Matt’s Blog: Calling on States to Preserve and Expand Veterinary Telemedicine Access to Protect Pets
By ASPCA President & CEO Matt Bershadker
Early in the pandemic, federal and state policymakers issued COVID-19 emergency orders that temporarily waived existing regulations and laws preventing veterinarians from using telemedicine—the process of using technology to deliver care over a distance.
Because telemedicine—such as Zoom or FaceTime video calls between veterinarians and clients—provided pet owners better access to care, these emergency orders were essential to protecting public health and ensuring animals could continue to receive treatment.
But even as pandemic restrictions are lifted, telemedicine is still vital in many communities where challenges to veterinary services existed pre-pandemic, putting pets at risk. Most states are now returning to antiquated laws that block the broad use of telemedicine for veterinarians, leaving countless people struggling to access lifesaving care for their pets.
According to the Veterinary Virtual Care Association, 24 state laws have provisions—most enacted well before the pandemic—requiring veterinarians to conduct in-person physical examinations before they can legally treat animals, even for routine conditions like flea infestations that can be diagnosed via telemedicine. Ten states specifically forbid veterinarians from using telemedicine technologies with new patients, often going so far as to classify such activities as "unprofessional conduct" for which vets can be officially disciplined.
California's outdated regulations require veterinarians to examine animals in person for each and every new condition (except in emergency cases), and prescription durations cannot exceed a year without another examination. California law also prohibits a veterinarian from using telemedicine technology to simply establish a patient relationship.
Several states have similar laws that mandate veterinarians conduct patient examinations before providing treatment. California, Nevada, Mississippi, Texas, Washington and Tennessee are among the states that explicitly prohibit a telemedicine-initiated veterinary relationship. Many of these states also place time limits on exams, requiring pet owners to bring animals into clinics at least once every 12 months to receive continued care.
These obstacles do not exist for human patients because the medical community appreciates that while physical examinations are sometimes required and can be useful, they are not always necessary. All 50 states enable physicians to establish a relationship with human patients using virtual care technologies, even for infants and nonverbal adults.
In some cases, telemedicine can have unique benefits—such as observing an animal's movements and behavior in their home environment—and many conditions can be easily treated without the inconvenience and travel expense of a clinic visit, which can also be stressful for fearful and anxious pets.
Exacerbating the accessibility of veterinary care is a critical shortage of veterinarians and other veterinary professionals in the workforce. A September 2020 study found that 75 million pets in the U.S. could be without veterinary care by 2030. Access to telemedicine can help bridge gaps in care created by these workforce shortages, which is part of the reason why veterinary associations including the American Association of Veterinary State Boards, Veterinary Virtual Care Association, Association of Shelter Veterinarians and the Veterinary Innovation Council support policies to enable veterinarians to begin working with new patients using virtual care technology.
Some states are considering the benefits of telemedicine fairly and responsibly. Policymakers in New Jersey, Virginia, Idaho and other states recently enacted forward-thinking telemedicine laws and regulations empowering veterinarians to offer telemedicine services to clients at their discretion.
Others are taking the matter to court. In 2020, a court sided with a Texas veterinarian who filed a complaint against the veterinary medical board for violating his freedom of speech by preventing him from using telemedicine to consult with clients without first conducting an examination. A pending lawsuit filed by the San Francisco Society for the Prevention of Cruelty to Animals similarly claims that California's regulation violates plaintiffs' right to freedom of speech by unduly blocking veterinarians' communications and violates plaintiffs' constitutional right to equal protection under the law since doctors who treat humans are not bound to the unreasonable examination standards required of veterinarians.
Ultimately, expanding access to veterinary telemedicine is about expanding access to veterinary care, and the animal welfare stakes are high. A 2015 study revealed that an estimated one million households rehome a pet every year, with many pet owners citing lack of access to affordable veterinary care among the top reasons for rehoming their pet. They also say they would've opted to keep their pets with them if they'd had access to critical services.
Across the country, many pet owners, including seniors, working families and people who live in areas with few or no veterinarians, can face significant financial, geographical and logistical barriers to accessing veterinary care for their pets. Pet owners may also face significant obstacles transporting large animals or potentially aggressive or fearful pets to clinics. It's clear that telemedicine is nothing short of a lifeline for these and many other pet owners. By making basic veterinary care accessible and affordable to those who need it most, millions of pets will be kept safe and healthy in their homes—and out of overcrowded shelters.
On all issues of medical care, doctors are appropriately relied on to make educated recommendations, and we should do the same here, entrusting highly trained, licensed veterinarians to determine when to use, and not use, telemedicine technology. We urge states to find appropriate solutions that create this allowance and flexibility for telemedicine in the highest interest of animals who need it, pet owners who rely on it and veterinarians who provide quality care through it.
Originally published in One Green Planet