Policy Advisory

Policy Advisory Board Policies and Guidelines (Veterinary Medicine)

Date: 12/06/2017
Referenced Sources: Division of Professional Licensure's Office

Webinars Based Programs for Continuing Education Credit

Policy Guideline -- Policy No. 13-02

 

From:       Board of Registration of Veterinary Medicine

Re:           Board Policy Guidelines: Webinars Based Programs for Continuing Education Credit

Date:        December 12, 2013
 

The Board of Registration of Veterinary Medicine (“the Board”) voted today to adopt the following Policy Guideline. The Policy Guideline does not have the full force and effect of law, as would a statute  or a  regulation, however, the Board uses policy guidelines as a way to clarify  issues related to the practice of veterinary medicine.

Policy No. 13-02

Introduction:

Pursuant to M.G. L. c. 112, § 55 and CMR 256 § 9.01: (1) and (4), licensed Veterinarians are required, as a condition of license renewal, to complete a minimum of 15 units of continuing education activities every licensure cycle (March 1 through February 28).  Not more than six hours of continuing education units shall be acquired through home study or other mediated instruction.  It has come to the attention of the Board that certain classes of online conferencing events, so called “webinars, interactive conferences, or online workshops,” are  being offered live via the internet and require interaction between the licensee and the provider of the continuing education.  The Board considers these online conferencing events acceptable for the balance of the required units of continuing education, and not subject to the six (6) hour limitation referenced above.

 This Policy Guideline   clarifies to licensees  otherwise approved continuing education credits that are delivered through online conferencing events. 

The Board will accept online conferencing events delivered through web based technologies as “live” credits so long as the events meet the following conditions:

1.         There instruction occurs in real time; and

2.         There is required interaction between the licensee and the instructor.

The online conferencing events are not limited by the 6 hours of “home study or other mediated instruction” limitations so long as the online conference event meets the above criteria. 

All continuing education requirements, regardless of delivery method, must meet the requirement set forth in 256 CMR 9.01. 

Vaccination Clinics

Policy Guideline – Policy No. 13-01

 

From:       Board of Registration of Veterinary Medicine

Re:            Board Policy Guidelines: Vaccination Clinics

Date:         November 14th, 2013

The Board of Registration of Veterinary Medicine (“the Board”) voted today to adopt the following Policy Guideline the administration of rabies vaccines at a vaccination clinic. The Policy Guideline set forth below does not have the full force and effect of law, as would a Massachusetts General Law or a Board rule or regulation. The Policy Guideline is intended to assist licensees with a recommended protocol and to assist the Board in formulating decisions that relate to issues in the practice of veterinary medicine.   

Policy No. 13-01

The Board seeks to clarify the services that can be provided by veterinarians in settings such as vaccine clinics, which are typically outside of a veterinarian's normal practice locations.

Under 256 CMR 7.01: Code of Professional Conduct (1), a licensee's practice shall conform to currently-accepted professional and scientific standards in the profession of veterinary medicine such as but not limited to the AVMA Principles. It is a currently-accepted professional and scientific standard that the proper use of vaccination is essential to the health of veterinary patients as well as the general public. It is also a currently-accepted professional and scientific standard that animals must be physiologically healthy and immunologically competent to respond to the vaccine.

Vaccination and revaccination programs, for preventive health care, should maintain the health of the animals and public health while minimizing adverse effects. Appropriate decisions concerning individual vaccine selection and vaccination choices are best made under a valid VCPR (veterinarian-client-patient relationship), wherein the practitioner and client determine the best patient care program.

It is a currently-accepted professional and scientific standard that a VCPR is established only when the veterinarian actually physically examines the animal in person. A VCPR is maintained by regular veterinary visits as needed to monitor the animal's health. If a VCPR is established, but the veterinarian does not regularly see the animal afterward, the VCPR is no longer valid.

The Board considers vaccinations of all kinds to be included in this requirement, and therefore veterinarians are prohibited from administering vaccinations unless a valid VCPR has been established and documented. This means that no vaccinations should be given to animals without a valid VCPR, which is established by conducting an appropriate physical examination and assessment of the animal.

The Board acknowledges that Chapter 140 Section 145 B (a) states that:

Each owner or keeper of a dog, cat or ferret that is 6 months of age or older shall cause such dog, cat or ferret to be vaccinated against rabies by a licensed veterinarian using a licensed vaccine according to the manufacturer's directions and shall cause such dog, cat or ferret to be revaccinated at intervals recommended by the manufacturer.

The Board also acknowledges that rabies is a extremely serious infectious disease that almost always causes death, and can be transmitted from animals to humans. Therefore, the Board recognizes the public health benefits of conducting rabies vaccination clinics. For this reason, the Board allows veterinarians to administer rabies vaccines at rabies vaccination clinics without first establishing the usual and customary VCPR. However, this is considered an exception only for rabies vaccinations at rabies vaccination clinics, and does not apply to the administration of other vaccinations, such as distemper, etc., which always require a valid VCPR.

Under 256 CMR 7.01: Code of Professional Conduct (2) A licensee shall

(c) Conduct all professional activities in accordance with federal, state, local and Board statutes and regulations.

Rabies vaccination clinics should follow rabies vaccine label indications/recommendations in compliance with all governmental regulations that may apply. It should also be noted that all rabies vaccinations shall be administered only by a licensed veterinarian.

