Vets refusing to give prescriptions for maintainence meds...legitimate or not?

[SteppinEasy]

I'll keep the details vague to protect identities, but I was completely shocked at my vet's today. Last year, my horse had a condition that required loads and loads of expensive tests to figure out. This condition isn't constant, but requires medicines whenever there's a flare-up. I've used the same vets for six or seven years and the practice treats my horses, dogs, barn cats and any other animal I feel the need to take to the vet.:lol:

Today when I went in to pick up some medicine (my first of one since March; the other I pick up every four months or so), I was told that I couldn't get any of the first medicine because the prescription had run out. The second medicine had doubled in price, and it wasn't cheap to begin with. The staff suggested I schedule a visit so the vet could check him out. When I asked for the written prescription on the one that was "still available" they refused.

Now, honestly, I'm not anti-vet. I'm not against vets making a living. But my horse's condition hasn't changed and won't change. There's zero reason to run all the crazy tests again when we already KNOW what's wrong. There's also no reason for the vet to come out again (we just had boosters last month) to tell me that the condition hasn't changed just so I can get the first prescription!:(

And what's up with not letting me have the second prescription? I've checked with SmarkPak and the prices are still exactly what they were four months ago there. I assume it's legal for the vet not to give it to me, but should it be? Is there some legitimate reason that my irritation made me miss?;) I totally felt like I was being nickle and dimed to death, and after years of prompt payments on bills big enough to send each individual vet's kids to college!!!

And incidently, are things the same with small animal vets? I have a dog that needs ear medicine fairly often (allergies)--am I going to encounter the same thing if I go to a small animal-only practice (after being seen regularly, of course) and ask for her regular meds? :confused: Or is this just a horse thing? After this, I'm really dreading trying to get my dog's uber-expensive ear meds the next time she has a flare-up! Sigh.

[RedMare01]

I thought that vets could not refuse to give a prescription if asked for one but could charge for it? I've never heard of a prescription "running out" for an animal...I wonder what the time frame is (I bet determined by this individual vet). Would they fill it for you there without the horse being seen again?

Caitlin

[msj]

I know there have been other threads about this and the answer is that vet are required by law to give you the script. Some may charge you for the script though. Check back in Horse Care forum cause someone even gave the exact wording about it.

Last week I asked for a script for Banamine and the vet was shocked that I could buy it for $25.15 from one of the vet supply catalogs (Valley Vet I think or it could have been Horse Health).

[Simkie]

I don't think it's unreasonable for a vet to want a yearly checkup before renewing an RX. My vets (small and large animal) and my personal doctor all require a yearly checkup before renewing anything.

[SteppinEasy]

I've never heard of a prescription "running out" for an animal...I wonder what the time frame is (I bet determined by this individual vet). Would they fill it for you there without the horse being seen again?

Caitlin


No, that's the thing...they WOULDN'T fill the prescription unless he was seen again!:no: Again, if this wasn't a regular medicine, I could see it, maybe, but not a regular med for a condition that isn't subject to getting better or worse--you just treat it when it happens.

Is it possible this is something that is coming out of the small animal world and I just never heard of it until now?

[lotc2005]

I feel your pain. This summer, one of the fillies I recently acquired managed to injure herself (as horses tend to do). She had a small, m&m sized puncture wound in the muscular part of her leg just in front of her elbow, no idea where or how she got it. I called my regular vet, whom I have been a client of for over 10 years, cats, dogs, horses, they all see this vet. Vet told me he couldn't come out to see my filly for two days. I said that was fine and requested a mild antibiotic, as I was concerned of an infection setting in, and still scheduled to have the vet out. The vet refused the antibiotic. When I stated that I was concerned of a potential infection, he just said my filly should be fine and he would see me in two days. I promptly called the vet that my BO uses (who is about 45 minutes away, my vet is 10 minutes away,) and he came out that day and prescribed an antibiotic. To make a long story short, the wound took three different antibiotics (one injectable) and about three weeks to actually heal. And to think that my vet was completely fine with waiting to come see the horse for two days with no antibiotics? Needless to say, I promptly cancelled my appointment I had scheduled with my vet.

This said, I don't understand vets.

[pony89]

My small animal vet's office won't write perscriptions without seeing the animal unless the animal has had a checkup within the last 12 months (has to be an actual checkup, not just a sick animal visit.) I assume it is to encourage preventative health care. I am also guessing they don't want the liability of dispensing drugs to an animal they haven't seen in years.

This issue has never come up with my equine vet, but if you got the answer from the staff, I would talk to the actual vet about it. They may have a general policy against it, but since the vet has seen him regularly for shots, etc., he may make an exception if you can discuss it with him directly.

[SteppinEasy]

I don't think it's unreasonable for a vet to want a yearly checkup before renewing an RX. My vets (small and large animal) and my personal doctor all require a yearly checkup before renewing anything.

Even though he saw the horse a month ago? Even without that check-up, we would still be well within the yearly requirement that people doctors require.

[TrakGeorge]

I don't think it's unreasonable for a vet to want a yearly checkup before renewing an RX. My vets (small and large animal) and my personal doctor all require a yearly checkup before renewing anything.

This might be the case. I remember a few years back I needed some bute for my horse and asked the vet I was working for if I could have a bottle. He knew the history of the horse, but because it had been so long since the horse was last in I needed to make a new appointment.

[2DogsFarm]

Check the Horse Care forum for a similar thread.

Someone posted AMVA info that stated a vet could not refuse to give an established client a prescription without an explanation.

Have you talked to your vet (not his staff) about this refusal?
Maybe his reason would make more sense than the "just because" you seem to be getting from staff.

