49 Pa. Code § 31.21 - Rules of Professional Conduct for Veterinarians

Preamble

The Board is empowered under section 5(2) of the act (63 P. S. § 485.5(2)) to adopt rules and regulations of professional conduct appropriate to establish and maintain a high standard of integrity, skill and practice in the profession of veterinary medicine. In accordance with this authority, the Board has determined that the following rules are necessary in the public interest to protect the public against unprofessional conduct on the part of veterinarians. The Board therefore adopts this professional conduct code for veterinarians practicing veterinary medicine in this Commonwealth. Some of the rules of conduct are imperatives, cast in the terms, "shall" or "may not." Veterinarians who fail to adhere to these rules will be subject to professional discipline. Other rules, generally cast in the terms "may" or "should," are intended as aspirational goals and define areas under which the veterinarian has professional discretion. No disciplinary action will be taken when a veterinarian acts within the bounds of discretion. References throughout this professional conduct code to imperative conduct on the part of veterinarians also apply to applicants for licensure and temporary permit holders where these persons render services under qualified supervision.

Principle 1. Competency.

(a) Veterinarians should strive continually to improve their veterinary knowledge and skill, making available to clients and their colleagues the benefit of their professional attainments. A veterinarian should provide opportunities for professional colleagues who request to observe the veterinarian's practice to develop or improve a professional colleague's veterinary medical skills.

(b) Veterinarians should seek, through consultation, the assistance of other veterinarians or other licensed professionals when it appears that the quality of veterinary service may be enhanced through consultation.

(c) A veterinarian shall recommend referral to a specialist or otherwise more qualified veterinarian in any case if the care and treatment of the animal is, in the veterinarian's sound judgment, beyond the veterinarian's capabilities or equipment. In that case, a veterinarian may accept or continue care and treatment of an animal after the veterinarian has done the following:

(1) Suggested referral.

(2) Explained the rationale for referral.

(3) Explained the possible complications from the veterinarian's lack of expertise or equipment.

(4) Obtained written consent from the client.

(d) Veterinarians shall participate in continuing education programs as provided under section 18 of the act (63 P. S. § 485.18).

(e) Veterinarians shall safeguard the public and the veterinary profession against veterinarians deficient in professional competence, professional conduct or ethical conduct as described in this chapter.

(1) When a veterinarian knows or has reason to believe that a professional colleague's actions demonstrate deviation from or failure to conform to the standards of acceptable and prevailing veterinary medical practice or professional incompetence, a veterinarian should bring the behavior to the attention of the colleague.

(2) A veterinarian shall bring the behavior of another veterinarian to the attention of the Board by sending a written report to the Bureau of Professional and Occupational Affairs, Professional Compliance Office, P. O. Box 2649, Harrisburg, PA 17105-2649 if one or more of the following applies:

(i) The veterinarian cannot informally resolve an issue of the deviation from or failure to conform to the standards of acceptable and prevailing veterinary medical practice or professional incompetence with the other veterinarian.

(ii) The veterinarian learns of repeated deviation from or failure to conform to the standards of acceptable and prevailing veterinary medical practice, professional incompetence or misconduct.

(iii) The matter involves animal abuse or neglect.

Principle 2. Professional responsibility.

(a) The principle objectives of the veterinary profession are to render service to society, to conserve livestock resources and to prevent and relieve suffering of animals. Veterinarians should conduct themselves in relation to the public, their colleagues and the allied professions so as to merit their full confidence and respect.

(b) Veterinarians have a moral and ethical responsibility to provide service when, because of accidents or other emergencies involving animals, it is necessary to save an animal's life or to relieve its suffering. Veterinarians should join with colleagues in their locality to assure that emergency services for animals are available to the public consistent with the needs of the locality.

Principle 3. Unprofessional or unethical conduct.

