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Disclaimer: Law, rules and regulations, not Guidelines, specify the requirements for practice and violating them constitutes professional misconduct. Not adhering to this Guideline may be interpreted as professional misconduct only if the conduct also violates pertinent law, rules and regulations.

The practice guidelines for veterinary medicine and veterinary technology in New York State, combined with New York State law, regulation and rule, are intended to provide practitioners with valuable information on good veterinary medicine and veterinary technology practice. The practice guidelines may also be useful to consumers and others. The practice guidelines were developed by the New York State Board for Veterinary Medicine and the State Education Department.

The practice guidelines do not replace legal requirements for practice nor are they grounds for professional misconduct. Practice guidelines do not carry the force of law or regulation. Practitioners must specifically become familiar with and observe the legal requirements associated with professional practice. The purpose of the practice guidelines is described in more detail in the attached memorandum dated March 15, 1999 at the end of this document. For specific legal requirements for the practice of veterinary medicine and veterinary technology in New York State contact the State Board for Veterinary Medicine or refer to:

  1. the law, or statute, authorizing the licensure of veterinarians and veterinary technicians, Article 135 of Education Law;
  2. Part 62 of the Regulations of the Commissioner of Education in Title 8 of the New York Code of Rules and Regulations, i.e., NYCRR Part 62 which provides details regarding licensing regulations and educational requirements;
  3. Education Law, Article 130, Sections 6509, 6510, and 6511 concerning professional misconduct; and
  4. 8NYCRR Part 29.1 (General provisions) and Part 29.6 (Special provisions) for the profession of veterinary medicine of the Rules of the Board of Regents. Additional information concerning unprofessional conduct is found in various sections of Part 29 of the Rules of the Board of Regents.

We hope you find these practice guidelines useful. If in doubt about the appropriateness of specific practices, you should consult the actual laws, rules, or regulations. You may direct any questions and comments to the State Board for Veterinary Medicine by calling 518-474-3817 extension 560, by e-mailing vetmedbd@nysed.gov, or by faxing 518-486-4846.

Guideline 1: Definitions of Terms

1.1

An ambulatory facility is a mobile practice center where veterinary medicine services are performed.
 

1.2

An emergency facility is a practice where a veterinarian is on the premises to deliver emergency services during advertised hours.
 

1.3

Animal includes every living creature except a human being.
 

1.4

AVMA is an acronym for the American Veterinary Medical Association.
 

1.5

Board is a short form for the New York State Board for Veterinary Medicine.
 

1.6

A client is an entity, individual, group or corporation that has entered into an agreement with a veterinarian for the purpose of obtaining veterinary medical services.
 

1.7

Continuing education is a program of professional education that is designed to contribute to the advancement, extension, enhancement or maintenance of competence in the practice of veterinary medicine (See Guideline 4).
 

1.8

A patient is an animal or group of animals that is receiving veterinary medical care.
 

1.9

General anesthesia is a condition caused by the administration of a drug or a combination of drugs sufficient to produce a state of unconsciousness or dissociation and blocked response to a given pain or alarming stimulus.
 

1.10

The practice of veterinary medicine is defined as diagnosing, treating, operating or prescribing for any animal disease, pain, injury, deformity or physical condition or the subcutaneous insertion of a microchip intended to be used to identify an animal.
 

1.11

Professional judgment includes any decision or conduct by a licensee pertaining to the practice of veterinary medicine as defined by Article 135, Section 6701, Title VIII of State Education Law.
 

1.12

Supervision
 

  1. When an individual is practicing under the general supervision of a licensed veterinarian, the veterinarian must be readily available to communicate with the person under supervision.
  2. When an individual is practicing under the direct supervision of a licensed veterinarian, the veterinarian must be on the same premises as the person under supervision.
  3. When an individual is practicing under the immediate personal supervision of a licensed veterinarian, the veterinarian must be within audible or visual range of both the person under supervision and the animal patient and be able to intervene personally in the procedure, if necessary.

1.13

Surgery is the treatment through incision, excision or other structural alteration of animal tissue.
 

1.14

VCPR refers to the Veterinarian/Client/Patient/Relationship (See Guideline 5.11).
 

