AHL client communications and the veterinarian-client-patient relationship
Normally, submissions are made through a veterinarian (Vet-client), since veterinarians form the first line of defense against disease and production problems in the field. We require that owners provide the name of a licensed veterinarian when submitting bodies of, or specimens from, either food-producing or companion animals to our laboratory. This allows us to inform the referring veterinarian about problems in their client's herds/animals that we may have identified in the laboratory.
The veterinarian is a key player in the problem-solving team. Responsibilities include:
- Select and submit high-quality specimens and carcasses representative of the problem. Make arrangements with the laboratory prior to submitting large numbers of carcasses/specimens.
- Provide a concise but adequate history, including signalment information, clinical signs, morbidity/mortality, treatments, vaccination,postmortem findings, and a tentative diagnosis.
- Inform the laboratory of previous submissions related to the case (include previous AHL laboratory numbers).
- Promptly communicate laboratory results and interpretation to owners. The AHL does not provide interpretation of results to owners.
Specimens may be submitted by animal owners (Owner-clients) ONLY for postmortems and ONLY if the name of a licensed veterinarian is provided. All animal owner PM submissions must be prepaid. By submitting the name of a licensed veterinarian, Owner-clients consent to the disclosure of test results to the licensed veterinarian.
Whether Vet-clients or Owner-clients, the client is responsible for payment of all costs of testing. Test results and all other communications are sent directly to the client online via LIMS, by email or fax throughout the day as various test groups are completed. A final cumulative report is emailed or faxed upon completion of all testing on all cases. The client may elect to receive reports by mail, in which case a final report is sent once billing is completed. In the case of Owner-clients, test results are also sent to the named licensed veterinarian. Test results will be sent to third parties (e.g., insurance companies) only upon written request of the client on the submission form.
The AHL does not accept submissions directly from owners without a veterinarian named as the primary contact. The AHL directs animal owners to contact their veterinarian for interpretation of their laboratory report. The AHL does NOT have a veterinarian-client-patient relationship (VCPR) with its clients, and does not give treatment recommendations. Rather, the AHL provides specialized testing services that can assist referring veterinarians in their diagnosis. Without a valid VCPR, College of Veterinarians of Ontario regulations prevent the AHL from providing interpretation and treatment recommendations to owners. Just as human patients deal through their own physician concerning lab results, it is appropriate to have Owner-clients deal through their own veterinarian concerning veterinary lab results. From CVO recommendations on “Ordering, performing and interpreting laboratory tests in Veterinary Clinical Practice”:
“Laboratory test reports often include indicators with respect to results that lie outside of normal ranges, which are useful to veterinarians. While laboratories may accept submissions from and provide results to non-veterinarian clients, as well, it is inappropriate for a laboratory employee to offer an interpretation, including a diagnosis, to a non-veterinarian client. Any non-member, or any person not supervised by a CVO member, who provides interpreted diagnostic laboratory test results directly to an animal’s owner or owner’s agent would be considered by the College to be practicing veterinary medicine without a license.”
In the event of a dispute with an owner’s current veterinarian, we ask for the name of a third-party veterinarian for laboratory data interpretation. Our routine practice is to bill veterinarians only - we bill the referring veterinarian at the owner’s request only if approved by the veterinarian. When animal owners appear at one of our labs in person with their lab submission, we require payment in advance (debit, or credit card)