Can expanding the RVT role improve access to care?

A proposal by the California Veterinary Medical Association to allow RVTs to establish veterinary-client-patient relationships was recently approved to enter the regulatory process.

By Kristen Green Seymour

Last week the California Veterinary Medical Board (VMB) allowed into the regulatory process a proposal by the California Veterinary Medical Association (CVMA) that calls for expanding the role of Registered Veterinary Technicians (RVTs), allowing them to act as agents of the veterinarian to establish a veterinary-client-patient relationship (VCPR) for the purposes of vaccines and parasite preventives.  

Work on the proposal began in 2021, and this approval means that it now enters California’s regulatory process which, according to Keith Rode, DVM, CVMA’s 2022–2023 president, generally takes years and includes several steps.  

A message to RVTs: “Your voice matters”  

“In 2021, the CVMA formed the Access to Care Task Force in response to an overwhelming need in California for those in economic hardship to receive veterinary care for their animals,” said Nicole Dickerson, an RVT on the CVMA RVT Committee and a member of that task force.  

“The availability of enough veterinarians to address the issue, especially in rural or economically depressed areas, is also a barrier to access to care. One of the opportunities they saw for expanding access in those cases was to increase the scope of what RVTs can do under the direct supervision of a veterinarian, she said. 

“The task force’s work was approved by the CVMA’s Board of Governors in 2022 and culminated in a position statement and a list of action items for the CVMA to pursue in an effort to do its part to address the access issue,” said Rode.  

Then the task force sent the “expanding the RVTs” topic to the CVMA RVT Committee, which “did a deep-dive into RVT education, core competencies, skills, and abilities,” ultimately determining that RVTs possess the knowledge and skill needed to establish a VCPR in place of the veterinarian when it comes to administering vaccines or performing preventive proceduresfor parasite control, such as running heartworm tests and administering parasite control medications prescribed by the veterinarian, he said.  

From there, the proposal was presented to the CVMA’s House of Delegates (comprised of approximately 75 veterinarians and RVTs from throughout California) as well as the CVMA’s Board of Governors in June 2022 for review and discussion.  

“The result of that assessment was widespread support for the measure,” Rode said. “Accordingly, I directed the CVMA staff to submit a request to the VMB to consider the proposal for a rulemaking (regulatory) process.  

“The CVMA staff compiled significant supporting data for the request and submitted both the request and the supporting data to the VMB in late 2022.” 

That brings us to this year, when the VMB analyzed the request, drafted proposed regulatory language, and, on January 25, presented that language to its voting board—which unanimously voted to approve the introduction of the proposed regulations into the regulatory process, said Rode. 

In the coming months, this proposal will undergo a 45-day public comment period, during which time anyone can go onto the VMB website and leave a comment. Over the coming months or years, it will go through several steps to become law, during which time Dickerson encourages RVTs to get involved in their state associations.  

“This is an example of what your involvement can do,” she said. “The CVMA has jumped a big hurdle, but we aren’t yet at the finish line. I think it’s important for RVTs to remember that their voice matters. Be the change that you want to see.” 

What approval of CVMA’s proposal means  

“This proposal, if made into law, would certainly symbolize a big step for our profession,” said Rode. “The CVMA believes that expanding the role of RVTs in veterinary practices in this specific capacity will benefit both the veterinary profession and the public.” 

Dickerson, who acted as a committee representative as well as a subject-matter expert at the VMB meeting where the proposal was discussed, agreed: “I think first and foremost, we have to look at these newly proposed regulations through the lens of access to care,” she said, quoting a 2018 University of Tennessee Access to Veterinary Care Coalition publication that found 25-30 percent of pet owners cannot afford veterinary care.  

This proposal could help individuals facing a financial barrier because, while the RVT visits are proposed to take place in an animal hospital setting, the idea is that they would cost less than a visit with a DVM. Once these clients go into the animal hospital, the RVT can act as a resource for information about other preventive health measures, like spay and neuter, or suggest a follow-up appointment with the veterinarian if anything concerning is found during the physical exam. Even better, they’ve potentially helped a pet owner overcome the hurdle of connecting with an animal hospital or clinic in the first place. 

But access to veterinary care isn’t only hindered by a client’s financial hardship or a lack of familiarity with local practices. “We’re also facing a shortage of veterinarians,” Dickerson said. This role expansion for RVTs relieves some of the patient burden on DVMs. And, she said, by keeping zoonotic disease at bay through preventive medicine, it serves public health. 

Of course, there’s also the impact on the RVT profession.  

“From an RVT’s perspective, I think this affords us some growth in the career,” Dickerson, an experienced RVT and a veterinary technician specialist (VTS) in emergency and critical care, said, specifying that the role is reserved for an RVT, not a veterinary assistant.  

“I hope it encourages those working in the field without a license to pursue one, elevating their role in the hospital.” She also hopes that this helps to slow the attrition they’re seeing of veterinary technicians, and that the new regulations inspire RVTs to stay in the profession for years to come.  

The goals don’t end there, though. Dickerson believes that the approval of this California proposal could set a national precedent. “At the very least,” she said, “we are laying the groundwork for conversations surrounding the ability of an expanded role of the RVT to help address access to care.” 

Still, this is only the beginning. “Currently, this proposed regulatory package is in the beginning of a long process,” Rode said. “The CVMA will continue to work with stakeholders to maximize the chance of a successful implementation, but there is a long way to go—and nothing is certain.” 

 

Photo credit: © gguy44   E+ via Getty Images Plus   

 

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