Many of you may be aware of a National Geographic television show featuring a charismatic individual who helps dog owners. I recently came across this video on the website and I urge you to watch it (preferably without the sound so as not to be distracted by his talking) and keep your eye on the dog. Here is what you will see:
Within the first 5 seconds, the handler kicks the dog in the abdomen. When the dog turns toward him he is jerked off his feet. A struggle ensues where the handler gets bitten several times and the dog is seen to be struggling for air. Finally he gets the dog onto the ground and the dogs tongue is blue and the dog is gasping for breath. When he finally gets the dog up it appears that there might be urine on the ground and that the dog voided his bladder in distress.
What you have witnessed is not dog training but abuse. Not only does the dog suffer, but clients are at risk if they attempt these interventions themselves. These are not appropriate measures and compromise the welfare of the dog and the safety of people. His explanations are false and not based on science as we know it. We as veterinarians must make our voices heard and let National Geographic and most importantly our clients know that these types of interventions are wrong and not in the best interest of dogs or people.
As a veterinary behaviorist I have dealt with behavior problems in companion animals for over 25 years and would never confront a dog this way. Not only would it be dangerous for me and the family, it would be harmful for the dog. My goal is diagnose the problem, and design humane treatment plans that help the family change the behavior of their dog so that they can safely live together. I hope all veterinarians can agree that this is the best approach.
I would love to hear your thoughts. Most importantly, go to the link and scroll down the page to “contact us” and click on that. Let National Geographic know what you think.
Thank you for your time
Debra F. Horwitz, DVM, DACVB
When I left home over a week ago for my first serious vacation in three years, I was certain I wouldn’t venture far from the poolside lounge chair. Weather and work had left me craving a tropical getaway to recharge. When we checked into our resort in Cabo San Lucas, I wasn’t disappointed……
What I didn’t expect, however, was to start thinking about veterinary medicine and how it’s practiced in Mexico…..but that’s just what happened. It turns out I didn’t miss my job, but I did miss work. After a quick email to the Los Cabos Humane Society, I was informed that they would be holding a Spay/Neuter clinic for two days this week and I would be welcome to come observe. LCHS was having two veterinarians from the Give Some Life Foundation come in to perform the surgeries.
In my life, I really haven’t been too far from home, save a couple of trips, and the idea of being picked up by a stranger and driven across town to the shelter was unnerving. Would anyone speak English? How long would I be gone? Would I have cell service? Though my wife didn’t stop worrying until I returned, I never looked back. We picked up the GSL Doctors, MVZ Joaquin Villasenor and MVZ Rebeca Serrano and headed to the shelter.
I didn’t know what to expect or if I could help (or what they might need help with). The two Doctors went right to work and were joined in surgery by a recent graduate, MVZ Eriksen Beccera. They referred to their approach as the “Efficient Spay Neuter Technique,” and boy was it…… In five minutes, I remembered what I like least about veterinary practice as I know it – all of the waste. Wasted time, wasted supplies, wasted resources. These people wasted nothing.
While the surgeons worked, the Shelter Doctor, MVZ Alan Ortiz, supervised induction, monitored patients, and increased anesthetic when needed. A team of assistants and veterinary students restrained patients for injections, transported them to and from surgery, and helped monitor their recovery. In the USA, there is always someone who is really running things behind the scenes, and it was no different here. Though she couldn’t speak any English, I found something in common quickly with Ceci, a shelter staff member, as she ran around the room trying to put only the needles in the sharps box before her boss could put the syringes in as well.
In just over nine hours of surgery, this group spayed or neutered 84 pets (mostly dogs), all free to residents of the Los Cabos area, and funded solely by donation. They did it without surgery tables, without proper lighting, and without gas anesthesia. The work was grueling. Barely inside (the group performed surgery the previous week on an outdoor basketball court), the lack of air conditioning, little breeze and stifling heat for 10 hours with very little sitting made me reflect on all the luxuries we take for granted. And my job was only to clean all the surgery instruments over and over…… I could see in the eyes of the team that it took an immense amount of mental focus to keep going without any idea when the demand would end, but I could also see a dedication to the cause they had given so much of their time for.
In short, my experience here did recharged me……it recharged my interest in the kind of medicine that can reach patients who may not otherwise get it. It left me ashamed of how we waste at home, but committed to addressing that problem. It left me in awe of these people who spend day in and day out dedicated to fighting a problem they know won’t be easy to solve, do so in the most challenging of conditions, AND do so on a volunteer basis. It also reminded me that no matter where we go, we can be reminded of how small the world really is and what we have in common. When one of the Doctors heard where I was from, he said he’d spent three years of his early training on a small town family owned dairy in Oregon. That dairy is in my hometown.
To help support Los Cabos Humane Society’s permanent no cost Spay/Neuter and education program, go to www.humanesocietycabo.com
To help support the Give Some Life Foundation’s efforts in the Baja region of Mexico, go to www.givesomelife.org
Practice Makes Perfect
Time to speak up
For too long, veterinarians and our national organizations have been too quiet regarding what exotic animals are sold as pets in this country. Unfortunately, many of the species sold have little history as domestic pets and complex husbandry requirements, and because of their popularity, they can even become threatened in nature. Many of these animals make poor companions, wind up languishing in less-than-ideal domestic environments, and finally die heartbreakingly in a situation that was doomed from the start. These fad animals quickly go out of style and are forgotten. Sadly, many of them have long life expectancies, and although the children or family members have moved on to new interests, these animals may still have years to live, with all of the same requirements for a decent life.
