Telehealth Concerns Increasingly Real Without VCPR


Telhealth has been something the American Veterinary Medical Association (AVMA) has been talking about since well before the pandemic. The AVMA then suggested what few argued with; after all, this seems to be common sense: Telehealth for pets should be done only when there is an established veterinary client patient relationship, known as VCPR.

Then, the pandemic hit. State veterinary practice acts were temporarily lifted out of necessity. Quickly all bets were off as the need for a veterinary client patient relationship was – for a time – legally lifted, which new direct-to-consumer telehealth providers took full advantage of. And it some ways it made sense.

Capitalizing on the demand, telehealth for pets became and continues to be “the wild west.” Seeing a get-rich-quick opportunity mostly non-pet-related entrepreneurs jumped into the fray, some attracting pet industry partners (mostly seeking to sell their own products).

When the pandemic retreated, state veterinary practice acts mostly returned to what they were. However, the direct-to-consumer telehealth companies continued to make promises to pet parents, offering low cost service and in the process diagnosing and dispensing drugs, though the legality of what they’re doing may be (at best) questionable.

More importantly, the veterinary professionals on the other end of the virtual platform have no history with you or your pet and don’t have access to medical records. Is this the best medicine?

Of course, pets, like small children, can’t explain what’s wrong. That’s why the American Academy of Pediatrics is guarded about allowing pediatricians open latitude with telehealth, and why restrictions similarly exist in veterinary medicine when is no VCPR.

It turns out most pet parents – if given a chance to think about the topic – do get it, when not lured unsuspectedly. According to one survey 88 percent of pet parents agree that having a veterinary relationship is best, where that veterinarian has examined the pet personally.

However, clever marketing, those low costs, the promise of “instant soup answers” does lure people. It turns out that most pet parents don’t remember or understand all prior issues to relay to the telehealth practitioner (who has no access to your pet’s records). And while we may think we know what our pet is feeling, in actuality that’s often not the case.

If the telehealth provider happens to be in another state (which is likely) you have zero legal recourse if the worst happens. In fact, some veterinary professionals on calls are sometimes located out of the country (though the generally don’t reveal this).

One argument is that this that telehealth is an opportunity for inexpensive access to care for busy people or folks who live a great distance from a veterinary clinic. All you need is one in-person visit to establish VCPR. And make no mistake, the AVMA is hugely supportive of telehealth, just with a professional who has an established relationship with you and your pet. It almost seems to be common sense.

Yes, having lost options vet options are a necessity. However, it turns out that without the VCPR, and as many online providers follow a “cookie cutter approach” how effective is that virtual visit? It turns out – not very. And in the long-run pet parents may wind up paying more and unnecessary prolonged suffering for the pet.

Also, some of these direct-to-consumer operations are concerning. For example, on the human side, relaxed telehealth restrictions created problems which are only now coming to light. From the U.S. Department of Justice, the founder/CEO of a California-based digital health company and its clinical president were arrested in connection with their alleged participation in a scheme to distribute Adderall over the internet, conspire to commit health care fraud in connection with the submission of false and fraudulent claims for reimbursement for Adderall and other stimulants, and obstruct justice. They’ve both been arrested.

“As alleged, these defendants exploited the COVID-19 pandemic to develop and carry out a $100 million scheme to defraud taxpayers and provide easy access to Adderall and other stimulants for no legitimate medical purpose,” said Attorney General Merrick B. Garland. “Those seeking to profit from addiction by illegally distributing controlled substances over the internet should know that they cannot hide their crimes and that the Justice Department will hold them accountable.”

Again, to be clear, there are tremendous advantages of telehealth, which may be cost saving, and offer access to care when there is an established VCPR which clearly benefit pet parents and most importantly the animals themselves. The hope is that more veterinary practices offer their own telehealth service for their clients.

(Steve with Dr. Gail Golab, AVMA Chief Veterinary Officer talk about this topic on June 21 in Austin, TX at the Convention of the American Veterinary Medical Association)