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  News from the Maryland Veterinary Medical Association                                                    Fall 2010

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Standards of Practice and Code of Ethics for the Practice of Veterinary Medicine; Civil Penalty Standards for Veterinarians; Requirements for Practical Training of Veterinary Students

Notice of Proposed Action

[10-169-P]

The State Board of Veterinary Medical Examiners proposes to:

(1) Amend Regulation .10 under COMAR 15.14.01 Standards of Practice and Code of Ethics for the Practice of Veterinary Medicine in the State;

(2) Amend Regulations .03 and .04 under COMAR 15.14.11 Civil Penalty Standards for Veterinarians; and

(3) Adopt Regulations .01—.07 under new a new chapter, COMAR 15.14.17 Requirements for Practical Training of Veterinary Students.

Statement of Purpose

The purpose of this action is to ensure that diagnostic images or pictures of patients maintained by a veterinarian are correctly identified by including certain information on the images; clarify that the State Board of Veterinary Medical Examiners (SBVME) may charge a veterinarian who employs or permits a veterinarian who does not possess a current veterinary registration to practice veterinary medicine; and establish the terms and conditions under which a third-year veterinary medical student working under the responsible direct supervision of a veterinary practitioner may practice veterinary medicine.

Comparison to Federal Standards

There is no corresponding federal standard to this proposed action.

Estimate of Economic Impact

I. Summary of Economic Impact. The economic impact on the SBVME as a result of the proposed regulatory amendments would be that associated with sending a copy of the revised language to its licensees via regular first-class mail. A veterinarian who fails to comply with the revised record-keeping regulation or who employs or permits a nonregistered veterinarian to practice veterinary medicine may be sanctioned by the SBVME. Lastly, a veterinarian who fails to properly supervise a third-year veterinary medical student may be charged for noncompliance with the SBVME’s new regulations. The SBVME is entirely special funded; however, civil penalty monies received by the SBVME are deposited into the State’s general fund.

 

Revenue (R+/R-)

 

II. Types of Economic Impact.

Expenditure (E+/E-)

Magnitude

 


 

 

 

 

A. On issuing agency:

Board fund

(E+)

$2,500

B. On other State agencies:

NONE

 

C. On local governments:

NONE

 

 

 

Benefit (+)
Cost (-)

Magnitude

 


 

 

 

 

D. On regulated industries or trade groups:

(1) Maryland-licensed veterinarians

(-)

Indeterminable

(2) Animal control facilities and shelters

(+)

Indeterminable

E. On other industries or trade groups:

NONE

 

F. Direct and indirect effects on public:

Maryland citizens

(+)

Indeterminable

III. Assumptions. (Identified by Impact Letter and Number from Section II.)

A. The SBVME will incur expenses through mailing notifications to its licensees regarding amendments to its regulations. The estimate for copying, mailing, and staff time is estimated to be $2,500.

D(1). A Maryland-licensed veterinarian who fails to comply with the SBVME’s regulations may be charged civil penalties. However, the amendment to the record-keeping regulation is expected to result in more accurate and easily identifiable patient records, which equates to an improvement in patient care.

D(2). Animal control facilities, which tend to have limited funding, and a limited number of veterinarians on staff, may benefit through the ability of third-year veterinary medical students to assist in examining and spaying or neutering animals to be adopted out by the facility. A veterinarian would be needed to directly supervise the work of the student. The student would gain valuable hands-on clinical experience which would better prepare the student for practicing medicine once the student has graduated from veterinary medical college.

F. The revised record-keeping regulation is expected to benefit Maryland pet owners who request copies of their pets’ records because there will be added assurance that the diagnostic images or pictures they are provided (or that may be released to subsequent treating veterinarians) are, in fact, those of their pets. The chance of veterinary hospital staff releasing diagnostic images for a pet belonging to another consumer would be significantly diminished.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Laura C. Downes, Executive Director, Maryland State Board of Veterinary Medical Examiners, 50 Harry S Truman Parkway, Room 102, Annapolis, MD 21401, or call 4108415862, or email to DownesLC@mda.state.md.us, or fax to 4108415780. Comments will be accepted through July 19, 2010. A public hearing has not been scheduled.

15.14.01 Standards of Practice and Code of Ethics for the Practice of Veterinary Medicine in the State

Authority: Agriculture Article, §§2-103, 2-304, and 2-310, Annotated Code of Maryland

.10 Record Keeping.

A. — C. (text unchanged)

D. A veterinarian shall label each radiograph and any other diagnostic image or picture with the hospital, clinic, or veterinarian’s name, the patient’s name, the owner’s name, and the date the [radiograph] image or picture was taken. Diagnostics include, but are not limited to, the following:

(1) Ultrasound;

(2) Magnetic resonance imaging (MRI);

(3) Computed tomography (CT) scans; and

(4) Any other device that is used to generate an image of a patient.

E. — G. (text unchanged)

15.14.11 Civil Penalty Standards for Veterinarians

Authority: Agriculture Article, §2-310.1, Annotated Code of Maryland

.03 Violations.

The Board may impose a penalty on a veterinarian who does any of the following:

A. — I. (text unchanged)

J. Employs or permits a veterinarian who does not possess a current veterinary registration to practice veterinary medicine;

[J.] K.[O.] P. (text unchanged)

.04 Classification of Violations for the Purpose of Determining Penalties.

