Years before there were acronyms like VCPR and VFD, Alabama veterinarian Ken McMillan was advocating the idea that cattle producers needed an ongoing relationship with their local large-animal practitioner and could greatly benefit from regular operation checks.
He felt a professional eye could help many operators improve profits, avoid potential health issues and boost herd reproduction rates. By January 2017, McMillan's long-ago idea will pretty much have to be standard operating procedure -- if a producer wants to have a vet on call to issue a Veterinary Feed Directive (VFD) or a prescription. The two will also need to have something the FDA has so nimbly named a Veterinarian Client Patient Relationship (VCPR).
McMillan, based at Cropwell and a longtime columnist for The Progressive Farmer magazine, is concerned the transition to that January 2017 mark is going to be challenging. He is most worried about the scarcity of large-animal practitioners in many areas and what he expects will be a last-minute crush from producers to create VCPRs. Most of those last-minute requests he suspects will come from producers who haven't traditionally relied on veterinarians to treat their herds unless it was a dire situation.
"If a veterinarian has not been on a farm and does not know that operation or that person, I don't think they will want to put their name or their license at risk," he said. "Producers need a consulting veterinarian who is overseeing their operation on a regular basis. They won't have to come to the farm every time there is a problem, but they will need to know the producer and the herd. Boots on the ground are just going to be very important as we make this change."
McMillan recounts a call he received from a producer who had a cow that had been in labor all day. The producer had been in his practice area for 30 years, and McMillan had never met him or been called out to the farm. He delivered a live calf for that producer but points out this anecdote describes a not altogether uncommon situation.
"If you have been the kind of producer who wants a veterinarian to come out to your farm once every 30 years, or even once every one or two years, that is not going to be possible as we move forward," he said.
ESTABLISHING A VCPR
McMillan stressed the VCPR is a very different relationship from one where a veterinarian is called on to deliver a calf or treat an individual animal. It requires the veterinarian to have detailed knowledge of the operation and an ongoing working relationship with that producer.
"There needs to be a high degree of trust between both parties, because the producer and the veterinarian will have an increased liability and accountability in assuring antibiotics are being used correctly and legally," he said.
The American Association of Bovine Practitioners (AABP) has guidelines for veterinarians explaining what is meant by a VCPR and how to establish one that meets federal requirements under the Food and Drug Administration CFR 21 (Code of Federal Regulations).
The AABP guidelines say a written and signed agreement needs to be in place between veterinarian and client, establishing who is responsible for drug use and administration of those drugs on the farm. If more than one veterinarian or practice works the farm, one will be recorded as the "Veterinarian of Record," meaning they assume overall responsibility for drug use, protocols, drug inventories and training.
While regular farm visits are an important component of the oversight required of the veterinarian of record, the AABP guidelines say these visits can be supplemented with communication via phone or electronic messaging. If a veterinarian, who is not the veterinarian of record, provides any professional service, it is his/her responsibility to let the veterinarian of record know and be informed of any findings. Treatment records and protocols must be in writing and maintained.
ISSUING AND STORING VFDS
The logistics of VFDs and the VCPR are common concerns for producers, veterinarians and medicated feed producers.
Kerry Keffaber, veterinarian and adviser for scientific affairs and policy at Elanco, is confident that before the VFD takes effect, the tools the industry needs to make the program work will be in place. While he said it's perfectly legal to use a notepad and physically write out a VFD, he believes electronic versions will be the preferred approach as they will largely eliminate the possibility of mistakes and make storage easier.
Keffaber said one company working to provide the service will be GlobalVetLINK. But he adds he won't be surprised to see others emerge to fill the niche. He said Elanco, "as one of the many sponsors looking to collaborate with all stakeholders from farm to fork, wants to make sure this process goes as effectively and efficiently as possible because we want this to be a success. I think there's a strong opportunity by moving forward together that we can leapfrog ahead in demonstrating responsible antibiotic use."
Those most challenged by the VFD may well be small producers who don't often use veterinarians, Keffaber said. He concurs with McMillan's view that it is important to move now to establish VCPRs with area practitioners. He said while most people who have livestock know who they would go to for a health emergency, they don't all have the kind of ongoing professional relationship with their veterinarian that would constitute a valid VCPR.
"What we've been told, and this is speculative, but those people with smaller herds who are long distances from a veterinarian may well experience the most challenges. They may, at this time, interact with a vet once or twice a year, maybe less than that. Now, they need long-term health plans. Even if you have one or two calves and are a part-time producer, this impacts you."
He stressed, "If an animal in the herd needs medication, there should be no barrier to getting access if steps are taken now. Everyone should prepare now to avoid a crisis situation in January."
Asked if veterinarians who are employed by animal pharmaceutical companies will be able to write VFDs if they can show a valid VCPR, Keffaber said this is not likely to be a model going forward.
"There is significant potential conflict of interest," he said of that situation. "We see it as imperative that producers have a long-term relationship with their local veterinarian who knows the health issues of their herds and can be available for follow-up."
For More Information and Updates on the VFD:
-- American Association of Bovine Practitioners: www.aabp.org
-- Elanco: www.elanco.us/products-services/beef/pulmotil/veterinary-feed-directive.aspx
-- GlobalVetLINK: www.globalvetlink.com
-- FDA's page for VFD information: www.fda.gov/AnimalVeterinary/DevelopmentApprovalProcess/ucm071807.htm
-- FDA's Code of Federal Regulations (CFR) 21: www.ecfr.gov/cgi-bin/ECFR?page=browse
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