The licensed veterinarian remains directly accountable for the safe and effective administration of rabies vaccine, including the information to be elicited from the client or legal representative before vaccination.

At minimum, prior to administering a rabies vaccine, it is recommended that  the veterinarian  obtain information regarding vaccines previously received, wounds and exposure to wildlife or domestic animals, preexisting quarantine and health conditions, allergies, and adverse events that occurred after previous vaccinations. Assessment of patient’s physical condition can usually be based exclusively on information elicited from the client or legal representative, and on the veterinarian’s observations of the animal’s condition. Physical examination and vital signs (i.e., temperature, pulse, respirations) measurement are usually not necessary before or after administration of rabies vaccines, unless specifically indicated.

While there is no Massachusetts requirement for a signature to be obtained prior to vaccination, state policy and regulation generally expects the consent of a client or legal representative regarding the vaccination of animals.

The licensed veterinarian must ensure that the permanent record contains all the required documentation. This documentation may simply consist of the use of a uniform rabies vaccination certificate, National Association of State Public Health Veterinarians (NASPHV) form #51, and a rabies tag provided by the vaccinating veterinarian.

Computer-generated vaccination certificates are sufficient, provided they contain the same information required in the NASPHV form #51.

According to 105 CMR 330, vaccination certificates for dogs must be filed by the vaccinating veterinarian within 30 days with the clerk of the city or town where the dog owner resides. One copy shall be provided to the dog owner, and one copy shall be retained by the vaccinating veterinarian. 256 CMR 5.01 requires a licensed veterinarian to keep medical records (i.e., vaccination certificates) readily available for four years after the last contact with the animal.

If you have any questions or concerns about this Policy Guideline, please contact the Board at  617-727-3080.  

Policy Statement Concerning Prescriptions

October 12, 2006

Upon request of the consumer, a Veterinarian shall provide prescription information to a pharmacy of choice. The method of providing prescription information shall be at the discretion of the prescribing Veterinarian. The prescription may be written or transmitted by any electronic means, in accordance with Massachusetts General Laws Chapter 94 C.

Approved Providers for Continuing Education Hours

The Board of Registration in Veterinary Medicine (Board) approved continuing education activities include, but are not limited to, the following:

 I. Successful completion of an educational program, course, seminar, or workshop meeting the requirements of 256 CMR 9.03(1) and endorsed or sponsored by the following organizations are approved for continuing education hours:

  1. Registry of Approved Continuing Education (RACE);
  2. Boards of Veterinary Medicine licensure of other states;
  3. Academic courses or continuing education programs offered by an  approved school of Veterinary Medicine; or
  4. Continuing education programs offered by the American Veterinary Medical Association (AVMA), any state veterinary medical association, or other organizations so designated by the Board..  The Board has designated the following organizations as approved providers for continuing education hours:

1. AVMA Allied Organizations:

    1. American Animal Hospital Association – AAHA
    2.  American Association of  Avian Pathologists AAAP
    3.  American Association of Bovine Practitioners AABP
    4.  American Association of Equine Practitioners AAEP
    5. American  Association of Feline Practitioners AAFP
    6.  American Association of Food Hygiene Veterinarians AAFHV
    7. American Association of Industrial Veterinarians AAIV
    8. American Association of Small Ruminant Practitioners AASRP
    9. American Association of Swine Veterinarians AASV
    10. American Association of Veterinary Clinicians AAVC
    11.  American Society of Laboratory Animal Practitioner ASLAP
    12.  Association of Avian Veterinarians AAV

2. AVMA recognized veterinary specialty organizations (RVSO):

    1. American Board of Veterinary Practitioners
    2. American Board of Veterinary Toxicology
    3. American College of Laboratory Animal Medicine
    4. American College of Poultry Veterinarians
    5. American College of Theriogenologists
    6. American College of Veterinary Anesthesiologists
    7.  American College of Veterinary Behaviorists
    8. American College of  Veterinary Clinical Pharmacology
    9. American College of Veterinary Dermatology
    10. American College of Veterinary Emergency and Critical Care
    11.  American College of Veterinary Internal Medicine
    12. American College of  Veterinary Microbiologists
    13. American College of Veterinary Nutrition
    14. American College of Veterinary Ophthalmologists
    15. American College of Veterinary Pathologists
    16. American College of Veterinary Preventive Medicine
    17. American College of Veterinary Radiology
    18. American College of Veterinary Surgeons
    19.  American College of Zoological Medicine
    20. American Veterinary Dental College

II.  Successful completion of a residency training program in the process of board certification in an AVMA specialty board or college, or successful completion of an organized internship with a Board approved provider. The Board has designated AVMA RVSO (AVMA recognized veterinary specialty organizations) accepted veterinary internship programs approved for continuing education activities.

Amended by the Board on April 12, 2012

Joint Policy Statement on Pet Shops

Issued in Cooperation between the Board of Registration in Veterinary Medicine and the Department of Agricultural Resources.

December 9, 2004

Issued in Cooperation between the Board of Registration in Veterinary Medicine and the Department of Agricultural Recources

This joint policy statement is issued in a cooperative effort between the Department of Agricultural Resources ( Department) and the Board of Registration in Veterinary Medicine ( Board). It is in response to information received by these agencies in the course of their operations. It has become increasingly apparent that there is a misunderstanding with regard to the standard of care that is required to be given to animals and their consumer owners in the pet shop industry. This joint statement is intended to clarify the standards of professional practice and services that are expected of all professionals and businesses and to which they will be held accountable by their respective licensing authorities.

