Frequently Asked Questions

If you don’t find the answers you’re looking for here, please contact the MVMA at mvma@michvma.org or 517/347-4710.

Abandoned Animals and Emergency Care
Accreditation and Travel Certificates
Compounding Drugs
Consent Forms
Contract Employees
Controlled Substances
Disposal of Dead Animals
Handling a Difficult Client
Licensed Veterinary Technicians and Practice Assistants
Licensure and Delegation
Medical Records
Medical Waste and Sharps
Microchips
Prescriptions and Internet Pharmacies
Rabies Protocols 
Vaccinations and Expired Medication
Who Can Own a Veterinary Practice?


Abandoned Animals and Emergency Care  

I have an animal that has been abandoned, what steps do I need to take?

The Abandoned Animal Law, Public Health Code 333.18838, states:

  • A veterinarian may dispose of an animal placed in the veterinarian's custody for treatment, boarding, or other care and abandoned by its owner by sending the notices required by this section. The veterinarian shall send a first written notice of an intent to dispose of the animal by certified mail to the owner, at his or her last known address and a second written notice not less than 5 days after sending the first notice. Upon the expiration of 5 days after sending the second written notice to the owner, a veterinarian may dispose of the animal.
  • The disposal of an animal does not release the owner from payment of costs incurred, including the disposal.
  • This section does not prevent the owner or agent from mitigating additional costs by removing the animal from custody of the veterinarian.
  • In the case of an animal abandoned by its owner, the owner is considered to have relinquished all rights to the animal.

Disposal can mean adopting the animal out, turning the animal over to a local shelter or humane society or, as a last resort, euthanasia. Sample letters can be found here: 1st Notification2nd Notification 

Can I be held legally responsible for administering emergency care on a stray animal brought in by a concerned citizen?

As stated in the Good Samaritan act, effective March, 2000, a veterinarian or veterinary technician is not liable for civil damages if an animal has been brought to the veterinarian by a person other than the owner of the animal. Also, the veterinarian will not be held responsible if he/she does not know who owns the animal or is unable to contact the owner of the animal before a decision must be made with respect to emergency treatment or euthanasia. The immunity granted by the Good Samaritan Act applies to both of the following: an injury to an animal or death of an animal that results from acts or omissions by the veterinarian or veterinary technician in providing treatment to the animal or; the euthanasia of a seriously injured or seriously ill animal.

This section does not, however, apply to an act or omission by a veterinarian or veterinary technician amounting to gross negligence or willful and wanton misconduct in providing treatment to an animal. Also, the veterinarian should notify the animal control authority in the county in which the animal is found of the disposition of the treatment rendered to the animal before the end of the first business day following the day treatment is rendered.

Accreditation and Travel Certificates  

What are the requirements to become an accredited veterinarian?

Accreditation is handled by USDA APHIS Veterinary Services and more information can be found on their website. Accreditation is a special designation that allows veterinarians to perform certain tasks generally regulated by USDA APHIS Veterinary Services. This includes activities such as issuing health papers for animals moving from state to state or from the US to another country. It also includes performing certain testing procedures such as EIA testing of horses. Michigan is unique in that administration of a rabies vaccine to dogs must be by an accredited veterinarian.

If I am accredited in another state, will that accreditation transfer to Michigan?

No. You need to be specifically licensed as a veterinarian and USDA accredited in each state where you perform accredited work.

Does my accreditation have to be renewed?

Yes, every 3 years.

Is continuing education required for accreditation renewal?

Yes, you need 3 units of APHIS Approved Supplemental Training (AAST) if you have Category I accreditation. You need 6 units of AAST if you have Category II accreditation. Click here for the AAST online modules. Until about March 2018, a veterinarian could get RACE credit for the USDA online accreditation modules. RACE credit is no longer an option so be aware as taking these online modules may not count as CE credit to renew your Michigan veterinary license. If you take a module at an AVMA conference or other Michigan-approved continuing education provider, your training may count as Michigan CE credit.

Who do I contact if I have questions about Michigan USDA accreditation?

Contact the Michigan USDA APHIS Veterinary Services District Office at 517/337-4700. 


Compounding Drugs 

Can a veterinarian compound medications in the office? Can a pharmacy dispense non-patient specific, compounded products to a veterinarian for office use?

According to LARA:

A veterinarian may compound medications in the office. All applicable laws, rules, and standards of practice must be followed while compounding. A veterinarian is not subject to the accreditation/inspection requirements of MCL 333.17748a, which pertain only to pharmacies who wish to perform sterile compounding.

A veterinarian may purchase non-patient specific, compounded products for in office use/administration from an FDA registered 503B outsourcing facility. You may find a list of FDA registered outsourcing facilities here. The 503B outsourcing facility would also need to be licensed in Michigan as a pharmacy.

Please note that a 503A pharmacy is limited to only dispensing compounded drugs based on a patient-specific prescription and may not dispense non-patient specific compounded drugs to a veterinarian for in office use. Also note that this email may need to be updated if the FDA issues new guidelines regarding animal compounding.


Consent Forms  

How important are consent forms? Because they disrupt my normal business, I hesitate to take the time to use them.

Yes, consent forms are valuable. The importance of documentation cannot be over-emphasized. Even exemplary advice and patient care is difficult to demonstrate without documentation. Signed consent forms document that the service was authorized, and risks were acknowledged by the client – which is what attorneys refer to as informed consent. Consider the use of consent forms prior to anesthesia, surgery, dental procedures, euthanasia, adoption, boarding, hospitalization or transportation and for situations involving behavior modification and zoonoses. Utilization of consent forms may provide an additional layer of protection and discourage certain types of allegations.


Contract Employees   

Is my relief veterinarian an employee or an independent contractor?