[SteppinEasy]

Check the Horse Care forum for a similar thread.

Someone posted AMVA info that stated a vet could not refuse to give an established client a prescription without an explanation.

Have you talked to your vet (not his staff) about this refusal?
Maybe his reason would make more sense than the "just because" you seem to be getting from staff.

Thanks, I'll look for that thread. No, I haven't talked with the vet directly. He was out on a farm call when I stopped by the office, and I was so mad it probably wouldn't have been a good idea to try and talk to him today anyway.

[pony89]

If your vet's office is the same as mine, the staff and the vet are sometimes two entirely different conversations. I wouldn't get too upset until you talk to the vet.

[Bluehorsesjp]

Have you talked to your vet (not his staff) about this refusal?
Maybe his reason would make more sense than the "just because" you seem to be getting from staff.

Or it could just be a new rule that the staff have been told to enact, but you might be the exception. For example, my vet will give me Adequan and legend at a discounted rate. If I don't order it through my vet himself and the office girls give it to me it is marked up at full price. So the legend I get in a vial for $89 becomes a legend shot in a syringe for $115.:eek:
Didn't know syringes were so expensive.

My small animal vet explained it to me this way. My Lab is on Deramax. He needs to have his liver enzymes tested once a year to make sure the Deramax is not killing that organ. The vet can not beat the pricing that a large online vet pharmacy can, they just don't buy it in bulk like online companies do. SO I now bring my dog in for his blood test and get a scrip to buy on line.

My large animal vet has been slower to get on the band wagon with this. So far they will not let me buy on line, but will give me a "better deal" than normal. It is a bit infuriating, but helps keep out relationship running smoothly. Their explaination is that they don't know how old the drugs are or how they have been stored....blah blah blah....

[Ruth0552]

When I worked in a small animal clinic we would not hand out scripts to people who had not had their animals seen WITH THAT ISSUE ADDRESSED in the past year. Example- dog gets ear infections, owner wants refill of otomax. Dog has only been seen once in past year for anal sac infection. No go on the Otomax.

And yeah, it is definitely illegal to refuse to write a script. I would have imagined with an appointment a month ago and the script filled every four months they would have a hard time giving you some crap about needing to test, not sure the horse still needs it, etc.

I understand vets need to make a living, but with all my boss's bemoaning about how his small animal practice wasn't making enough money, he still sends three daughters to private schools and lives in an expensive town with perfectly good public schools. That vet spent a lot of time comparing his practice to an MD's, though.

[shakeytails]

I'm glad the vets I use are cool. I can stop in at the mostly small animal/ mixed practice vet and tell them I need Otomax, for example. They don't even ask if that particular dog has been seen by the vet. They just ask if I want the big bottle or the small one! I once saw one of the local vets at the local convenience store and asked if he had any Rimadyl. He was out, but he would have sold it to me had it been in his truck. It's also no problem to get any of the common horse drugs like banamine, bute, tranqs, etc. I can also get anything I need from my regular horse vet.

I've never felt the need to ask either practice to write me a prescription, but I'm fairly certain they would.

[lesson junkie]

SteppinEasy-I worked in a mixed practice several years ago as receptionist. We could not send prescription meds out if the vet was out of the office unless we talked to the vet first. It didn't matter if it was routine or not-if we didn't talk to the doc the meds couldn't go out of the office. It was awkward sometimes, especially when the client was in your position with a chronic condition under our clinic's care.

If you talked to the doc, then I don't have an explanation unless the medication you need is under new regulation. I hope you get a satisfactory answer.

[spurgirl]

I would talk DIRECTLY to your vet, esp. since he'd just seen the horse for your fall shots, or whatever, the previous month. I had a similar problem with my horses' having their teeth floated last spring. Vet practice has 3 vets....I have had Dr. X almost exclusively for seven or eight years...So now Dr. Y, in the same practice, is now a trained "super dentist", has the power floating equip., 2 vet techs, and his pull along stocks-now, the office stated only HE can do teeth PROPERLY-at over $150 a horse, plus another farm call !!! Ummm, don't think so. I had quite a go round with the office staff, and then talked to the vet. After 15 years of using this practice, suddenly neither of the other vets could do routine floating when they came for checkups/vaccs ? So, I asked for all that money back from the previous floats if Dr. X had been incompetent in all those years of appointments-paid in full each and every time he came...Needless to say, Dr. X came and did all the checkups, vaccinations AND routine floatings.;)

[CosMonster]

I bet it's just a miscommunication/overzealous staff issue since the horse has been seen so recently by that vet, and it's a routine med. I have to say, though, that my vet will write routine scripts for me whenever I ask without charging (bute, banamine, antibiotics, etc.), and it's one of the things I really appreciate about him. I wouldn't leave an otherwise good vet just because of that or anything, but boy is it nice to know I can just call him up and he'll take care of it.

[Ghazzu]

Issuing a prescription *or* filling one requires a valid veterinarian-client-patient relationship and in most places means that the DVM needs to assess the animal periodically to determine whether the drug and dosage are still appropriate.

Your initial post was too vague for me to get a good idea of whether that is the case here, but I suspect that is at the bottom of it.

[Ghazzu]

I'm glad the vets I use are cool. I can stop in at the mostly small animal/ mixed practice vet and tell them I need Otomax, for example. They don't even ask if that particular dog has been seen by the vet. They just ask if I want the big bottle or the small one! I once saw one of the local vets at the local convenience store and asked if he had any Rimadyl. He was out, but he would have sold it to me had it been in his truck.

Policies like that can come back to bite the DVM in the hindquarters bigtime.

