Atoll's Technical Tips: VCPR
What is it? Why do I need it? How can I get one?
*This info is specific to the U.S.*
What is it?
A veterinary client patient relationship is a legal agreement, an ethical framework, and a guide for appropriate relations between a veterinarian, a client (producer, animal owner, pet parent etc.), and a patient or patients (the animal or flock). In an established VCPR, a veterinarian agrees to take responsibility for the medical care (including diagnosing and prescribing medications), record keeping, follow-up, recommendations, and relevant, timely client communication regarding an animal or flock. A client agrees to make the animal or flock available for physical, in-person inspection, often enough for the veterinarian to have a reasonable understanding of the animal or animal’s health status. This length of time (usually every one to two years) is defined by the veterinarian and also by the laws of the state in which they are practicing. For example: in Oregon, a valid VCPR requires a minimum of one in person exam or herd check per year. Without this exam or herd check, it is illegal for any veterinarian to diagnose or prescribe for an animal. There are a few states where this relationship can be established virtually, but this is rare and tends to be frowned upon by national organizations like the American Veterinary Medical Association. Additionally, a client agrees to follow medical instructions from the veterinarian. Failure on the part of the veterinarian or the client to fulfill their responsibilities can mean losing this relationship and therefore losing access to veterinary care.
Why do I need a VCPR?
As mentioned above, without a VCPR which, in most states, must be established in-person, a veterinarian is not legally allowed to diagnose or prescribe. A veterinarian can give general information but are unable, legally, to give advice specific to a particular patient or case. In particular, prescription medications like antibiotics, cannot be dispensed in the absence of a VCPR. If I, as a veterinarian, choose to break the laws governing the establishment of VCPR’s I risk fines, loss of my license, and even jail time. No, thank you.
This is why when a veterinarian is cold called for an emergency by a client they have never met or seen before, or not seen in many years, or who has not followed their directions in the past, they will be extremely hesitant to give advice over the phone and will almost always insist on an in-person appointment. Many veterinarians have to turn down a lot of these calls to be able to keep their agreements with clients who are already established.
How do I get a VCPR?
It is essential to establish a VCPR before you need one (see above). You do this by calling around to veterinarians until you find one that you like, who is available to see new clients. You make an appointment with her (statistically, it will be a her as we outnumber hims in the field at this point) for a farm visit or a time to take a representative sample of your flock into the clinic. A farm call is best because allowing the veterinarian to understand the full context of your sheep will enable them to more accurately assess whatever arises in the future. This appointment is also an opportunity to ask any and all management questions you may have. It is a worthwhile investment in that you have a veterinary partner going forward but also have a chance for an expert to walk around your farm and help with troubleshooting. At this appointment you can also request a skill share-- perhaps you want to learn how to draw blood or trim hooves?
This appointment establishes your VCPR, but not indefinitely. You will need to repeat this periodically, in most cases annually. Ask your veterinarian what they expect of you and then do your bit. If your veterinarian is failing to do their bit, ask them about it. If nothing changes, get a new vet.
In areas with veterinary shortages, you may need to get creative. For example, in Oregon I am available to establish VCPRs with producers, regionally. This means that a handful of producers in a similar geographical region join forces and pay to have me out once per year. We often make a party of it-- we do a couple of workshops on topics or skills they are interested in, share a meal, and I do farm visits to establish or maintain VCPRs. This legally and ethically allows me to provide telemedicine to these clients, including advising, prescribing, triaging etc. for the year. If you are an Oregon resident and want information about this please email me at: leaningonourcrooks@gmail.com
In a pinch, there are consultation services that can offer general advice and information that can help get a shepherd through hard times when they physically or financially cannot get veterinary care. These services are also helpful affordable troubleshooting options even when a shepherd has regular veterinary care. I happen to run one. Here is information about that service.
I would like to give a shout-out that I often hear producers complaining about: that they are in a veterinary shortage area, when in reality, the shortage is only in veterinarians who are willing to work for free and in the absence of a VCPR. I live in the Rogue Valley in Oregon. This is not a service shortage area, there are several veterinarians who see large animals and are accepting new patients. However, for all the reasons described in this article, if a producer has chosen not to establish or maintain a VCPR and attempts to get a same-day appointment for a sick animal-- they may be out of luck. The moral of this story is get the vet before you need them and be willing to pay for the service.
If you are finding this free column helpful, but not interested in subscribing, please consider buying my sheep and I a cup of tea.