The foregoing question is probably not something that keeps most practice owners awake at night. Maybe it should be. Not properly handling a relief veterinarian relationship can lead to a finding by state and/or federal agencies that a relief veterinarian is an employee of the practice, and lead to the practice being liable for past income, FICA, unemployment insurance, and other taxes not withheld for other practice employees. In a worst-case scenario, such a relief veterinarian could be entitled to all the benefits of an employee, not only related to employment taxes, but also related to benefits and payments made by the practice to other employees, including paid time off, 401 (k) contributions, and the like.

To help ensure that relief veterinarians are considered independent contractors, practices should follow the following guidelines:

  1. Have a written agreement reciting important attributes of the engagement demonstrating an independent contractor relationship, including those listed below.
  2. Deal with a relief veterinarian who sells his or her services through a separate legal entity such as a limited liability company or corporation, and who legitimately deducts expenses related to the performance of services from its own income.
  3. Spell out the nonexclusive nature of provision of the services.
  4. Document business terms as you would with any other vendor, including the scope of services, fees, invoicing requirements, and payment terms. The less control exercised by the practice over the scope of services, the better.
  5. Pay on a daily or other lump sum basis, not by the hour or task, and to the entity providing relief veterinarian services, not personally to the veterinarian.
  6. Be sure to issue an IRS Form 1099 to the relief veterinarian for the services.
  7. Do NOT use relief veterinarians as a substitute for an additional doctor, but only occasionally during vacations, medical leaves of absence, and the like.

Read the Full Explanation Provided by the AVMA of Relief Veterinarian, Employee vs. Independent Contractor Here 

 

Controlled Substances  

I have a client who travels a lot and wants me to give her a two-month supply of a controlled substance. Am I allowed to do this?

Yes, you can give a client a two-month supply, but please only do so only for a client with whom you have an established veterinarian/client relationship and keep detailed records of the transaction.

If we are out of a controlled substance but need it to treat one of our patients, can we get it from a neighboring veterinary clinic?

Yes, you can get the drug you need from a neighboring clinic. However, if you are transferring a schedule 2, you would need to fill out the DEA 222 form. If you are transferring schedule 3-5, you will need to create an invoice for your records. Not having a clearly defined paper trail is simply inviting trouble, should something go wrong and the DEA investigates.

Do I still need to submit my annual controlled substance inventory to the State?

Per MCL 333.7321 (2) “Beginning May 1, 1989, and annually thereafter, each person licensed under this article to manufacture, distribute, prescribe, or dispense controlled substances shall inventory all schedule 2 to 5 controlled substances possessed by the person at the time of the inventory. A person described in this subsection may conduct the annual inventory required under this subsection not more than 30 days before May 1, but shall conduct the inventory not later than 60 days after May 1. A person described in this subsection shall retain the inventory required under this subsection for not less than 2 years after the date of the inventory's creation and shall make the inventory available for inspection by the department at the request of the department.”

Sample State of Michigan Annual Controlled Substance Inventory Form 

Schedule 2 drugs should be listed separately from all other drugs and exact counts should be made. For substances listed in schedules 3, 4 and 5, the count or measure may be estimated, but if the container holds more than 1,000 dosage units (pills, etc.), then an accurate count is required. Federal law also requires a biennual inventory be taken and kept on the premises. 

Please note the inventory required by the State of Michigan is different from the inventory required by the DEA. After the initial inventory is taken, the DEA requires a new inventory of all stocks of controlled substances on hand to be done at least every two years. The biennial inventory may be taken on any date, which is within two years of the previous biennial inventory date. It requires the same information as the initial inventory of all controlled substances on hand and is maintained at the registrant’s location for two years and is not sent to the DEA. 

Sample DEA Biennial Inventory Form


How do I report dispensed controlled substances to the State of Michigan?

Board of Pharmacy Administrative Rule 338.3162b states all pharmacies, dispensing practitioners and veterinarians who dispense controlled substances in Schedules 2-5 are required to electronically report this prescription data to the Michigan Automated Prescription System (MAPS).

In an effort to provide more accurate and current prescription information to health professionals, the current reporting schedule has been changed from the 1st and 15th of every month to a daily reporting requirement starting July 1, 2014.  More information can be found on the LARA website.   

You may report your data to the State using one of the two following ways:

1. MAPS Online
In addition to requesting MAPS reports, MAPS Online provides pharmacies and dispensing  practitioners the option to submit prescription data via the Data Entry link within the MAPS Online portal. Submitting prescription data through MAPS Online offers tracking mechanisms to the user, to ensure data has been downloaded successfully and to view any prescription record errors, 24 hours after the upload. Registration to MAPS Online is required to request MAPS reports and to submit prescription data.
MAPS Online Registration
Instructions for MAPS Online Registration
Prescription Data Entry Instructions

2. State of Michigan Data Exchange Gateway
The State of Michigan Data Exchange Gateway (DEG) is the file transfer method used to transfer prescription data to MAPS and also provides users the option of automated data submissions. Registration to the DEG begins with the user emailing MAPS at mapsinfo@michigan.gov with their request for access to the DEG. Registration materials will be forwarded to the user for assistance with access to the DEG along with a user id and password (please allow 5-7 business days for processing).
State of Michigan Data Exchange Gateway Web-Interface Users Guide
State of Michigan Data Exchange Gateway SSLFTP/SFTP Client Setup 

Contact the Michigan Board of Pharmacy with specific questions through their website or at 517/373-1737.


What data needs to be submitted through MAPS?