[chaltagor]

There's also no reason for the vet to come out again (we just had boosters last month) to tell me that the condition hasn't changed just so I can get the first prescription!.

Did your horse get an exam? My vets do not do exams when they stop out for vaccines. It is an extra cost to have a full physical exam done. Things can change, new studies, new meds, new procedures etc. The vet wants to come out, do an exam and talk to you specifically about how your horse has been doing related to these problems.

[WaningMoon]

According to this it differs state to state. And it says your state does have to write one.http://members.verizon.net/~vze2r6qt/supplies/legal.htm

[ToN Farm]

What about meds like Legend and Adequan? Why would an exam be necessary before prescribing either? My vet really charges a lot for both.

[vineyridge]

What about meds like Legend and Adequan? Why would an exam be necessary before prescribing either? My vet really charges a lot for both.

I just got a quote for Legend from my vet. He plans to charge $115 per vial and requires an advance purchase from me of six vials--says that's the minimum purchase from his supplier. Since I don't do IV shots, the vet farm call would be on top of the $115, making each shot $150. My advance payment would be in the neighborhood of $700.

Legend is not that expensive from places like Smart Pak, and if I've got to pay in advance and am the only customer there is no justification (like keeping it in unpaid inventory) for that amount of mark up.

In Mississippi, vets are actually offended at the idea of having to write prescriptions, AMVA or no AMVA. However, I think this is very fertile ground for potential lawsuits on the grounds of unfair trade practices. I seem to recall that the professions are subject to anti-trust and unfair trade practice laws as much as any other business. It seems to me that requiring patients to purchase medicines from the seller that are prescribed by the seller should violate such laws.

[BornToRide]

To make more money. I can apperciate that they may want to enure the animal is OK, but this is almost forcing the owner to pay more than necessary. It costs me $60 to get a rabies shot for my dogs because they refuse to give them the shot without having a full examination done. IMO this is over the top. There should be a short physical version that would cut the cost to a more reasonable fee. I know very well that my dogs are OK and really do not need to be examined prior to receiving a vaccination. I'd do it myself if it would be possible with rabies.

[AngelainTexas]

This is a hot topic. I have worked in veterinary medicine for 21 years. I can see both sides. I think if the clinic carries the product then the vet should not HAVE to write a scrip, it should be their choice. But if it is something they don't carry they definately should do it. A lot of the on-line pharmacies don't get their products from the manufactor, they buy from second hand sources so the manufactors will NOT stand behind their product should something go wrong.

Also, someone else mentioned needing the client patient relationship to be current. This is very true and can bite them in the ass if something happens.

I personally would do what a lot of others have suggested and speak to the vet personally.

[shakeytails]

To make more money. I can apperciate that they may want to enure the animal is OK, but this is almost forcing the owner to pay more than necessary. It costs me $60 to get a rabies shot for my dogs because they refuse to give them the shot without having a full examination done. IMO this is over the top. There should be a short physical version that would cut the cost to a more reasonable fee. I know very well that my dogs are OK and really do not need to be examined prior to receiving a vaccination. I'd do it myself if it would be possible with rabies.

If I don't get my dogs to a rabies clinic, I have my horse vet vaccinate when he's here for a horse call. No exam fee or anything, just the cost of the shot. I just call and tell him to make sure to put some rabies vacs on the truck. Of course, this option doesn't work very well if your horses and dogs don't live at the same place!

[BornToRide]

If I don't get my dogs to a rabies clinic, I have my horse vet vaccinate when he's here for a horse call. No exam fee or anything, just the cost of the shot. I just call and tell him to make sure to put some rabies vacs on the truck. Of course, this option doesn't work very well if your horses and dogs don't live at the same place!
Yes, I have heard that as well and I will take advantage of that next time :)

[Rick Burten]

Due to the litigious nature of our current society, most medical professionals have adopted a CYOAF(Cover Your Own Ass First) attitude. This means that before they prescribe, they are going do do whatever it takes to cut down if not eliminate the risk of a lawsuit. I don't necessarily like it, but I damn sure understand it.

[Fharoah]

I don't think the it is unreasonable for vets to want and re-examine the horse yearly before renewing the script. Nor do I think it is worth being upset about.

[steelerino]

Yes, I have heard that as well and I will take advantage of that next time :)


Also check your local animal control, we do walk in rabies shots here at the shelter for the public & there is no exam fees.

[whbar158]

I agree its likely an answer they are to give esp if the vet is out, I had a problem about a year ago when I had to go pick up some meds and I had talked to one of the vets at the practice and he told me to go pick it up, and it would be all ready for me to pick up and would be put on the farms account (it was for the farms horse). Well the vet had to go out on an emergency call and didn't get it all set up right and the staff didn't want to give me anything without the vets approval (which I totally understand as it is hard to be answer questions that you don't know the answer to and the person who does isn't there!). He had not left a note or told them anything, then finally they got me the meds then tried to make me pay for all of it because I wasn't on the account, but it all got worked out. It was esp confusing because the took my name and my horse came up who was suppose to be deleted out of their system as he had moved and I use a different practice for him. I would wait to talk to the vet about it and see if the staff was just being cautious about handing out meds.
I am lucky that the practice I use for my horse is pretty easy going and have been a long time client (except for a few years when my horse was a different farm and I used their practice), I can usually get any basic med from any of the vets I know any time I need it.

[SteppinEasy]

I've been fixing dinner, so sorry for the delay.

Again, I wouldn't have any problem with this it weren't a maintainence drug that I have to buy regularly. Or if the vet hadn't done a full exam when he came out to give vaccinations a month ago.

