The Price of Success

My company, Animal Policy Group, employs a team of four researchers who track legislation and state board or agency actions in 50 states and the District of Columbia 365 days a year. Believe it or not, last year we monitored over 15,000 pieces of legislation affecting veterinarians or pets.

Most of those bills fell to the wayside, but the lesson was clear: Advocates and industry have ramped up plans to regulate our space amid the rise of pet nation, the public’s engagement with pets inside and outside of the house, and a growing appreciation for the human-animal bond. That is the price of success. Just ask Silicon Valley, the fracking industry and other hot economic sectors.

What follows is a primer on major policy issues. Not that you need to drop everything and do something about a particular issue, but take five minutes to learn what’s looming. I’ll move quickly through each topic and define:

1. The issue
2. Why the issue matters
3. The likelihood of change

Access to Care

1. This is the hottest topic in veterinary circles: How do we persuade a large percentage of pet owners (maybe 50% or greater) to access veterinary care? The surge in practice revenue and the demands of new pet owners during the pandemic exacerbate the issue.
2. It matters as veterinarians never want their services to be considered a luxury, nor should we tolerate millions of pets going untreated for the majority of their lives.
3. Expect industry initiatives here but not necessarily legislation. A political fix isn’t apparent.

Animal Abuse Laws

1. States continue to explore two measures: mandatory registries of convicted animal abusers and requirements that veterinarians report animal abuse suspicions.
2. It matters because the surge in pet awareness and the understanding of the human-animal bond has made animal abuse a priority for many animal welfare organizations, though not many veterinary medical associations.
3. States will continue to pass legislation one by one as veterinarians cannot make a convincing case that they should not be called upon to act when a client or patient shows signs of abuse.

CBD and Medical Marijuana

1. Pressure is building to allow veterinarians to prescribe or provide cannabidiol for patients, or at least discuss the topic with clients, particularly as states legalize recreational and medical use.
2. It matters because of widespread confusion about whether CBD and medical marijuana products are efficacious in pets and what veterinarians are allowed to do.
3. As research expands and human usage grows, you might expect more states, especially “blue” or progressive jurisdictions, to fall in line.

Compounding

1. Drug distributors, pharmacies and veterinarians are of many minds on this topic.
2. It matters because most veterinary practices want the latitude to handle compounding themselves or purchase compounded drugs for usage and dispensing. The federal government asserts its authority.
3. Progress, however you define it, will continue to be slow, though not at a snail’s pace.

Corporate Practices

1. While there is much buzz, no serious legislation is pending that would restrict or separately regulate multisite veterinary practices.
2. It matters because of the rapid growth of corporate practices and consolidators, which has led to legions of baby boomers selling their clinics at very attractive prices.
3. Don’t expect the genie to re-enter the bottle. Corporate practices are here to stay.

Declawing

1. Scores of cities, counties and New York State have banned the elective veterinary declawing of cats.
2. The profession is divided over removing a veterinarian’s decision-making power involving onychectomies. The differences often are generational.
3. Millennial and Generation Z veterinarians ultimately will drive more states to follow New York’s lead, but it is not a hot issue, so the pace will be slow.

Drugs

1. Proposals to restrict or impose mandates on a veterinarian’s prescription or medication activities are active in state legislatures. This is often tied to political attacks on the opioid problem.
2. It matters because of limitations on the ability of veterinarians to comply due to a lack of software when reporting to state authorities. Well-founded resistance can be found when a veterinarian’s judgment is interfered with during the treatment of a patient.
3. Until politicians think the opioid issue is under control, expect the pace of legislation to accelerate as states adopt e-prescriptions, Prescription Monitoring Program (PMP) requirements, dose restrictions and the like.

Grooming

1. Many local governments and some states are imposing standards and licensing requirements, though veterinary grooming usually is exempted.
2. It matters because the value of grooming is growing in the eyes of pet owners. Standards vary widely.
3. Whether governments need to step in and regulate grooming is a hot topic, but expect cities and counties to briskly pass regulations. Pet owners and veterinary associations for the most part have stayed out of the battle.