When entering prescription data into MAPS for controlled substances dispensed for animals, please keep in mind the following tips:
  • Customer ID: Use the pet owner's identification (driver's license or Michigan ID card) for all controlled substances dispensed for animals.
  • Birth Date: Use the pet owner's date of birth.
  • Patient First Name: Use the pet owner's first name.
  • Patient Last Name: Use the pet owner's last name.
  • NDC Code: Entry requires 11 digits.
  • Rx Number: The system will not accept letters or dashes (-,/); enter only a maximum of 7 digits.
The NDC Guidelines reviews the different formats of NDC codes and how to apply different formats for data reported to MAPS.

Are there exemptions to the controlled substance reporting process?

Reporting exemptions include controlled substances administered to patients, samples of controlled substances provided to a patient, and controlled substances that are dispensed by a physician at a medical institution for a maximum of 48 hours. If a dispenser or practitioner does not have online capabilities, prescription data may be recorded on a CD in the ASAP 4.1 format and mailed to MAPS for submission into the MAPS database.A waiver may be requested by those dispensers or practitioners who do not have the appropriate software to record prescription data, which will enable dispensers to submit their prescription data in paper form. Upon approval of the waiver application, a MAPS Claim Form is required to be completed for each controlled substances dispensed and then mailed to MAPS for submission into the database. 

MAPS Request for Waiver from Electronic Filing Form

MAPS Claim Form


I have several veterinarians at my practice. Can a veterinarian without a controlled substance license use controlled substances obtained by someone else in the practice with a license?

A veterinarian with a Michigan Controlled Substance License and DEA Registration may delegate the administration of a controlled substance to another veterinarian who does not possess a Michigan Controlled Substance license. It’s important that veterinarians realize that this delegated function falls under the Public Health Code Section 333.16215 (I) which states that "a license shall not delegate a task or function that requires the level of education, skill, and judgment required of a licensee.” To comply with the law, the licensed veterinarian must make the determination that a controlled substance is required and must prescribe the substance before the unlicensed veterinarian administers the substance. This means that the unlicensed veterinarian is working under the same constraints as a veterinary technician when controlled substances are involved (such as with euthanasia).

While an associate would save the cost of the DEA registration fee, we ask our members to carefully consider these factors: 

  • As an agent for the practice or registered veterinarian, you can administer or dispense a controlled substance from the practice’s supply, but you cannot order or write prescriptions to be filled outside of the practice. Only a registered practitioner can execute a prescription.
  • A registered practitioner is required by law to conduct a background check of any person they authorize to order, dispense, prescribe, or administer a controlled substance. This can be time consuming and comes at a cost – something that not all practices are willing to do.
  • The registered practitioner’s license would be at risk if the agent were to misuse or divert controlled substances and the registered practitioner did not have sufficient safeguards in place to prevent this from occurring.

Destruction of a Controlled Substance

Most distributors will take back expired medications, but some will not due to the cost associated with destroying the substances. However, the instructions on how a veterinary practice should destroy these substances are not any different than what is recommended for the same task in a personal household. Unless you have a large quantity of substances that need to be discarded. If this is the case you will need to hire an approved contractor to assist with this.
View DEA Disposal Instructions Here

The DEA agent stressed that the two most important parts are to make the substance non-retrievable, and to record your action:

“The process utilized to render a substance "non-retrievable" shall permanently alter the substance's physical or chemical condition or state through irreversible means and thereby render the substance unavailable and unusable for all practical purposes. A substance is considered "non-retrievable" when it cannot be transformed to a physical or chemical condition or state as a controlled substance or controlled substance analogue.”

You will need to complete a Registrant Record of Controlled Substances Destroyed DEA Form 41. If you are destroying a schedule 2 substance, you will need to complete and submit a 222 form. Substances considered schedule 3-5 do not have a special form, but you should record in detail your actions with these substances in case you need to submit proof to the DEA.

View a List of Michigan Household Drug Take Back Programs Here


Disposal of Dead Animals

How can veterinarians dispose of dead animals?

The disposal of dead animals is regulated by state law and may also be regulated by local ordinance. Details can be found in a brochure from the Michigan Department of Agriculture and Rural Development (MDARD) and at the MDARD website

According to MDARD, "in general, all dead animals must be disposed of within 24 hours after death. The following methods of disposal are allowed by law: burial, burning, composting or rendering. Alternatively, you can contact your local landfill to see if they accept dead animals." When animals cannot be disposed of within 24 hours, there are options for temporary cold storage. This includes refrigeration at no more than 40 degrees Fahrenheit for up to 7 days or freezing at 9 degrees Fahrenheit or below for up to 30 days. These requirements do not apply to "road kill." Note that burning (incineration) will require state and possibly local permits; composting is an option intended for livestock owners to handle daily mortalities on their farm; and animals sent to rendering must be handled and transported by a Michigan licensed dead animal dealer. Animals that have been euthanized with sodium pentobarbital should not be sent to rendering if there is any chance the rendered product would be used in pet food.

There are some pet cemeteries in Michigan that offer burial and/or cremation services. Pet cemeteries are not licensed by the state. They have no state mandate to operate according to standards required of human cemeteries. You are encouraged to make your clients aware of this should they chose burial at a pet cemetery.

How can owners dispose of dead pets (non-livestock)?

Owners need to follow state law and any local regulations. Details can be found in a brochure from the Michigan Department of Agriculture and Rural Development (MDARD) and at the MDARD website. When owners choose to bury animals on their own property, they need to bury their pet within 24 hours after death (or after cold storage), assure burial is at least 2 feet beneath the natural surface of the ground, not allow the animal to be in contact with water (such as lake, stream, groundwater), assure the burial is at least 200 feet away from any wells that supply drinking water, and abide by any local ordinances. Additional requirements are in the MDARD brochure. Cremation services and burial at pet cemeteries are other options. Pet cemeteries are not licensed by the state. They have no state mandate to operate according to standards required of human cemeteries. You are encouraged to make your clients aware of this should they chose burial at a pet cemetery.