I hope this is merely a misunderstanding. Today's weirdness came completely out of the blue.

Ghazzu, or any other vets out there, are there any regulations on how long it would take for a prescription to "run out?"

[Ghazzu]

Ghazzu, or any other vets out there, are there any regulations on how long it would take for a prescription to "run out?"

In general, the maximum span would be a year, I'd guess, but there are some things that I wouldn't extend that far.

I don't know that it's that codified, more like what is or isn't going to get your butt in a sling if you get hauled up before the board--in short, practicing good medicine.

Antibiotics, obviously, but things like anti-seizure medications, steroids, certainly NSAIDs like Rimadyl--especially in Labradors, eye medications, etc.

I can't help but wonder what kind of outrage there would be on this board should someone post that their DVM handed them a bottle of pills without even looking at the animal and the creature died...

Again, not a commentary specifically on the OP, as I don't know the circumstances, but more on many of the responses.
Y'all seem to think you have a blanket right to any prescription drug your little hearts desire, sometimes.

[whbar158]

I'm pretty sure my vet wouldn't want to just hand over anything besides banamine, bute, and some ACE and maybe some mild anti-biotics just to have on hand. I am pretty sure that I would be able to get adequan or legends without an exam (unless my horse was lame or something weird), but she does see my horse at least twice a year, usually 3 or more (he likes her, and just acts like such a baby when shes there!).

[BornToRide]

Also check your local animal control, we do walk in rabies shots here at the shelter for the public & there is no exam fees.
I will, thank you!:)

[regeventer]

Thank you Ghazzu.

Go look at the AVMA statement - prescriptions with A VALID DOCTOR PATIENT RELATIONSHIP!!!!

[BornToRide]

Thank you Ghazzu.

Go look at the AVMA statement - prescriptions with A VALID DOCTOR PATIENT RELATIONSHIP!!!!And how is that generally interpreted?? Seems a bit ambiguous to me.

[Ghazzu]

And how is that generally interpreted?? Seems a bit ambiguous to me.

One would hope that it included an examination of the animal for whom the prescription was written for the condition or illness for which the prescription drug was prescribed.

There are exceptions for herd health issues.

[LAZ]

I have a long-standing and good relationship with my vet clinic and they are happy to write me a script if I ask for it. They are also really good about letting me have common drugs without question--banamine, general antibiotics, ace, bute, eye meds, etc (anything that helps with a potential emergency).

However, they come to my barn regularly and know that if I have any question or doubt that I will be on the phone to them immediately and they will see the animal in question.

A good client/vet relationship really does make a difference on both ends, I think.

[TheOrangeOne]

I had a vet tell me they wouldn't write me a script for adequan (or legend, forget which) unless I had them come by and do xrays to be sure there was a need? However, if I'd like to buy from them, it wouldn't be necessary. This is for a sporthorse, so I'd say reasonable preventative thing

[yellow-horse]

I have my vet out once a year for coggins,teeth and rabies shots, i do the rest myself, i have 3 horses, 1 is on pergolide forever, thats not going to change, we don't need bloodwork unless there is a change in the horses condition or other sym[pton that the dose needs to be adjusted, so my vet just writes a script at the yearly visit, the only reason i have her out once a year, other than i can't do teeth is to have a vet. we have a relationship albeit usually i see her once a year, knock on wood, if my rx ran out before her yearly visit or i was late for the yearly visit she has written me a scrip, her scrips are renewable for a year at a time.

[denovo]

I have a long-standing and good relationship with my vet clinic and they are happy to write me a script if I ask for it. They are also really good about letting me have common drugs without question--banamine, general antibiotics, ace, bute, eye meds, etc (anything that helps with a potential emergency).

However, they come to my barn regularly and know that if I have any question or doubt that I will be on the phone to them immediately and they will see the animal in question.

A good client/vet relationship really does make a difference on both ends, I think.


I have a very similar relationship with my clinic. They are wonderful, and I can nearly always get a bottle of ace/bute/anti biotic to just have on hand...but they also konw that we tend to err on the cautious side, and ALWAYS phone to talk if we're not sure. Nearly all of the barn client's use them, too, so they come to the barn on a very regular basis, and know me pretty well.
I have jsut recently started my 15 yr old 3'6 horse on Legend, and my vet just leaves it with me to give(my SO will give the IV shots).
I also once phoned in, concerned that a client horse possibly had a bladder infection. Vet calle another clinic, closer to me(mine is a good 1/2 hr away), gave them the scrip for a minor anti biotic, and told me what to wathc for in the next 48 hours, in case she needed to come. I was eternally grateful, and actually fully expected to have to have her out, which I th ink is part of the good vet/client relationshiop. :)

[Auventera Two]

No, that's the thing...they WOULDN'T fill the prescription unless he was seen again!:no: Again, if this wasn't a regular medicine, I could see it, maybe, but not a regular med for a condition that isn't subject to getting better or worse--you just treat it when it happens.


Sounds like you're talking about ulcers and Gastrogard. :lol: I had the same problem. Wanted a script for Gastrogard so I could buy the treatment regime for $400 cheaper online. NOPE. The vet refused and said I HAD to buy it at their clinic, and they were NOT releasing the script to me. I called my other vet who has been seeing our animals for 10+ years, and they said we'd have to see the horse first (so another $65 large animal exam fee), then we'd charge you a fee for releasing the script, and it's pretty hefty - usually around $30-$40 or so. I said, even if the equine hospital faxes you the report and findings of the gastroscope, and their recommendations to do Gastrogard, you STILL need to see the horse AGAIN - 2 days after this initial diagnosis???? Yep. I said forget it, I'll just buy the stupid medication from the equine hospital. Good grief.

