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Report to Licensees
of the
LOUISIANA
BOARD OF VETERINARY MEDICINE
Volume 16, No. 2
January 2007
Board Members 2006-07
Patrick R. Bernard, DVM, President
Mica F. Landry, DVM, Vice-President
William H. Green, DVM, Secretary-Treasurer
Glenn R. Walther, DVM, Member
Lon Randall, DVM, Member
Table of Contents
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Board meeting dates for 2007 are scheduled on Tuesdays, at 8:30 a.m. as
follows:
February 1 April 5 June 7 August 2 October 4 December
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Prescriptions and Related
Matters
By Mike Tomino
The Board continues to
receive questions regarding prescriptions which is encouraged. You may
recall that an article was contained in an earlier Board newsletter
addressing more specifically prescriptions and internet pharmacies. The
purpose of this article to provide you with updated information on
providing prescriptions in general.
In reviewing the Louisiana
Veterinary Practice Act and the Board’s Rules, pursuant to Rule 1039A, a
veterinarian is required to “conduct his practice on the highest plane of
honesty, integrity, and fair dealing with his clients in time and services
rendered and in the amount charged for his services, facilities,
appliances, and drugs.”
I direct your attention to
Rule 705G which addresses “Providing Prescriptions.” Pursuant to Rule
705G(1) “a client is not obligated to purchase a prescription medication
from the prescribing veterinarian.” Therefore, a client can have a
prescription filled by any authorized entity at his discretion.
However, Rule 705G(2)
states that a veterinarian shall not be required to write a prescription
for any medication that in his medical opinion is not appropriate for the
patient’s medical care. Some professional organizations may have an
opinion that suggests testing for heart worms every two (2) to three (3)
years. If a veterinarian is of the medical opinion that his patient must
be seen and/or tested on an earlier basis, such is within the scope of his
professional judgment pursuant to the Veterinary Practice Act and the
Board’s Rules. Of course, a veterinarian must act in a reasonable manner
and conform to the prevailing standard of veterinary medical practice
regarding such issue.
In addition, pursuant to
Rule 705G(3), “a veterinarian may refuse to write a prescription if it is
not directly requested by a client with whom a
veterinarian-patient-client relationship exists.” Furthermore, Rule 1014
provides that a licensed veterinarian shall not violate the confidential
relationship between himself and his client. For a veterinarian to
provide a prescription to an internet pharmacy without a direct request
from his client, also subjects the veterinarian to disciplinary action by
the Board for violating the confidential relationship between himself and
his client by sharing treatment information with a faceless third party by
way of internet and/or facsimile.
The Board has been asked
whether a veterinarian can refuse to give a prescription to a paying
customer if the drug is one he is prescribing and using on that customer’s
animal. The factual scenario at issue involves a veterinarian providing
the annual examination, heart worm test and shots to a dog. The
veterinarian in the past provided legend drugs, including Heartguard, to
the client for administration to the patient. However, in this particular
instance the client directly requested the prescriptions so that she might
“price shop”. The veterinarian then refused to provide the
prescriptions.
Pursuant to Board Rule
705G(2), if the VCPR has been established with the client and the client
directly requests a prescription from the veterinarian, the veterinarian
has an obligation to provide the prescription if in his medical judgment
such is appropriate for the care of the animal.
Please keep in mind that
to refuse to write a prescription for a drug that the veterinarian
generally would provide and/or administer to the client’s animal
(patient), does not support a defensive argument that “in his medical
judgment such is inappropriate for the care of the animal.” Also, in
absence of the veterinarian’s professional opinion that such drug is
inappropriate for the care of the animal, for a veterinarian to refuse to
write a prescription for the sole reason that it is a product that he does
not use would arguably be a violation of the law.
You may also wish to note
that pursuant to Rule 1001, the Board has adopted the Principles of
Veterinary Medical Ethics of the American Veterinary Medical Association.
Principle IVA(1) provides that attending veterinarians are entitled to
charge a fee for their professional services. In interpreting this
principle, the Board has ruled that a reasonable fee to review a patient’s
file and write a prescription directly requested by the client is not a
violation of the Veterinary Practice Act or the Board’s Rules.
