Report on Consultation

Consultation Period: November 4, 2020 to February 12, 2021

Submissions: 25 Submissions

What is the Issue?

The College has had regulatory provisions related to conflict of interest since the Veterinarians Act was adopted in 1989. These provisions are contained in Sections 42-44 of Regulation 1093.

Over the past 30 years, the College has not provided specific guidance to these provisions. This has resulted in most inquiries related to conflict of interest being referred to the regulation directly. This choice may have also inadvertently resulted in veterinarians being somewhat unaware of these provisions.

Given the type of questions that continue to emerge in licensure, accreditation, and practice advice, the College believes that clarity is required to assist veterinarians in understanding the long-existing provisions.

In the long term, the College remains dedicated to achieving a clearer and more concise approach to conflict of interest through legislative reform. In the interim, however, Council has directed that a Professional Practice Standard be drafted to aid veterinarians in recognizing and understanding the current conflict of interest provisions.

The intent of the proposed Professional Practice Standard is not to rewrite the current regulatory provisions nor to offer interpretation that deviates from regulatory requirements. Many of the provisions use complicated wording and their intentions can be lost in the regulatory language used. Instead, the intent of the draft Standard is to offer a more plain-language explanation of the provisions to help veterinarians in determining whether they are in a conflict of interest. The aim of the document is to make the provisions more visible to foster greater reflection amongst veterinarians and encourage those seeking additional guidance to contact the College directly.

In June 2020, Council reviewed the first proposed draft Professional Practice Standard: Conflicts of Interest in the Practice of Veterinary Medicine. Following discussion, Council directed that the proposed draft be circulated for public consultation.

Why is it Important

The ability to manage real and perceived conflicts of interest is an essential component of professional practice. It is important for veterinarians to be able to identify, understand, and address the different forms of conflict of interest that may arise throughout their careers. Over the years, the College has received several questions from veterinarians related to this topic. A clear and concise Standard that outlines professional expectations in a plain-language approach will serve as a helpful resource for veterinarians seeking to ensure that they adhere with regulatory requirements.

Consultation Process

The draft Professional Practice Standard was sent for public consultation for a 100-day period during which members of the College and members of the public were asked to provide their feedback.

What we Heard

Major Themes

1. Some expectations appear confusing and hard to understand

2. Requests for more information/examples/tools to help understand the requirements and expectations

3. Consensus that the regulation by itself is confusing

Additional Themes

4. Questions related to veterinarian/client conversations regarding conflicts of interest

Sample Comments

The following quotes, summarized from comments received, reflect suggestions received through the College consultation:

• An example would help make this issue clearer. It appears that the conflict is accepting rebates/discounts for volume or loyalty purchases. It is not clear if that conflict still exists if the discounts are passed on to the client, or if the products in question are the medically appropriate choices for the patients. I think many veterinarians would read this and come to the conclusion that it doesn't mean them, when it might. It is not clear enough to tell.

• There may need to be a clear flow chart for determining conflict of interest scenarios.  It would also be helpful to members to understand the reason for the need to amend the document/add items.  Have there been specific challenges or complaints?  Have all groups been formally consulted (non-practicing veterinarians, fed vets, provincial vets etc?)

• This document is fairly clear however I have a couple of questions: - Can you clarify how/if item 9 impacts locum veterinarians? For example, if a locum is working out of a few different facilities is this a conflict of interest? - In a situation where a veterinarian has their own “niche” practice, a great example being hospice care, and does general practice locum work on the side, are they allowed to refer a client in the general practice to their hospice service? In particular, if the niche practice is the only option in the geographical area, there may be no choice but to refer that patient to their own service but it seems this would be a violation of items 6 and 9.

• An example would help make this issue clearer. It appears that the conflict is accepting rebates/discounts for volume or loyalty purchases. It is not clear if that conflict still exists if the discounts are passed on to the client, or if the products in question are the medically appropriate choices for the patients. I think many veterinarians would read this and come to the conclusion that it doesn't mean them, when it might. It is not clear enough to tell.

How We Responded

College staff made minor changes to the proposed Standard based on the consultation feedback. The ability to make further changes was hindered by the College’s inability to alter the meaning of the regulatory provisions. College staff also recommended the development of an associated guide to help address questions raised in the consultation. These revisions and recommendations, along with all the consultation feedback received, were brought forward for Council review and consideration.

Council reviewed the amended proposed draft Professional Practice Standard: Conflicts of Interest in the Practice of Veterinary Medicine at its March 2021 meeting and directed that the draft standard be published. Council also approved the recommendation for an associated guide to be developed.