A veterinarian who engages in unprofessional or unethical conduct may be subject to disciplinary action under section 21(1), (11), (12) or (20) of the act (63 P. S. § 485.21(1), (11), (12) or (20)). Unprofessional or unethical conduct includes:

(1) Placing the veterinarian's professional knowledge, attainments or services at the disposal of a lay body, organization or group for the purpose of encouraging unqualified groups or individuals to perform surgery upon animals or to otherwise practice veterinary medicine on animals that they do not own.

(2) Performing or participating in a surgical procedure when the veterinarian knows that surgery has been requested with intent to deceive a third party.

(3) Performing surgical procedures on a species for the purpose of concealing genetic defects in animals to be shown, raced, bred or sold. If the health or welfare of an animal requires correction of a genetic defect, the surgical procedures will be permitted. In these instances, the veterinarian shall clearly inform the owner of this fact and note the reason for the surgery on the veterinary medical record of the animal.

(4) Engaging in merchandising.

(5) Representing conflicting interests, except with written consent of parties known to the veterinarian given after a full disclosure of the facts. Representing conflicting interests includes being employed by a buyer to inspect an animal for sale and accepting a fee from the seller and providing veterinary medical advice regarding a common matter to multiple persons interested in the matter.

(6) Issuing any certificate attesting to the physical condition or soundness of an animal without first having personally examined the animal within a reasonable period of time and, by actual inspection and appropriate tests, determined that the animal meets the requirements for issuance of the certificate. A veterinarian may permit an employee to collect samples from animals for tests under the veterinarian's direct supervision.

(7) Failing to personally sign any official health document issued by the veterinarian unless the use of a signature stamp is authorized by law.

(8) Issuing a presigned or prestamped official health document.

(9) Allowing inapropriate use of the veterinarian's signature stamp.

(10) Engaging in conduct which a reasonable person would believe is intended to coerce, pressure or intimidate another person to file, not file or withdraw a complaint made to the Board or any law enforcement official regarding matters related to a veterinarian's practice.

(11) Offering compensation beyond continued or corrective treatment of an affected patient or the replacement value of a patient, which a reasonable person would believe was intended to induce another to file, not file or withdraw a complaint made to the Board or any law enforcement official regarding matters related to a veterinarian's practice.

(12) Abusing, harassing or intimidating a client, former client, colleague, associate veterinarian or employee in the course of professional practice.

(13) Making any false, misleading or deceptive statement or claim as defined in Principle 5(a) (relating to advertising).

(14) Delegating a veterinary medical service to a certified veterinary technician, veterinary technician specialist or individual not licensed to practice veterinary medicine that is beyond the scope of practice for that individual as defined by law or regulation or who the veterinarian knows or should know is not qualified by education, training, experience, license or certification, to perform. The veterinarian delegating a veterinary medical service shall perform a reasonable investigation of the delegatee's ability to competently perform the service before delegating the service and shall provide supervision of the service consistent with the acceptable and prevailing standards of veterinary medical practice. A veterinarian who delegates a veterinary medical service to an individual not licensed to practice veterinary medicine shall be responsible for the acts and omissions of the delegatee.

(15) Abusing or neglecting any animal, as defined in § 31.1 (relating to definitions), whether or not the animal is a patient.

(16) Failing to report a matter to the Board as required by Principle 1(e).

Principle 4. Fees.

(a) Financial arrangements for the rendering of veterinary services should be in accord with professional standards that safeguard the best interests of the client and the animal. Fees for professional services shall be clearly explained to the client in advance of billing.

(b) Veterinarians may not pay or receive commissions, rebates or other forms of remuneration for referral of clients for professional services, without informing the client of the arrangement.

(c) Veterinarians may not solicit or accept a commission, rebate or referral fee in connection with the referral of a client to purveyors of merchandise or services, including purveyors of dog food, cremation or burial services, caskets, urns, insurance, breeding stock and livestock supplies, unless the payments are fully disclosed to the client.

(d) Veterinarians may not participate in an action which would have the effect of coercing, pressuring or achieving agreement among veterinarians to conform to fixed fees or a fee schedule.