Veterinarians need to speak out about this. If people take animals into their homes, they are duty bound to care for them and provide them with the best lives they can. These creatures share the same life force we do. For that reason alone, they deserve our care and respect. Every effort must be made to educate ourselves about the animals that we keep so that we understand what they need to prosper. We must help and encourage clients to do all that they can to research the animals they adopt, so the endeavor is rewarding to all involved.
“Respect all life” is not a hollow slogan. It is what we have been charged to do—protect animals and provide a voice to the voiceless. For too long, we have not taken an active role in monitoring what species are being sold. For too long, we have sat silently while animals with little chance for successful lives in captivity were offered to the public. It is time we changed that. We are better than that. Monitor what is being sold in your community. Pay attention to trends of new species that you see being brought to your hospital. Speak out to local, state, and federal agencies about your concerns regarding certain animals, based on your veterinary training and experience. Veterinarians must provide a strong, sensible voice concerning exotic species that are currently available for sale. Government agencies must once again listen to our counsel and come to see us as an animal-health resource.
See you next week, Kev
Practice Makes Perfect (originally posted May 19, 2008)
Get a hobby
My name is Kevin Fitzgerald, and I am a small-animal veterinarian in Denver, Colo. I have been asked by the nice folks at Veterinary Medicine to put together a weekly blog about small-animal medicine in the new millennium. I am not the most computer-literate person. To me, the word blog seemed faintly obscene, and I had to ask someone what one was. I am from the ’60s, and the new world with its new words--words like blog and podcast--seem positively foreign. Nevertheless, I acquiesced and will happily write a weekly account of life in the trenches and life by our code.
Veterinary medicine is a harsh mistress. The rewards she grants are spectacular, but her price is high. We must stay current and must continue to grow, but it seems that we learn best from our mistakes. It is a new type of monastic life. We must constantly study, strive to absorb new facts, acquire new skills, and rededicate ourselves to our oath. Still, the gifts we receive are astounding, and the direction in which veterinary medicine may take our lives is fantastic. Last November, I was lucky enough to go with a group from the Denver Zoo to the polar bears of Churchill, Manitoba. This February, I went with a group from the North American Veterinary Conference to the wildlife of Antarctica. I have been like Forrest Gump, in the right place at the right time.
It is a taxing life, but veterinarians that I have known to be the most successful all have a secret. They have a hobby. They have a hobby that is nothing like their work, has nothing to do with veterinary medicine. They fish, play tennis, or play music. Some take photographs. Others paint. While they do their thing, no one is sick, no one is scared, no one is crying. It is their time, purely selfish and indulgent. It is time to recharge their batteries, rest, and regroup. I am older than a lot of you, younger than some others, but I can tell you this: Get a hobby. You’ll be better for it (and so will your clients, patients, coworkers, and family). Totally get into it, and maximize your downtime. Work hard as always, yes, but breathe and live. Don’t let them grind you down.
See you next week, Kev
I just read a book called the "no asshole rule". I hope not to offend by the title but I didn't write the book! :) I will use "those people" in my post. :) In my years of working in a veterinary practice I have had the "pleasure" to work with many of "those people". They have been my managers, owners, associates and my staff. Some have been my drug reps or even the people who I had to deal with for utilities. As a newbie in my career I found these people to be very intimidating and though I could see and experience the effect they were having on my practice I had a hard time knowing how to deal with it. I was able to figure that out with experience and confidence but later ran in to a new issue. What do you do when "those people" or should I say "that person" is the owner. You can't fire them. You try talking to them but they are often oblivious to their actions and the effect they have on the team members, clients and even productivity. So what do you do? I would sure love to hear your feedback on this topic. After reading this book and thinking of my experiences I am going to develop this topic. I think it is a necessary evil of being a manager!
This vacation was long overdue. You know the feeling. For me, there are certain times of the year when the word just sounds nice. It conjures up this idyllic kind of recovery, an escape.
This year, my wife and I made it happen. We were headed to Martha’s Vineyard, a spot we’d never visited before. Our plan was to stay in Hyannis, Mass., and take a ferry to the island for the day. No big plans; we just made them as we went along.
The 45-minute boat ride to the island was just as anticipated -- smooth, clear skies, perfect. We jumped off the ferry to take care of the first order of business, transportation.
Within minutes I signed a death waiver, paid for the day’s rental, and put on my helmet to take a test drive. I quickly learned that your feet can’t stop a motorized bicycle, but I tried more than once anyway.
In fact, it was my second time on a motorcycle. The first was when I was 12 years old. My uncle let me take his Honda 100 out for a spin on a dirt road. As I recall, the contraption just happened to “get away from me.” I popped a wheelie. The homeowner sitting on his porch didn’t even flinch as I skidded into his yard taking a 20-yard swath of sod along with me.
I’m middle-aged now, but I thought of the episode as I straddled the Vespa that day on Martha’s Vineyard.
I made it around the block at 5 mph as required by the rental establishment. I sensed the open road. I yearned for it. I even put on a good show for my rental Sensei as I rounded the corner, keeping the scooter mostly steady. Thankfully, my wife remained oblivious to my display of bravado.
She put on her helmet, and we were off. Within seconds, I muscled open the throttle. We were cruising along a beautiful stretch of winding beach roadway. I looked down at the speedometer: 20 mph, 25 mph. Was it maxed? Back off, there was plenty of torque left. I opened it up all the way. We hit our top speed of 35 mph going downhill.