Knowing what I know NOW, I would have just bought Ulcergard online since it needs no script, and it's the exact same thing.

[Auventera Two]

I had a vet tell me they wouldn't write me a script for adequan (or legend, forget which) unless I had them come by and do xrays to be sure there was a need? However, if I'd like to buy from them, it wouldn't be necessary. This is for a sporthorse, so I'd say reasonable preventative thing

So they only truly care about the horse and his needs, if it means your $$$$ will be going somewhere else to buy the medication. But if you're buying it through THEM, they don't really care if the horse actually needs it or not, because they'll just happily take your $$$$ and give the horse the adequan regardless of actually "need". Nice.

[Guilherme]

I don't think it's unreasonable for a vet to want a yearly checkup before renewing an RX. My vets (small and large animal) and my personal doctor all require a yearly checkup before renewing anything.

Quite true and quite reasonable.

A vet. has an independant duty to evaluate the condition of an animal before presecribing any medication. This is an ethical and legal obligation. They are not a "taxi" that takes you where you want to go. Further, they're not a "public conveyance" where you get to ride simply by paying the fare.

Most human Rx's run out nowadays after a year (at least with my insurance plan and some under state law). Controlled substances are even more tightly controlled.

I don't know the vets in question but if they are real professionals (and the OP going to them for seven years suggests that they are, or at least she thinks so) then the requirement for a recheck before renewal is not unreasonable.

G.

[Lori T]

I work for a specialty practice (animal skin and ears) and we will not give a prescrition if we have not seen the animal in more than a year..too much liability. We have people call who we haven't seen in more than a year, were prescribed antibiotics, they never followed up with rechecks and now want more meds...sorry, we have no way of knowing if the new condition is the same as the first one we prescribed the meds for..and as other people posted, some drugs require blood work to make sure it isn't doing harm to the body. Yesterday I had a woman yell at me because we would not prescribe a drug to a cat we had not even seen and that the drug had originally been prescribed by her regular vet for another cat! She could not understand that we were not going to give it to her!
Now on the other hand, I can walk into my horse's vet office and get pretty much any drug with no problem..but my vet comes out pretty regularly and so he knows my horses.

[Rubs Not Pats]

The State board in the state of Arizona says Doctor-Patient-Client relationship is seeing the animal within the year. Our doctors will not just refill things like otomax unless it is a continuation of a problem they are currently treating within a short period of time , say 30 days. Things change, dog doesn't get better, now has pseudomonas and bam owner is on way expensive drugs and pissed. We have also done the dog a tremendous disservice. So it depends on the problem. If the dog has atopy, little different, they might get a refill later. Heartworm preventitive, current test within a year, no problem. If a dog has chronic pain and has all of it's testing up to date nsaids no problem, after answering a few tech questions. If there are changes, it gets seen. But for thyroid, seizure medicine, insulin, etc these need to be monitored for levels, so each animal is different and the doctor decides up front how many refills before more testing. As a rule, we need to see the pet for that specific problem or no treatment advice. Shampoo, even medicated, dietary suppliments (Cosequin, etc) we do not require a visit, most people spending $60 on cosequin are seen anyway.
Our board will sanction your license in a heartbeat and sorry your bi$ching about it is not worth my doctor getting an attorney and spending numerous days defending his license at the board, which here functions like a which hunt. You are guilty until you drown kinda thing.

Horses are a little different because in the show world it is so common to use NSAIDS. People are on Regumate, adequan , legend etc. I would imagine a yearly exam would suffice here but I am not running an equine hospital.

For the record, unless it is an animal only drug, we are required to write a perscription and post a sign stating some perscriptions may be availiable at a pharmacy. We issue a script if the conditions have been met.

[BornToRide]

work for a specialty practice (animal skin and ears) and we will not give a prescrition if we have not seen the animal in more than a year..too much liability.
I can certainly see this as a concern.

[regeventer]

Alot of states don't spell out the length of time that constitutes a valid client/patient relationship, but the consensus is 1 yr.

And believe me, a board cares not that you, as a client, are unhappy that the access to meds is inconvenient. You yourself may never call your vet on it, but somebody will and those people are creating this atmospere.

[Pretttywaste]

I imagine this varies greatly by location but I work for a vet (small animal only) and we do not write prescriptions for anything that we carry in our pharmacy - and if the rx is for something we do not carry we will call it into a pharmacy of the clients choice, but we still do not write rx slips. We do not approve petmeds.com or any other online pharmacy under any circumstances - not even for heartworm preventative. I guess the owners have had a lot of problems with clients being shipped the wrong medications or wrong dosages, or even expired meds. We will price match in most cases so it is not really a money issue but more just making sure the client gets what was prescribed.
As far as refills...it depends on the individual situation. Certain meds require bloodwork to be done yearly, or even every few months. When someone calls in a refill we have to double check with the doctors and then call the client back to let them know if it was approved or not, and this goes for all meds and all clients. A lot of people get really upset about our policies, and honestly I can't blame them. It is a pain in the butt sometimes but our doctors really do have your animals best interest in mind.

On another note... maybe the receptionist you spoke to was new and wasn't familiar with your horse and that you regularly get the medication. I would call back and NICELY ask to speak with or leave a message for the doctor to find out what's up.

[FindersKeepers]

As someone mentioned, conversation with office staff and with the doctor are very different. I call doctor's offices all day (human) for a living. In many offices, there is a "gatekeeper" that answers all calls and won't let you talk to anyone else... I won't get into more details, but they are infuriating.