(e) Veterinarians may not solicit clients or announce fees and services in a manner that is misleading, fraudulent or deceptive.

Principle 5. Advertising.

(a) Advertising by veterinarians is permissible when it does not include false, deceptive or misleading statements or claims. A false, deceptive or misleading statement or claim is one which does one or more of the following:

(1) Contains an unrealistic prediction of future success or a guarantee that satisfaction or a cure will result from the performance of professional services.

(2) Refers to secret drugs or secret methods of treatment for special services and which could be characterized as deceptive.

(3) States or implies that a veterinarian is a specialist, unless the veterinarian is a diplomate of an American Veterinary Medical Association-recognized specialty organization.

(4) Contains a material misrepresentation of fact.

(5) Contains a representation or implication that is likely to cause a reasonable person to misunderstand or be deceived, or fails to contain reasonable warnings or disclaimers necessary to make a representation or implication not deceptive.

(b) Testimonials and endorsements by veterinarians pertaining to veterinary products or veterinary equipment are permissible if all of the following guidelines are met:

(1) If an endorsement represents that the endorser uses the endorsed product, the endorser shall be a bona fide user of the product.

(2) The endorser shall be able to adequately substantiate that the endorser's experience with the product is representative of what consumers will generally achieve with the advertised product in actual conditions of use. Adequate substantiation implies publication of a report in a journal in which articles are open to peer review or in a publication recognized by reputation as a source of reliable scientific information.

(3) The endorser's qualifications shall be consistent with the expertise that the endorser is represented as possessing with respect to the endorsement.

(4) The endorsement shall be supported by an actual exercise of the endorser's expertise in evaluating product features or characteristics which shall include an examination or testing of the product as extensive as someone with the same degree of expertise would need to evaluate the product features or characteristics to support the conclusions presented.

(c) Advertising by veterinarians for emergency veterinary services shall provide information as to whether a veterinarian is on the premises, or on call, and shall specify the hours during which emergency services are available.

(1) For the purposes of this section, "on the premises" means that a veterinarian is physically present at the veterinary establishment and is immediately available to render emergency services. "On call" means that a veterinarian is available to return calls requesting emergency services within a reasonable time and is available to render emergency services within a reasonable time.

(2) Veterinarians shall disclose specific limitations (that is, exotics/avian/large animal/small animal) when advertising emergency services.

Principle 6. Professional relationships.

(a) Veterinarians should seek for themselves and their profession the respect of their colleagues. Veterinarians may not belittle or injure the professional standing of another member of the profession or condemn the character of that person's professional acts in a manner which is false or misleading.

(b) Veterinarians may seek, through consultation, the assistance of other licensed professionals, including chiropractors, dentists, dental hygienists and physical therapists, when it appears that chiropractic, dental, dental hygiene or physical therapy procedures will enhance the quality of veterinary care. Chiropractic, dental, dental hygiene and physical therapy procedures shall only be performed upon animals by chiropractors, dentists, dental hygienists and physical therapists in conjunction with the practice of veterinary medicine and under the direct supervision of a veterinarian, subject to a limitation provided by law or regulation.

(c) When a veterinarian is called into consultation by an attending veterinarian, the consultation should be conducted in a spirit of professional cooperation to assure the client's confidence in and respect for veterinary medicine. Findings and discussions with the client shall be handled in a manner that avoids criticism of the attending veterinarian by the consultant.

(d) Veterinarians who act as consultants may not revisit the animal or communicate in person with the client without the knowledge of the attending veterinarian.

(e) In dealing with referrals, veterinarians acting as consultants may not take charge of a case or problem without the consent of the client and notification of the referring veterinarian.

Principle 7. Responsibility to clients and patients.

(a) Except as provided in this subsection, veterinarians may choose whom they will serve, but may not neglect an animal with which the veterinarian has an established veterinarian/client/patient relationship.

