As a veterinarian, one of the things I dreaded (besides more paperwork) when the Veterinary Feed Directive (VFD) came about was hearing producers say, “This is just an excuse for vets to charge me more money.”
I also didn’t look forward to having to turn away potential clients when they asked for a VFD because I did not have a valid veterinary-client-patient relationship (VCPR) with their operation. I was sure when they heard the word “relationship,” they would run for the door, reminding me of my dating experiences in college.
As with many things government, the VCPR appears complicated. It really isn’t. As scary as it may seem, it is a relationship. It says Dr. X is your veterinarian, and you are the client. And for those people who need clarification, several branches of the government help define exactly what that relationship looks like. Let’s face it: For the noncommittal types, a phone call isn’t going to cut it as a relationship.
Certainly, phone calls are a good thing, but they don’t replace face-to-face interaction. When was the last time a physician prescribed a new medication for you without seeing you? Exactly.
The VCPR came about for a good purpose. As prescription medications became more restricted, guidelines were developed surrounding the use of extra-label drug use. Have you ever wanted to use Baytril for scours because you’ve been told it works really well?
This is an example of extra-label usage. The label says it is indicated for use in bovine respiratory disease, not diarrhea. Other examples are using medications in a different dosage or route or species than what is on the label.
Why does this matter? There are several good reasons. First, the product has not been used in every way you may want to use it. Therefore, it may not be safe or effective. Withdrawal periods ensure the safety of our food supply. When used extra-label, the established withdrawal period changes.
Then it becomes an educated (or often uneducated) guess that can land you on the violative residue list. By the way, it is illegal to use Baytril for diarrhea. Ask your veterinarian why; it will make for a good ice-breaker.
This is where the VCPR is a good thing. It is simply impossible and way too expensive for pharmaceutical companies to pursue multiple drug labels. It is estimated it takes 10 years and 2.6 billion dollars to bring a new medication on the market. Adding label claims takes time and a lot of money. So the VCPR allows veterinarians to work with their clients to use medications that may not have the exact label claim for their situation.
Now that you understand why the VCPR exists, and why it is a good thing meant to help and guide our medication choices, let’s do a quick rundown of the small print. The accompanying sidebar (on page 44) is the frame-able version of the VCPR. One thing you may notice is: There is a lot of responsibility placed on the veterinarian. (Vets noticed this also.) As the client, you have two main responsibilities: to follow the veterinarian’s directions and to keep records.
The record-keeping portion may be completely new for you. Or perhaps you keep good records already. I have found some of my clients needed to add a place to record the amount given and the person who administered the medication. This is information you need to know as a producer.
Not only does it help you track your inventory, but it may reveal why a particular medication isn’t working. (They may be giving a Holstein the same dose as a Jersey.) Your records need to include date, product name, route, amount and administrator name or initials.
Specifically, records should identify the animal or groups of animals treated, the species, the number of animals if a group was treated, the condition being treated (diagnosis), the medication name, duration of treatment (number of treatments and how often – once a day for three days, for example), withdrawal period (meat and milk, if applicable).
These records need to be kept for two years and made available for inspection. Veterinarians have guidelines for the information contained on the medication label. The use of software helps with the record-keeping process. Be sure to make backups of your software so historical information on treatments is available for the two-year period.
Associations like the American Veterinary Medical Association and the American Association of Bovine Practitioners helped give input to the FDA on development of the VCPR. Additionally, some states have regulations that may be more restrictive or may more clearly define some of the guidelines.
These state regulations can be found at a variety of websites, including the FDA page. For example, I live in Texas, and Texas makes a clarification a VCPR may not be solely established by telephone or electronic means.
Please don’t ask a veterinarian to write you a VFD or prescription if they have never done any work for you. If you haven’t hired a veterinarian, or view your veterinarian as a gatekeeper to medications, look for a veterinarian who will provide value in a way important to you.
Your veterinarian should be a trusted adviser and a part of your management team. Their license is on the line when they write a prescription or VFD. Their veterinary education cost them a fortune they are likely still paying for. So you will be hard-pressed to find one who doesn’t take this stuff seriously. Help them help you. 
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Angela Daniels
- Veterinarian
- Circle H Headquarters LLC
- Email Angela Daniels
Veterinarian-client-patient relationship
The veterinarian-client-patient relationship (VCPR) is the basis for interaction among veterinarians, their clients and their patients, and is critical to the health of your animal.
A VCPR means all of the following are required:
1. The veterinarian has assumed the responsibility for making clinical judgments regarding the health of the patient, and the client has agreed to follow the veterinarian’s instructions.
2. The veterinarian has sufficient knowledge of the patient to initiate at least a general or preliminary diagnosis of the medical condition of the patient. This means the veterinarian is personally acquainted with the keeping and care of the patient by virtue of a timely examination of the patient by the veterinarian or medically appropriate and timely visits by the veterinarian to the operation where the patient is managed.
3. The veterinarian is readily available for follow-up evaluation or has arranged for the following: veterinary emergency coverage, and continuing care and treatment.
4. The veterinarian provides oversight of treatment, compliance and outcome.
5. Patient records are maintained.
