In today’s world, telecommunication has become second nature. In the past few years, the average person has booked a doctor’s appointment with telehealth as well. While so many technological advances are revolutionizing the way health care services are delivered to humans, many pet parents and veterinary professionals are wondering, what about the non-human members of the family?
Currently, there are federal requirements for the veterinarian-client-patient relationship (VCPR) that are different from that of the human doctor-patient relationship. While these requirements may have made sense to protect animals in the past, some are now preventing animals from getting the care they need and deserve. The following will explain the VCPR and the impact telehealth and teletriage can have to improve efficiency for the veterinary industry and re-envision the ways animals receive care.
The Veterinarian-Client-Patient Relationship (VCPR)
When referring to the client from a veterinarian point-of-view, the veterinarian is referencing the owner of an animal or group of animals that a veterinarian is treating. Currently, in order to diagnose and treat an animal, a veterinarian has to follow strict state and federal requirements. One requirement in particular poses a challenge for scaling veterinary telehealth services.
The FDA defines the VCPR and requires that in order to be treated and prescribed medication, there must be a physical examination of the animal or timely and medically appropriate visit to the premises where the animal is kept. The FDA does not allow the VCPR to be established through electronic communication. However, once there is the initial physical examination, the VCPR can continue electronically through telemedicine.
There are many treatments and procedures that are absolutely necessary for a pet to be seen in a clinic or emergency facility, however, there are many acute and chronic conditions, minor injuries, and wellness related questions that can easily be handled through telehealth. In some cases, not receiving timely treatment for a minor issue can turn into major issues down the road.
Dr. Cherice Roth, Chief Veterinary Officer at Fuzzy, puts it into perspective, “As a telehealth veterinarian today, the fact that I can’t give medication to a pet I know is in pain without first laying hands on it is gut-wrenching or that I can’t protect a pet’s family by putting the animal on flea and tick prevention is ghastly.”
The Shortage of Veterinarians
Anyone that has tried to book a veterinary appointment over the past few years knows that the wait to book an appointment can be weeks, even for routine vaccinations. Even with an appointment, wait times can still be a few hours. This poses even bigger challenges for lower income families and those in rural areas.
There has been an increase in pet ownership without a substantial increase in new veterinarians entering the field. The number of pet dogs and cats has increased from 140 million in 2019 to 149 million in 2020 in the U.S., which is about a 7% growth. And the rate of new pet parents and pet parents adopting additional pets has had a steady increase through 2021 and 2022. At the same time, the number of new veterinarians entering the field each year usually increases by just 2.7% annually, while roughly 2,000 vets retire from the profession.
Whether it’s the “pandemic pet boom,” sustained work from home policies, or lower human birth rates replaced by increased pet adoptions, the vet industry is faced with a labor crisis. Research suggests that there will be an estimated shortage of 15,000 veterinarians in the U.S. by 2030. This would leave roughly 75 million pets without veterinarian care. With veterinarians taking on more clients, burnout continues to be a major concern. This is why it is crucial for the veterinary industry to rethink and modernize the process for pets to get care.
Veterinary Telehealth to the Rescue
Telehealth is a broad term used to refer to the use of any type of digital technology to deliver health information, education or care remotely. Since 2020, telehealth has become common for human doctor-patient relationships. It is used for minor illnesses, prescriptions, home care strategies, recommended courses of treatment, and more. It saves time and money for both doctors and patients. For the veterinary field, telehealth includes a broad range of tools that veterinarians can use to enhance the delivery of care to animals.
Here are examples of medications that if prescribed virtually would reduce the need for vet visits:
- Prescription-strength medication and preventatives for flea and tick infestations and flea allergy dermatitis (FAD), which in turn would reduce intestinal parasite infestations.
- Fluoxetine or Prozac used to treat behavioral issues in dogs and cats.
- Apoquel to provide relief from itching.
- Sedatives for anxious or aggressive dogs and cats. Common uses are for trips to the vet or longer travel.
- Heartworm prevention in puppies and kittens less than 6 months of age.
- Cerenia, used as an anti-nausea medication for carsick pets.
- Certain non-steroidal anti-inflammatory drugs (NSAIDs) used to relieve pain, reduce inflammation, and reduce high body temperatures.
Every pet parent has had moments when they're worried about something regarding their pet’s health - with little idea how serious it actually is. Teletriage services can be used to help pet parents assess the urgency of a pet’s condition, get advice to help make a pet more comfortable, and provide peace of mind in knowing what to do next.
There are acute conditions that veterinarians can triage and recommend treatment for via telehealth. Such as:
- Acute vomiting and symptomatic treatment like cerenia to stop the vomiting.
- Dewormers for puppies and kittens with intestinal parasites or as a broad spectrum treatments for some cases of diarrhea.
- Topical treatments, including but not limited to treating puppies with clinical signs of sarcoptic mange.
Some eye medications for eye infections.
- Oral antifungals for suspected ringworm in cats.
- Some pain medications for short-term symptomatic treatment of sudden onset limping in dogs.
- Acute coughing or sneezing.
- Minor wounds or injuries.
Other instances where veterinary telehealth could be appropriate are monitoring chronic conditions and consultations with pet behaviorists and nutritionists.
Like telehealth for humans, there are situations where telehealth for pets is not appropriate. If an animal is experiencing a medical emergency, they should go to a veterinary hospital right away. When in doubt or if a pet parent is having trouble reaching a hospital or clinic, there are companies that offer 24/7 telehealth services like, Fuzzy, which connects pet parents to live veterinarian support to assist whenever a situation arises.
The impact of a modernized veterinary-client-patient relationship can be transformative to the lives of veterinarians, pet parents, and most importantly, pets.
With new, more efficient ways to care for pets, more health professionals may be attracted to the veterinarian field. Less burnout and less overwhelm means hospitals can have the staff to treat the patients they need to treat. More time on a veterinarian’s schedule means they are able to treat a larger number of patients. A pet’s vet records, profile, and past consultations can easily be uploaded and shared virtually, delivering efficient and personalized treatment. Another benefit is that veterinarians can observe a pet’s symptoms or how they behave at home in their own environment.
For certain needs, telehealth can take out the transportation, time, and cost barriers for pet parents. This could be especially beneficial for lower income families, families in rural areas, and those with limited mobility. Physical examinations are still necessary, however, regular telehealth visits can empower pet parents to better assess their pet’s overall needs and learn ways to provide them with preventative health care from home. This can include proper diet and nutrition, meeting mental and physical needs, skin and coat care, and prioritizing oral health. Preventative health is crucial to prolonging a pet’s life.
Another significant benefit is minimizing the number of vet visits for anxious pets. Going to a veterinary clinic or hospital can be a stressful experience for an animal. In some cases, medication is needed for cats and dogs that experience severe anxiety or exhibit aggressive behavior when going to the vet. Again, not every visit can be avoided, however, telehealth can reduce the number of live vet visits for an anxious pet and provide other options for care.
The Future of Veterinary Medicine is Virtual
Veterinary telehealth is about more than just efficiency, it’s about pet parents being the hero for their pets. Modernizing the VCPR requirements to be more inclusive of the ways in which care is allowed to be delivered to pets through telehealth would transform the veterinary industry.
Dr. Roth sums it up best, “The future of veterinary medicine is a virtual veterinary clinic, one where the simple things are addressed without a pet owner having to go to a clinic. When a pet does go to a clinic, it’s with purpose, support and need. The virtual veterinary clinic experience is seamless for the pet owner, pet and care delivery team. This helps to address the lack of inclusive access and allows the hospital teams to have the right pets in front of them.”