Microchipping

1. This issue has returned to the legislative and municipal ordinance arenas with proposals for mandatory microchipping aimed at providers of pet services, including animal shelters.
2. It matters because the United States lags far behind peer countries in the percentage of microchipped pets.
3. Public interest in the topic has waned, so don’t expect a spate of new laws. The absence of organized opposition makes some victories likely for proponents.

Noneconomic Damages

1. Four to six states every year consider legislation that would remove the bar on noneconomic (emotional loss) damages for negligent veterinary actions.
2. It matters because a 1,000-year-old common-law rule is the key driver in keeping veterinary costs under control. Lawyers aren’t interested in low-dollar injury lawsuits.
3. While the subject of reform continues to draw academic interest, don’t expect the rules to change anytime soon.

Pet Food Labeling

1. Lawsuits and legislation continue to percolate in attempts to restrict manufacturer claims and allow the use of phrases such as “human food grade.”
2. It matters because of the broad interest of veterinarians and the public in having trusted information when pet food is selected.
3. The issue attracts little attention, so legislators are not inclined to prioritize it.

Pet Health Insurance

1. Growing numbers of people are signing up for pet insurance, fueled in part by COVID-era adoptions and media coverage. This has triggered legislation aimed at tighter insurance regulations.
2. It matters because the insurance industry is making meaningful progress in adopting a national model pet insurance law.
3. Consumers are not pushing for any particular solutions, so the industry initiative should prevail.

Pet Store Animal Bans

1. Cities, counties and some states are accelerating the adoption of bans on the sale of dogs and cats in stores.
2. Pet adoptions generally are excluded from such bans.
3. It matters because of rising concerns about shortages of dogs and consumer access to pets. Animal welfare and animal rights organizations are winning the day in most cases. Until an agreement is reached with breeders regarding humane breeding standards and certification, you can expect the “puppy mill” argument to frame the debate. Interest is growing in restricting the import of exotic species.

Reciprocity

1. This seemingly arcane topic is vital for many veterinary practices, namely the ability of veterinarians and credentialed veterinary technicians/nurses to move across state lines without having to retake previously passed national board exams.
2. It matters in terms of addressing shortages of veterinary professionals and the migration of Americans between regions, although some parties view the issue as important only for corporate, multistate practices.
3. Pressure will grow to remove reciprocity restrictions in some states. The battle is beginning.

Telemedicine

1. The use of telemedicine, or virtual care, has increased during the pandemic.
2. It matters as the profession remains divided about what should happen when COVID abates and we proceed to the new version of normal.
3. All eyes will be on the 17 states that during COVID waived restrictions on the establishment of a telemedicine veterinarian-client-patient relationship. The focus will be on data about any problems and whether veterinary practices want the freedom to continue to deploy consumer-friendly tools.

Veterinary Malpractice

1. Arizona proposed legislation spelling out standards for veterinary malpractice.
2. It matters not as a topic of public interest nor advocacy, but because legislative action might have the unintended consequence of making the public believe a problem exists.
3. Too early to tell if the 2021 Arizona Legislature will take action.

Veterinarian and Technician/Nurse Shortages

1. COVID exacerbated the burnout factors as demand for pet health care surged.
2. It matters because of the potential impact on veterinary teams and pet owners if chronic shortages are not addressed by the industry and accreditors.
3. Organizations and companies are focusing on strengthening the four-year academic degree and creating a master’s-level extender, so expect to see action and pilots in the near term.

Veterinary Services Tax

1. A handful of states, most recently Kentucky, impose taxes on veterinary services.
2. It matters because taxes increase the price of veterinary care.
3. Expect at least one more state to adopt the tax because of budget challenges.

WORDSMITHS AT WORK

A working group at the National Association of Insurance Commissioners is developing a model pet health insurance law known formally as the Pet Insurance Act. Participants precisely defined several phrases, including one of utmost interest to pet owners and veterinarians.

As of early 2021, the definition of preexisting condition reads: “Any condition for which a veterinarian provided medical advice, the pet received treatment for, or the pet displayed clinical signs related to or contemporaneous with the stated condition prior to the effective date of a pet insurance policy or during any waiting period.”