In response to Politics & Policy columnist Mark Cushing’s article “We’re at a Critical Point in Veterinary Medicine” [December 2024/January 2025], I feel compelled to clarify several points regarding telemedicine and its implications for veterinary practice. While Mr. Cushing rightly highlights the challenges surrounding access to veterinary care [go.navc.com/4fcBgOu], his discussion of the Texas court case involving Dr. Ronald Hines and its implications for telemedicine contains significant inaccuracies that warrant correction.
First, the 5th Circuit Court of Appeals ruling in Dr. Hines’ case did not invalidate the Texas veterinarian-client-patient relationship statute. The court’s decision was an “as applied” challenge, narrowly focused on whether Texas’ VCPR statute violated Dr. Hines’ First Amendment rights based on the specific facts of his case. The court did not declare the Texas prohibition on establishing a VCPR through electronic means unconstitutional. Instead, the ruling created a limited exception for Dr. Hines’ email communications, which were deemed protected speech. Importantly, the Texas VCPR statute remains in full effect and requires an in-person examination to establish a VCPR.
Furthermore, the court explicitly noted that Dr. Hines did not engage in activities such as physically examining animals, performing surgeries, administering vaccines or prescribing medications — all of which constitute conduct subject to regulation by the state and, in the case of prescribing, by the federal government. The court’s decision does not provide blanket authorization for veterinarians to bypass state or federal VCPR requirements via telemedicine. Instead, it underscores the importance of distinguishing between protected speech and actionable conduct under state law.
Also worth noting is that the Texas attorney general may ask the U.S. Supreme Court to review the decision. If no further action is taken, the ruling will apply only in the 5th Circuit (Texas, Louisiana and Mississippi) and will not set a nationwide precedent.
The case underscores the need for veterinarians to remain vigilant in adhering to their state’s VCPR statute and simultaneously adhere to the federal VCPR in situations where that applies. To that end, I urge veterinarians to consider the following in light of this case:
- Adhere to your state’s VCPR requirements. Establishing a VCPR through an in-person examination minimizes the risk of misdiagnoses and ensures compliance with state and federal regulations.
- Do not prescribe medications without a properly established VCPR. Activities such as prescribing medications or performing medical procedures fall squarely within the realm of “conduct” and are regulated by state and federal law.
- Recognize the potential risks to your license. Telemedicine companies may promote services that appear to circumvent VCPR requirements, but it is the individual veterinarian, not the company, who will face disciplinary action for violations.
The American Veterinary Medical Association is actively working to address these complex issues. On behalf of 108,000 veterinarians and their patients, we are collaborating with stakeholders to ensure that telemedicine tools are integrated responsibly and effectively into veterinary practice. The AVMA is a lead partner in the Coalition for Connected Veterinary Care, an alliance of more than 70 veterinary and animal health organizations dedicated to advancing care through technology while preserving the integrity of the VCPR. For more information, visit avma.org/connectedcare.
I appreciate Mr. Cushing’s efforts to draw attention to the challenges facing veterinary medicine. However, it is vital to accurately convey the legal and professional responsibilities associated with telemedicine to safeguard both animal health and welfare and the continued public trust in our profession.