The veterinarian-client-patient-relationship (VCPR) is the essential basis for interaction among veterinarians, their clients, and their patients.  It is critical to providing quality veterinary care and vital to animal welfare by allowing a veterinarian to regularly assess a pet’s entire physical status, family environment, and to regularly communicate with the owner. AAHA defines VCPR to require all of the following: 

• The veterinarian has assumed responsibility for making medical judgments regarding the health of the patient and the need for medical treatment, and the client (owner or caretaker) has agreed to comply with the veterinarian’s instructions. 
• The veterinarian has sufficient knowledge of the patient to initiate at least a general or preliminary diagnosis of its medical condition. This means the veterinarian has physically examined the patient within the past 12 months, or more frequently as dictated by the age of the patient, medical condition or treatment therapy such as with controlled substances.  
• The veterinarian is available for ongoing care of the patient or has arranged for emergency coverage or continuing care and treatment of the animal by an appropriate veterinary professional. 
• The veterinarian maintains complete and legible medical records, including assessment and treatment plan, in such a way that another veterinarian will be able to proceed with the continuity of care and treatment of that patient. 
  
  • Refer to the Medical Records Section of the AAHA Standards of Accreditation for detailed recommendations. 
• In specific situations (e.g., rescue shelters, disaster response, hoarding intervention situations) “patient” may refer to a group of animals and “sufficient knowledge of the patient” means the veterinarian: 
  • conducts medically appropriate and timely visits to the facility where the animals are housed, 
  • conducts examination of representative patients/animals and review of medical records and laboratory or diagnostic procedure records, and 
  • consults with those individuals providing care to the animals regarding ongoing health management programs.

Similar to the position adopted by the AVMA, we believe that Telehealth plays a role in augmenting the VCPR, but only within the context of a previously established physical examination. With the exception of emergency teletriage and poison control services, AAHA, like the AVMA, opposes remote consulting using telemedicine, offered directly to the public when the intent is to diagnose and/or treat a patient in the absence of a VCPR. Notably, we feel that telehealth tools such as video consultation, telephone consultations, text messaging or other online platforms should only be used by a veterinary business to aid in the diagnosis, prescription and formation of treatment plans if the pet has been examined on the physical premises of that veterinary practice or by a mobile practitioner in the pet’s  home within the previous 12 months. 

Telemedicine and the VCPR relationship may change in the future with changes in technology but the veterinary profession must respond carefully to protect the integrity and ethics of the VCPR as well as to ensure good animal welfare. 

Resources: 

• AVMA Veterinary-Client-Patient Relationship (VCPR) 
• AVMA state VCPR definitions and provisions 
• Canada Veterinary-Client-Patient Relationships (VCPR)
• AVMA Client FAQs
• AVMA VCPR Provisions
• VCPR State Laws (as of April 2020)

Adopted by the American Animal Hospital Association Board of Directors September 2019.