At that moment, I became keenly aware of how much traffic was starting to back up. My confidence shifted down a little as we passed the 45-mph speed limit sign. I looked again, and there was a line of cars winding behind me like a a snake closing on its prey. We were being chased on the way to Chappaquiddick, no less.
After eight minutes, the East Coast patience came to an end. The first car blasted by us. So did the second. The third moved in tighter as it passed. It’s a textbook aggressive-driving move designed to intimidate and offer protest. The fourth followed with a string of barely audible expletives. And there were 20 more behind.
Just then, during my heightened state of panic, I felt something pressed against my back. It was shaped like a rectangle. I felt the corners, and I made the connection. My wife, well, was reading.
I was fighting for our lives, and she took it as an opportunity to catch up on a good book? Talk about trust.
The lesson I learned hit me on the boat ride back to Hyannis. Two people, even on the same scooter, can have very different experiences. How does this apply to your work life? How about your interactions with co-workers, subordinates or bosses?
Think about it. I sure did.
Ernie the Puppy Steals Owners Hearts and also Diamond Earring, Wins 2010 North American Favorite Pet Story
December 15, 2010 (Pittsburgh, PA) As the season of giving to loved ones nears, The North American Pet Health Insurance Association announces “Ernie the Puppy Steals Owners Hearts and also Diamond Earring”, as the winner of the 2010 Favorite Pet Story to highlight the need of pet health insurance. The pet health insurance industry also encourages responsible pet owners to provide a special and critically valuable gift of pet health insurance to their beloved pets this holiday season.
Paul & Sara Michaels will have additional money for this year’s holiday season thanks to pet health insurance. Early this year the Seattle couple decided that they wanted a Havanese puppy. They located Ernie and immediately knew he was a great dog. This was their first dog and they were really surprised at how loyal and loving he was, always wagging his tail and he would seldom bark. The family started to create a routine that included long walks in the evenings, and lazy Sundays at home. It was during lounging on the bed with Ernie on a lazy Sunday morning that the unexpected occurred. According to Paul, “Ernie had been with us just a few weeks, and we just loved him more and more every day. He was greeting Sara with his usual morning kisses and snuggles. He has this special way with Sara; he snuggles up to her neck and kisses her ears. Suddenly Sara looked at me with her eyes wide as saucers, and feeling her earlobe…"Oh my God, I think he just…" I stared back and said "Your earring???" We quickly did a hard-target search through the sheets, comforter, pillows…nothing. All through our frantic scramble, Ernie watched, wanting to join in this new game, of course unfazed that he had just eaten 1/2 of my wife's anniversary present. Ernie was rushed to The Animal Medical Center. They asked if we had pet insurance and they seemed relieved when we answered yes! An X-ray showed that Ernie had in fact swallowed it, followed by an endoscopy to remove the earring from his little tummy, so it wouldn't hurt his intestines if he tried to pass it.
Mr. Michaels went on to comment that it is refreshing to be treated to such world-class care by the veterinary staff and also the customer service of the pet health insurance provider. “We were very concerned and they were all fantastic and helpful as we went through this emergency with Ernie. We'll always remember that feeling of panic when we didn't know what was going to happen after he ate the earring, and we'll never forget the way that the pet health insurance company took such amazing care of our Ernie. The follow-up paperwork was handled professionally and made it so painless and easy for us. We received detailed, personalized e-mails from a staff that made us feel like our little boy was their number one priority. We are encouraging all of our family and friends to purchase pet health insurance and for the holiday’s we are providing a few policies for our family members with pets”, continued Paul Michaels.
This is the second year that pet insurance companies across North America have joined to celebrate North American Pet Health Insurance Month presented by the North American Pet Health Insurance Association (NAPHIA). In addition to raising awareness of the values and benefits of pet owners providing responsible care, the month also includes a contest for North America’s Favorite Pet Story and nominations for North America’s Favorite Veterinarian. Grand prizes of $1,000 will be awarded to “North America’s Favorite Pet Story” and “North America’s Favorite Veterinarian”. In addition, the winner of each will choose a worthy animal shelter, pet rescue or pet health research group to receive a $1,000 donation!
According to NAPHIA everyday across North America hundreds and on some days thousands of pets face economic euthanasia at veterinary hospitals because pet owners are not prepared to provide needed care. Importantly, these are not pets that require extensive treatments or a course of care that would subject the pet to pain. These are pets that require more medical care than the pet owner can afford.
The point of Pet Health Insurance Month is to share great stories like Ernie’s. “This lovable and well-cared for puppy will help other pet owners to be responsible and prepared for an unexpected illness or injury. The real winners of the North American Pet Health Insurance Month are the increasing numbers of pets that are protected and receiving needed care”, explained Laura Bennett, Chair, NAPHIA Board of Directors. “NAPHIA receives inquiries continuously from pet owners that are in need of critical care. Unfortunately, once the pet is diagnosed with a specific illness or serious emergency like Ernie, insurance will not cover that immediate need. Over 50% of loving pet owners in the United States and Canada will purchase a holiday present for their pet. NAPHIA encourages all responsible pet owners to consider pet health insurance as the best possible gift that will provide security and peace of mind for your family! ”
About The North American Pet Health Insurance Association
Founded in 2007, the North American Pet Health Insurance Association is committed to educating and promoting the values and benefits of pet health insurance to North American pet owners, the general public, and the veterinary industry. September is North American Pet Health Insurance Month. Pet parents can enter their stories, pictures and favorite veterinary practices for special prizes and an educational grant for the veterinary care provider. To learn more, visit our website at http://www.naphia.org
As a Practice Manager, I only have four really big pet peeves – the annual process of quoting health insurance rates; salespeople who want to talk to me about my credit card processing rates; discussions about different types of suture (boring!), and…….yellow page ads. This week, I began the process of saying goodbye to the ads!