In enforcing the above
cited legal authority, the Board will apply a “fair and reasonable”
standard with regards to whether or not a specified amount constitutes a
permissible fee which may include a fair and reasonable cost for faxing or
mailing. As you are well aware, the time and involvement in reviewing
files and writing prescriptions may vary from case to case depending on
various factors. Therefore, the Board will make a determination of what
is “fair and reasonable” with regards to a fee for prescription writing
based upon the facts of the situation presented. Also, as an alternative
to your office faxing or mailing the prescription to the pharmacy, you may
request the client to do so, however, such a request is more in the nature
of a business decision.
Furthermore, please
understand that if a veterinarian abuses his prescriptive authority by
charging unfair or unreasonable amounts for prescription writing, or
dilatory/defiant acts in providing prescriptions in otherwise appropriate
cases, he will be subject to sanction by the Board under existing legal
authority. More importantly for your profession as a whole, there exists
the potential loss of dispensing rights due to the legislative actions of
other interested entities or persons. You would be wise not to supply
them with ammunition for their cause.
In concluding, with
regards to the issue of providing prescriptions, please keep in mind your
legal obligations, as well as your rights, so as to avoid any unnecessary
and legal woes. Also, the Board office and I are available to answer any
questions you may have concerning the issue of prescriptions.
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License
Renewals Statistics
As of November 20, 2006, license renewals for the
2006-07 renewal year are as follows:
1072 Active DVMs, 211 Inactive DVMs, 2 Faculty DVMs, 67
RVTs, 118 CAETs, and 4 REDs.
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Disciplinary
Cases
Case No. 06-1003V –
Based on the
Consent Order, the Board found that the respondent veterinarian was in
violation of LSA RS 37:1526A and Board rules, Title 46, Part LXXXV, Sec.
1001 et seq., Section 1023, and AVMA Principle VI.A of Principles of
Veterinary Medical Ethics in that the respondent was negligent in failure
to properly diagnose and treat the patient. Respondent was fined $250 and
ordered to pay the amount of cost recovery for the proceedings.
Case No. 06-0316V –
Based on the Consent Order, the Board found that the
respondent veterinarian was in violation of LSA RS 37:1526A and Board
rules, Title 46, Part LXXXV, Sec. 1001 et seq., Section 1023, in that the
respondent was negligent in failing to properly diagnose and treat the
patient’s, which includes providing accurate information to the client for
an informed decision. Respondent was reprimanded, fined $500, and ordered
to pay the amount of cost recovery for the proceeding.
Case No. 06-0619C (A, B) –
Based on the Consent
Order, the Board found that the respondent certified animal euthanasia
technicians were in violation of LSA RS 37:1554A(12) and 1555 and Board
rules, Title 46, Part LXXXV, Sec. 1201 et seq., Section 1223H, in that the
respondents performed animal euthanasia without a current certificate.
Respondents were each fined $100 and ordered to pay the amount of cost
recovery for the proceedings.
Case No. 07-0713C (A, B, C, D, E, F) –
Based on the Consent Order
agreed to by the Board, the Board found that the respondent certified
animal euthanasia technicians were in violation of LSA RS 37:1554A(12) and
1555 and Board rules, Title 46, Part LXXXV, Sec. 1201 et seq., Section
1223H, in that the respondents performed animal euthanasia without a
current certificate. Respondents were each fined $100 and ordered to pay
the amount of cost recovery for the proceedings.
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Rules Update
Please
call or write the Board office for a copy of any Notice of Intent or Rules
described below.
Rule 400, 403, 405, 409, 413 – Continuing Veterinary
Medicine Education –
Proposed rule alters the requirements and program approval of continuing
veterinary medicine education for annual renewal of veterinary medicine
license, from 16 credit hours per year to 20 credit hours per year with an
expansion in the nature and substance of acceptable credit hours.
Proposed rule to become effective, after promulgation, for the period of
time (July 1, 2007-June 30, 2008) for the 2008-2008 annual license renewal
and every annual license renewal period thereafter. Notice of Intent
published January 20, 2007.
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Current Information/Addresses
Many licensees have had changes in address (business and
home), as well as employment, since the 2005 natural disasters. Please let
the Board office know of any changes, permanent and temporary, to your
information. A “Change of
Information” form can be downloaded from the Board’s website,
www.lsbvm.org, under the “Renewals” section.
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