GENERAL STANDARD OF PRACTICE FOR VETERINARIANS

All veterinary professionals are expected to meet the criteria and ethics mandated by law in the conduct of the veterinary services rendered. This includes maintaining a current license in good standing. See 256 CMR 7.01. While much of the information is codified at Chapter 256 of the Massachusetts Code of Regulations, there may well be additional relevant local, state and federal laws, rules and regulations for which the veterinary professional will also be accountable. See 256 CMR 7.01(2)(c). No veterinary professional will be excused from compliance with all requirements.

Licensing and Operation of Pet Shops 330 CMR 12.00 regulate pet shops.

RELATIONSHIP WITH PET SHOPS

Veterinary Professionals are not relieved from their professional responsibility to conform to the currently accepted standards of practice in the profession, by virtue of their employment by a Pet Shop or any other employer or corporation. It is the responsibility of the veterinary professional to maintain a clean and sanitary service area, equipment and attire. See 256 CMR 7.01(2)(i). Likewise, it is a violation, for which the veterinary professional will be held accountable, to aid or abet the unlawful, substandard practice of veterinary medicine.

The use of acceptable diagnostic testing and appropriate treatments, surgeries and follow-up care in the pet shop shall be recommended as it would in any other veterinary situation.

THE VETERINARIAN-CLIENT-PATIENT RELATIONSHIP

Many of the responsibilities of a veterinary professional are invoked when a relationship is established between the veterinarian and his or her patient and client. It is crucial therefore, to understand that the elements of a veterinarian relationship include:

  1. When a veterinarian has assumed the responsibility for making medical judgments regarding the health of (an) animal(s) and the need for medical treatment, and the client, who is the owner of the animal(s) or animal's caretaker has agreed to follow the instructions of the veterinarian;
  2. When there is sufficient knowledge of the animal(s) by the veterinarian to initiate at least a general or preliminary diagnosis of the medical condition of the animal(s); and,
  3. When the practicing veterinarian is readily available for follow-up in case of adverse reactions or failure of therapy.

Such a relationship can only exist when the veterinarian has recently seen and is personally acquainted with the keeping and care of the animal(s) by virtue of examination of the animal(s), and/or by medically appropriate and timely visits to the premises where the animal(s) are kept. The Board will scrutinize the medical records of the animal(s) and the routines of the veterinarian to determine whether such a relationship exists. Failures on the part of its licensees to fulfill their professional responsibilities regarding proper veterinarian-client-patient relationships will be disciplined.

In the pet shop setting, the three-pronged analysis needs to be applied when ownership of the animal is transferred. The relationship with the new owner needs to be established.

EXAMINATIONS AND RECORDS

256 CMR 7.01(2)(g) requires that the veterinarian have personal knowledge of the animal(s) through an actual examination before he or she can issue a certificate of health. Examinations must be thoughtful and complete and the requisite time should be allotted to ensure that all examinations are conducted in a thorough manner. The results must be documented and maintained in accordance with law and regulation.

At the very least a typical examination involves: 1) An inspection of, or "looking" at, the animal; 2) Palpation, or a "feeling" with the hands, to examine the size, consistency, texture, location, and tenderness of the organs or body parts; 3) Auscultation, "listening" through a stethoscope, to the patient's lungs, heart and intestines, to evaluate the frequency, intensity, duration, number, and quality of sounds, and, 4) Vital signs, such as heartbeat, breathing rate, and temperature, should all be observed, measured and recorded.

A veterinarian is responsible for maintaining a separate record of each examination conducted on each animal examined. See 256 CMR 5.02. The only exception to this rule that the Board will recognize is the medical records that are required to be kept for groups of animals that are treated as a group. The Board will not recognize the examination of animals at pet shops or for the purposes of transportation to pet shops as a group.

Veterinarians must assure that records are properly maintained. Currently, veterinarians are required to keep records for a period of 4 years and Pet shop regulations require that records be kept for a period of 12 months after the date of purchase, sale or give away of the dog, cat or psittacine bird. Please see 330 CMR 12.09(1) (d) and (e).

MEDICATIONS

In the case of dispensing and/or prescribing medications, the Board will always make an initial determination of whether there is a valid veterinarian-client-patient relationship. This will serve as the basis for the valid dispensing and/or prescription of controlled substances for the benefit of the animal. See 256 CMR 7.01(2)(e).

The Board also expects that all veterinarians will familiarize themselves and remain in compliance with all local, state and federal requirements, relative to the handling, dispensing and labeling of drugs and medications. See 256 CMR 5.02. Drugs and medications dispensed for specific animals shall be for specific veterinary medical problems. For groups of animals, dispensing shall be done judiciously and with an appropriate medical basis.

In the pet shop setting the veterinarian is required to make a diagnosis and prescribe medication for a specific animal. For example, the label information should include the identity of an animal through the use of an appropriate identification system (i.e., microchip number or other corresponding information).

Veterinarians caring for animals in a pet shop shall not declare an animal fit for sale while it is receiving a prescribed course of medication. For example, if the veterinarian has prescribed medication for a period of 7 days, the veterinarian must examine the animal after the completion of the 7-day course of medication and determine if it is healthy and fit for sale.