I’m sure we’re not the first practice to decide that this money is better spent elsewhere, but that doesn’t dampen my absolute joy in doing so. Our community sits at the convergence of geographical areas that are covered (of course) by multiple yellow page books – six to be exact- and once you’ve made the commitment to be in one or more, it’s hard to know which one you can live without. After years of debating with the practice owner, we’re going to try living without any of them.
I’ve endured an ongoing circle of yellow page ad discussions with my boss – “why do we need them?” as he’s signing all of the checks, and “why don’t we have a bigger ad?” when a client has mentioned their difficulty finding us. Over the years, we’ve reduced our ad size (though with the “discount” they were giving you before, the smaller ad is almost the same price), and done the “blind phone number” ad to track calls and revenue generated. It’s not that we don’t get something from the ads; it’s just no longer enough.
Here’s why we’re dumping them:
1. Our staff and families are a varied mix of the community – older, younger, professionals, kids in school, etc., and no one can remember the last time they personally opened a book…..it’s all internet now.
2. Even if someone out there does still use them, who’s to say that they diligently replace the old with the new, which means we’re still in many of their books from years past.
3. $7,692.00 per year can buy a lot of other types of advertising – my favorite being the way our practice financially supports a zillion community organizations. Now we can support a zillion and then some, and get a more positive response than we ever got in these books.
4. After a few months, I will never, ever, have to deal with another yellow page salesperson! The annual parade of these people who think they know our business better than I do, and want to “counsel” me on how to generate new clients, makes me want to stick my head under water.
So far, I’ve had the pleasure of delivering the news to a couple of reps…… both asked me to “take a few minutes and discuss how I would be otherwise spending our advertising money,” as if they could turn me around with a few magical words of wisdom. When I explained that such information was irrelevant to them, one even argued that it certainly was relevant, as they could show me how it would be a big mistake to leave their book. When that failed, she took the approach that we couldn’t have an internet listing if we didn’t have an ad in the book – apparently, she’s not aware that such information is NEVER removed from the internet (especially if you want it to be), so as long as we don’t change our phone number, we’ll always be there. Case in point – you can still find our number on the web under corresponding associate veterinarians who have been long gone from our clinic.
Two down, four to go…..it feels great to scratch one pet peeve off of my list, AND save several thousand dollars in the process!
I just bought a house with my future husband and I’ve been asking everyone I know tips on how to live happily ever after…
On the fourth of July, I found myself scrubbing the basement floor with bleach instead of playing with sparklers and watermelon in our backyard.
The plumber that fixed our drain had splattered poop water all over the floor.
Everybody say it in chorus now, ‘Welcome to home ownership!’
As I scrubbed the floor, I heard a joke on my favorite radio show about how dogs are better than wives. My ears perked up and I paid attention.
Maybe man’s best friend has better advice than anyone on how to be a good wife and companion...
1.) Dogs get more excited to see you the later that you come home
2.) Dogs like it if you leave stuff on the floor
3.) Dogs will not wake you up in the middle of the night and ask, ‘if I die will you get another dog?’
4.) If your dog runs away he will not take half of your stuff with him.
5.) Dogs love it when all of your friends come over and spill food
6.) Dogs can appreciate lots of body hair
7.) Dogs don’t expect gifts
8.) Dogs don’t criticize you
9.) Dogs don’t take your clothes
10.) Dogs don’t talk
I am fine to let the dog win on some of these categories… In fact I am happy to take away a good lesson from the dog’s list.
Thanks for teaching me a valid lesson Fido. Life isn’t to be taken so seriously and with a little bit of understanding and teamwork even scrubbing poop doesn’t have to be such a nasty job.
Pet Health Insurance Association Breeding Higher Standards with Addition of AKC and CFA Pet Healthcare Plan CEO
Stephen Popovich, President & CEO of PetPartners, Inc. – AKC and CFA branded pet healthcare insurance plans, joins Pet Insurance Association Board of Directors.
September 22, 2010 (Pittsburgh, PA) The North American Pet Health Insurance Association (NAPHIA) is gathered in Allegheny County, just outside of the city of Pittsburgh, for the Annual Fall Conference and Board Meeting. The association announced today the addition of Stephen Popovich, the President & CEO of PetPartners – American Kennel Club (AKC) and Cat Fanciers’ Association (CFA) branded pet healthcare insurance plans.
According to Loran Hickton, Executive Director of NAPHIA, “Steve and his team at PetPartners, under the brands AKC Pet Healthcare Plan Insurance and CFA Pet Healthcare Plan Insurance, (http://www.petpartners.net/programs/) have developed a great relationship within the breeder community for cats and dogs and have done an exceptional job supporting and growing the value of pet insurance for all pet owners. Steve adds an additional level of experience and expertise with his many years in the fields of human and animal health. He is a seasoned executive and industry leader who will champion collaboration among all of the leading pet insurance providers, as we deliver the highest standards and the most positive principles of all pet health insurance providers.”
“As an industry that has been spared some of the challenges of the difficult economy because of the fantastic bond we enjoy with our dogs and cats, it is most important to continue the work of our industry to increase value and make pet insurance more commonplace for pet owners. I am honored to join my colleagues within our industry that share the commitment of transparency and increasing value and understanding of all quality pet healthcare insurance. As an industry, we are committed to focus on those issues that provide immediate and clear value. Uniformity in electronic claims processing is very important to all stakeholders and speeding up the delivery of pet insurance is just one example. Good and proper collaboration means more value for pet owners and better value for our team members and our companies,” stated Popovich.