That being said, it's not unusual to bne refused a medication if the animal, or human for that matter, has not been seen or treated for that condition in the last 6-12 months. The one clinic that I use will not give you anything other than bute without examining the horse. My dog's vet won't even fill heartgaurd meds if they see you purchased your last pack more than 6 months prior... therefore possibly having a lapse somewhere.

It's obnoxious, BUT there is reason for it.

I would call and leave a message asking your vet to call you back. That's it. No more details than that. Then when the actual vet calls you, talk to him, and I'm willing to bet you can pick up your presecriptions the same day.

As for refusing the written script... they can't refuse that if it's a regular medication your horse is on. They have to give you the paper script... they can charge for it, but they can't refuse it.

[JSwan]

I don't think it's unreasonable for a health care provider to actually examine the patient periodically. (human or animal)

I have noticed that small animal providers, ahem, can sometimes be a bit out of control on what a pet "needs". I fired my old vet after a simple annual exam involved several hundred dollars worth of tests, their lobby became full of expensive potions and unguents that pets just HAD to have... it got a bit annoying. I'm not a fan of the vet office/day spa combo. But their practice had evolved from a large/small animal rural practice into an urban one. So that makes sense.

Guess that's an individual preference.

My pets generally spend most of their time rolling in the excrement of various species - to them every day on the farm is a "day spa". :dead:

[animaldoc]

1. A veterinarian may not prescribe any medication without a valid client-patient relationship. Most state boards define that as a patient that has been seen for that problem within the past year. If your horse was just seen a month ago and had a complete exam, you should be OK for a VCPR.

2. A veterinarian generally (and it may depend on the state) may not refuse to write a prescription (that you could take somewhere and fill) for a patient that has a valid VCPR. This doesn't mean they can't refuse to dispense (or Rx) a medication they don't think is indicated - like you want the horse to have thyroid meds and they don't think the horse needs it because a thyroid panel was normal - but it does mean they can't force you to buy medications from them if you want a prescription to go get them elsewhere. Veterinarians are NOT required to fax prescriptions to internet pharmacies etc. but they have to give you a written prescription if you request one and you can take it where you want.

So what happened to the OP?

rachael

[ASB Stars]

I had my (former) Vet explain to me that he would not give me a script for anything that he carried, or could order. Essentially, I had to buy it through him, or else. I pointed out that the only thing I had asked for scripts on was Pergolide, which he didn't carry. He just looked at me...

My current Vet has his office manager send scripts anywhere I need them to go, thank you very much! I get my Adequan, Banamine, IV and tab bute, etc. AND Pergolide without any angst. Better Vet, better services. Imagine!

[Pretttywaste]

2. A veterinarian generally (and it may depend on the state) may not refuse to write a prescription (that you could take somewhere and fill) for a patient that has a valid VCPR. This doesn't mean they can't refuse to dispense (or Rx) a medication they don't think is indicated - like you want the horse to have thyroid meds and they don't think the horse needs it because a thyroid panel was normal - but it does mean they can't force you to buy medications from them if you want a prescription to go get them elsewhere. Veterinarians are NOT required to fax prescriptions to internet pharmacies etc. but they have to give you a written prescription if you request one and you can take it where you want.

l[/QUOTE]

This is NOT always true. Laws vary by location. I think that it should be that way everywhere but it is not. I wouldn't want the OP to get mad and call her vet threatening to sue them for withholding a prescription (not that she would, just saying!) when it is perfectly legal for them to do so as long they carry the medication.

[Auventera Two]

I don't think it's unreasonable for a health care provider to actually examine the patient periodically. (human or animal)

I have noticed that small animal providers, ahem, can sometimes be a bit out of control on what a pet "needs". I fired my old vet after a simple annual exam involved several hundred dollars worth of tests, their lobby became full of expensive potions and unguents that pets just HAD to have... it got a bit annoying. I'm not a fan of the vet office/day spa combo. But their practice had evolved from a large/small animal rural practice into an urban one. So that makes sense.

Guess that's an individual preference.

My pets generally spend most of their time rolling in the excrement of various species - to them every day on the farm is a "day spa". :dead:

After my hound had $5,000 worth of surgery and after-care to put his leg back together, the surgeon *highly* recommended he do hydrotherapy - in their water spa - at $75 a session - twice a week - for at LEAST 6 weeks. Ok, that would total about another $900. I guess I was a horrible doggie mom because I didn't do it. We did more traditional types of therapy but I already drained the bank account, plus some. I felt like a total heel every 3 days when I took him in for bandage changing, and they wanted to know if/when I was going to start the hydrotherapy. ppppppfffffffttttt. It was a very stressful time.

[vineyridge]

2. A veterinarian generally (and it may depend on the state) may not refuse to write a prescription (that you could take somewhere and fill) for a patient that has a valid VCPR. This doesn't mean they can't refuse to dispense (or Rx) a medication they don't think is indicated - like you want the horse to have thyroid meds and they don't think the horse needs it because a thyroid panel was normal - but it does mean they can't force you to buy medications from them if you want a prescription to go get them elsewhere. Veterinarians are NOT required to fax prescriptions to internet pharmacies etc. but they have to give you a written prescription if you request one and you can take it where you want.l

This is NOT always true. Laws vary by location. I think that it should be that way everywhere but it is not. I wouldn't want the OP to get mad and call her vet threatening to sue them for withholding a prescription (not that she would, just saying!) when it is perfectly legal for them to do so as long they carry the medication.