1.15

A veterinarian is a person who has received a professional degree from a college of veterinary medicine and is authorized to practice veterinary medicine under the laws, rules and regulations of the State of New York.
 

1.16

A veterinarian on call is a veterinarian who is able to respond in a timely fashion to a request for veterinary service.
 

1.17

A veterinary facility is any fixed or mobile establishment, veterinary hospital, animal hospital, clinic or premises where veterinary medicine is practiced.
 

1.18

A veterinary technician is a person who has received a professional degree from a program of veterinary technology and/or is authorized to practice veterinary technology under the laws, rules and regulations of the State of New York.
 

Citations of Pertinent Law, Rules or Regulations:

  • Education Law, Section 6701 - Definition of practice of veterinary medicine
  • Education Law, Section 6703 - State Board for Veterinary Medicine
  • Education Law, Section 6702 - Practice of veterinary medicine and use of title "veterinarian"
  • Education Law, Section 6708 - Definition of practice of veterinary technology
  • Education Law, Section 6709 - Practice of veterinary technology and use of title "veterinary technician"
  • Education Law, Section 6711 - Requirements for a professional license as a veterinary technician

Guideline 2: Providing Professional Services

Before providing service it is important that a valid VCPR (see Definition 1.14 and Guideline 5.11) is in place and you have obtained informed consent from the client. In the course of providing professional services,

2.1

The veterinarian should:

  1. provide professional services in a timely manner;
  2. conduct a complete physical examination, including, but not limited to, weight (small companion animals), TPR, auscultation of heart and lungs, ocular and otic systems, integument, and musculoskeletal system, on every patient or a number of representative members of a herd or flock;
  3. if providing small companion animal services, assure the availability of an appropriate waiting area for clients and their animals;
  4. provide clients with direct contact information on how to obtain veterinary services in case of emergency, as well as who to contact for services in her/his absence. A sign should be displayed at the entrance of the veterinary facility with a telephone number and location where veterinary care is available when the veterinary facility is closed. An answering machine or service should notify the public of the business hours of the veterinary facility and when veterinary care is available;
  5. assure that housing of in-patients is appropriate for the proper provision of veterinary care;
  6. maintain an appropriate identification system for all animals admitted to the veterinary facility in which the veterinarian practices;
  7. employ appropriately licensed staff;
  8. provide written notice to client(s) should there not be appropriate personnel to assure proper veterinary care at any time while an animal is an in-patient in a veterinary facility. Such notice may be in the form of a clearly legible sign posted in a conspicuous place or a notification on a hospitalization consent form;
  9. advise clients, as appropriate, of any diseases that currently pose an imminent danger to livestock, companion animals, and/or people within the locale;
  10. perform or provide laboratory procedures, as appropriate, for diagnosis and monitoring of medical and/or surgical conditions, including but not limited to:
    1. urinalysis, including microscopic exam of sediment;
    2. hematology, including CBC with differential WBC;
    3. identification of external and internal parasites;
    4. blood/plasma/serum chemistries;
    5. necropsy and histopathology;
    6. serology; and
    7. microbiology.
  11. perform or provide imaging procedures, as appropriate, for the diagnosis and monitoring of patients, in a manner that complies with all currently applicable rules and regulations for safe use of such modalities in the jurisdiction. Veterinarians and veterinary technicians should be familiar with and adhere to all rules of Section 16.54 of the New York State Health Code as it applies to veterinary radiology;
  12. perform or provide access to appropriate diagnostic procedures to monitor cardiac health status, i.e. ECG and/or ultasonography;
  13. when offering disposal service, provide for proper storage of carcasses of animals (refrigeration or freezing) as well as disposal methods that meet all jurisdictional requirements.

Citations of Pertinent Law, Rules or Regulations:

Guideline 3: Referrals

3.1

As a New York State licensed veterinarian, you should refer the client to another qualified veterinarian under the following conditions:

  1. when the attending veterinarian determines that he or she is not able or sufficiently qualified to meet a client's or patient's needs;
  2. when additional or alternative services are required or requested that the attending veterinarian is unable or unwilling to provide; and/or
  3. when an emergency situation exists where the attending veterinarian cannot respond in a timely fashion as dictated by the described condition of the patient

Citations of Pertinent Law, Rules or Regulations:

Guideline 4: Continuing Professional Competence

Licensed veterinarians and veterinary technologists practice in a world of evolving science, technology, increased consumer expectations and other emerging issues. Practice in this changing environment requires ongoing development of knowledge and skills. It is critical that licensees remain current with changes and developments in the profession to provide quality services and to ensure public protection.