How can owners dispose of livestock?

Livestock owners need to follow state law and local regulations. Details can be found in a brochure from the Michigan Department of Agriculture and Rural Development (MDARD) and at the MDARD website. Most livestock owners will use on-farm burial, composting, or a Michigan licensed dead animal dealer and rendering service. On-farm burial can include individual graves or common graves. There are limits on the number of graves and weight of animals per acre. Composting methodology is regulated with specific requirements for set up and monitoring. Details can be found at the MDARD website. Animals that have been euthanized with sodium pentobarbital should not be sent to rendering if there is any chance the rendered product would be used in pet food.  


    Handling a Difficult Client  

    Can I refuse to provide future veterinary care for a difficult client?

    Veterinarians may choose whom they will serve. If there is ongoing treatment, providing a referral rather than severing the veterinary-client-patient relationship, veterinarians may avoid allegations of abandonment. When there is not ongoing medical condition, you can inform the client, preferably in writing, that veterinary services will no longer be provided. In an emergency, you should render service to the best of your ability. Notify the client of your intentions before an emergency arises to help avoid misunderstandings at a potentially emotional time.


    Licensed Veterinary Technicians and Practice Assistants

    What is the difference between a veterinary technician and an assistant in my practice?

    Michigan recognizes veterinary technicians as a licensed health profession subfield of veterinary medicine. A person holding a Michigan license as a veterinary technician can practice as a veterinary technician. Veterinary technicians can use the terms “animal technician” or “animal technologist.” A person who does not hold a Michigan license, while he or she may have training or experience, may not function in the same role as a licensed veterinary technician. Unless specifically authorized by virtue of having a license, a person may not use the terms “veterinary”, “animal technician”, or “animal technologist” in their title. If you employ or work with licensees and non-licensee assistants, keep in mind how you title your staff, the scope of actions permitted by licensees and non-licensees, and your responsibilities in supervising (veterinary technicians and veterinary students) versus delegating and monitoring (non-licensed assistants) your staff.

    What is the scope of practice of licensed veterinary technicians?

    The Michigan Public Health Code, Act 368 of 1978, defines “Practice as a veterinary technician” as “means the practice of veterinary medicine based on less comprehensive knowledge and skill than that required of a veterinarian and performed under the supervision of a veterinarian.” Veterinary technicians may not, though, diagnose animal diseases, prescribe medical or surgical treatment, or perform as a surgeon. A key point is that veterinary technicians must practice under the supervision of a veterinarian. “Supervision” in the Public Health Code is defined as “includes that degree of close physical proximity necessary for the supervising veterinarian to observe and monitor the performance of a veterinary technician.” Another aspect of practice in the Public Health Code for both veterinarians and veterinary technicians is specified limited immunity for emergency treatment or euthanasia of animals whose owner is unknown or cannot be reached. There is also some immunity for reporting abandoned, neglected, or abused animals. These protections do not apply to anyone except licensed veterinarians and licensed veterinary technicians.

    What can assistants who are not licensed veterinary technicians do in my practice?

    Assistants can help you, but not in the same way as a licensed veterinary technician. Veterinarians may delegate procedures to others but the concept of providing supervision to a veterinary technician to practice as a health professional does not apply to general assistants. Also remember that if you delegate anything that is within the practice of veterinary medicine, you must examine the animal first before you ask anyone to do something with it or to it. After delegation, you have a responsibility to observe and monitor performance to assure that expectations are met. Based on a July 2018 Michigan Court of Appeals decision be aware that surgery may not be delegated to anyone other than another licensed veterinarian. The specific rule from the Board of Veterinary Medicine that specifies how to delegate when you do appropriately delegate is:

    R 338.4911 Veterinary examination of patient when procedures are delegated; veterinarian observation of delegatee's performance.

    Rule 11. A veterinarian shall not delegate the performance of acts, tasks, or functions that fall within the practice of veterinary medicine unless the veterinarian has first examined the patient on which the delegated procedures are to be performed and determined the need for such veterinary services. The delegating veterinarian shall observe and monitor the performance of the delegated procedures to the extent necessary to ensure that the activities of the delegatee are within the scope of the orders, assignments, or prescriptions of the veterinarian.

    To add to this, here is how the Public Health Code defines the practice of veterinary medicine:

    “Practice of veterinary medicine” means:

    (a) Prescribing or administering a drug, medicine, treatment, or method of procedure; performing an operation or manipulation; applying an apparatus or appliance; or giving an instruction or demonstration designed to alter an animal from its normal condition.

    (b) Curing, ameliorating, correcting, reducing, or modifying a disease, deformity, defect, wound, or injury in or to an animal.

    (c) Diagnosing or prognosing, or both, a disease, deformity, or defect in an animal by a test, procedure, manipulation, technique, autopsy, biopsy, or other examination.

    Are there certain acts, tasks, or functions that may not be delegated?

    Yes. Based on a recent (July 12, 2018) Michigan Court of Appeals decision, a veterinarian may not delegate any surgery to anyone other than another licensed veterinarian. In this case, a veterinarian whose license had been revoked, was performing spay-neuter surgeries based on delegation from a licensed veterinarian. The Court cited MCL 333.16215(1) which prohibits a licensee from delegating an act, task, or function that, “under standards of acceptable and prevailing practice, requires the level of education, skill, and judgement required of [a] licensee…” Testimony at the hearing established that the “acceptable and prevailing practice” for veterinary medicine does not allow for the delegation of surgery to an individual who is not licensed at the time. Unless there is further direction by the Michigan Court of Appeals or the Michigan Supreme Court, the decision in this case is the law of Michigan.

