Policy Statement
Published: July 2019
Revised: November 2023
Introduction
With the formation of a veterinarian-client-patient relationship (“VCPR”) a veterinarian assumes a variety of professional responsibilities. In accordance with Regulation 1093, one of these responsibilities is for licensed veterinarians to provide after-hours care services to animals that they have recently treated or treat regularly. These services may be provided in a variety of ways, and are contingent on finding the right balance between meeting legislative requirements, managing client expectations, assuring patient needs, and supporting the health of the individual veterinarian.
Overview of Regulation 1093, Section 20 (Veterinarians Act)
The legislated requirements for licensed veterinarians to provide after-hours care services are outlined in Section 20 of Regulation 1093, In particular, this section clarifies that:
- A licensed veterinarian is responsible for providing reasonably prompt services outside of regular practice hours if the services are medically necessary for animals that they have recently treated or that they treat regularly;
- The services required under subsection (1) may be provided by the licensed veterinarian, their associate(s), or by referral to another licensed veterinarian who has agreed to cover the referring licensed veterinarian’s practice;
- When a licensed veterinarian provides after-hours care services by referring to an emergency clinic, the referring veterinarian is responsible for promptly continuing to provide medically necessary services to the animal after discharge from the emergency clinic until the services are no longer required or until the client has had a reasonable opportunity to arrange for the services of another licensed veterinarian;
- A licensed veterinarian is required to inform their clients as to how they can access veterinary services outside of the licensed veterinarian’s regular practice hours;
- A licensed veterinarian is required to promptly inform their clients if the licensed member makes changes to how they offer after-hours care services;
- A licensed veterinarian is required to keep records of every time they provide after-hours care services information to their clients; and
- If an animal is to be hospitalized/housed in a veterinary facility after regular practice hours, the licensed veterinarian treating the animal shall inform their client of the supervision arrangements for that animal.
Requirement to Provide After-Hours Care Services
Licensed veterinarians have a variety of options when deciding how best to provide access to after-hours care services for animals that they have treated recently or treat regularly. These options include (singularly or in combination):
Providing “on-call” services either by themselves or in cooperation with other licensed veterinarians at the same accredited facility or through an in-house teletriage service;
Arranging coverage agreements with other licensed veterinarians at neighbouring accredited facilities who have agreed to share the provision of “on-call” services;
Referring clients to another accredited facility that provides 24/7 services and has agreed to accept the referrals;
Referring clients to an independent, Ontario accredited teletriage service; and
Referring clients to an accredited Emergency Clinic.
Licensed veterinarians are permitted to determine which options best suit their practice and expertise and are not required to maintain the same options at all times. They are permitted to set the times and parameters in which they will offer their services. They may also employ a combination of different methods to ensure the timely and responsible provision of after-hours care services
Communicating After-Hours Care Services to Clients
If a licensed veterinarian chooses to make alterations to their after-hour care services, either permanently or to cover planned absences such as vacations, they are required to take steps to notify their clients of the changes as soon as possible. Such steps may include a telephone message, signage on the door of the facility or electronic notice. In accordance with Section 20 of Regulation 1093, licensed veterinarians are required to keep record of the information that was provided.
Requirement for Continuity of Care in an Emergency
Licensed veterinarians are required to see an animal that they have recently treated or treat regularly after said animal is discharged from an emergency clinic if ongoing medical care is necessary, until emergency services are no longer required, or until the client has had a reasonable opportunity to arrange for the services of another licensed veterinarian.
Unforeseen Circumstances
Licensed veterinarians are expected to attempt to notify their clients of any unforeseen circumstances, such as severe weather or illness, that will affect their provision of after-hour care services. However, the College does recognize that there will arise circumstances in which a licensed veterinarian is unable to reasonably provide after-hours care services or timely notification. In these instances, the College expects a licensed veterinarian to keep records that note the reasoning behind the circumstances and the information that was provided to clients.
Requirement for Informed Consent when an Animal is Hospitalized After-Hours
Licensed veterinarians are expected to obtain informed client consent that ensures that the client understands and accepts the level of care and supervision provided when animals are housed in a veterinarian’s accredited facility overnight and that the level of care may vary based on circumstance.
Legislative Authority
R.R.O. 1990, Reg 1093, s. 20 (Veterinarians Act)
Resources
The following can be found at the College’s website at cvo.org:
Professional Practice Standard: Establishing, Maintaining, and Discontinuing a Veterinarian-Client-Patient Relationship (VCPR)
Guide to the Professional Practice Standard: Establishing, Maintaining, and Discontinuing a Veterinarian-Client-Patient Relationship (VCPR)
College publications contain practice parameters and standards which should be considered by all Ontario veterinarians in the care of their patients and in the practice of the profession. College publications are developed in consultation with the profession and describe current professional expectations. It is important to note that these College publications may be used by the College or other bodies in determining whether appropriate standards of practice and professional responsibilities have been maintained. The College encourages you to refer to the website (www.cvo.org) to ensure you are referring to the most recent version of any document.