4.1

The veterinarian and veterinary technician should:

  1. maintain and update professional knowledge and skills through continuing education and review of current literature, etc;
  2. complete appropriate professional training before performing any procedure or therapy; and
  3. have access to a library of current veterinary reference materials containing readily available textbooks and journals, internet databases, etc.

Citations of Pertinent Law, Rules or Regulations:

Guideline 5: Professional Practice

New York State licensed veterinarians and veterinary technicians should:

5.1

exercise the same care, skill and diligence in treating patients consistent with that of other members of the veterinary medical profession in good standing in the locality or community in which you practice, or in similar communities;
 

5.2

conduct your practice on the highest plane of honesty, integrity and fairness in dealing with your clients and patients;
 

5.3

disclose to clients any potential conflict of interest, (e.g., if you are providing services to both the buyer and seller of the same animal);
 

5.4

never make any attempt, directly or indirectly, to adversely influence the sound professional judgment of another veterinarian or veterinary technician;
 

5.5

not render any services or advice that could deceive or betray the public;
 

5.6

not issue a health certificate/certificate of veterinary inspection for any animal unless you have thorough knowledge, as a result of actual inspection and appropriate tests, that the animal meets the specifications and conditions certified;
 

5.7

treat all animals entrusted to you in keeping with professional standards of humane care and treatment; this includes the use of chemical restraint, sedation and pain management, when appropriate;
 

5.8

decide what medical or surgical cases you should accept in your professional practice; once you accept a patient, you should determine what course of treatment will be followed in consultation with the client;
 

5.9

advise the client regarding any treatment to be provided to the patient without using undue influence;
 

5.10

not allow any layperson, corporation, or other entity to control, influence, or exploit the relationship between the client/patient and the veterinarian;
 

5.11

A VCPR exists when all of the following are satisfied:

  1. The veterinarian has assumed the responsibility for making medical judgments regarding the health of the patient with the assent of the owner of the animal or their duly authorized agent.
  2. The veterinarian has sufficient knowledge of the patient to initiate at least a general or preliminary diagnosis of the medical condition of the patient. This means that the veterinarian is personally acquainted with the keeping and care of the patient by virtue of:
    1. a timely examination of the patient by the veterinarian, or
    2. medically appropriate and timely visits by the veterinarian to the operation where the patient is managed, or
    3. medically appropriate and timely visits by the patient to the veterinary facility where the veterinarian is working.
  3. The veterinarian is readily available for follow-up evaluation and oversight of treatment and outcomes, or has arranged for appropriate continuing care and treatment.
  4. Patient records are maintained.

5.12

only prescribe, deliver, or have delivered prescription drugs when a VCPR has been established and you have determined that the prescription drug is therapeutically indicated for the health and/or well being of the animal. You cannot fill prescriptions from other veterinarians.

  1. Written prescriptions can be filled at a pharmacy of the client's choice. A written prescription for a drug must be provided upon request if a valid VCPR has been established. All written prescriptions should include the following information:
    1. the name, address, telephone number, license number and signature of the prescribing veterinarian;
    2. the name and address of the client;
    3. the species and name, number or other identifying information for the animal;
    4. the name, strength and quantity of the drug(s);
    5. directions for use including, if applicable, withdrawal time;
    6. date of issue;
    7. number of refills; and
    8. Dispense as Written box.
  2. Drugs dispensed from a veterinary pharmacy should be labeled with the following information:
    1. name, address and telephone number of the facility;
    2. client's name;
    3. the species and name, number, or other identifying information for the animal;
    4. date dispensed;
    5. directions for use, including withdrawal time and precautionary information, if applicable;
    6. the manufacturer's trade name of the drug or the generic name, strength (if more than one dosage form exists), quantity of drug and the expiration date when established by the manufacturer; and
    7. name of prescribing veterinarian.
  3. Drugs should not be prescribed for a duration that is inconsistent with the patient's medical condition. The drug should not be prescribed for a period of more than one year from the date that you have examined the patient and prescribed the drug, unless you have conducted a subsequent examination of the patient and determined that there is a continued need for the prescribed drug.
  4. Childproof containers should be used unless otherwise requested by the client (an exception would be a drug that is prepackaged, for example, and dispensed with appropriate labeling).