“While this difficult economy presents challenges for consumers and pet owners, it is also driving a robust market for pet insurance; in fact, the market in North America is very strong and has grown over 400% in just the past few years,” continued Hickton.
Surveys and research by the American Veterinary Medical Association and the American Pet Products Association indicates that today most pets are regarded as members of the family. Over 60% of North American households have at least one dog, cat, bird, or other companion animal. Many have more than one. There are more than 75 million pet dogs in the U.S. and Canada and nearly 85 million pet cats. Projected 2010 pet expenditures for North America are over $48 billion, of which $25 billion will be spent on veterinary related care.
Prior to joining PetPartners in 2005, Steve Popovich enjoyed a 25-year track record in various financial positions, both corporate and operations, with several global companies including Tyco International and Georgia-Pacific. Steve holds an accounting degree from the University of Florida and an MBA in Finance from Sacred Heart University in Fairfield, CT.
About PetPartners Inc.
As long time insurance professionals and pet lovers, the team at PetPartners fully understands our customers' pet health insurance needs and expectations. At our offices in Raleigh, North Carolina, we have a great blend of insurance experience and veterinary expertise working within best-in-class operating systems and practices. We proudly offer our customers unsurpassed pet health coverage at competitive prices with friendly and caring service. For more information, visit http://www.petpartners.net
About 'Meet The Breeds'
PetPartners is also a proud sponsor and pet health insurance partner of 'Meet The Breeds' the largest gathering of pet enthusiasts in the world taking place October 16th and 17th with attendance of over 35,000. Meet the Breeds, hosted by the American Kennel Club (AKC) and Cat Fanciers’ Association (CFA) is returning to the Jacob Javits Center in New York City. Last year’s attendees enjoyed 200 individually decorated official breed booths that allowed dog and cat lovers to interact with dogs, cats, puppies and kittens and learn about their history and unique attributes directly from the experts; 100 vendor booths offered every imaginable product for pets and their owners; and five ongoing demonstration rings featured law enforcement K9s, grooming, agility, obedience and an interactive ‘Cat Idol’ showcase and more. You can visit the Meet the Breeds website at http://www.akc.org/meet_the_breeds/
About the North American Pet Health Insurance Association
Founded in 2007, the North American Pet Health Insurance Association (NAPHIA) is committed to educating and promoting the values and benefits of pet health insurance to North American pet owners, the general public, and the veterinary industry. For more information, visit http://veterinarycommunity.dvm360.com/view/North American Pet Health Insurance Association or call 412-319-7730 / 412-908-9766.
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Formaldehyde is considered to be a dangerous chemical. In low doses it irritates the eyes and respiratory system. It can cause ataxia, nausea, fatigue, and dermatitis. Chronic exposure can result in memory loss, abdominal pain, weakness, and otitis. It is a toxin and it may be carcinogenic. Its use in vaccines is currently very controversial. It is officially recognized as “bad stuff.”
So, I have a question: How come every anatomy professor I know of has lived to such an old age? I have lectured at all but three of the veterinary schools in the United States, and nearly all the anatomy professors are old. Even the younger ones look old, but that may be the result of the stress induced by a classroom full of freshman veterinary students.
Is it possible that the preservative qualities of formalin exceed its toxic properties?
America's foremost business philosopher died in December. I've never met him, but I am still mourning. Years ago, I asked several members of the Veterinary Economics editorial advisory board who they'd spend $2,000 to see speak. And consultant Don Dooley topped his list with Jim Rohn.
I'd never heard of him. But anyone Don would spend that kind of money to hear was someone I was interested in knowing more about. So I bought a set of cassette tapes. (Yes, tapes! Can you even play those anymore?) And another set. And another set. I have since spent literally hours listening to Jim Rohn talk. I count him as one of my many mentors.
I recently revisited Jim's session on goal setting. It's a very good exercise. You sit down, and make a list of 50 things that would make your life the most amazing life you can imagine. Things you'd like to do, or see, or achieve, or own. (He says kids have no trouble doing this. We grown folk seem to struggle a bit more.) The point is to think big. If you could wave a wand and have it all, what would really do it for you?
When you have your list of 50 items, go through the list and mark each of them with a timeline: one year, three years, five years, and 10 years or more. Then go through all the one-year dreams and aspirations and pick the four that are most important. Here's the part he says is most critical.
For each of those goals write a paragraph about why this is an important goal. What would it mean to you if you achieved it? What would it make of you? What would you have to do or learn or become to get there? This emotion, he says, gives the goal life.
So, you get the idea. You'd go on to identify the top four three-year goals and the top four five-year goals and so on and write your paragraphs. And you'll wind up focused and inspired, of course.
I really do like this exercise. When I've finished I feel like I've evaluated my life and made a plan. And that helps me feel like I'm running my life instead of letting it run me. Always a nice thing.
Are you intrigued? Here's some great news. You can get this goal setting audio program on itunes for about $4. That is a seriously good value. Just search for Jim Rohn. I hope you enjoy it!
I finally get an hour to leave work and have lunch with Robert, only to receive an urgent text from Cathy about an emergency situation back at the hospital. Ugh, I guess I'll have to pencil Robert in for another time.
Watch Generation Vet 11: Lunch, Interrupted at http://bit.ly/cugdId
Catch all the great content between minisodes at www.generationvet.com.
