Understanding the Veterinary-Client-Patient Relationship (VCPR)
The OVMA office receives calls from owners asking for clarification as to why their veterinarian requires their animal to have a health exam prior to a prescription being filled, a vaccine being administered, or other health services being performed.
By Oregon law, a licensed veterinarian must have a valid Veterinary-Client-Patient Relationship with you and your animal in order to provide veterinary services.
What is a Veterinary-Client-Patient Relationship (VCPR)?
Except where the patient is a wild or feral animal or its owner is unknown, a Veterinary-Client-Patient Relationship (VCPR) shall exist when the following conditions exist:
- The veterinarian must have sufficient knowledge of the animal to initiate at least a general or preliminary diagnosis of the medical condition of the animal.
- This means that the veterinarian has seen the animal within the last year and is personally acquainted with the care of the animal by virtue of a physical examination of the animal or by medically appropriate and timely visits to the premises where the animal is kept.
A VCPR must be in place for a veterinarian to be able to legally provide treatment, prescribe medications, or administer vaccines to an animal. The veterinarian must have examined the animal within the last year in order to establish the VCPR.
Once the VCPR is established, the veterinarian may agree to waive exams during the subsequent 12 months, unless the animal is brought in with a new health problem (which would require a diagnostic examination) or is scheduled for sedation (to determine the animal's tolerance for anesthesia).
This requirement is spelled out in the Administrative Rules (OAR 875-015-0030 (h)) which govern the practice of veterinary medicine in Oregon. The Oregon Veterinary Medical Examining Board oversees these requirements as the licensing agency of veterinarians and certified veterinary technicians in Oregon.
Why is an exam needed before vaccines are given?
Since animals age far faster than humans, a yearly exam can detect health issues that are not readily apparent to the owner. Vaccinating an unhealthy animal may exacerbate the animal's ill-health or the vaccine may be ineffective. To make an analogy to human health, patients are often asked how they are feeling to ensure that they are in good health before receiving a vaccination. For instance, human patients may not be given a flu shot while they have an active fever. Because animals cannot tell us how they are feeling, an exam is important prior to vaccinations being administered.
What are the required components of an exam to establish a VCPR?
A valid VCPR cannot be established online, via e-mail, or over the phone. It can only be established by a veterinarian performing a physical examination of your animal.
According to the Oregon Administrative Rules establishing Minimum Practice Standards for veterinary practices (OAR 875-015-0030 (h)):
"A physical exam shall be performed to establish or maintain a VCPR; and then each time an animal is presented with a new health problem, unless the animal’s temperament precludes examination, or physical exam is declined by the owner*. For each physical exam the following conditions shall be evaluated and findings documented when applicable by species, even if such condition is normal:
- Current weight;
- Body condition;
- Eyes, ears, nose and throat;
- Oral cavity;
- Respiratory system including auscultation of the thorax;
- Palpation of the abdomen;
- Lymph nodes;
- Musculoskeletal system;
- Neurological system;
- Genito/urinary system;
- All data obtained by instrumentation;
- Diagnostic assessment;
- If relevant, a prognosis of the animal's condition;
- Diagnosis or tentative diagnosis at the beginning of custody of animal;
- Treatments and intended treatment plan, medications, immunizations administered, dosages, frequency and route of administration;
- All prescription or legend drugs dispensed, ordered or prescribed shall be recorded including: dosage, frequency, quantity and directions for use. Any changes made by telecommunications shall be recorded. Legend drugs in original unopened manufacturer's packaging dispensed or ordered for herd use are exempt from this rule. Legend and prescription drugs are as defined by the U.S. Food and Drug Administration in 'FDA and the Veterinarian'.
- Surgical procedures shall include a description of the procedure, name of the surgeon, type of sedative/anesthetic agent(s) used, dosage, route of administration, and strength, if available in more than one strength;
*Note: This section of administrative rules does not supersede (emphasis added) the requirement to provide a physical exam if:
1. The patient has never been seen before by the veterinarian.
2. If the patient has not been seen by the veterinarian in more than one year’s time.
3. If the patient has been presented to the veterinarian for a new health problem."