Prescription drug laws

I have folks get mad at me from time to time when I say that I can't fill a prescription because the pet hasn't had a physical exam within the last year.

Here's the deal.

1) Even in the case of medications that are recurrent and we think we're on the right dose, we may not be. Lots of drugs require monitoring to make sure we're doing the right thing. When I suggest or require blood work for a dog on thyroid supplement, it's not just for poops and giggles. It's because thyroid supplement needs CHANGE OVER TIME. Sometimes they don't. Sometimes they do. I can't predict.

2) Most importantly - IT'S ILLEGAL FOR ME TO PRESCRIBE A MEDICATION TO A PET THAT DOES NOT HAVE A VALID "VETERINARIAN-CLIENT-PATIENT-RELATIONSHIP." This is also known as a VCPR. The same goes in human medicine. If the prescribing physician has not seen the patient within the last year, it's illegal to prescribe. The relationship can be applied to all doctors in a practice. In other words, if any doctor in the practice has seen the pet, then another doctor could, if appropriate, prescribe a medication even if they have not personally seen the pet.

By the way - one veterinarian can't just call another hospital and say, "Hey, would you fill XYZ medication for this pet" if the receiving hospital has never seen the pet. That makes the hospital filling the medication a "pharmacy" and pharmacy laws then apply. Without a registered pharmacist on staff, you're not a pharmacy. Operating as such means big-time fines.

These laws apply to ALL legend drugs. Even the ones that seem harmless. These laws include heartworm prevention!

Oddly enough, there can be two forms of the SAME medication (take, for instance, certain dewormers). One may be over the counter version of the same strength that you could go to the store and buy with no prescription. However, if I happen to buy a different bottle of the stuff (same ingredient, same everything) and it has the magic words, "Caution: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian" then it's illegal for me to sell without all of the i-dotting and t-crossing listed above. Silly, 'eh? Borderline stupid. But, so it is...

So don't get mad at your veterinarian because they say that a physical exam is required for them to fill a medication. They're not just screwing with you. It's not just about money. It's about good medicine, and it's always valuable to make sure you get what you need (nothing less, nothing more). Sometimes it's just plain required by federal law.

AMH