MGL c. 94C, Sec. 7 requires a Massachusetts Controlled Substances Registration in order to prescribe, dispense, administer or possess a controlled substance. A U.S. Drug Enforcement Administration Registration is required for controlled substances in Schedules II-V. Massachusetts' law also recognizes as controlled substances those prescription drugs that re not federally scheduled (Schedule VI).

Most practitioners need to register only their primary place of business. However, storing controlled substances at additional locations, such as pet shops, requires additional registrations. Medication must be dispensed for the individual animal.

Access to all controlled substances is limited to licensed, authorized persons. All controlled substances in Schedules II-V must be in a double-locked, permanently affixed cabinet or medication cart with a perpetual inventory. Controlled substances in Schedule VI must be in a locked medication room or closet.

At no time may a pet shop, pet shop employee or other non-veterinarian prescribe or dispense medication to a pet shop customer.

CONFLICT OF INTEREST

Veterinary professionals must be cognizant of the prohibitions against conflicts of interest when treating pets after their transfer (barter, exchange, adopt out, give away or otherwise transmit ownership of an animal to someone other than the pet shop)

The Board will hold veterinary professionals accountable for conflict of interest breaches. Veterinarians who have pet shops as clients need to identify the client and pet shop animals versus personally owned animals. The client may be the pet shop as a corporation or a d/b/a (individuals doing business as).

The veterinarian must identify his/her client and assure that the veterinary-client-patient relationship is not compromised by a conflict of interest. When a veterinarian has a pet shop as a client, the veterinarian must understand that all the pet shop animals are patients of the veterinarian. Upon the transfer of a pet shop animal the acquirer of the animal becomes the owner and the pet shop no longer is an owner. Upon the transfer of the pet shop animal the veterinarian may not maintain a veterinary-client-patient relationship during any warranty period.

Animals not owned by the pet shop and requiring monitoring, must be housed and treated at a veterinarian facility. If a pet shop is owned by a corporation, the corporation is the owner of the animal. The Veterinarian may direct treatment of animals owned by the pet shop, at the pet shop.

Veterinarians must assure that they do not foster the unlicensed practice of medicine by not identifying the true owner of the animal.

PET SHOPS

Pet Shops are required to be licensed under the laws of the Commonwealth. In order to maintain a license in good standing, pet shops will be required to work with their veterinary medical staff to ensure compliance with all local, state and federal requirements, as well as conformance with generally accepted, current practice standards within the field of veterinary medicine. The Department will not relieve Pet Shops from these requisite business and medical practices solely for economic reasons. When the health, safety or welfare of animals or the public is found to be compromised, then Pet Shops will be subject to appropriate disciplinary actions, which may include administrative penalties, suspension or revocation of licensure.

Pet shops employing veterinarians to examine animals within the pets shop facility must provide veterinary medical staff with the adequate resources to comply with the law, including, but not limited to clean and sanitary conditions, access to animals for proper and regular examination, sufficient time to conduct proper examinations, allow for proper dispensing of prescription medicines and controlled substances, resources for maintenance of medical records and for the examination, diagnosis and treatment of animals within the custody and control of the pet shop.

It is expected that veterinarians working for pet shops will establish valid client/veterinarian relationships and be active participants in the establishment of medical protocol and bio-security practices to protect both human and animal health. The protection of human and animal health will be achieved through the veterinarian's awareness and involvement with the pet shop.

The Department will inspect and review business practices for complicity with veterinary professionals in violations of controlling laws, rules and regulations. Such complicity that compromises the health, safety and welfare of amimal health or the public or renders an animal sick or diseased will lead to appropriate disciplinary action, including administrative penalties, suspension or revocation of licensure. See 330 CMR 12.00.

Board Policy Guidelines on the Identification of Board Certified Veterinarians

Policy Guideline 

 

From:       Board of Registration of Veterinary Medicine

Re:            Board Policy Guidelines on the Identification of Board Certified Veterinarians

Date:         December 8, 20111

The Board of Registration of Veterinary Medicine ("the Board") voted today to adopt the following Policy Guideline. The guideline set forth below does not have the full force and effect of law, as would a Massachusetts General Law or a Board rule or regulation. However, the Board uses policy guidelines as an internal management tool in formulating decisions that relate to issues in the practice of veterinary medicine.

Policy No. 11-02

Introduction:

The Board Statutes and Regulations set forth the standards of practice for all licensed veterinarians in the Commonwealth.  Specifically, 256 CMR §2.01 defines a Veterinary Specialist (Veterinary Diplomat) as a veterinarian currently certified by a specialty board recognized by the AVMA or the Board.  The regulation governing advertising, 256 CMR §5.03, provides a licensee may, by using print or electronic media, provide information to the public by advertising which is not false, fraudulent, misleading or deceptive. However, a licensee shall not use any advertising that contains any statement or claim that a licensee is a veterinary specialist unless the licensee meets the definition of that term contained in 256 CMR §2.01.

Policy:

Any advertisement or notice regarding a board certified specialist, that also lists other services in the advertisement or notice, should use care in wording the communication so that it does not imply board certified specialty status regarding the other services. One is either board certified, having met all of the criteria of the specialty college or board, or one has no board credentials. In the opinion of the Board, the mixing of board certified specialists and non-specialists, or their services, under common headings which do not clearly identify the board certified specialists and their specialty services, is misleading and should not be used by any licensee.

