ILLEGAL PRACTICE Q & A
1. What is illegal veterinary practice?
Anyone who engages in any aspect of the practice of veterinary medicine without
having a current California veterinary license is practicing illegally. According to
the California Business of Professions Code, Section 4825:
It is unlawful for any person to practice veterinary medicine
or any branch thereof in this State unless at the time of so
doing, such person holds a valid, unexpired, and unrevoked license as provided in this
chapter.
2. What constitutes the practice of veterinary medicine?
According to the California Business and Professions Code, Section 4826:
A person practices veterinary medicine, surgery, and dentistry, and the various
branches thereof, when he or she does any one of the following:
(a) Represents himself or herself as engaged in the practice of veterinary medicine,
veterinary surgery, or veterinary dentistry in any of its branches.
(b) Diagnoses or prescribes a drug, medicine, appliance, application, or treatment of
whatever nature for the prevention, cure, or relief of a wound, fracture, bodily
injury, or disease of animals.
(c) Administers a drug, medicine, appliance, application, or treatment of whatever
nature for the prevention, cure, or relief of a wound, fracture, bodily injury, or
disease of animals, except where the medicine, appliance, application, or treatment is
administered by a registered veterinary technician or a veterinary assistant at the
direction of and under the direct supervision of a licensed veterinarian subject to
Article 2.5 (commencing with Section 4832) or where the drug, including, but not
limited to, a drug that is a controlled substance, is administered by a registered
veterinary
technician or a veterinary assistant pursuant to Section 4836.1. However, no person,
other than a licensed veterinarian, may induce anesthesia unless authorized by
regulation of the board.
(d) Performs a surgical or dental operation upon an animal.
(e) Performs any manual procedure for the diagnosis of pregnancy, sterility,
or infertility upon livestock or Equidae.
(f) Uses any words, letters, or titles in such connection or under such circumstances
as to induce the belief that the person using them is engaged in the practice of
veterinary medicine, veterinary surgery, or veterinary dentistry. This use shall be
prima facie evidence of the intention to represent himself or herself as engaged in the
practice of veterinary medicine, veterinary surgery, or veterinary dentistry.
3. What are some examples of illegal practice?
Any procedure performed by a non-licensed person, and without veterinary supervision could be considered illegal.
Examples include:
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Non-anesthetic dental procedures
Equine tooth floating
Castration
Chiropractic
Physical Therapy
Rehabilitative Services
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Ear cropping/ tail docking
Reproduction services such as Artificial
Insemination, rectal palpation, ultrasound
or embryo transfer
Nutrition consulting
Acupuncture
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ILLEGAL PRACTICE Q & A
4. Are there any exceptions to the rule?
Yes. The business and professions code states the following practice exemptions:
(a) Practicing veterinary medicine as a bona fide owner of one's own animals. This
exemption applies to the following:
(1) The owner's bona fide employees.
(2) Any person assisting the owner, provided that the practice is performed
gratuitously.
(b) Lay testing of poultry by the whole blood agglutination test. For purposes of this
section, "poultry" means flocks of avian species maintained for food production,
including, but not limited to, chickens, turkeys, and exotic fowl.
(c) Making any determination as to the status of pregnancy, sterility, or infertility
upon livestock, equine, or food animals at the time an animal is being inseminated,
providing no charge is made for this determination.
(d) Administering sodium pentobarbital for euthanasia of sick, injured, homeless, or
unwanted domestic pets or animals without the presence of a veterinarian when the
person is an employee of an animal control shelter and its agencies or humane society
and has received proper training in the administration of sodium pentobarbital for
these purposes.
5. What constitutes “supervision” by a veterinarian?
Title 16 of the California Code of Regulations provides the following definitions:
(a) “Veterinarian” means a California licensed veterinarian.
(b) “R.V.T.” means a registered veterinary technician certified by the Board.
(c) “Unregistered assistant” means any individual who is not an R.V.T. or a licensed
veterinarian.
(d) “Supervisor” means a California licensed veterinarian or if a job task so provides
an R.V.T.
(e) “Direct Supervision” means: (1) the supervisor is physically present at the
location where animal health care job tasks are to be performed and is quickly and
easily available; and (2) the animal has been examined by a veterinarian at such time
as good veterinary medical practice requires consistent with the particular delegated
animal health care job task.
(f) “Indirect Supervision” means: (1) that the supervisor is not physically present at
the location where animal health care job tasks are to be performed, but has given
either written or oral instructions (“direct orders”) for treatment of the animal
patient; and (2) the animal has been examined by a veterinarian at such times as good
veterinary medical practice requires, consistent with the particular delegated animal
health care task and the animal is not anesthetized as defined in Section 2032.4.
(g) “Animal Hospital Setting” means all veterinary premises which are required by
Section 4853 of the Code to be registered with the Board.
(h) “Administer” means the direct application of a drug or device to the body of an
animal by injection, inhalation, ingestion, or other means.
(i) “Induce” means the initial administration of a drug with the intended purpose of
rendering an animal unconscious.
