Today's Veterinary Business

DEC 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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3 4 Politics & Policy columnist Mark Cushing is founding partner of the Animal Policy Group and a former litigator. He serves on the Today's Veterinary Business editorial advisory board. Dosage restrictions on con- trolled substances or opioid prescriptions pose a challenge in veterinary medicine. Some states imposing dose restrictions require a prescription be for no more than five, seven or 10 days. These truncat- ed lengths are of concern with at- home compliance, the fear being an animal owner will not want to bring a pet back to the clinic for a recheck to get the balance of a longer course of treatment. This is clearly prob- lematic for cases where the proper course of treatment requires a pre- scription longer than is allowed. Mandatory continuing edu- cation regarding opioids. Many states have implemented specific requirements for safe handling, re- cordkeeping, abuse prevention and awareness continuing education as a result of the opioid crisis and following the human medical lead. While one might hope for all the states to agree, or for Congress or the FDA to impose a national regula- tory scheme, we should expect that these issues, like most veterinary matters, will remain the prerogative of individual states. But you can be sure the number of states imposing some type of obligation on veteri- narians is likely to grow each year. What Can or Should the Veterinary Profession Do to Be Proactive? From discussions at conferences and articles in the trade press, clearly there is no national consen- sus on how the profession should deal with these issues. On the one hand, a majority of practitioners apparently believe that the evi- dence of opioid abuse by veterinar- ians or their clients is so small as to not warrant any new mandates on practitioners. On the other hand, a majority of practitioners and veterinary associations do not rec- ommend that veterinarians stand up in the middle of a nationwide opioid crisis and proclaim that vet- erinarians have no role in solving the problems. Where Does All This Leave Us? First, the topic needs more discus- sion at veterinary conferences so that a clear consensus can be formed. Not a top-down approach, perhaps, but through individual veterinarians sharing and debating views on the solutions under consideration. The Indiana Veterinary Medical Associa- tion led such a stakeholder process over the past two years and made sure veterinarians are aware of the choices and have a seat at the table in the state capital, where alter- natives are being considered. This model could work in any state, and Indiana VMA leaders are willing to share information and how-to tips. Second, state regulatory bodies such as pharmacy boards and health departments are open to discussing with veterinarians the feasibility of different means of reporting opioid or controlled substance prescrip- tions. Most, if not all, veterinary prac- tices lack the software to report to a state agency, as this has not been a professional requirement and soft- ware providers have not developed veterinary applications. Human health care has such offerings, of course, given the daily reporting required at state and federal levels. If practitioners nationwide can reach a consensus as to what is fea- sible, then we could take solutions to the regulatory agencies and push for uniform requirements. The great- est challenges involve reporting and pre-investigation duties before a prescription is issued or filled. Anyone who picks up a news- paper or reads online media will un- derstand that the U.S. opioids crisis is massive and devastating to individ- uals, families and communities. It's not going away. Veterinarians must take careful steps, and act thought- fully, but time is running out on any hope that these clouds will pass. If part of your job involves handling opioids or controlled substances, you should expect that the government considers you part of the solution to the crisis.

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