(1) During a veterinarian's regular business hours, a veterinarian may not refuse to provide euthanasia to relieve the suffering of an animal that is physically presented to the veterinarian at the veterinarian's facility. A veterinarian may provide euthanasia for an animal under this paragraph without a veterinarian/client/patient relationship if the owner is unknown or cannot be contacted. If the owner is unknown, the veterinarian shall make a reasonable attempt to determine the identity of the animal's owner, including, at a minimum, checking the animal for a tag, tattoo or microchip. If the owner is known or identified, the veterinarian shall make a reasonable attempt to contact the owner, including, at a minimum, telephoning or using another contact method found on the animal's tag or microchip, and obtain consent to euthanasia or treatment. If the owner cannot be identified or cannot be contacted, the veterinarian shall exercise proper veterinary medical judgment to determine whether to provide euthanasia or other veterinary medical care to the animal.

(2) If a veterinarian deems it necessary to discontinue the treatment of an animal with which the veterinarian has a veterinarian/client/patient relationship, the veterinarian shall give written notice to the client of his intention to withdraw and provide reasonable time, based on the condition of the animal and the availability of alternative veterinary medical services, to allow the client to obtain necessary veterinary care for the animal.

(b) Veterinarians shall consider first the welfare of the animal for the purpose of relieving suffering and disability while causing a minimum of pain or fright.

(c) Veterinarians and their staffs shall protect the personal privacy of clients, unless the veterinarians are required by law to reveal the confidences or it becomes necessary to reveal the confidences to protect the health and welfare of an individual, the animal or others whose health and welfare may be endangered. Personal information that should be protected under this section includes a client's Social Security number and sensitive financial information and confidential health information about the client. Veterinary medical records of a client's animals shall be released to the Board or its agents upon demand, as set forth in section 27.1(b)(1) of the act (63 P. S. § 485.27a(b)(1)). Any portion of a veterinary medical record relevant to public health shall be released to public health or law enforcement officials upon demand. Veterinary medical records shall be released to the general public only with the written consent of the client, subpoena or court order.

(d) Veterinarians shall practice in accordance with current advancements and acceptable and prevailing standards of care in veterinary medicine, including using current proven techniques, drugs and scientific research that may affect treatment decisions. Veterinarians shall practice in accordance with advancements and acceptable and prevailing standards of veterinary medical practice in this Commonwealth related to the pharmacologic properties, indications and contraindications of drugs and biologics.

(e) Veterinarians shall explain the benefits and reasonably anticipated significant potential risks of treatment options to clients. When the client or client's agent is present, veterinarians shall document, by signature, the client's consent for euthanasia and other treatments that have significant potential risks. If the client is not present to provide a signature, veterinarians shall attempt to contact the owner by telephone or other established means to obtain oral consent and shall document the oral consent in the animal's veterinary medical record. This subsection does not preclude a veterinarian from obtaining general consent to treatment that is effective whenever circumstances require veterinary medical intervention in the best interests of the patient within parameters previously discussed with the client.

(f) Veterinarians shall serve as patient advocates especially regarding the alleviation of pain and suffering, consistent with the acceptable and prevailing standards of veterinary medical practice. Veterinarians shall utilize analgesic drugs, dosages, treatment intervals and combination therapies proven to be safe and effective in different species and in various conditions of age, illness or injury in accordance with current veterinary medical knowledge and acceptable and prevailing standards of veterinary medical practice in this Commonwealth.

(g) If a client desires to consult with another veterinarian about the same case, the first veterinarian shall readily withdraw from the case, indicating the circumstances on the veterinary medical record of the animal, and shall forward copies of the animal's veterinary medical records in a reasonable period of time to other veterinarians who request them. For purposes of this subsection and subsection (h), the reasonableness of the period of time shall be based on the nature of the animal's condition and the transfer shall be sufficiently timely to accommodate the animal's veterinary medical needs, but may not be longer than 3 business days after the client makes the request.

