House OKs expansion of veterinary telehealth, bucking some vet groups

Beth LeBlanc
The Detroit News

Lansing — The Michigan House approved legislation Thursday that would allow veterinarians more freedom to schedule telehealth visits, recommend alternative treatments such as acupuncture and delegate their tasks to others in certain situations.

The bills, which passed the state House 85-17 and 71-31, would codify in law veterinary telehealth rules that were expanded during the COVID-19 pandemic. The pandemic rules allowed veterinarians to hold a telehealth visit with an animal without a primary, in-person visit currently required under law to establish a "veterinarian-client-patient relationship."

Currently, without the prior establishment of a veterinary-client-patient relationship, vets are barred from scheduling telehealth visits except in the case of emergencies or when it involves shelter animals. 

"To be clear, what we are proposing is already allowed to be used to treat animals in animal shelters," said Rep. Julie Alexander, the Hanover Republican who sponsored the legislation. "What we're proposing is already allowed in emergency situations or emergent care.”

The Michigan Veterinary Medical Association came out strongly against the legislation as it worked its way through committee earlier this month. The group argued the legislation would allow unscrupulous licensed veterinarians who live outside of Michigan to provide subpar care as well as open the door to "pill mills" to prescribe medication indiscriminately to animals via virtual visits to meet a quota.

"Telehealth should be a tool in the tool box and it should be used," said John Tramontana, CEO of the Michigan Veterinary Medical Association. "It just shouldn’t be solely used.”

Tramontana said substandard care could not only harm pets but also damage the state's food supply if an issue with larger farm animals was not identified properly in a virtual visit. Stakeholders worked for years on legislation to address telehealth but the rules working their way through the Legislature go much further than the bill originally agreed upon, he said. 

"Our bill has been hijacked by those looking to profit from Michigan consumers and deliver substandard care," Tramontana said. 

Veterinarian Dwight McNalley, former chairman of the State Board of Veterinary Medicine, said rules temporarily suspending the requirement for initial in-person visits were allowed solely because of the pandemic and should not be made permanent. 

"We feel telemedicine can be an important tool to help provide quality care to our pets but it needs to be regulated," he said. 

But there were plenty others who supported the bills in committee earlier this month, with some arguing it was ideal for those in rural areas or with animals that might be more aggressive or anxious.

Molly Tamulevich, Michigan state director for the Humane Society, told lawmakers earlier this month that the bills also would increase access to veterinarians for those who might experience transportation, cost or time as a barrier to care.

"Many families have time constraints that are incompatible with the hours veterinary clinics keep or have transportation issues and can't get to the office," Tamulevich said.

Veterinarian Akshay Verma argued that rules were still in place under the legislation that would hold veterinarians accountable, regardless of whether a visit was completed virtually or in-person. The bill also would require veterinarians to be "readily available" in case of an emergency, adverse reaction to treatment or follow-up evaluation.

"We’re still liable for any decisions we make," Verma said. "We can still lose our license.”

The legislation would allow vets to include within their scope of practice treatments such as dental care, physical therapy, acupuncture, homeopathy and other alternative remedies.

The bills also would allow a vet to delegate some tasks if there is a supervising veterinarian or if there is an established veterinarian-client-patient relationship. Exceptions would be made for emergency care.