While establishing and maintaining a veterinarian-client-patient relationship takes some time and effort, it’s likely simpler than expected, according to one beef cattle veterinarian.
Creating a relationship with a veterinarian can provide great value to producers, says *Dr. Cody Creelman, beef cattle veterinarian at Veterinary Agri-Health Services in Airdrie, Alta. Although a large percentage of producers have no relationship with a veterinarian — the figure is at about 40 per cent in Alberta — Creelman recommends setting up a herd health consultation to access a vet’s knowledge, ensure proper treatment of animals and pharmaceuticals, and to adhere to new regulations on antimicrobial use.
Creelman’s practice specializes in beef cattle, only dealing with cow-calf and feedlot operations, and is part of the Distributed Teaching Hospital Network, working with veterinary students. Veterinary Agri-Health Services developed a thorough format for herd health consultations to meet the requirements of a veterinarian-client-patient relationship (VCPR), as well as existing requirements for prescribing and dispensing pharmaceuticals.
As of December 1, 2018, Health Canada requires that all antimicrobials used in animals are prescribed by and used under the oversight of a registered veterinarian, as stated on the Canadian Veterinary Medical Association’s website. In order for a veterinarian to write a prescription, they must have a documented, valid VCPR with the producer. Even if a producer has previously worked with a veterinarian, this does not necessarily mean they have a current VCPR.
To fulfill this requirement, a producer must establish a relationship with their vet in which the latter has a strong understanding of the herd. The relationship must be documented in medical records and verified by herd visits, giving the vet sufficient knowledge of the herd’s specific health challenges and allowing them to properly assess, diagnose and treat any medical conditions.
In Alberta, as with most provinces, the veterinary industry is self-governed through the Alberta Veterinary Medical Association, which sets out the provincial bylaws and requirements for prescribing and dispensing pharmaceutical products.
“We need to be able to have within our records how many animals that producer has, where he is at, that we’ve seen those animals within a reasonable amount of time, that we understand what’s going on from a herd health perspective,” says Creelman. “Once all of that has been documented, then we’re able to write a prescription.”
If a new producer without a VCPR wanted to start working with any of the vets at Creelman’s practice, they would need to visit the practice for an initial consultation. A vet will sit down with the producer to fill out a herd medical record covering all the details of the herd and its management. This includes herd size, location and geography, calving season, when they start feeding in the winter, mineral programs, deworming, concerns specific to location and any challenges the producer anticipates.
Then, they’ll create a customized vaccination protocol that covers females, bulls and calves, laying out the exact timing and recommended products for the year. They will also review a basic animal health protocol guide that outlines the practice’s expectations for treating diseases and issues that a cow-calf producer may encounter in their herd.
After this initial consultation, Creelman will schedule a site visit with the new client to verify the herd information and condition. With that, the producer would be one of Creelman’s fully integrated clients and hold a valid VCPR. He’ll write the necessary prescriptions for the year’s vaccination protocol. If they’ve discussed any potential health challenges the producer is concerned about, Creelman will ensure they have a prescription for those treatments in case they’re needed.
Once a VCPR is established, it is up to the producer to maintain that relationship. When a producer needs to consult a vet about an issue, the vet adds this communication to the herd medical record. However, going through the initial process does not guarantee the VCPR will remain valid if the producer doesn’t continue the relationship.
“If we did all of that on day one and I didn’t hear from you, and then three years later you came into my practice wanting a bottle of NuFlor, we no longer would have a vet-client relationship,” he says. “There is some room for interpretation, but it has to be reasonable.”
While some producers have expressed concerns about the practicality of these requirements, Creelman doesn’t believe that is an issue. “If a producer genuinely wants to work with me and values that relationship, there’s no impracticality about it — I’m doing all the work,” he says. The initial consultation is free of charge at his practice as a show of good faith.
“We’re going to establish that vet-client relationship together, and now it’s your responsibility as a producer to then work with me and develop that relationship even further,” he says. “I’ve done, I feel like, above and beyond what is expected in order for us to have all of the regulatory components crossed off, but more importantly all of the prudent antimicrobial usage crossed off as well.”
In fact, most of these regulations were in place prior to antibiotics changing from over-the-counter to prescription products; the rules regarding prescribing and dispensing pharmaceuticals have not changed.
“There’s certainly some onus on the producer to be a little bit proactive in this relationship, that it can’t necessarily be five o’clock Friday afternoon with an expectation to walk into any vet clinic across Canada and be able to get access to a product within seconds,” he says. “There is time that is required to go into this to make it all work.”
When a situation like this arises, Creelman will explain to producers that they need to do a herd health consultation and establish a VCPR before he can write that prescription. Often, he knows the producer isn’t happy that they aren’t able to quickly buy what they need.
“But it doesn’t take very long, and it happens every single time, that once they recognize that I’m putting in the time and resources and providing value to them…you see their shoulders relax and they start to smile,” he explains. “There was nothing to be worried about, nothing to be up in arms about and at the end of the day they’ve gotten a lot of value over sitting face-to-face with a professional who’s dedicated to taking care of animals.”
When he’s faced criticism from producers on this topic, Creelman highlights the underlying objectives of the new regulations.
“It would be very difficult for the industry to look itself in the mirror and truly say that there wasn’t misuse of antimicrobials,” he says. “Our job as either ranchers or as nutritionists or as veterinarians is to just improve that usage every day so everyone has access to those tools in the future.”
For producers who want to get the most out of this relationship, Creelman advises putting in the effort before health challenges occur. He recommends working with your vet during the slower summer months to build this connection.
“I think the best piece of advice for producers is just to be proactive in that relationship and to really think ahead and try to make sure that everything is covered.”
He believes expectations need to shift in response to meeting the new regulations. “I think a lot of veterinarians are really keen to make this all work, but at the end of the day they need just a little bit of extra time to be able to put all of the things in place,” he says. “It is a lot of regulatory components that we have to put in, so if we can just get a little bit of help there, then there should be no issues in the future.”
*NOTE: Since this article was written and published in Canadian Cattlemen’s September 2019 issue, Dr. Cody Creelman has left Veterinary Agri-Health Services in Airdrie and has launched his own consulting and subscription service for producers called, Cow Boss.