A controversial subject in our practice continues to be our decision to run our own low cost cat neuter program. Sure, we participate in programs run by the local shelter and other advocacy groups to get cats and dogs spayed and neutered, but this particular program is our own. It has not been without debate.....we regularly take a look at whether or not it continues to make sense for us, and as you might guess, our closest local competitor wasn't too excited when we rolled it out.
The truth is, it never was our idea. We were approached by an advocacy group a few years ago and asked if we would offer some promotion to celebrate national Spay/Neuter Month. We decided to offer a special on every Thursday of the month - a low cost cat neuter. At first, we were willing to do it for two reasons.......we are very community minded and the practice owner feels an obligation to "give back,"; and we knew that Thursday was a day we had less traffic and plenty of labor. The program was a huge success. Near the end of the month, we started looking at our expenses on a cat neuter scheduled for surgery as part of any other day of the week vs. our expenses on a cat neuter scheduled as part of a high volume, well planned process. We realized that at our regular fee for the service (pretty reasonable to begin with) we were no more profitable when done on another day than we were at the lower cost when done as part of the program.
How can that be? When performed on a regular surgery day, other than actual surgery time, the process takes the same labor as any other procedure.....admit appointment, paperwork, logging into our procedure board, clean up, cage occupancy, cage cleaning, laundry, more paperwork, discharge appointment. With our low cost program, we mail the surgery paperwork in advance and expect it to be completed upon arrival. There is no admit appointment, they're not logged into our procedure board, participants must bring a large enough hard plastic carrier with laundry to avoid recovery in our cages, the discharge paperwork is pre-printed, and there is no discharge appointment.
I can account for every cent of our expenses, and I promise you, there is no difference in profitability in the two models. We don't take any medical shortcuts....we still do a pre-anesthetic exam, use the same anesthetic agents, maintain complete medical records, etc. Because of the popularity of the program, we decided to continue it on a schedule based on demand. Several years later, we offer it on the first Thursday of each month and we've gone from neutering approximately 150 cats per year to an average of nearly 500. If nothing else, we can feel good about doing our part to help fight an overpopulation problem that may never be won.
While conventional wisdom may consider that this program devalues veterinary medicine, I can tell you that many of our clients, not to mention the community, feel just the opposite. At a time when we risk quality veterinary care becoming inaccessible to some pet owners, this is a way we can reassure our clients that we care about the needs of our community, which has a large feral cat population.
From a business standpoint, this particular block of time was not in demand, and if you believe that labor can often be considered a fixed cost, then most of the expenses associated with neutering 30+ cats in two hours was coming out of our pocket either way. Although it wasn't our goal, we have recieved more positive attention from the community then we could have ever paid for, and based on numbers alone, we are making a difference. Mostly however, I can't ever consider something a 'devalued service' if it is a 'community service' and in a town of under 10,000 there is no other way to survive.
This past week I have spent time doing one of my least favorite activities...the hiring process! It is just one of the necessary evils of my job. So, how do I get through it? Well I find the humor or should I say horror in what people find appropriate methods of applying to my posted job. I am a pretty logical person and I would say I have greaet common sense and I often assume that others do to. There are things I think one just knows and doesn't require training. I am wrong. Here are some of the things I received this week
1. The attached photo which is a resume I received. I didn't get the resume itself as an attachment - NOPE! I received it as you see it. It was a photo of a crunched up resume.
2. I got an email of a resume but the photo in the corner was a young lady flipping me off!
3. Of course I got tons of "I love animals"
4. I received many emails, no resume attached, just an email that was as casual as the one I send to my pals.
So what is the worst resume or lack thereof you received?
1. Good Listener: Most clients will choose their favorite veterinarian by their “bedside manner” versus their veterinary skills and education. My personal belief is that you can be the most knowledgeable veterinarian on earth, but if your communication skills are lacking, you will struggle as a private practitioner. We must always strive to be courteous to every client and patient we interact with. We need to have the mindset of putting each client and pet first and treating them as if they are our only appointment that day. We need to take a few minutes to sit and listen to our client’s concerns before we jump into the examination. I heard so many professors in veterinary school say that “a good history is your best diagnostic step.” I am sure all of you heard the same thing. Often times, we get caught up in our busy days while continuing to practice great medicine, but in our client's eyes, we may be rushing to get them out the door. We can take a minute or two during each examination to sit down and listen to our clients concerns and still maintain efficiency in the work place. If we take the time to be interactive with our clients and their pets, we will always be seen as heroes in their eyes.
2. Optimistic: Optimism is always a better path than pessimism. We need to be open to all options when dealing with the treatment of our patients. We should offer all available treatment options no matter the cost, even if it requires sending a patient to a specialist. Pre-judging our clients is the biggest mistake we can make. For example, many of us are too quick to judge the client that walks in wearing street clothes and carrying a malnourished, heartworm and flea infested dog. We think to ourselves that this client does not care about the best options for the pet, so he or she will probably only do the bare minimum. WHOOPS!! We just lost another chance to practice great medicine. The part of the story you do not know is that this pet was found as a stray 2-3 weeks ago and the client has been doing the best he can to earn the pet’s trust. Now that the pet trusts him, he has brought him in for treatment. We must remember to never pre-judge, but this is much easier said than done. After all, we are all human. Keep the mentality to always be optimistic. My philosophy is if a pet is truly suffering, I do all that I can to help the client understand that it may be time to let go. However, if I can tell that the pet is comfortable, I lay all of the options on the table. I always end my conversation by saying to the client “you will not have to make this decision on your own, I am going to let you know when it is time.” By keeping an optimistic attitude and by letting the client know that you are there for them, you will win their trust every time.