Board Policy Guidelines: Standards of Practice for Large Animal Practitioners

From: Board of Registration of Veterinary Medicine

 

Re: Board Policy Guidelines: Standards of Practice for Large Animal Practitioners

Date: April 14, 2011

The Board of Registration of Veterinary Medicine ("the Board") voted today to adopt the following Policy Guideline. This policy guideline is intended as a recommended protocol for the Board to follow. The guideline set forth below does not have the full force and effect of law, as would a Massachusetts General Law or a Board rule or regulation. However, the Board uses policy guidelines as an internal management tool in formulating decisions that relate to issues in the practice of veterinary medicine.

Policy No. 11-01

Introduction:

The Board Statutes and Regulations set forth the standards of practice for all licensed veterinarians in the Commonwealth. Specifically, 256 CMR 5.00 Practice, set the standard for:

  1. Medical Records
  2. Drugs and Medication
  3. Advertising
  4. Hospital Safety
  5. Requirements for Full Service Veterinary Facility
  6. Requirements for Emergency Service Veterinary Facility

 

All licensed Veterinarians, regardless of whether they are large or small animal practitioners are held to the standards set forth in this section, and all of 256 CMR.

More specifically, the Board would like to advise all large animal practitioners that standards regarding prescription writing, medication dispensing, medication labeling, as well as the contents of medical records, remain the same for ALL Licensed Veterinarians.

Approved Supervisors for Temporary Permits

October 14, 2010

The Board of Registration of Veterinary Medicine ("the Board") voted today to adopt the following Policy Guideline. This policy guideline is intended as a recommended protocol for the Board to follow. The guideline set forth below does not have the full force and effect of law, as would a Massachusetts General Law or a Board rule or regulation. However, the Board uses policy guidelines as an internal management tool in formulating decisions that relate to issues in the practice of veterinary medicine.

Policy No. 10-01

Introduction:

The Board Statutes and Regulations allow for those candidates who have graduated with a foreign degree in veterinary medicine, and who have passed the NAVLE exam, but have not fully completed the ECFVG or PAVE programs to apply for a temporary permit, that is valid for six (6) months, and may be renewed one time.

In accordance with MGL 112 Chapter 56A and CMR 256 4.01 (1), and after candidates have demonstrated qualifications, they may practice veterinary medicine "under the direct supervision and control of a duly licensed veterinarian practicing in the Commonwealth "

For the purpose of supervising those practicing with temporary permit, the Board considers a "duly licensed veterinarian" to have met the following qualifications:

  1. Supervising veterinarian must be licensed for a minimum of four (4) years from the date of candidates application

Supervising Veterinarian must be in "good standing" with the Board. Should a pending investigation or disciplinary matter be under review of the Board, the verification of "good standing" shall be determined by the Board on a case by case basis.

Dispensing of Veterinary Drugs During Emergency Situations

Re: Board Policy Guidelines: Dispensing of Veterinary Drugs by a Non-Prescribing Veterinarian During Emergency Situations
 

Date: July 12, 2007

The Board of Registration of Veterinary Medicine ("the Board") voted today to adopt the following Policy Guideline. This policy guideline is intended as a recommended protocol for the profession to follow. The guideline set forth below does not have the full force and effect of law, as would a Massachusetts General Law or a Board rule or regulation. However, the Board uses policy guidelines as an internal management tool in formulating decisions that relate to issues in the practice of veterinary medicine.
 

Policy No. 08-01

Purpose:

The purpose of this policy statement is to offer guidance regarding the circumstances in which a non-prescribing veterinarian may dispense prescription drugs to an animal in the Commonwealth, with whom the veterinarian does not have a genuine veterinarian-client patient relationship, during a time of emergency or crisis.

Policy:

Under normal circumstances, an individual holding a license issued by the Massachusetts Board of Registration in Veterinary Medicine to practice veterinary medicine in the Commonwealth may dispense or prescribe controlled substances only in the course of his or her professional practice after establishing a genuine veterinarian-client patient relationship as required by 256 CMR 7.01(2)(e).

However, it is Board policy that in emergency situations, a non-prescribing veterinarian who does not have a genuine veterinarian-client patient relationship may dispense prescription veterinary drugs to an animal when necessary to save life or relieve suffering. The Board recognizes that all veterinarians should first consider the needs of the patient and act in a manner that relieves disease, suffering, or disability while minimizing pain or fear. In emergencies, veterinarians have an ethical responsibility to provide essential services to animals when necessary to save life or relieve suffering, subsequent to client agreement, even in the absence of a genuine veterinarian-client patient relationship. [See Principles of Veterinary Medical Ethics of the American Veterinary Medical Association].

"Emergency situations", for the purpose of permitting the dispensing of prescription veterinary drugs by a non-prescribing veterinarian, means those situations in which the non-prescribing veterinarian who proposes to dispense a prescription veterinary drug determines:

(1) That Federal law restricts this drug to use by or on the order of a licensed veterinarian; and

(2) That the immediate administration of the veterinary drug is necessary for proper treatment of the patient; and

(3) That no appropriate alternative treatment is available, including administration of a controlled substance which is not a veterinary drug; and

(4) That it is not reasonably possible for the licensed veterinarian providing the prescription to dispense the veterinary drug to the patient.