This is precisely the behavior on the part of vets that I personally think SHOULD be tested in court. Doctors are not permitted to be the sole dispensers of the drugs that they want their human patients to use, so why should vets get a pass? To me refusing to write a script because the vet carries the medication is just as bad as refusing to write one period. Ever heard of restraint of trade? Of tied houses? Vets should be sued over this, and a nationwide class action suit against AMVA, the vet ethics boards, and some individual vets in every state would make a lovely set of defendants. After all, the AMA has gotten sued over stuff like this; the bar associations have been sued over fee schedules; and vets are NOT bullet and bombproof. Bring a big enough suit and the whole profession will cave.

[Ghazzu]

Vets should be sued over this, and a nationwide class action suit against AMVA, the vet ethics boards, and some individual vets in every state would make a lovely set of defendants. After all, the AMA has gotten sued over stuff like this; the bar associations have been sued over fee schedules; and vets are NOT bullet and bombproof. Bring a big enough suit and the whole profession will cave.

Do your research before you get so hot under the collar.

First, AVMA has no regulatory power.
Second, from the AVMA code of ethics:

Dispensing or prescribing a prescription product requires a VCPR
Veterinarians should honor a clients request for a prescription in lieu of dispensing.


Without a VCPR, veterinarians merchandising or use of veterinary prescription drugs or their extra-label use of any pharmaceutical is unethical and is illegal under federal law.
Third, most state regulations already mandate the writing of a prescription in lieu of dispensing, if the client requests.

Therefore, the logical action is to submit a complaint to the board in the state in which the DVM is licensed, rather than going on some jihad class action against the profession.

[vineyridge]

According to a site that is referenced in this thread, about twenty states do not require a vet to write scripts. I've checked in my state through my state representative, and the vet board is adamantly opposed to any legislation that would make writing scripts mandatory. The only way to get their attention would be a lawsuit, since the vet board COULD do it by regulation, but won't.

The states that don't already require, either by regulation or by legislation, vets giving the client the option of buying elsewhere would be the focus of any lawsuit, and in almost all states, including mine, pretty broad fair trade legislation is already on the books.

I know the AMVA doesn't have "authority" over vets, but neither did the AMA, and it's gotten sued numerous times over restraint of trade issues.
http://en.wikipedia.org/wiki/Wilk_v._American_Medical_Association

Want to explain why vets in my state won't follow the AMVA Code of Ethics that you cited.

[lizathenag]

I buy my horse drugs (when I rarely need them) from my vet. He will come out in the middle of the night if my horse needs him. The online companies don't do that. I may pay more for the meds but what I am buying is customer service.

[Ghazzu]

Want to explain why vets in my state won't follow the AMVA Code of Ethics that you cited.

I bet a number of them do, whether the state makes them or no. Do you have any statistics, or are you just assuming that because they don't *have* to, they aren't?

But if you really want to know, why not ask them?

I've always written prescriptions when asked, and sometimes when not asked--because if it's an expensive med, I'd just as soon have the owner ranting about CVS and not me, ans I'd rather not have to deal with the overhead.

[SteppinEasy]

For those who have asked me for updates, here's where things stand right now.

I first had a conversation with a vet in the practice (NOT my regular vet, who I had requested to speak with, and NOT anyone who has ever seen my horses, or any of my animals, for that matter). Long story short, that conversation deteriorated rather rapidly, to the point where my next phone call was going to be to the KY AVMA to issue a complaint...

BUT...

I managed to keep my cool. Since my regular vet had the day off, I did something I never do and called him at home. I told him everything that had happened and he wanted names of the office staff I spoke with as well as which other vet. He apologized profusely, said he didn't have a clue what X and Y were thinking by behaving that way and even offered to bring me the medication to my house. At no charge, for either the farm call or the medicine, which was completely unnecessary but did a lot for healing the rift.:cool:

When he called me back later in the day (I refused the house call and told him all I wanted was a price match on the meds, which is what he usually gives me anyway), he told me he was considering making a complaint to the licensing board himself about the other vet. He said something else is going on with this guy. I didn't ask for details. So all's right with my horsey world again.

This incident with my horse's ulcer meds caused me to call my dog's allergy specialist to find out what their policies are about refills, since my dog is on Mometomax regularly. That one costs @$40 dollars from the specialist; I can get it online for $22 and free shipping.

It was the infamous deja vu all over again. Sigh. The specialist said they wouldn't give me a refill because the last time she saw my dog (August) for her ears, she didn't have to give her a refill because I still had meds left over from her last attack. That which would make the prescription over six months old, which was a bad thing, I guess. After hearing that, I was ready to pull out my hair again. My dog has seen this specialist for several years, we know exactly what she's allergic to (horse manure, sadly:lol:) and we know what best treats the infrequent attacks she has.

Given all the talk here about the standard being a year for most places, I'm just planning to write to the specialist and ask her to mail my dog's records to me--I DO have the legal right to those, don't I Ghazzu?--so that I can take them to my regular vet from now on.

I wish someone would actually come up with real guidelines for vets so things wouldn't vary so much from practice to practice...

[Ghazzu]

Given all the talk here about the standard being a year for most places, I'm just planning to write to the specialist and ask her to mail my dog's records to me--I DO have the legal right to those, don't I Ghazzu?--so that I can take them to my regular vet from now on.


You have a right to the records or a summary thereof. You may be charged "reasonable" costs for copying, postage, etc.

[Ghazzu]

Long story short, that conversation deteriorated rather rapidly, to the point where my next phone call was going to be to the KY AVMA to issue a complaint...

.

Glad you worked things out with your regular DVM, but if you need to file a complaint, the state VMA isn't the place to go.
There should be a state licensing board or a state board of registration. Governmental entity.
They deal with complaints.