3. Leadership: If you are going to be successful in practice, especially as a practice owner, you must be a leader. Being a true leader revolves entirely around trust. You have all heard the saying “practice what you preach,” and this has never been more true than when it comes to leadership. We can all tell a staff member how we want something done, but if we do not take the time to show them how to do it and believe in their skills, that staff member will never succeed. If our staff members fail, we all fail. We must also be a leader when it comes to our recommendations in practice. I am very passionate about weight control and wellness blood work in my practice. I do all that I can to educate clients in these areas, however, that is not enough. My personal pets are in their ideal weight range, eat very healthy foods and treats, and I perform wellness blood work on them every year. Therefore, in that aspect of life, I do all I can to practice what I preach and be a leader for my clients and staff.
4. Deliver: This part of the GOLD standard allow us to come full circle and understand that we can possess all of the previous attributes (Good Listener, Optimism, and Leadership), but we must be able to put them all together and deliver them in our daily practice style. While in the exam room, we must be good listeners and courteous to our clients and patients, be optimistic when it comes to our patient’s treatment plan and our client’s suggestions or concerns, and we must be a leader to our staff and in our recommendations. If you master all of these characteristics, you will deliver excellence every time.
When employees say “I am burned out”, they are really recognizing, feeling, and expressing Compassion Fatigue. The problem is that technicians do not know about compassion fatigue…as a result of the general widespread use of the term, burnout. ~Figley & Roop, 2006
When compassion fatigue affects our employees, our entire practice suffers. Our practice then becomes afflicted with organizational compassion fatigue. According to Patricia Smith, “when management, workers, volunteers, clients and patients suffer varying levels of Compassion Fatigue, they incorporate their symptoms into the “corporate culture” of the organization. Eventually, the productive mission of the organization is replaced by policies, procedures and goals that reflect high levels of dysfunction…when compassion fatigue among employees hits critical mass, the organization itself suffers.”
We all want our practices to be a place where our clients are treated with compassion, our patients receive the best quality medical care, and our team can pursue personal and professional goals in a supportive environment. This type of positive work environment will result in a team that displays some basic traits, including:
Yet when compassion fatigue is affecting our workplace and our team, then this is when the work environment has become “toxic”: (~Figley and Roop, 2006)
Just as with individual compassion fatigue, there are both personal and professional reasons to minimize compassion fatigue. It is difficult for each individual to reach their potential in this toxic environment, and it is also difficult for the organization as a business to survive and grow. Profitability of the practice is definitely affected. Service organizations must recognize that addressing [compassion fatigue] is part of a reasonable standard of practice for any profession that entails direct service to traumatized “clients”. The cost of not doing so is immeasurable. ~Saakvitne & Pearlman, 1996
What does organizational compassion fatigue look like, so we can recognize these symptoms in our own practice and make necessary changes?
Symptoms of organizational compassion fatigue: (~Smith, 2008)
When left unaided, stress levels rise. Employees, particularly the line staff and middle management, feel helpless, then hopeless. Resentment, hostility and blame surface… ~Smith, 2009
In an article by Paul B. Hofmann appearing in the Healthcare Executive in Sep/Oct 2009, there are many factors that lead to compassion fatigue among healthcare workers. These include inadequate professional training, poor mentoring, low staffing, and an organizational culture that does not encourage, value and recognize exemplary displays of compassion. Hofmann goes further in saying that if employees do not believe they are respected and appreciated for their efforts, and if they do not feel cared about by those who have responsibility for them, it will be more difficult for them to establish and maintain a truly caring environment for patients. “Inevitably, compassion fatigue will have an adverse impact on staff recruitment, retention, morale and performance,” says Hofmann.
If we agree with Hofmann as to the factors leading to compassion fatigue among healthcare workers, we recognize that there are plenty of places to help our employees move through and out of the fog of compassion fatigue. We need to provide professional training from their first day, and never stop encouraging them to continue their learning and growing. Mentoring is perhaps the most important task that a manager performs, yet it requires sensitivity to know which employees need mentoring and how they can be best served. It also requires time, to create personal bonds, set professional boundaries, and develop trust so that employees are open and responsive to being mentored by their management team. Low staffing is a reality for many of our practices, as we struggle with each unexpected loss of an employee and try to fill in that space using the “warm body” technique. This is avoidable if our management team continually accepts resumes and applications for all positions even when there is no opening, and conducts ongoing interviews to line up the best candidates for when an opening occurs. If the management has established open communication with each team member, they are also better prepared to know when an employee may be reaching a personal or professional goal that will take them from the practice (i.e. graduating school, completing certification, etc.), or realize when an employee is struggling and thus involuntary termination is unavoidable. Employee loss should never be a surprise, in most cases. If it is, then the management is not projecting employee needs very far into the future.
Organizational culture is so important to minimizing organizational compassion fatigue. As Hofmann stated, our management team (including practice owners and all levels of supervision) must encourage, value and recognize exemplary displays of compassion by the employees. This could be extra time spent with a grieving client, staying late to provide patient care that is necessary, or an employee supporting their teammate through a difficult case. We must be careful not to assume this is unprofitable “down time” or just someone “riding the clock”, when instead it may be the extension of compassion that you really want and need from your team members. Feel free to use the word “compassion” as often as possible when describing activities that you are praising, as this will help them make the connection that it is this display of compassion that is being recognized. As managers in general, it is easy to focus on the problem or trouble employees that constantly need guidance and counseling. However, those employees who probably deserve the support of management the most are those who need to see real examples of how much they are respected and appreciated. This goes beyond tangible rewards and “employee of the month” plagues to words and actions that provide them the feeling that they are cared about. This is where that personal bond is so important.