In case of an emergency situation as defined above, a veterinarian who does not have a genuine veterinarian-client patient relationship may dispense a prescription veterinary drug for the immediate treatment of the patient upon receiving authorization from the prescribing licensed veterinarian provided that:

(1) The quantity prescribed and dispensed is limited to the amount needed for the immediate treatment of the patient during the emergency period; and

(2) The prescription contains all the information required in M.G.L. c. 94C; and

(3) The dispensing veterinarian creates a medical record containing all information required in 256 CMR 5.01; and

(4) All veterinary drugs and medications dispensed shall meet the requirements of 256 CMR 5.02; and

(5) The prescription is written, or transmitted by any electronic means, in accordance with M.G.L. c. 94C. If the prescribing veterinarian is not known to the dispensing veterinarian, the dispensing veterinarian must make a reasonable good faith effort to determine that the prescription came from a licensed veterinarian, including a callback to the prescribing veterinarian using his or her phone number listed in the telephone directory or other good faith efforts to verify his or her identity.

For the purposes of this policy, the words "amount needed for the immediate treatment of the patient" shall mean the quantity of a controlled substance that is necessary for the proper treatment of the patient until it is possible for such patient to have a prescription filled by a pharmacy as required by M.G.L. c. 94C, sec. 9.

Authority: M.G.L. Chapter 112, Section 58; and 256 CMR 1.00 et seq.

Dispensing of Prescription Veterinary Diets by a Non-Prescribing Veterinarian

Re: Board Policy Guidelines: Dispensing of Prescription Veterinary Diets by a Non-Prescribing Veterinarian When the Prescribing Veterinarian Does Not Stock the Veterinary Diet or the Client Does Not Have Ready Access to the Prescribed Diet

Date: July 12, 2007

The Board of Registration of Veterinary Medicine ("the Board") voted today to adopt the following Policy Guideline. This policy guideline is intended as a recommended protocol for the profession to follow. The guideline set forth below does not have the full force and effect of law, as would a Massachusetts General Law or a Board rule or regulation. However, the Board uses policy guidelines as an internal management tool in formulating decisions that relate to issues in the practice of veterinary medicine.

Policy No. 08-02

Purpose:

The purpose of this policy statement is to offer guidance regarding those circumstances in which prescription veterinary diets may be dispensed by a non-prescribing veterinarian to animals in the Commonwealth with whom the veterinarian does not have a genuine veterinarian-client patient relationship.

Policy:

Under normal circumstances, an individual holding a license issued by the Massachusetts Board of Registration in Veterinary Medicine to practice veterinary medicine in the Commonwealth may dispense or prescribe veterinary diets only in the course of his or her professional practice after establishing a genuine veterinarian-client patient relationship as required in 256 CMR 7.01(1).

However, the Board recognizes that prescription veterinary diets are available only by prescription through a veterinarian, and that veterinarians may at times not stock all available veterinary diets necessary to save life or relieve suffering. Additionally, clients may not have ready access to the prescription diets for a variety of reasons, such as closure of the prescribing veterinarian's office on a particular day or lack of geographical proximity to the diet. Consequently, it is Board policy that in situations like those described above, another veterinarian who does not have a genuine veterinary-client patient relationship with that animal may dispense a prescribed veterinary diet to that animal.

A non-prescribing veterinarian may dispense a prescription veterinary diet for the treatment of a patient upon receiving the authorization of the prescribing licensed veterinarian, provided that:

(1) If the dispensing veterinarian creates a medical record, then that record should contain all the information required by 256 CMR 5.01; and

(2) The prescription is written, or transmitted by any electronic means, in accordance with M.G.L. c. 94C. If the prescribing veterinarian is not known to the dispensing veterinarian, the dispensing veterinarian must make a reasonable good faith effort to determine that the prescription came from a licensed veterinarian, including a callback to the prescribing veterinarian using his or her phone number listed in the telephone directory or other good faith efforts to verify his or her identity.

Authority: M.G.L. Chapter 112, Section 58; and 256 CMR 1.00 et seq.

Guidelines for Complementary and Alternative Veterinary Medicine

Date: April 10, 2008

The Board of Registration of Veterinary Medicine ("the Board") voted today to adopt the following Policy Guideline. This policy guideline is intended as a recommended protocol for the profession to follow. The guideline set forth below does not have the full force and effect of law, as would a Massachusetts General Law or a Board rule or regulation. However, the Board uses policy guidelines as an internal management tool in formulating decisions that relate to issues in the practice of veterinary medicine.

Policy No. 08-04

Introduction

These guidelines are intended to help veterinarians make informed and judicious decisions regarding medical approaches known by several terms including "complementary," "alternative," and "integrative." Collectively, these approaches have been described as Complementary and Alternative Veterinary Medicine (CAVM). The Massachusetts Board of Registration in Veterinary Medicine ("The Board") recognizes the interest in and use of these modalities and is open to their consideration.

The Board finds the practice of CAVM as the practice of Veterinary Medicine, as defined in M.G.L. c. 112 § 58. The practice of all veterinary medicine, including CAVM, should be held to the same standards.