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ILLEGAL PRACTICE Q & A
6. What if a business is not actually performing the service, but is hosting someone who is?
The law states that aiding and abetting illegal practice is a crime. According to the California Business and
Professions Code section 4831:
Any person, who violates or aids or abets in violating any of the provisions of this
chapter, is guilty of a misdemeanor and upon conviction thereof shall be punished by a
fine of not less than five hundred dollars ($500), nor more than two thousand dollars
($2,000), or by imprisonment in a county jail for not less than 30 days nor more than
one year, or by both the fine and imprisonment.
7. What constitutes a “dental operation?”
According to Title 16 of the California Code of Regulations, Section 2037 states:
The term “dental operation” as used in Business and Professions Code section 4826
means:
(1) The application or use of any instrument or device to any portion of an animal's
tooth, gum or any related tissue for the prevention, cure or relief of any wound,
fracture, injury or disease of an animal's tooth, gum or related tissue; and
(2) Preventive dental procedures including, but not limited to, the removal of
calculus, soft deposits, plaque, stains or the smoothing, filing or polishing of tooth
surfaces.
(3) Nothing in this regulation shall prohibit, however, any person from utilizing
cotton swabs, gauze, dental floss, dentifrice, toothbrushes or similar items to clean
an animal's teeth.
8. What does the law say about chiropractors working on animals?
The California Code of Regulations, Title 16, Section 2038 states:
(a) The term musculoskeletal manipulation (MSM) is the system of application of
mechanical forces applied manually through the hands or through any mechanical device
to enhance physical performance, prevent, cure, or relieve impaired or altered function
of related components of the musculoskeletal system of animals. MSM when performed upon
animals constitutes the practice of veterinary medicine.
(b) MSM may only be performed by the following persons:
(1) A veterinarian who has examined the animal patient and has sufficient knowledge
to make a diagnosis of the medical condition of the animal, has assumed
responsibility for making clinical judgments regarding the health of the animal and
the need for medical treatment, including a determination that MSM will not be
harmful to the animal patient, discussed with the owner of the animal or the
owner's authorized representative a course of treatment, and is readily available
or has made arrangements for follow-up evaluation in the event of adverse reactions
or failure of the treatment regimen. The veterinarian shall obtain as part of the
patient's permanent record, a signed acknowledgment from the owner of the patient
or his or her authorized representative that MSM is considered to be an alternative
(nonstandard) veterinary therapy.
(2) A California licensed doctor of chiropractic ( “chiropractor”) working under
the direct supervision of a veterinarian. A chiropractor shall be deemed to be
working under the direct supervision of a veterinarian where the following protocol
has been followed:
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ILLEGAL PRACTICE Q & A
(A) The supervising veterinarian shall comply with the provisions of
subsection (b)(1) prior to authorizing a chiropractor to complete an initial
examination of and/or perform treatment upon an animal patient.
(B) After the chiropractor has completed an initial examination of and/or
treatment upon the animal patient, the chiropractor shall consult with the
supervising veterinarian to confirm that MSM care is appropriate, and to
coordinate complementary treatment, to assure proper patient care.
(C) At the time a chiropractor is performing MSM on an animal patient in an
animal hospital setting, the supervising veterinarian shall be on the
premises. At the time a chiropractor is performing MSM on an animal patient in
a range setting, the supervising veterinarian shall be in the general vicinity
of the treatment area.
(D) The supervising veterinarian shall be responsible to ensure that accurate
and complete records of MSM treatments are maintained in the patient's
veterinary medical record.
(c) Where the supervising veterinarian has ceased the relationship with a chiropractor
who is performing MSM treatment upon an animal patient, the chiropractor shall
immediately terminate such treatment.
(d)(1) A chiropractor who fails to conform with the provisions of this section when
performing MSM upon an animal shall be deemed to be engaged in the unlicensed practice
of veterinary medicine.
(2) A veterinarian who fails to conform with the provisions of this section when
authorizing a chiropractor to evaluate or perform MSM treatments upon an animal shall
be deemed to have engaged in unprofessional conduct.
9. What about a veterinarian who prescribes medications to or treats an animal without examining it first, is
that illegal?
It is, except for in a few rare circumstances such as providing lifesaving emergency care for a wild animal or for a
domestic animal with no known owner. For all other instances, California state law requires that a veterinarian
establish a Veterinary Client-Patient Relationship (VCPR) prior to initiating any treatment or therapy for an animal. The
California Code of Regulations, Title 16, Section 2032.1 says:
(a) Except where the patient is a wild animal or its owner is unknown, it shall
constitute unprofessional conduct for a veterinarian to administer or prescribe a drug,
medicine, appliance, or application or treatment of whatever nature for the prevention,
cure, or relief of a wound, fracture or bodily injury or disease of an animal without
having first established a veterinarian-client-patient relationship with the animal
patient or patients and the client. It shall also constitute unprofessional conduct for
a veterinarian to prescribe, dispense, or furnish either a veterinary drug, as defined
by Section 1747.1, Title 16, California Code of Regulations, or a dangerous drug, as
defined by Section 4022 of the code, without having first established a veterinarianclient-patient relationship with the animal patient or patients and the client.