    What are the exceptions to practicing as a veterinarian?

    The Public Health Code has four exceptions to what is considered to be the practice of veterinary medicine. In other words, these are activities that can be carried out without veterinary supervision or delegation or without a license. These are found in MCL 333.18814. A general summary is:

    • Livestock owners administering to their own livestock
    • People using animals in biomedical research
    • Pullorum testing under NPIP
    • Regularly employed veterinarians of USDA or veterinarians employed full-time inspecting animals as food for human consumption

    References for Veterinary Technician FAQs:

    If you have questions about specific activities related to supervision and/or delegation, consider contacting MVMA’s attorney. Each member may have a 15-minute free consultation as a member benefit. Contact the MVMA for more information.

    Licensure and Delegation  

    Is there a way to check on the status of a DVM license?

    The Department of Licensing and Affairs (LARA) handles all licensure for health professionals in the State of Michigan. Anyone can verify a license by contacting LARA’s Verification Unit at 517/241-9427 or visiting the State of Michigan website.

    I have met the requirements for licensure as a Michigan veterinarian but do not have my license yet – can I practice as a veterinarian?

    No. You need to actually have your Michigan veterinary license, Michigan Board of Pharmacy license, DEA registration, and USDA accreditation before you can fully perform all the functions of a veterinarian in Michigan. Once you have graduated from veterinary school you are in limbo until you get your licenses. When it comes to just activities considered to be the practice of veterinary medicine, as a veterinary student, there were special provisions for you to perform certain functions while being supervised by a licensed veterinarian. As a non-student, non-licensed individual, guidelines for supervision by a licensed veterinarian do not apply. It is possible for a licensed veterinarian to delegate certain veterinary practice tasks to you. Surgery is not something that can be delegated.

    What is delegation?

    “Delegation” is defined in the Michigan Public Health Code. It means “an authorization granted by a licensee to a licensed or unlicensed individual to perform selected acts, tasks, or functions that fall within the scope of practice of the delegator and that are not within the scope of practice of the delegatee and that, in the absence of the authorization, would constitute illegal practice of a licensed profession.” MCL 333.16104

    There are limits as to what can be delegated. When delegation is appropriate, veterinarians may delegate the performance of acts, tasks, or functions that fall within the practice of veterinary medicine as long as:

    • The veterinarian first examines the animal and determines the need for the procedure being delegated and
    • The veterinarian provides oversight through appropriate observation and monitoring.

    Specifically, the rule from the Board of Veterinary Medicine is:

    R 338.4911 Veterinary examination of patient when procedures are delegated; veterinarian observation of delegatee's performance.

    Rule 11. A veterinarian shall not delegate the performance of acts, tasks, or functions that fall within the practice of veterinary medicine unless the veterinarian has first examined the patient on which the delegated procedures are to be performed and determined the need for such veterinary services. The delegating veterinarian shall observe and monitor the performance of the delegated procedures to the extent necessary to ensure that the activities of the delegatee are within the scope of the orders, assignments, or prescriptions of the veterinarian.

    Are there certain acts, tasks, or functions that may not be delegated?

    Yes. Based on a July 12, 2018 Michigan Court of Appeals decision, a veterinarian may not delegate any surgery to anyone other than another licensed veterinarian. In this case, a veterinarian whose license had been revoked, was performing spay-neuter surgeries based on delegation from a licensed veterinarian. The Court cited MCL 333.16215(1) which prohibits a licensee from delegating an act, task, or function that, “under standards of acceptable and prevailing practice, requires the level of education, skill, and judgement required of [a] licensee…” Testimony at the hearing established that the “acceptable and prevailing practice” for veterinary medicine does not allow for the delegation of surgery to an individual who is not licensed at the time. Unless there is further direction by the Michigan Court of Appeals or the Michigan Supreme Court, the decision in this case is the law of Michigan.

    Who can administer a rabies vaccination?

    Rabies vaccinations for dogs must be given by a licensed and accredited veterinarian. The accreditation requirement is in PA 339 of 1919, the Dog Law:

    287.266 Sec. 6 (8) The owner of a dog that is required to be licensed under this section shall keep the dog currently vaccinated against rabies by an accredited veterinarian with a vaccine licensed by the United States department of agriculture.

    The Michigan Department of Agriculture and Rural Development (MDARD) has additional information here. MDARD does advise that a licensed and accredited veterinarian may direct a Michigan licensed veterinary technician to administer a rabies vaccination to a dog as long as the licensed and accredited veterinarian has first examined the animal and is close enough to observe and monitor the veterinary technician. The licensed and accredited veterinarian must issue and sign the rabies certificate.

    Rabies vaccinations for other animals must be given by a Michigan licensed veterinarian or as otherwise allowed by the Michigan Public Health Code. A licensed but not accredited veterinarian may direct a Michigan licensed veterinary technician to administer a rabies vaccination to an animal other than a dog as long as the licensed veterinarian has first examined the animal and is close enough to observe and monitor the veterinary technician.

    References for FAQ Graduated but not yet Licensed as a Veterinarian

    Is it legal to act as an animal chiropractor without a veterinary license?

    No. Practicing chiropractic on an animal without a veterinary license is illegal according to the Board of Veterinary Medicine. Chiropractic procedures when performed on animals are considered to be the practice of veterinary medicine. Chiropractors licensed in Michigan have a scope of practice limited to humans. It is possible, however, for a veterinarian to delegate some veterinary procedures as long as he or she first examines the animal, determines the need for specific procedures, and provides appropriate observation and monitoring during the delegated procedures. When it comes to using titles related to chiropractic procedures, be aware that only licensed chiropractors can use terms such as “chiropractic” and “chiropractor” in their title.