(h) If a client requests referral to another veterinarian or veterinary hospital, the attending veterinarian shall honor the request and facilitate the necessary arrangements, which includes forwarding copies of the veterinary medical records of the animal in a reasonable period of time to the other veterinarian or veterinary hospital.

(i) A veterinarian who keeps a client's animal while the practice is closed (including evenings and weekends) shall inform the client, either orally or in writing, whether a veterinarian, certified veterinary technician or veterinary assistant will be on the premises and what level of monitoring the animal will receive during that time.

Principle 8. Drugs.

(a)

(1) The term "drug" means:

(i) Substances recognized in the official United States Pharmacopoeia, official National Formulary, or Federal Food and Drug Administration Approved Animal Drug Products, or any supplement to them.

(ii) Substances intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease in man or other animals.

(iii) Substances (other than food) intended to affect the structure or any function of the human body or other animal body.

(iv) Substances intended for use as a component of any substance specified in subparagraph (i), (ii) or (iii), but not including devices as that term is defined in section 2 of The Controlled Substance, Drug, Device and Cosmetic Act (35 P. S. § 780-102).

(2) The term "prescription drug" means any drug required by Federal law, including Federal regulation, to be dispensed only by a prescription.

(b) A veterinarian shall only prescribe prescription drugs to animals that are under the veterinarian's care. "Under the veterinarian's care" means that the veterinarian or one of the veterinarian's licensed associates has examined the animal or has made medically appropriate and timely visits to the premises where the animal is kept.

(c) Prescription drugs dispensed by a veterinarian, other than drugs for food animals, shall be dispensed in child resistant packaging or in the manufacturer's original packaging, except when the client specifically requests other packaging.

(d) Prescription drugs dispensed by a veterinarian shall be labeled with, at a minimum, the following information:

(1) The name, address and telephone number of the prescribing veterinarian and the name and telephone number of the dispenser, if different.

(2) The brand or generic name of the drug.

(3) The potency and the quantity of the drug.

(4) The number of refills allowed, if any.

(5) Adequate directions for use, which shall include quantity of dose, frequency of administration or application, duration of administration or application, and route or method of administration or application.

(6) Any cautionary statement specified by the veterinarian or required by law.

(7) The name of the patient, if applicable.

(8) The date the drug was dispensed.

(9) The expiration date of the drug.

(e) Veterinarians shall dispense or administer only drugs, including prescription drugs, that are within the expiration date specified by the manufacturer, and shall dispense or administer only drugs that will not expire within the prescribed treatment period.

(f) Veterinarians shall maintain records related to drugs in accordance with § 31.22 (relating to recordkeeping rationale).

Notes

49 Pa. Code § 31.21

The provisions of this § 31.21 adopted February 1, 1965; amended January 12, 1979, effective 1/13/1979, 9 Pa.B. 154; amended March 18, 1994, effective 3/19/1994, 24 Pa.B. 1481; amended November 27, 1998, effective 11/28/1998, 28 Pa.B. 5870; amended May 12, 2000, effective 5/13/2000, 30 Pa.B. 2357; amended December 5, 2003, effective 12/6/2003, 33 Pa.B. 5920; amended April 17, 2009, effective 4/18/2009, 39 Pa.B. 1985; amended July 16, 2010, effective 7/17/2010, 40 Pa.B. 3952; amended November 2, 2012, effective 11/3/2012, 42 Pa.B. 6897.

The provisions of this § 31.21 amended under sections 5(2) and 21(11) and (12) of the Veterinary Medicine Practice Act (63 P.S. §§ 485.5(2) and 485.21(11) and (12)).

This section cited in 49 Pa. Code § 31.1 (relating to definitions); 49 Pa. Code § 31.38 (relating to code of ethics for certified veterinary technicians); and 49 Pa. Code § 43b.21 (relating to schedule of civil penalties-veterinarians and veterinary technicians-statement of policy).