veterinary medicine. When we deny your request to just give you a medication without an exam, it is not because we do not have a desire to help you. It is because we want to do it properly. As you can see, both reasons are inter- twined. We want to be assured we are doing the right thing for your situation and we also want to do it legally. Your animal’s care is of great importance to us.
–Dan
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