      What can be done if someone is thought to be practicing veterinary medicine without a license?

      Practicing veterinary medicine without a license is a felony under the Michigan Public Health Code (MCL 333.16294). Complaints and concerns can be directed to the prosecuting attorney in the jurisdiction where the alleged offenses are occurring. It is our experience, though, that local prosecuting attorneys are often too busy to take on these cases. If the person thought to be practicing without a veterinary license has a license in a different health profession, an option would be to file a complaint with the Michigan Department of Licensing and Regulatory Affairs (LARA). Complaints can be filed here.

      As an alternative, MVMA has developed letters in conjunction with the Michigan Department of Agriculture and Rural Development to send in situations where an MVMA member feels there may be illegal practice activity. If you have a situation like this, please contact the MVMA office for more information.

      Are there certain activities/situations that are specifically not the practice of veterinary medicine and can be done without having a license?

      Yes. In general, these are:

      • Livestock owners administering to their own animals
      • People using animals in biomedical research
      • People conducting pullorum testing through the USDA National Poultry Improvement Plan (NPIP)
      • Regularly employed veterinarians of USDA or veterinarians employed full-time inspecting animals as food for human consumption

        References for FAQ Licensure, Delegation and Practicing Without a License


        Medical Records  

        How long do I have to keep veterinary records?

        See item no. 4 below. Per changes to the Veterinary Administrative Rules there is now a law that governs the data contained in and maintenance of records at a veterinary clinic: R338.4921 Medical records; requirements. Rule 21.

        A veterinarian who practices veterinary medicine in Michigan shall maintain a medical record for each patient that accurately reflects the veterinarian’s evaluation and treatment of the patient. Entries in the patient record shall be made in a timely fashion. The patient record shall contain documentation of a valid veterinarian-patient-client relationship.

        A record shall be maintained on either a herd or flock, or an individual patient. Records shall be legible and shall be retrievable. A record shall be maintained in either a written, electronic, audio, or photographic format.

        A record for an individual patient, group, herd, or flock shall document all of the following:

        1. Identification that may include, but not be limited to, a tattoo, tag number, lot number, pen number, age, name, markings, sex, and species of the patient, as available.
        2. Date of the last veterinary service.
        3. Name, address, and telephone number of the client.
        4. Location of patients, if not at the location of the veterinary practice.
        5. Reason for the contact including, but not limited to, the case history, problem and/or signs of a problem, and whether the contact was a routine health visit or an emergency call.
        6. Vaccination history, when appropriate and if known.
        7. Results of the physical examination and a list of abnormal findings.
        8. Laboratory reports and other reports, when appropriate.
        9. Diagnostic procedures utilized and the reports that pertain to these procedures.
        10. Procedures performed including, but not limited to, surgery and rectal palpations.
        11. Daily progress notes, if hospitalized.
        12. Documentation of informed consent, if appropriate.
        13. Documentation of diagnostic options and treatment plans.
        14. Records of any client communication deemed relevant.
        15. Documentation of prescribed medication.
        16. Records shall be maintained for a minimum of 7 years from the date of the last veterinary service.

        Based on the statute of limitations for bringing certain claims against veterinarians, other general record guidelines include professional malpractice (2 years), negligence (3 years), property damage (3 years) and breach of contract (6 years).

        If a client asks for a copy of the animal’s record, what are my obligations?

        There is no law regarding this subject in Michigan. While the records do belong to the veterinary practice, ethically the veterinarian should provide the client a copy or summary of the medical records when requested. The AVMA’s Principles of Veterinary Medical Ethics states as follows on the topic of medical records:

        1. Veterinary medical records are an integral part of veterinary care.
        2. Medical records are the property of the practice and the practice owner.
        3. Ethically, the information within veterinary medical records is considered privileged and confidential. It must not be released except by court order or consent of the owner of the patient.
        4. Veterinarians are obligated to provide copies or summaries of medical records when requested by the client.
        5. Without the express permission of the practice owner, it is unethical for a veterinarian to remove, copy, or use the medical records or any part of any record.


        Medical Waste and Sharps  

        Is there a list of State-approved medical waste removal services?

        The Michigan Department of Environmental Quality has the best information.

        What are sharps as defined by the state?

        Sharps are part of the medical waste that is regulated by the State of Michigan. They include needles, scalpels, syringes and IV tubing with needles attached, and those parts of a syringe, with or without an attached needle, that are contaminated with an infectious agent.


        How do I develop a plan for medical waste management at my practice?

        The State of Michigan has provided several documents to help get you started:
        Michigan's Medical Waste Regulatory Program
        Sample Medical Waste Management Plan
        Medical Waste Regulatory Program Frequently Asked Questions
        Information on Sharps
        Sharps Collection Programs for Michigan Residents

        Carcass Disposal

        The Michigan Department of Agriculture & Rural Development's rules entitled "Bodies of Dead Animals" for on farm composting were approved with the Great Seal on September 26, 2007. The rules provide for composting of dead animals and animal tissue within a structure, in open piles, windrows, and contained vessels. These additional alternatives for disposal of dead animals will assist producers who have no rendering services, licensed landfills that accept dead animals, or soil types for proper burial. Learn More Here


        Microchips  

        Are licensed veterinarians the only ones authorized to microchip an animal?

        According to the Board of Veterinary Medicine, microchipping for identification purposes is not considered a veterinary procedure as I understand the process and therefore is routinely done be shelters, breeders, etc. The chip numbers should be recorded with the company that manufactures the chips so they can be put in a national database.


        Prescriptions and Internet Pharmacies  

        When writing a prescription and sending a client home with medications, what is the minimum labeling that needs to be on the items?