[vineyridge]

Ghazzu, maybe you didn't read my earlier post in this thread. I HAVE talked to both local vets. One will write a prescription if it is something that he does not carry himself on premises, but since he determines what drugs are to be used, he almost always wants to use things that he carries. For instance, there is Schering Plough version of Heartgard Plus that is much cheaper than Heartgard Plus. He doesn't carry it, and won't write a script for it because he has an equivalent to provide.

The other one will order maintenance meds like Legend and Adequan, that he does not carry at (say) a $30 markup per vial from Smart Pak. But he says that to order, he has to buy six vials, so I'd have to pay in advance for all six, since I'd be the only one using the med for my old man. That would mean plunking down right at $700 just for the drug, plus the farm calls for the IV injections would bring each shot in at $150. That would be $450 for the first three weeks, then three months at $150 per month. Then another $700 bucks for him to order the next six months worth. This one WILL NOT under any circumstances write a script because he can get anything he needs almost overnight.

I live in Mississippi, and every dog needs to be on heartworm preventative from the day they are weaned, just about. That's a huge expense for a dog owner, and even more for a multiple dog owner who cares for strays and other unwanted dogs. There isn't any flexibility in the local vets for that. The hound people don't even bother with the vet for their heartworm preventatives--they just give cattle Ivomec which is non-prescription (wonder why?) in a well known dosage per ten pounds of dog.

[Ghazzu]

Ghazzu, maybe you didn't read my earlier post in this thread. I HAVE talked to both local vets..

There are only two veterinarians in Mississippi?

I understand the ones you happen to be dealing with are not being cooperative, but that doesn't mean that no one is willing to write a prescription.
That's all I'm trying to say.

[equinelaw]

Just out of curiosity, the Vet down the street has a "club" you can join for Meds. She charges $50 and comes out and looks at the horse. Then you pay $25 a year and can buy any of the drugs they carry at a 10% discount from what the average retail Vet charges--not as cheap as an on-line course--but with no diagnoses, no examinations, no limits. . . . . .

Nobody asks for who or why you need the drugs.

Is this the other extreme and is it unethical or illegal?

[Ghazzu]

Just out of curiosity, the Vet down the street has a "club" you can join for Meds. She charges $50 and comes out and looks at the horse. Then you pay $25 a year and can buy any of the drugs they carry at a 10% discount from what the average retail Vet charges--not as cheap as an on-line course--but with no diagnoses, no examinations, no limits. . . . . .

Nobody asks for who or why you need the drugs.

Is this the other extreme and is it unethical or illegal?

I would say that it definitely violates ethics guidelines, and,very probably, regulations in whatever state it is, since that does not describe a valid V-P-C relationship.

However, unless someone complains (and if one's vet is giving them a "deal", who's going to the board?), it is unlikely any action will be taken.

[Guilherme]

Just out of curiosity, the Vet down the street has a "club" you can join for Meds. She charges $50 and comes out and looks at the horse. Then you pay $25 a year and can buy any of the drugs they carry at a 10% discount from what the average retail Vet charges--not as cheap as an on-line course--but with no diagnoses, no examinations, no limits. . . . . .

Nobody asks for who or why you need the drugs.

Is this the other extreme and is it unethical or illegal?

I'd need to know a bit more about this, but as written it seems to push the limits of legal and ethical conduct.

G.

[equinelaw]

I'd need to know a bit more about this, but as written it seems to push the limits of legal and ethical conduct.

G.

I have never used the service. All I know comes straight off their website. Its a toughy because you do have to have the yearly $50 exam, but there does not seem to be requirement for ongoing care. Otherwise, why would it exist as separate from the regular practice?

I live in East Aiken near the Aiken Complex. TAC has a website. Just saying:cool:

[7HL]

In Pennsylvania:


The Veterinary regulations only state the following concerning prescriptions:

Principle 7 (c) - "In the choice of drugs, biologics or other treatments, veterinarians should use their professional judgment in the interests of the animal, based upon their knowledge of the condition, the probable effects of the treatment and the available scientific evidence which may affect these decisions."

Honestly I have no trouble in my vet seeing my horse and evaluating what my horse needs.

To many horse owners become amateur vets and then start self diagnosing what they think their horse needs. The internet has made many, what they believe as, all knowing.

[Jeff Wolf]

SE,

I've seen this before, too. I'm gettin' here late, but I would have recommended that you talk directly to your vet. You did, and it worked out!

The staff gets protective, and thinks about the bottom line a lot more than the vets do, frequently. Our regular vet lives very not close, and because we've demonstrated that we're not morons, he'll provide us with many of the more common prescription meds that can be given topically, orally or injected, with the understanding that we call first and discuss symptoms and history with him before administration.

He trusts us, we trust him. He's been out here, and talked to us, knows how we care for our horses, and is comfortable with our level of knowledge as well as our judgement. We don't know everything, but after the diagnosis, a lot of this stuff doesn't require a doctor, or a staff.

You just can't be a moron! :lol:

Sounds like you have much the same relationship with your vet and his staff. :)

[Pretttywaste]

This is precisely the behavior on the part of vets that I personally think SHOULD be tested in court. Doctors are not permitted to be the sole dispensers of the drugs that they want their human patients to use, so why should vets get a pass? To me refusing to write a script because the vet carries the medication is just as bad as refusing to write one period. .

While I honestly do see both sides of the issue and completely understand our doctors perspective I agree that they should not be able to withhold prescriptions. Again, at MY clinic it is not a money issue as we will price match - but I imagine it can certainly be a pain in the butt for a lot of our clients either way. I just wanted to point out that depending on your location it is not illegal for them to do so.