Proposed midlevel role poses unacceptable risks

Proposals that would create a new midlevel practitioner (MLP) role raise serious concerns about the future of quality care for veterinary patients. Sometimes referred to as a veterinary professional associate (VPA), their duties would overlap those of a veterinarian and veterinary technician.

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Although it ultimately failed, a bill that would have authorized the creation of the VPA role was introduced in the Florida House of Representatives earlier this year. Additionally, Colorado State University’s College of Veterinary Medicine in Fort Collins is in the process of developing a VPA degree program called a master of veterinary clinical care. Based on an available curriculum draft, the program would encompass a mere 65 credit hours—which is about half the credit hours required by most doctorate in veterinary medicine (DVM/VMD) programs—and consists of 3 semesters of fully online lecture with no laboratory, a fourth semester of truncated basic clinical skills training, and a short internship/practicum.

Currently, there is no accredited national educational program, no national test, and no regulatory structure to ensure people filling the proposed midlevel position would deliver safe and effective care. Yet, the intent is that these VPAs would be diagnosing, prognosing, recommending treatment, and even performing surgery. Allowing an insufficiently trained individual to perform these skills endangers patients and clients across practice types and poses unacceptable risks for animal health and public health, in general.

Complicating the concept of a midlevel practitioner is federal law that limits prescribing and dispensing medications to a veterinarian—meaning that what an MLP could do for their patients would be severely limited. Some have suggested that MLPs could operate from protocols, but any veterinarian in practice knows that protocols only go so far; patients are unique and so are their needs. Any deviation from a protocol would require intervention by a properly trained and licensed veterinarian, creating unnecessary duplication, risks for patients when such intervention must be immediate, and likely confusion in care provision. Addressing this functional issue would require legislative and regulatory changes in all 50 states and at the federal level, take many years, and be incredibly costly. In addition, given that the proposed MLP would operate under a supervising veterinarian, that veterinarian would be liable for all actions of the MLP…

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