        R 338.4920 Safeguards for drugs used in practice of veterinary medicine. Rule 20. (1) If drugs are dispensed in the manufacturer's original container, the
        original instructions shall be included.

        (2) If drugs are dispensed in other than the manufacturer's original container, both of the following provisions shall apply:

        (a) The container shall be equipped with a child-safe lock mechanism, if appropriate.  

        (b) The veterinarian's own label shall be affixed to the container and shall include all of the following information:

        (i) The date the drug was dispensed.

        (ii) The name of the patient.

        (iii) The name of the client.

        (iv) Complete instructions for use of the drug.

        (v) The name of the drug.

        (vi) The strength for unit dose.

        (vii) The quantity dispensed.

        (viii) The withholding time for food-producing animals and poultry.

        (ix) The expiration date of the drug, when appropriate.

        (x) The veterinarian's name or clinic's name, telephone number, and any appropriate precautionary statements, such as "Keep out of reach of children."


        May I fill a prescription written by another veterinarian if I have a relationship with the veterinarian but not with the client?

        There are three main ways a client may fill any prescription written for use in their animal: from the issuing veterinarian if they keep it in stock; the veterinarian can write (or call in) a prescription to a local pharmacy that stocks the medication; the veterinarian can provide a prescription so the client can get the medication from an online pharmacy. In Michigan veterinary prescription drugs are to be used or prescribed only within the context of a veterinarian-client-patient relationship (VCPR). Although it sounds like you have a standing relationship with the doctor, if the VCPR isn’t in place we would strongly recommend you do not fill the prescription. If there were to be an issue after the animal ingests the drug your license may be at risk if the VCPR isn’t in place. If the doctor in question doesn’t work with another pharmacy, etc. it might be better to transfer the drug in question to the clinic itself and then allow them to dispense as appropriate. You had stated this was not a controlled substance, but the recommendation is based on the best way to protect your actions in general. 

        A client asked me to write a prescription rather than have me dispense the drug out of my clinic. What are my rights and responsibilities?

        Both the AVMA and MVMA recommend that a valid Veterinarian Client Patient Relationship (VCPR) is in place. Veterinarians are not obligated to prescribe when requested to do so by a third party, i.e. a pharmacist. The request must be made by the client. It is ethical for veterinarians to refuse a prescription if clients do not follow instructions, i.e. yearly heartworm test, lab work to evaluate drug effects, etc. Veterinarians should be willing and able to explain to a client when a prescription is appropriate based on AVMA Principles of Veterinary Medical Ethics.

        May I charge for authorizing a prescription?

        The American Veterinary Medical Association (AVMA) does not have a position on this subject. According to the Michigan Board of Pharmacy, there are no regulations preventing a veterinarian from charging a fee for writing a prescription. In general, veterinarians must charge adequately for their professional services to cover the costs of maintaining a veterinary clinic, paying staff, and offering quality medical care to a client’s animal. Some veterinarians have chosen to charge a prescription issuance fee in those cases when the veterinarian does not directly dispense the medication to the client. Some have considered implementing a policy to charge a specified fee, whether a drug is dispensed or prescribed. Others have reviewed fees and the need for any adjustments within the context of all services rendered. And still others charge for their professional services using units of time (e.g. when reviewing prescription drug authorizations or conducting telephone consultations with clients).

        Am I obligated to write a phoned or faxed prescription request from a pharmacy?

        If you are asked to approve a prescription, you should do so only if the prescription is medically appropriate for the patient and you have a valid veterinarian-patient-client relationship. The decision as to whether a prescription drug should be used for a patient is made by you – the veterinarian – not a pharmacy.

        What about internet pharmacies. If they are outside Michigan, must I be licensed in the state of the pharmacy to authorize the prescription?

        No, the client has the option of filling a prescription at any authorized pharmacy. In this example, the veterinarian’s practice of veterinary medicine, which would include writing a prescription, would be confined to his or her state.

        Veterinarians may want to advise clients who choose to fill prescriptions through the Internet to select a VIPPS pharmacy - one that is certified by the National Association of Boards of Pharmacy and has its seal of approval. The national pharmacy association developed the Verified Internet Pharmacy Practice Sites (VIPPS) program in 1999 in response to public concern over the safety of Internet pharmacy practices. VIPPS pharmacy sites are designated by a hyperlink seal. To be VIPPS certified, a pharmacy must comply with the licensing and inspection requirements of the state in which it is located and in each state where it dispenses pharmaceuticals. These pharmacies must also demonstrate compliance with criteria that include patient rights to privacy, authentication and security of prescription orders, adherence to a recognized quality assurance policy, and provision of meaningful consultation between patients and pharmacists.

        If I believe an internet pharmacy has performed an illegal act (for example, dispensing a prescription drug to my client without my authorization as the attending veterinarian who has a veterinarian-client-patient relationship), what should I do?

        Report it! The American Veterinary Medical Association (AVMA) has created a Pharmacy Complaint Form to simplify the reporting process for practitioners. The form identifies the organizations to which the form should be sent. Regulatory agencies cannot act unless they have factual complaints to pursue. Forms can be found on the AVMA website. If you are unable to locate this form on the web contact MVMA at 517/347-4710 and we will send you a copy of the complaint form.

        I’d like to be able to fill human prescriptions for my employees as a benefit to them. Can I do this legally?

        After consulting with the Michigan Board of Veterinary Medicine, we received the following recommendation: "Veterinarians should not fill prescriptions for human treatment. It is probably a fairly common practice as the drugs are the same but it is still dispensing to treat humans and that is practicing human medicine without a license."

         

        Rabies Protocols    

        Is rabies vaccination required for animals in Michigan?

