Blogs

The workforce shortage and a heavy patient load are forcing practices to re-evaluate how work gets done. Practice managers and owners are considering new ways to get more done with limited resources. Staff utilization has been at the forefront of industry discussion for some time, but the recent pandemic has exacerbated our workforce issues and forced practices to not just talk about improved utilization but put a new plan into action. Pretty much everyone in the industry agrees that the key to improving efficiencies is to improve staff utilization. This means staff working at the highest level of their ability, reducing redundancy, and cutting out non-essential tasks. But before this occurs, it is critical that managers, owners, and other practice leaders know and understand the regulations that govern how and what your staff can do before you delegate tasks. “Not following these can cause heavy fines and in the most severe cases, the license of the attending doctor can be revoked for allowing an unlicensed person to perform under their supervision,” cautions Missy Filarecki, CVPM, CFFP, practice manager of Just Cats Veterinary Clinic. She is also a member of the VHMA ethics committee. “Both the unlicensed individual performing the duties and the veterinarian allowing it can be disciplined.”

Is your practice creating legal risks by not following or overlooking guidelines?

The first way to determine if your practice is following your state guidelines is through due diligence and research. “The resources are always available either online or reaching out to the state veterinary licensing board,” says Ashley Richards, CVPM, a VHMA ethics committee member who is a clinic launch associate that provides support for new hospital openings.

“Each state has specific rules and guidelines for what a licensed person versus a non-licensed person can do,” says Filarecki. For example, in New York, veterinary technicians must have a license to perform duties such as blood draws, administering vaccinations, monitoring anesthesia, and more. While in Vermont, a neighboring state, it is not required to hold a license to perform those duties.

How can staff really understand what the limits are?

Richards says this starts with the practice's leadership team - the owner, medical director and/or practice manager should ensure they fully understand what the limits are. “The leadership team is then responsible for communicating to associate DVMs and paraprofessional teams; this includes answering any questions and reaching out to the state board representative if needed for clarity,” she explains.

To further implement the messaging, Filarecki recommends holding regular staff meetings.  And when there’s a new hire, these regulations should be reviewed so everyone knows how important it is to follow these guidelines.

With a workforce shortage, Filarecki reports it’s getting more common for veterinarians to delegate their duties down to the veterinary technician. “Certain duties are acceptable to delegate, some are not, and the team should be educated on the difference,” she points out. While the veterinary technician is an amazing critical and versatile employee, they are not trained or educated to treat the patients as the veterinarian should, Filarecki says.

“By placing the veterinary technician in that position, the practice is putting the patient’s health at risk; and it puts the license of both the veterinarian and the technician at risk as well,” she continues. “If a practice does not have the appropriate veterinary staff to complete an appointment with appropriate patient care, the better path is to cancel that appointment.”

While Richards believes that licensed veterinary technicians should be fully leveraged and play a vital role in our profession, she adds it is essential that hospitals understand their state's practice act and regulations.

Research, Communicate, Review…then Repeat to Ensure a Safe and Compliant Practice

As the manager of your practice, it’s very important that you make sure your staff fully understands state guidelines, train your entire staff on them, then review them and revisit them periodically as they change.

“As a manager, I would address guidelines individually during their new hire orientation so that they are aware from day one,” says Richards. “I would revisit the guidelines at least once a year or when any changes are made (either by the guidelines or by staff changes). This should be addressed at doctor and team meetings.”

Additionally, if a team member's job title and associated responsibilities change (such as a veterinary assistant becoming a licensed veterinary technician), Richards suggests that you ask your employee to review how the guidelines affect their new role with the individual as well as the doctor. And, if there was a situation in which a team member acted outside of the guidelines, Richards affirms the practice leadership should address the lapse immediately.

In states where no licensing is necessary, Filarecki says there may be no distinction between veterinary assistants and technicians. “With a national veterinarian shortage, it is common for veterinarians to move from state to state, and they don’t necessarily understand the difference between veterinary technicians and assistants if they have never worked in a state that requires licensure. It is the duty of the manager or owner of the practice to educate the doctor and let them know who their team is and what they can legally do,” she says.

Ignorance is never an excuse under the law. Taking the time to become and remain “in the know” about the regulations that govern your state is perhaps one of the best things you can do for your practice and the patients it serves.

Posted on behalf of the Ethics Committee.