Circumstances commonly require that veterinarians extrapolate information when formulating a course of therapy. Veterinarians should exercise caution in such circumstances. If they themselves are not qualified, veterinarians may incorporate individuals licensed in human alternative professions, only through referral and consultation.

Terminology

These guidelines identify CAVM as a heterogeneous group of preventive, diagnostic, and therapeutic philosophies and practices.

Current examples of CAVM include, but are not limited to, aromatherapy; Bach flower remedy therapy; energy therapy; low-energy photon therapy; magnetic field therapy; orthomolecular therapy; veterinary acupuncture, acutherapy, and acupressure; veterinary homeopathy; veterinary manual or manipulative therapy (similar to osteopathy, chiropractic, or physical medicine and therapy); veterinary nutraceutical therapy; and veterinary phytotherapy.

Responsibilities

M.G.L. ch. 112 § 58 define and regulate the practice of veterinary medicine including many aspects of CAVM. These guidelines support the requisite interaction described in the definition of the veterinarian-client-patient relationship. Accordingly, a veterinarian shall examine an animal and establish a preliminary diagnosis before any treatment is initiated.

Diagnosis should be based on sound, accepted principles of veterinary medicine. Currently accepted treatment methods should be discussed with the owner or authorized agent when presenting the treatment options available. Owner consent should be obtained prior to initiating any treatment, including CAVM.

Medical records must meet statutory requirements. Information should be clear and complete. Records should contain documentation of client communications and owner consent.

Animal Dental Scaling without Anesthesia

Date: April 10, 2008

The Board of Registration of Veterinary Medicine ("the Board") voted today to adopt the following Policy Guideline. This policy guideline is intended as a recommended protocol for the profession to follow. The guideline set forth below does not have the full force and effect of law, as would a Massachusetts General Law or a Board rule or regulation. However, the Board uses policy guidelines as an internal management tool in formulating decisions that relate to issues in the practice of veterinary medicine.

Policy No. 08-05

In Massachusetts, only licensed veterinarians can practice veterinary medicine. Veterinary medicine includes veterinary surgery, medicine and dentistry. Anyone providing dental services other than a licensed veterinarian, or a directly supervised (as defined by 256 CMR 2.01) and trained veterinary technician, is practicing veterinary medicine without a license and can be subject to fines and/or criminal charges.

It is the position of the Board of Registration in Veterinary Medicine that dental scaling procedures performed on pets without anesthesia is inadequate and often medically unsound for the following reasons:

  1. Professional dental scaling includes scaling the surfaces of the teeth both above and below the gum line, followed by dental polishing. A critical part of a dental scaling procedure is scaling the tooth surfaces that are within the space between the gum and the root, where periodontal disease is active. Access to this area of every tooth is impossible without anesthesia in a canine or feline patient. Removal of dental tartar on the visible surfaces of the teeth has little effect on a pet's health, and provides a false sense of accomplishment. The effect is purely cosmetic.
  2. Dental tartar is firmly adhered to the surface of the teeth. Removing tarter with a hand scaler requires instruments that must have a sharp working edge to be used effectively. Even slight head movement by the patient could result in injury to the oral tissues of the patient, and the operator may be bitten when the patient reacts.
  3. Inhalation anesthesia using a cuffed endotrachel tube provides three important advantages - the cooperation of the patient with a procedure it does not understand, elimination of pain resulting from examination and treatment of affected dental tissues during the procedure, and protection of the airway and lungs from accidental aspiration.
  4. A complete oral examination, which is an important part of a professional dental scaling procedure, is not possible without anesthesia in a canine or feline patient. The surfaces of the teeth facing the tongue cannot be examined, and areas of disease an discomfort may be missed.

Veterinary Practice of Out-of-State Veterinarians in the Commonwealth During a Time of Emergency or Crisis

March 9, 2006

The Board of Registration of Veterinary Medicine ("the Board") voted today to adopt the following Policy Guideline. The guideline set forth below is intended as a recommended protocol for the profession to follow. It does not have the full force and effect of law, as would a Massachusetts General Law or a Board rule or regulation. However, the Board uses policy guidelines as an internal management tool in formulating decisions that relate to issues in the practice of veterinary medicine.

Policy No. 06-01

Purpose:

The purpose of this policy statement is to offer guidance regarding the ability of licensed, out-of-state veterinarians who are not licensed to practice veterinary medicine in Massachusetts to provide care to animals in the Commonwealth during an emergency or disaster.

Policy:

Under normal circumstances, an individual must hold a license issued by the Massachusetts Board of Registration of Veterinary Medicine to practice veterinary medicine in the Commonwealth. However, the Board recognizes that there may be a need for out-of-state veterinarians to assist in the provision of veterinary care to Massachusetts animals during a disaster or a time of emergency.

It is Board policy that a veterinarian who does not hold a current license to practice veterinary medicine in Massachusetts may provide gratuitous aid or relief, as described in M.G.L. Chapter 112, Section 58(4), to animals in the Commonwealth without a Massachusetts license during a time of disaster or emergency. See also M.G.L. 112, section 58A and M.G.L. Chapter 112, section 60. The out-of-state veterinarian providing the gratuitous aid or relief must hold a valid current license to practice veterinary medicine in another state and may not represent himself, temporarily or otherwise, as a veterinarian licensed to practice veterinary medicine in Massachusetts. Additionally, the out-of-state veterinarian must comply with all federal, state and local laws governing the practice of veterinary medicine in the Commonwealth for the duration of time that the veterinarian provides gratuitous aid or relief. See M.G.L. Chapter 112, section 58. The ability of the out-of-state veterinarian to practice veterinary medicine in the Commonwealth of Massachusetts without a license is limited to the duration of the crisis or emergency. An emergency or crisis is defined as an official state of emergency declared by the Governor of the Commonwealth or as declared by the Board.