5.13

not prescribe, dispense, deliver, or order any controlled substance unless you are currently registered with the Federal Drug Enforcement Administration (DEA). However, if you are not a veterinarian registered by the DEA but you are a DEA unregistered veterinarian employed by a DEA registered veterinarian you may [dispense or] administer controlled substances if the DEA registered veterinarian has designated you to do so and you administer such substances under his or her direction and supervision [knowledge that you are using the drugs in the usual course of your employment].
 

5.14

General Medical Records Requirements

Veterinarians must prepare contemporaneous, permanent treatment records which reflect the actual treatment or services rendered. Such records should contain patient information regarding the examination, health assessment and/or treatment of the patient.

Medical records must be legibly and accurately written, complete, properly filed, retained and accessible in a manner that does not compromise the security and confidentiality of the records.

Each report, diagnosis, prognosis, and prescription made or issued by a corporation practicing veterinary medicine must bear the signature of one or more veterinarians who are in responsible charge of such report, diagnosis, prognosis, or prescription (Business Corporation Law § 1504 (c). A similar provision is in the Limited Liability Company Law requiring the same for professional service limited liability companies (Limited Liability Company Law § 1204(c)). In addition, the Electronic Signatures and Records Act (ESRA) provides that "signatures" made via electronic means are legally binding, just as hand-written signatures.

Veterinarians (or their practice) must establish, implement and monitor an effective system of author identification for medical records and/or medical orders to ensure the integrity of the authentication and protect the security of all transmissions, records and record entries.

Electronic medical records must include electronic signatures or computer-generated signature codes with date and time stamp for each entry. There must be an audit capability implemented to track access and edits by users.

Medical records must be adequate and retained for a period of three years from the date of treatment in accordance with Board of Regents Rules section 29.6 (a) (3). These records must be in their original or legally reproduced form.

Veterinary practices must ensure the confidentiality of patient records. Original medical records, information from or copies of records must be released only to or as authorized by the client or to individuals as permitted by Federal and State laws.

Content

The medical record must contain information to support the diagnosis, justify diagnostic testing, therapeutic interventions including surgery and hospitalization, and describe the patient's progress and response to medications and services.

All records must document, as appropriate, at a minimum the following:
 

  • Client identification and a description of the patient, including species, sex, age, breed, weight and individual identifying characteristics, which may include name or number;
  • Evidence of a physical examination, including a health history and a statement of the conclusion or impressions drawn;
  • A preliminary, working or final diagnosis, as appropriate to the case;
  • Results of all diagnostic tests including imaging or other assessment modalities performed on the patient;
  • Results of all consultative evaluations of the patient and findings by clinical staff or outside consultants involved in the care of the patient;
  • Properly executed consent forms for diagnostic testing, procedures and treatments;
  • All diagnostic and therapeutic orders, nursing documentation and care plans, reports of treatment, medication records, radiology, and laboratory reports, vital signs and other information necessary to monitor the patient’s condition;
  • Documentation of all complications, hospital acquired infections, and unfavorable reactions to drugs and anesthesia;
  • An assessment of the outcome of care and provisions for follow-up.
  • A summary of client communication including results of diagnostic intervention with differential or definitive diagnosis or revised plan based on client’s request for alternatives to recommendations.
  • Medical records for outpatient encounters, or information to justify admission and continued hospitalization and describe the patient's progress and response to medications and services, must be completed as soon as possible, but within 72 hours.

5.15

Anesthesia and surgery. You should use appropriate and humane methods of anesthesia (general or local), analgesia and sedation to minimize pain and distress during procedures. The veterinarian should comply with the standards listed below.

