The importance and value of the Veterinarian-Client-Patient relationship

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Two important dates have recently passed for chicken farmers in Canada.

As of December 1, 2018, Health Canada moved all medically important antimicrobials (Category I, II, and III) to the Prescription Drug List. This means that these antimicrobials can now only be obtained with a vet prescription (requiring an effective relationship with a veterinarian, or VCPR) and are no longer available over the counter.

Shortly after, on January 1, 2019, the revised Raised by a Canadian Farmer Animal Care Program came into effect, making it mandatory that chicken farmers develop a flock health plan. While these are two separate initiatives, they align in recognition of the important role played by veterinarians in maintaining animal health, public health, and mitigating consequences associated with animal diseases.

What is a VCPR?

The veterinarian-client-patient relationship (VCPR) at its core describes the professional working relationship between a veterinarian, a client, and the patient. This must be established before a veterinarian can extend professional services to a client, except in emergency circumstances. A VCPR is not established by simply signing a contract with a veterinarian. Rather, the medical records must show evidence of professional interaction between the veterinarian, client, and patient. This can include records of diagnostic tests, recommendations, case follow-up, and farm visits. The medical records must substantiate that an appropriate VCPR exists.

In Canada, the provincial regulatory body for veterinarians sets the standard for what is necessary and sufficient for a valid VCPR. In Ontario for example, a VCPR exists when the following conditions are met. First, the veterinarian has described the scope and extent of their services and the client has accepted these. The veterinarian assumes the responsibility for clinical assessments, decisions, and recommendations regarding the health and welfare of the animals. The veterinarian must be satisfied that they have recent and sufficient knowledge of the patient, management, and facilities in order to make informed assessments. Lastly, the client agrees to follow the veterinarian’s recommendations and prescriptions. The establishment of a VCPR can happen through conversation, with key aspects noted in the medical record.

Under the VCPR, the client may work with more than one veterinarian, depending on what veterinary specialization is needed. In the context of agriculture, this relationship may not necessarily be established with the poultry farmer, but rather with a designated agent that is authorized to represent the owner, such as a flock manager or field service person. And once a VCPR is established, it is usually not necessary for the veterinarian to physically be at the farm each time they make a recommendation. Once they are familiar with the flock and the farmer or flock manager, advice and recommendations may sometimes be given over phone or email, based on lab results, for example.

VCPR and developing a flock health plan

Consulting with a poultry veterinarian in order to develop a flock health plan is a great way to initiate a VCPR and can be the backbone of this relationship. The purpose of the flock health plan is to create a planned, managed approach to flock health that promotes both the health and welfare of the birds. The plan is a living document that should provide strategies for disease prevention, rapid diagnosis, and effective treatment.

To assist with this, a flock health plan SOP has been provided in the new Animal Care Program manual. A poultry veterinarian can further assist with recommending appropriate vaccination programs and protocols for disease prevention and managing sick or injured birds. Veterinarians should be considered members of the flocks’ health management team, as they can play a valuable role in development and design of production systems and prevention practices.

Benefits of working with a veterinarian

Investing in a VCPR and working with a veterinarian is not only useful at the time of a flock health emergency when treatment is needed, but also in developing and reviewing farm management techniques to avoid emergencies in the first place. The expertise and advice of a veterinarian can not only improve flock health, but also the bottom line.

By working on preventative healthcare in the flock, the veterinarian can help you to improve key performance and welfare parameters such as feed conversion ratio, livability, condemnations, and footpad scores. Even a small improvement can have a large impact on profit. For example, the economic benefit of veterinary advice leading to a 1% reduction of condemnation in a chicken broiler flock of 25,000 marketed at 2.2 kg, would lead to an additional 550 kg per flock. If priced at $1.60 per kg, it would translate to a gross increase in income of $880, that otherwise would be lost.

A 2% reduction in mortality would bring in $1,750, which could be achieved through mitigation of issues with E. coli infection or necrotic enteritis. Working with a veterinarian on preventative flock health can have an excellent return on investment for your farm.

 

With credit to the Ontario Association of Poultry Veterinarians for content in this article.

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