 

Authority: M.G.L. Chapter 112, Section 58;
M.G.L. Chapter 112, section 60, and 256 CMR 1.00 et seq.

Renewal of an Inactive License

The Board of Registration of Veterinary Medicine ("The Board") voted today to adopt the following Policy Guidelines. These policy guidelines are intended as a recommended protocol for the profession to follow. The Board utilizes these and other guidelines as an internal management tool in formulating decisions that relate to issues of the veterinary medicine profession.

December 9, 2004
Renewal of an Inactive License

Policy: #05-02

PURPOSE:

The purpose of this bulletin is to offer guidance to Licensees regarding Clarification of Renewing and inactive license.

POLICY:

The Board of Registration in Veterinary Medicine Regulations 256 CMR 3.00 state the requirements for returning an inactive (expired) license to a current standing.

A veterinarian is only allowed one license registration in Massachusetts. A veterinarian does not have the option of pursuing a new and different license registration in order to avoid the requirements for renewal of licensure described in 256 CMR 3.00. Once a veterinarian obtains license registration for the first time, that registration number is the only license number that will be associated with that individual in Massachusetts.

It is Board policy that candidates for renewal of inactive licenses must appear before the Board for an interview, scheduled at the Board's reasonable convenience. The Board in its discretion will waive that requirement only under extraordinary conditions of hardship.

Authority: M.G.L. Chapter 112, Section 54; and 256 CMR 3.00

Continuing Education in First Year of Licensure

The Board of Registration of Veterinary Medicine ("The Board") voted today to adopt the following Policy Guidelines. These policy guidelines are intended as a recommended protocol for the profession to follow. The Board utilizes these and other guidelines as an internal management tool in formulating decisions that relate to issues of the veterinary medicine profession.

December 9, 2004
Continuing Education in First Year of Licensure

 

Policy: #05-03

PURPOSE:

The purpose of this bulletin is to offer guidance to Licensees regarding Continuing Education Requirements in First Year of Licensure

POLICY:

The Board of Registration in Veterinary Medicine Regulations 256 CMR 9.00 state the requirements for continuing education.

It is Board policy that all new licensees are exempt from the Continuing Education requirements for the license period that includes the date of initial licensure, unless the new license was obtained by reciprocity.

The Board does encourage new licensees to voluntarily take continuing education during their first year of licensure.

Authority: M.G.L. Chapter 112, Section 54; and 256 CMR 9.00

Further Clarifications of Temporary Permits

The Board of Registration of Veterinary Medicine ("The Board") voted today to adopt the following Policy Guidelines. These policy guidelines are intended as a recommended protocol for the profession to follow. The Board utilizes these and other guidelines as an internal management tool in formulating decisions that relate to issues of the veterinary medicine profession.

December 9, 2004
Clarifications for Temporary Permits

Policy: #05-04

PURPOSE:

The purpose of this bulletin is to offer guidance regarding expectations and responsibilities of those holding a temporary permit.

POLICY:

The Board of Registration in Veterinary Medicine Regulations 256 CMR 4.00 state the requirements for Temporary Permits.

A veterinarian with a Temporary Permit is not allowed to work unsupervised until proof of valid and current Massachusetts licensure is in his or her possession. This includes a wallet license, and/or a wall certificate, and/or any documentation from the Board stating that the veterinarian has a current license.

It is the sole responsibility of the individual holding the Temporary Permit to ensure that all requirements for full licensure are met, as described in 256 CMR 3.01.

Substantiated evidence of any veterinarian on a Temporary Permit working unsupervised may result in discipline against the supervising licensee and denial of licensure for the Temporary Permit.

Authority: M.G.L. Chapter 112, Section 54; and 256 CMR 4.00

Specialists seeking Full Licensure

The Board of Registration of Veterinary Medicine ("The Board") voted today to adopt the following Policy Guidelines. These policy guidelines are intended as a recommended protocol for the profession to follow. The Board utilizes these and other guidelines as an internal management tool in formulating decisions that relate to issues of the veterinary medicine profession.

December 9, 2004
Veterinary Specialists seeking Full Licensure

Policy #05-05

PURPOSE:

The purpose of this bulletin is to offer guidance and clarifications for those veterinary specialists who are seeking full licensure.

POLICY:

The Board of Registration in Veterinary Medicine Regulations 256 CMR 3.03(5) state the requirements for waiving licensure examination for veterinary specialists.

If a veterinary specialist who has previously been granted a waiver by the Board decides to seek full licensure, that veterinarian must adhere to the licensure requirements described in 256 CMR 3.00.

It is the sole responsibility of the individual holding the specialist waiver to ensure that all requirements for full licensure are met.

Substantiated evidence of any specialist practicing beyond the scope of his or her waiver may result in revocation of the waiver and denial of licensure.

Authority: M.G.L. Chapter 112, Section 54; and 256 CMR 3.00

Referenced Sources:

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