Legal Complications of Complementary Medicine: What’s In Your Practice Act?
At a time when an increasing number of veterinary professionals offer complementary therapies, lawyers warn about the pitfalls of providing services that are not included in practice acts – or referring clients to non-veterinary professionals for such services. Even selecting a holistic approach versus traditional care could be a violation of the state’s veterinary practice act, which could lead to fines or other sanctions against the veterinarian, said legal professionals at the American Veterinary Medical Association (AVMA) conference last month
To protect a practice and abide by laws, lawyers suggest that practitioners read their practice acts regularly and ask questions about how state laws are interpreted.
“One state does this, one state does that, and one state does something else,” said Duane Flemming, DVM, JD, during a day of legal presentations. “You have to be very careful of these rules,” he added. Although the research can be “dry as dust,” Flemming urged his colleagues “to get into these debates [about the definition of veterinary medicine] before laws are introduced” without their input or they are penalized for breach of contract.
“It is incumbent upon veterinarians to know what’s in their practice acts,” he added. “You need to understand what it means to practice veterinary medicine. It sounds trite, it sounds basic, but it’s not.” The American Association of Veterinary State Boards has a link to practice acts on its website.
Flemming and Douglas Jack, Esq., have identified five approaches to veterinary medicine definitions within practice acts. These different definitions impact the services that professionals can legally provide and whether they are covered by malpractice insurance, which is why lawyers advise frequent readings of each practice act.
A representative from the AVMA professional liability insurance company who attended the lecture said insurance professionals emphasize the role practice acts and state boards play in veterinary medicine when they visit veterinary colleges. “We tell students, ‘what you can do and cannot do is decided by state legislatures,’” said Richard Shirbroun, DVM, who has seen a slight increase in complementary/alternative medicine malpractice cases and allegations of professional misconduct within that realm over the last few years.
“Insurance companies are limited by practice acts,” he explained. Even if a veterinarian provides the service, “it might not be [considered as] the practice of veterinary medicine” as defined by the state. And if a service is not included in a state practice act, veterinarians may not be covered by insurance.
Some states provide an exhaustive list of services that doctors can offer pets and other animals; others list services that fall under the umbrella definition of veterinary medicine, and a few use the words “including but not limited to” for complementary medicine, which leaves the door open to interpretation.
To illustrate the diverse nature of definitions, Flemming pointed to Arkansas, which has a “complementary/alternative medicine inclusive” definition that lists services that can be performed by veterinarians. A “simple” definition, used by Tennessee and Alberta and Ontario, Canada, does not refer to specific treatments while Ohio has a “complex” definition that lists approved services.