Pulse - April 2024 - 10

because the same standards of care apply to
telemedicine and in-office visits. A practitioner
is not going to be given a free pass or held to
a lesser standard of care just because they are
practicing via telemedicine. The level of clinical
rigor must be the same. "
Adds Bonnie Lutz, an attorney based in
Irvine, California, who specializes in defending
veterinarians in malpractice lawsuits and
administrative actions: " The statute clearly states
that the same standard of care applies when an
animal is examined by synchronous audio-video
communication as in person. I am concerned that
this will lead to mistakes in diagnoses and allegations
of malpractice by animal owners or the
Veterinary Medical Board. "
Teller becomes especially concerned when a
telemedicine consultation is a one-off done outside
the client's normal relationship with their
veterinarian, such as with a direct-to-consumer
platform. " I believe that leads to fragmentation
of care, " she explains. " If the veterinarian has not
been able to previously get to know the client
and do a physical exam on the patient, there is
a significantly increased opportunity for misdiagnosis
and inappropriate prescribing of
medications. "
Also at issue: AB 1399 violates the Food and
Drug Administration's federal VCPR definition,
which " cannot be met solely through telemedicine "
for covered activities, including extralabel
drug use and issuing veterinary feed directives.
It's too early to know what effect AB 1399
10
will have on the practice of veterinary medicine
in California - the sixth state to allow a
patient-client relationship to be established by
electronic means. In the meantime, the use of
telemedicine will almost certainly continue to
grow within the profession.
" Veterinarians should be open to telemedicine
because it can benefit them, their clients
and patients, " says Singer. " Some patients might
not get care any other way. The big hesitancies
for veterinarians tend to be that they feel they
are above it, they don't want to offer something
that's not good enough, or they are worried
about doing something wrong. I don't believe
any of these reasons is realistic. "
" My best recommendation is to utilize telemedicine
appropriately in your practice and
understand the state and federal laws, " adds
Teller, " because with the passage of AB 1399,
some of what you can do in California is in
conflict with what you can do under federal law,
which supersedes California law. "
Weinstein encourages practitioners incorporating
telemedicine to make sure their clients
are aware of the limitations of a telemedicine
consultation, including not being able to touch
the patient or clearly see areas such as the inside
of the mouth or ears. " It's important to set the
expectation of what we can and cannot do, "
she says, " and encourage the client to bring the
patient in if there is something pathologically
wrong. That way, we can put our hands on the
patient and get a feel for what is going on. " P
WEINSTEIN
ENCOURAGES
PRACTITIONERS
INCORPORATING
TELEMEDICINE TO
MAKE SURE THEIR
CLIENTS ARE AWARE
OF THE LIMITATIONS
OF A TELEMEDICINE
CONSULTATION,
INCLUDING NOT BEING
ABLE TO TOUCH THE
PATIENT OR CLEARLY
SEE AREAS SUCH AS
THE INSIDE OF THE
MOUTH OR EARS.
APRIL 2024
PULSE
Pulse - April 2024

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