(b) A veterinarian-client-patient relationship shall exist when all of the following
occur:
(1) The veterinarian has assumed responsibility for making medical judgments
regarding the health of the animal(s) and the need for medical treatment, has
discussed with the client a course of treatment and if applicable has instructed
the client as to the appropriate directions for administering the drugs or
treatments.
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ILLEGAL PRACTICE Q & A
(2) The veterinarian has sufficient knowledge of the animal(s) to initiate at least
a general or preliminary diagnosis of the medical condition of the animal(s). This
means that the veterinarian has recently seen and is personally acquainted with the
care of the animal(s) by virtue of an examination of the animal or by medically
appropriate and timely visits to the premises where the animals are kept, and
(c) A dangerous drug or a veterinary drug shall not be prescribed for a duration which
is inconsistent with the animal patient's medical condition or type of drug prescribed
which in no event shall exceed more than one year from the date that the veterinarian
has examined the animal patient and prescribed such drug, unless the veterinarian has
conducted a subsequent examination of the patient to determine the patient's continued
need for the prescribed drug.
10. If a California licensed veterinarian agrees to oversee a lay person performing a service, what does that
mean for the veterinarian?
Anytime a veterinarian supervises either an RVT or a veterinary assistant (in this case a lay provider), the veterinarian
assumes liability. The law says:
(a) The supervising veterinarian shall be responsible for determining the competency of
the R.V.T. or unregistered assistant to perform allowable animal health care tasks.
(b) The supervising veterinarian of a R.V.T. or unregistered assistant shall make all
decisions relating to the diagnosis, treatment, management and future disposition of
the animal patient.
(c) The supervising veterinarian shall have examined the animal patient prior to the
delegation of any animal health care task to either an R.V.T. or unregistered
assistant. The examination of the animal patient shall be conducted at such time as
good veterinary medical practice requires consistent with the particular delegated
animal health care task.
11. Can illegal activity go on in a veterinary practice?
Yes. The law states that specific tasks may be carried out by RVT’s only. Other tasks may be appointed to nonlicensed veterinary assistants under varying degrees of veterinary supervision. It is illegal for a veterinarian to direct or
allow a non-licensed veterinary assistant to perform “RVT specific tasks.” Title 16 of the California Code of
Regulations states:
(a) Unless specifically so provided by regulation, a R.V.T. shall not perform the
following functions or any other activity which represents the practice of veterinary
medicine or requires the knowledge, skill and training of a licensed veterinarian:
(1) Surgery;
(2) Diagnosis and prognosis of animal diseases;
(3) Prescription of drugs, medicines or appliances.
(b) An R.V.T. may perform the following procedures only under the direct supervision of
a licensed veterinarian:
(1)
(2)
(3)
(4)
Induce anesthesia;
Apply casts and splints;
Perform dental extractions;
Suture cutaneous and subcutaneous tissues, gingiva and oral mucous
membranes,
(5) Create a relief hole in the skin to facilitate placement of an
intravascular catheter
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ILLEGAL PRACTICE Q & A
(c) An RVT may perform the following procedures under indirect supervision of a
licensed veterinarian:
(1) Administer controlled substances.
(d) Subject to the provisions of subsection(s) (a), (b) and (c) of this section, an
R.V.T. may perform animal health care tasks under the direct or indirect supervision of
a licensed veterinarian. The degree of supervision by a licensed veterinarian over a
R.V.T. shall be consistent with standards of good veterinary medical practices.
Title 16, Section 2036.5 states:
(a) Unregistered assistants shall be prohibited from performing any of the functions or
activities specified in subsections (a) (b) and (c) of Section 2036 of these
regulations, except that an unregistered assistant under the direct supervision of a
licensed veterinarian or registered technician may administer a controlled substance.
(b) Subject to the provisions of subsection (a) of this section, unregistered
assistants in an animal hospital setting may perform auxiliary animal health care tasks
under the direct or indirect supervision of a licensed veterinarian or the direct
supervision of an R.V.T. The degree of supervision by a licensed veterinarian over an
unregistered assistant shall be higher than or equal to the degree of supervision
required when an R.V.T. performs the same task and shall be consistent with standards
of good veterinary medical practices.
12.
Can veterinarians refer patients to non-veterinarians for care or consulting services?
No. It is illegal for a veterinarian to refer a patient to anyone other than another veterinarian. If a veterinarian feels that
an animal needs chiropractic care, dental care, physical therapy, nutrition consulting, or any other kind of therapeutic
modality, the veterinarian must supervise the person performing the task, unless that person is another California
licensed veterinarian.
13.
Who is responsible for investigating illegal practice and enforcing the law?
The California Veterinary Medical Board, which is a subsidiary of the California Department of Consumer Affairs.
According to the California Business and Professions code, Division 1, Chapter 1.5:
The Legislature finds and declares that:
a) Unlicensed activity in the professions and vocations regulated by the Department of
Consumer Affairs is a threat to the health, welfare, and safety of the people of the
State of California.
b) The law enforcement agencies of the state should have sufficient, effective, and
responsible means available to enforce the licensing laws of the state.
c) The criminal sanction for unlicensed activity should be swift, effective,
appropriate, and create a strong incentive to obtain a license.
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