We can create healthy work places, and here are some guidelines to help us reach that goal:
Eight Laws Governing A Healthy Workplace
1. Provide a respite for the team.
2. Provide continuing education for team.
3. Provide acceptable benefits to aid staff in practicing beneficial self care.
4. Provide management and team with tools to accomplish their tasks.
5. Provide direct management to monitor workloads.
6. Provide positive, team-building activities to promote strong social relationships between colleagues.
7. Encourage “open door” policies to promote good communication between team members.
8. Have grief processes in place when traumatic events occur onsite.
As we conclude the last of our five post series, we would love to hear hear your thoughts regarding compassion fatigue, so if you leave a comment on this blog, your name will be put into a drawing for your own copy of Overcoming Secondary Stress in Medical and Nursing Practice by Robert J. Wicks, which I will mail to you. All comments must be received by November 9. Be sure to include your email address so I can let you know on November 10th, if you were the winner! - Rebecca
Other posts written by Katherine are:
I was disappointed to read the “Hot Button” column in the November issue of Veterinary Economics. Despite a number of concerns facing the veterinary industry today, VE elected to print the second submission in seven months by the same author, and, more or less, about the same topic.
In devaluing low-cost spay and neuter (LCSN) clinics, Dr. Craig Woloshyn (who is credited as a member of the VE Advisory Board) has even used some of the same language that was printed in his April 2010 article. I responded then, and feel compelled to do so again.
To be certain, I am not a spay/neuter activist – I manage a multi-doctor mixed practice in rural Oregon. We have worked extensively for years with our local shelter and other providers of LCSN programs and continue to run one specific program of our own. Our practice grosses seven figures; our Doctors and staff, as well as myself, are all paid well above the nationwide average salary for our positions – all with a fee schedule that continues to be a bargain by some standards.
My problem is two-fold. First of all, Dr. Woloshyn is wrong…..LCSN programs can be a productive component of fighting pet overpopulation. I don’t have to be a DVM to understand that, with respect to social problems, failing to act has an exponentially negative effect, even if taking action falls short of our desired outcome. Unless he is suggesting that cats and dogs would reach a “nature imposed” population ceiling if allowed to breed freely, then the case can be made that the problem would be much worse if not for our industry’s efforts.
So if we can agree that altering pets improves, even if slightly, the forecast for population, the subject of low cost programs is still left to debate. In the past, our practice typically performed a total of 300 feline spay/neuter procedures per year, and that number was the same from year to year despite economical changes and our practice growth. After expanding our cooperation with local humane organizations and creating our own in-house low-cost cat neuter program, that number rose to nearly 1,000 procedures per year. For anyone doing the math, that’s 700 cats per year that are no longer procreating, and while that may not dent Dr. Woloshyn’s 40% unaltered statistic, it’s certainly a move in the right direction.
Though pet overpopulation pales on the list of other social problems that we face in this world, it’s a relief to know that the same approach is not being applied to decisions about other issues such as famine, illiteracy, or disaster relief. What kind of world would it be if we only applied our resources where total success could be achieved?
My second problem is the decision to print what is essentially a retread of old ideas. All I seem to read lately is ‘101 ways’ for consultants to say the same thing…..Veterinarians should charge more and stop worrying about it. Continuing to focus on this one issue (which we all decide on our own anyway) is shortchanging the need to hear about real problems. For every veterinarian who under charges, there is one who overcharges (that is a blasphemous statement, no doubt), and who’s business is that but their own?
Lower cost practices can’t damage the industry…have you ever seen an association of fine dining establishments lobby to eliminate McDonalds? Instead, they understand the concept of target marketing, and creating (selling) the “experience” of a customer visit, not to mention great food. Here’s an interesting exercise for managers – ask your clients to rank their priorities for a visit to your practice (I have). It’s a truth most would rather not hear, but many clients put the resolution of their pet’s medical problems way down the list - often behind customer service, thorough explanations, wait time, convenience of hours, cost of services, etc.
The veterinary industry faces many serious issues - the evolving role of the certified technician; the lack of business preparation in new graduates; how to bridge the mentor role from one generation to the next; the role of staff in “training” new graduates; and the inconsistency of state’s practice acts, to name just a few. Isn’t it time to break some new ground and get outside of the box? I admit, 15 years ago, I was fascinated by the cutting edge advice from veterinary management experts, but that excitement has been replaced by the feeling that today’s consultants are still singing a few really old songs.
So, you’re intrigued. The dvm360.com community looks interesting. You have a couple questions you’d like to ask. You have some opinions to share. But how?
It’s easy to join the circle. Here’s all you need to do:
1. Go to http://www.dvm360.com and click on “community” in the blue navigation bar. (If you’re reading this on the veterinary community, congratulations! You’ve done this part already…)
2. Click “join the circle” in the green navigation bar at the top of the community page.
3. Fill out the required sections of the form. (There aren’t many. User name. E-mail. Password. Birth date.) Some things to keep in mind:
> You can’t change your user name later. So pick something you can live with.
> Your age will display. At least for now. (We have asked our tech team to change this, but it’s harder than you’d think.) So if you’re really uncomfortable with that, lie.
And you’re in! Two minutes and no problem…
The next step is to tell your colleagues a little about yourself by editing your profile description.
Want to see someone actually do the steps? Watch the video!