Today's Veterinary Business

AUG 2018

Today’s Veterinary Business provides information and resources designed to help veterinarians and office management improve the financial performance of their practices, allowing them to increase the level of patient care and client service.

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While Graff recommends that veterinarians ask their respective boards of licensure for guidance on cannabis, Cital says many boards have gone too far. "The California Veterinary Med- ical Board has overreached with its mandate that veterinarians cannot discuss marijuana hemp products or CBD [cannabidiol]," Cital said. "They mentioned CBD specifically when we know that, at the federal level, CBD derived from hemp is legal." State licenses aren't the only thing practitioners could risk if they discuss cannabis with clients. "Many practitioners also hold DEA [Drug Enforcement Admin- istration] licensure, which could be implicated given marijuana is federally illegal," Graff said. When it comes to veterinary nurses, "It depends on the state that you're in and what you're talking about," Cital said. "If you're talking to owners about marijuana-derived cannabi- noids, that is opening you up for rep- rimand from the veterinary medical board in your state," he said. "If you're discussing CBD sourced from indus- trial hemp or hemp products, that, legally — even at the federal level — does not open you up to anything." Cital's medical record notes are purposely vague when he consults on cannabis. "I write something to the effect of, 'Discussed endocannabinoid support,'" he said. "I think that's a great way to protect the practi- tioner from legal recourse." Embracing cannabis as a treat- ment option in a veterinary practice can: • Boost revenue. • Improve the client relationship. • Increase job satisfaction. How? Picture this: You are managing the care of an epileptic dog. The patient hasn't responded to traditional medications, and the client is frustrated watching her dog's health decline. After doing research, the client comes to you with a question: Do you think cannabis might help? You tell her that because of the legal status of marijuana and the possible implications for your veterinary license, you aren't comfortable discussing cannabis with her, but you have a certified cannabis counselor on your team. You tell her she can schedule a consultation with the counselor. When the client returns for the consul- tation, the cannabis counselor has reviewed the dog's medical records. The counselor recommends an appropriate product, dosage, frequency and administration method, along with baseline blood work. The counselor also explains how to obtain the product. The client leaves feeling as if she has been listened to and taken care of. When the client purchases the recom - mended product, she uses the practice code provided by the counselor, and a portion of the sales price is credited to the practice because an affiliate program has been set up with a distributor. Four weeks later, the client returns for a follow-up exam and blood work to ensure no unintended consequences of the cannabis treatment and to confirm that the dog is on a therapeutic dose. You, the veterinarian, ask how the dog is doing and she reports that the seizures have significantly lessened in fre- quency and severity. She can't wait to discuss the changes with your cannabis counselor. When you review the blood work, you see no adverse side effects of the cannabis treatment. Your cannabis counselor calls the client to discuss the results and to recom- mend continuing the dosage and frequency. The counselor feels empowered and valued, a sign of improved job satisfaction. Consultant Casara Andre, DVM, cVMA, has launched a program designed to teach veterinary nurses how to discuss cannabis with pet owners. Nurses who pass the course become certified cannabis counselors. "It's geared toward technicians just because the legalities with this topic are so sticky that technicians seem to be a good option to be on the forefront for patient advocacy and discussing this without con- cern, because we don't hold a DEA license," said program instructor Stephen Cital, RVT, RLAT, SRA, VTS-LAM. THE PATH TO CANNABIS More information is available at www.veterinarycannabis.org.

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