        Rabies vaccination, with few exceptions, is required by state law for dogs and ferrets. Local municipalities may have requirements, too. A few local municipalities require rabies vaccination for cats. Rabies vaccination of dogs is tied to dog licensing. Dogs may be licensed as early as 16 weeks of age, must be licensed by 6 months of age, and must be kept current on rabies vaccinations. Proof of rabies vaccination, with few exceptions, is required for licensing. Ferrets (except those at research facilities) over 12 weeks of age are required to be kept current on rabies vaccinations.

        Who can administer a rabies vaccination?

        Rabies vaccinations for dogs must be given by alicensed and accredited veterinarian. This requirement is in PA 339 of 1919, the Dog Law:

        287.266 Sec. 6 (8) The owner of a dog that is required to be licensed under this section shall keep the dog currently vaccinated against rabies by an accredited veterinarian with a vaccine licensed by the United States department of agriculture.

        The Michigan Department of Agriculture and Rural Development (MDARD) has additional information here. MDARD does advise that a licensed and accredited veterinarian may direct a Michigan licensed veterinary technician to administer a rabies vaccination to a dog as long as the licensed and accredited veterinarian has first examined the animal and is close enough to observe and monitor the veterinary technician. The licensed and accredited veterinarian must issue and sign the rabies certificate.

        Rabies vaccinations for other animals must be given by a Michigan licensed veterinarian or as otherwise allowed by the Michigan Public Health Code. A licensed but not accredited veterinarian may direct a Michigan licensed veterinary technician to administer a rabies vaccination to an animal other than a dog as long as the licensed veterinarian has first examined the animal and is close enough to observe and monitor the veterinary technician.

        What if I think rabies vaccination is contraindicated for one of my canine patients?

        State law, PA 339 of 1919 also known as the Dog Law, does not provide for any exceptions to rabies vaccination when licensing is required. If your client wants to seek an exemption, your client could contact their local animal control agency or local agency that issues dog licenses to seek a possible exemption. Rabies titers may not be used in lieu of rabies vaccinations. The reason is that studies have shown there is no consistent relationship between an animal’s rabies titer and whether or not it is protected from disease when challenged with live rabies virus (JAVMA Vol 248, No. 5, March 1, 2016 pg. 508).

        What are the protocols for animal bites and situations where animals are potentially exposed to rabies?

        The National Association of State Public Health Veterinarians (NASPHV) provides extensive written guidelines on animal rabies. The State of Michigan developed a flow chart (see Guidance Documents and Educational Materials) on how to handle cases of animals biting humans (or other animals) and cases of common domestic animals being bitten by wild animals. There is an additional flow chart for exotic and zoo animals.

        Are animal bites reportable in Michigan?

        Yes, the Michigan Public Health Code requires that any animal bite be reported to the public health agency where the bitten person resides, as well as where the bite occurred, within 24 hours of the bite incident. [R325.180 (Rule 10) (6)]. The purpose for this reporting is to allow for rapid assessment of the risk for rabies exposure, and if necessary, arrange for the capture and confinement of a live dog, cat, or ferret for a 10-day observation period, or the laboratory examination of an animal head. You can find your local health department here.

        What are the protocols for humans potentially exposed to rabies?

        You can find a flow chart of the protocols for humans potentially exposed to rabies here. Determinations about human exposure are made by a physician, a local health department, or the state health department (Michigan Department of Health and Human Services).


          Vaccinations and Expired Medications   

          I have a client who is going to a local kennel to get their dog vaccinated. Is this legal?

          No. According the Michigan Animal Industry Act, PA 466 of 1988, veterinary biologics, with few exceptions, are to be administered by veterinarians. See details here. Unless there is a licensed veterinarian at the kennel administering vaccinations, there could be a violation of Michigan law. For additional information and potential follow up, you could contact the State Veterinarian at the Michigan Department of Agriculture and Rural Development at 800-292-3939. Alternatively, if there is concern that an individual may be practicing veterinary medicine without a license, you may contact MVMA. See question below:

          I have a client who is taking their dog back to the breeder to get vaccinations. Is this legal?

          No. According the Michigan Animal Industry Act, PA 466 of 1988, veterinary biologics, with few exceptions, are to be administered by veterinarians. See details here. Unless there is a licensed veterinarian at the breeding facility administering vaccinations, there could be a violation of Michigan law. For additional information and potential follow up, you could contact the State Veterinarian at the Michigan Department of Agriculture and Rural Development at 800/292-3939. Alternatively, if there is concern that an individual may be practicing veterinary medicine without a license, you may contact MVMA at mvma@michvma.org.  


          Who Can Own a Veterinary Practice? 

          Based on a recent review of Michigan laws regarding the formation of businesses, it is our opinion that anyone can be an owner of a veterinary practice in Michigan, if the practice is incorporated or organized in the proper business form. Michigan business formation laws permit veterinary practices either to incorporate as professional corporations (known as “PCs”) or organize as professional limited liability companies (known as “PLLCs”). In addition, the business formation laws permit veterinary practices to incorporate as “simple” corporations or organize as “simple” limited liability companies (known as “LLCs”). If a veterinary practice is incorporated as a professional corporation or organized as a professional limited liability company, only licensed veterinarians may be owners. However, if a veterinary practice is incorporated as a “simple” corporation or organized as a “simple” limited liability company, both veterinarians and non-veterinarians can be owners. Therefore, non-veterinarians can be owners of a veterinary practice provided the practice is not incorporated as a professional corporation or organized as a professional limited liability company.

          MVMA members have access to the full opinion and legal analysis done by our attorney on this issue. Please contact us for additional information. 


          Michigan Veterinary Medical Association

          2144 Commons Parkway
          Okemos, MI 48864-3986

          517.347.4666

          517.347.4710

          mvma@michvma.org

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