A. (text unchanged)

B. For a violation of Regulation [.03G—I] .03G—J, a penalty may be imposed by the Board considering the nature and gravity of each violation consistent with the following standards:

(1) — (3) (text unchanged)

C. For a violation of Regulation [.03J—O] .03K—P of this chapter, a penalty may be imposed by the Board considering the nature and gravity of each violation consistent with the following standards:

(1) — (3) (text unchanged)

15.14.17 Requirements for Practical Training of Veterinary Students

Authority: Agriculture Article, §§2-301 and 2-304, Annotated Code of Maryland

.01 Purpose.

The purpose of this chapter is to establish the terms and conditions under which a veterinarian may supervise the practical training of a veterinary medical student.

.02 Application.

This chapter applies to all veterinary practitioners in the State who supervise veterinary medical students who practice veterinary medicine.

.03 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) “AVMA” means the American Veterinary Medical Association.

(2) “Board” means the State Board of Veterinary Medical Examiners.

(3) “Responsible direct supervision” means competent, immediate, and active supervision by a veterinary practitioner. The veterinary practitioner shall be:

(a) In the immediate vicinity of where the work is being performed; and

(b) Actively engaged in supervising this work throughout the entire period it is being performed, including:

(i) Providing clear and specific directions on what work is to be done;

(ii) Being cognizant of how the assigned work is being performed; and

(iii) Being immediately available to provide advice when the assigned work is being performed.

(4) “Shelter owner” means a person who rents, leases, or otherwise has control of the premises where the facility is located.

(5) “Veterinary practitioner” means a licensed and registered veterinarian engaged in the practice of veterinary medicine.

(6) “Veterinary preceptee” means a student of veterinary medicine practicing veterinary medicine who has successfully completed 3 years of veterinary education at an institution approved by the Board and who works under the responsible direct supervision of a veterinary practitioner.

.04 Requirements of Veterinary Practitioners.

A veterinary practitioner who offers practical training to a veterinary medical school student shall:

A. Ensure that the veterinary medical school student meets the definition of a veterinary preceptee before permitting the student to practice veterinary medicine under the responsible direct supervision of the veterinary practitioner.

B. Provide responsible direct supervision to the veterinary preceptee at all times the veterinary preceptee is working with a patient.

C. Upon request by the Board, or the Board’s representative, provide written documentation evidencing the validity of the practical training instruction being given by the veterinary practitioner to the veterinary preceptee. This documentation shall indicate, at a minimum, that the veterinary medical school student has been approved, by the veterinary medical college at which the student is enrolled, to participate in practical training. This documentation shall be maintained at the hospital where the veterinary practitioner is employed.

.05 Written Approval from Client.

Before allowing a veterinary preceptee to perform surgery on a patient unassisted by the veterinary practitioner, the veterinary practitioner shall obtain written approval from the client. This written approval shall include, at a minimum, the following information:

A. Client’s name;

B. Pet’s name;

C. A statement which indicates the following:

(1) The number of years successfully completed by the veterinary preceptee at an AVMA-accredited school of veterinary medicine;

(2) That the veterinary practitioner providing responsible direct supervision to the veterinary preceptee is educationally, medically, and legally responsible for any medical, surgical, diagnostic, and therapeutic decisions made by the veterinary preceptee; and

(3) That any unassisted surgical procedures will be carried out only when the veterinary practitioner is providing direct supervision;

D. A statement that any and all questions about the work to be performed by the veterinary preceptee on the client’s pet have been answered to the client’s satisfaction;

E. A statement or list of procedures to be performed that the client can either accept or reject;

F. The client’s, or authorized agent’s, printed name and signature;

G. The veterinary practitioner’s printed name and signature; and

H. The date the written form is completed.

.06 Written Approval from Humane Society or Animal Shelter.

Provided an animal upon which surgery is to be performed is owned by a humane society or animal shelter, and the surgery is to be performed in the humane society or animal shelter, the veterinary practitioner shall obtain written approval from the owner of the humane society or animal shelter before allowing the veterinary preceptee to perform any surgeries upon animals unassisted by the veterinary practitioner. This written approval may cover the entire period during which the veterinary preceptee is working under the responsible direct supervision of a veterinary practitioner. This written approval shall include, at a minimum, the following information:

A. Name of humane society or animal shelter;

B. A statement which indicates the following:

(1) The number of years successfully completed by the veterinary preceptee at an AVMA-accredited school of veterinary medicine;

(2) That the veterinary practitioner providing responsible direct supervision to the veterinary preceptee is educationally, medically, and legally responsible for any medical, surgical, diagnostic, and therapeutic decisions made by the veterinary preceptee; and

(3) That any unassisted surgical procedures will be carried out only when the veterinary practitioner is providing direct supervision;

C. A statement that any and all questions about the work to be performed by the veterinary preceptee on the animals have been answered to the satisfaction of the shelter owner;

D. A statement or list of anticipated procedures to be performed that the shelter owner can either accept or reject;

E. The shelter owner’s, or authorized agent’s, printed name and signature;

F. The veterinary practitioner’s printed name and signature; and

G. The date the written form is completed.

.07 Penalties.

After giving a veterinary practitioner notice and an opportunity to be heard, the Board may impose a civil penalty instead of, or in addition to, suspending or revoking the veterinarian’s license if the veterinarian fails to comply with the Board’s requirements set forth in this chapter.

EARL F. HANCE
Secretary of Agriculture

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© 2010 Maryland Veterinary Medical Association

Annapolis, MD 21403 • (410) 931-3332 • fax (410) 931-2060 • MVMA@KeyAssnMgt.comwww.mdvma.org