But in California, veterinary telehealth is so highly restricted that it is mostly used for follow-up care after an in-person visit or for triage in an emergency.
A bill winding its way through the Legislature would lift the requirement that veterinarians see an animal in person first before they treat it through telehealth. Assembly Bill 1399 offers a smart and reasonable change that could help tens of thousands of underserved pets get needed care. The Assembly has already passed the bill, and the Senate should do so as well.
Currently, veterinarians must set up a relationship with the client and the animal in person for a specific issue or ailment before they can later treat the animal through a video exam — and only for that specific problem. When a different issue comes up, the owner and animal must go to the vet in person again before the veterinarian can treat the animal remotely regarding that problem.
This new measure would allow a veterinarian to set up the initial relationship with the pet and its owner via video screen and see the animal in person only when either the owner or the veterinarian request it.
The bill was co-written by Assemblymembers Laura Friedman (D-Glendale) and Josh Lowenthal (D-Long Beach) and endorsed by the San Diego Humane Society and the American Society for the Prevention of Cruelty to Animals. Both organizations see the expansion of telehealth as a way to reach people who can’t find a vet nearby or have limited means to travel to a veterinarian.
There are all sorts of obstacles to getting an animal to a veterinarian. Access is very difficult now because of a shortage of veterinarians in California and across the country. The problem is particularly acute in rural and low-income communities where there are fewer veterinary practices, says Lori Teller, a veterinarian and president of the American Veterinary Medical Association.
Some animals simply don’t do well on the trip to the veterinarian’s office or in the facility once they get there. A study by two veterinary researchers at UC Davis found that cats exhibited signs of stress — heavier breathing, dilated pupils, “negative” ear positioning — when taken to an office for an exam, but were more relaxed at home during video exams. The researchers also said a stressed cat may hide its symptoms for self-preservation. They concluded that telemedicine could be helpful for routine consultations and in areas where people have little access to care.
And veterinarians say they can assess animals well on video. Much of the information a vet gleans will come from talking to the owner, and that can work just as well if the owner is at home.
The bill sets some commonsense restrictions. For example, prescriptions for antibiotics — which veterinary authorities worry are overly relied upon — can be written only for a 14-day period. A refill would require an in-office visit. Also, veterinarians cannot prescribe controlled substances or xylazine unless they have seen the animal in person.
Although veterinarians providing telehealth services are not required to be connected to a practice in California, they are required to be licensed in California and must be able to provide the client with a list of nearby veterinarians in case they want to see one in person.
No veterinarian would be required to offer telehealth services. And telehealth cannot replace in-office visits for numerous procedures, including blood work. It would be up to the veterinarian to decide when and why to see an animal in person. And a pet owner can always choose to see a veterinarian in person.
The California Veterinary Medical Association is neutral on the bill and the California Veterinary Medical Board supports it. Both groups said they will adopt those positions once they see amendments in the bill to which the authors have agreed. But the American Veterinary Medical Association opposes it, arguing that an initial in-person visit with an animal is essential. The AVMA also expressed concern that the bill opens the door to online direct-to-consumer veterinary services more concerned with dispensing drugs than offering care.
No veterinarian should carelessly prescribe medications, whether it’s in a clinic or an online visit. Those are serious concerns, and if there are problems that risk the health of animals, they need to be addressed by state and federal regulators. We shouldn’t overly restrict a much-needed portal for care over the fear there might be a few bad actors.
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