  1. Every animal should be given a physical examination within 24 hours before the administration of an anesthetic or as dictated by the animals condition. The results of the physical examination should be noted in the patient's medical records.
  2. Appropriate drugs and equipment to treat medical emergencies should be readily available.
  3. Supplemental heat for intra-op, post-op and critical care patients should be available when appropriate.
  4. Surgery should be conducted in an appropriate surgical environment at the level of practice commensurate with the practice of one's peers.

5.16

Compliance with OSHA requirements is required and a notebook of Material Safety Data Sheets (MSDS) should be kept and be readily available to all employees.
 

5.17 Multi-doctor practice – guidance on supervision

Principals in veterinary practices – whether operating as sole proprietorships, partnerships (including professional limited liability partnerships), professional service corporations, or professional limited liability companies – are responsible for the environment under which doctors are employed to work.

The standard operating procedures by which the practice assigns and transfers responsibility for care—and the method in which this is reflected in the medical record—is the responsibility of the principals in the practice, regardless of the legal organization of the veterinary practice.

Principals are responsible for standard practice procedures. Among other matters, these procedures address medical recordkeeping, adherence to professional standards, and compliance with NYS statutes and regulations. Licensed veterinarians and veterinary technicians are accountable for the care they provide, but principals may be held liable when practice procedures compromise patient care or supervision of personnel.

To ensure adequate patient care and regulatory compliance, practitioners and clients must know who is responsible for the care of each patient at any time. This is especially critical for multi-doctor practices, specialty practices, and 24-hour facilities, where personnel shifts can make it difficult to know who is in charge of a given case. Failure to maintain clear lines of responsibility can blur accountability and lead to poor patient care and client uncertainty.

The practice’s medical records must clearly identify the treating veterinarian for each visit. Likewise, if a patient is admitted, the veterinarian who is responsible for the overall care of the patient must be identified. The responsible veterinarian may provide care through the supervision of other appropriate personnel, but that individual is accountable for any complaints that may arise about the quality of supervision.

Citations of Pertinent Law, Rules or Regulations:

Guideline 6: Professional Behavior

The veterinarian or licensed veterinary technician should not:

6.1

willfully harass, abuse or intimidate a client or patient either physically or verbally;
 

6.2

fail to wear an identifying badge, that is conspicuously displayed and legible, indicating name and title;
 

6.3

fail to conspicuously post at the site of the practice the names and field of licensure of all of the principal professional licensees engaged in practice at that site;
 

6.4

issue prescriptions for drugs that fail to contain the following information; the date written, prescriber's name, address and telephone number, profession and registration number, client's name, address, strength and quantity of the prescribed drug or device, as well as the directions for use by the patient;
 

6.5

fail to use scientifically accepted infection prevention techniques appropriate to the profession for the cleaning and sterilization or disinfection of instruments, devices, materials and work surfaces; and
 

6.6

fail to properly handle sharp instruments and utilize protective garb and covers for contamination prone equipment.

Citations of Pertinent Law, Rules or Regulations:

  • Regents Rules, NYCRR Part 29 - Unprofessional conduct
  • Regents Rules, NYCRR Part 29.1 - General provisions for all professions
  • Regents Rules, NYCRR Part 29.6 - Special Provisions for Veterinary Medicine

Guideline 7: Pharmaceuticals

7.1

The following should not be held or offered for sale:

  1. prescription medication that is returned by the client;
  2. adulterated and/or misbranded drugs or devices;
  3. drugs beyond their expiration date; and
  4. drugs inappropriately stored.

7.2

Appropriate locked storage for controlled substances should be available in accordance with DEA regulations.
 

7.3

A separate refrigerator, with temperature monitoring, for proper storage of medications, laboratory kits and biologics based on the manufacturer's recommendations (separate from staff food storage) should be available.

Guideline 8: Fees

8.1

Fee disputes can often lead to complaints of professional misconduct. The Office of the Professions does not negotiate or resolve fee disputes. However, other claims of professional misconduct may arise as a result. When investigated, many times these complaints are found to originate in disputes over fees, but the veterinarian as well as the Department will have had the burden of the investigation. To avoid these complaints, veterinarians should:

  1. clarify the billing and payment conditions with clients at the outset of evaluation and treatment, and specify the financial arrangements in terms that the client can understand;
  2. make the client aware of the cost involved for the recommended treatments so the client can make informed choices and not incur excessive expense.