http://channel.nationalgeographic.com/series/dog-whisperer/3252/Overview#tab-Videos/05198_00
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
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!
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--see
m 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
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
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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?
Editors' Links:
Dr. Miller's Mind Over Miller Articles from Veterinary Medicine
Dr. Miller's Cartoons
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.
For a large part of my management career I have been a strong believer, practitioner, and proponent of Servant Leadership. Servant Leadership is pretty much self explanatory. In a nutshell, a servant leader leads by serving those for whom he is responsible for – employees and customers. In last month’s post we talked about what I call “the Steve Jobs Effect.” Servant Leadership, depending on your point of view, could be called the opposite of “The Steve Jobs Effect.”
However, recently I’ve encountered a darker side to Servant Leadership…
As a servant leader, I believe it is my responsibility to ensure that fairness, standards, and openness are at the center of what I, as a manager, do. I believe it is my job to try and bring out the best in people. To remove the road blocks that staff members might encounter in performing their jobs or specific tasks, or empowering them with tools so that they can overcome those road blocks themselves. To me, Servant Leadership means that, fundamentally, I believe in people. It means that I have faith that people want to do a good job and respond better to encouragement, and a fair process, than threats, shouting, and summary dismissals.
But what happens when certain employees don’t, despite your best efforts, respond to this process? What happens when employees actually consider the process, and therefore you, fundamentally flawed? What happens when trust, fairness, and even faith, turn out to be misplaced?
The answer, of course, is simple – nothing.
While individual failures are disappointing, and extremely disheartening, they are part of the process and they are the cost of servant leadership. Nobody is perfect – including servant leaders – and not everyone will necessarily understand what you are trying to do, or why. However, if you have surrounded yourself with people who you have treated with respect, fairness, and who tried to make a success in both their lives and their jobs they themselves will be the ones to remind you – verbally or by their actions – of a simple fact:
Doing the right thing, whether it is ultimately right or wrong, is never a bad thing.
Certainly we should learn from our mistakes, but individual failures in a sea of success should not make you give up or consider the odd failure anything other than an unfortunate side-effect of the process. To all those disheartened, discouraged, and disappointed, servant leaders out there please don’t loose the faith. If servant leadership was easy, it wouldn’t be special, they wouldn’t call it leadership, it wouldn’t cost anything, and it wouldn’t have value.
For those who wish to know more about Servant Leadership I strongly recommend James C. Hunter’s The Servant.
If you have any leadership crisis of faith stories or issues please feel free to comment below.
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.
I'm reading a great book titled In the Company of Animals by James Serpell that explores the historical and contemporary relationship of pets to people. I ran across a reference to Aesculapius/Asklepios (Roman/Greek), the eventual god of medicine. You know! The guy with the caduceus, the rod, that symbol used for centuries for human medical doctors: a staff with wings on top and two snakes entwining it.
Yeah.
So it turns out that that rod, with wings and two snakes, is the rod for Hermes, that super-fast messenger for the Greco-Roman gods. Aesculapius' staff has no wings on top and has a single serpent entwining it. That image I've included? It's the veterinary caduceus which, more than often not, is the RIGHT one. The one with no wings and only one serpent.
Is it because veterinary medicine came into its own long after human medicine had been started--so they got it right early on? Are veterinarians just better educated about the symbolism of ancient Greece and Rome?
Take your pick.
Rock those proper caduceuses, doctors!
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This post is in response to Dr. Craig Woloshyn’s article “Cheap spays, neuters won't fix the animal overpopulation,” published in the November 15, 2010 issue of Veterinary Economics. Dr. Woloshyn makes a number of assertions about the effectiveness, financial viability, and quality of spay and neuter programs that require rebuttal:
1. We've had very little effect on the dog and cat population in this county, nor will we with this approach. Dog and cat populations are affected by factors we haven't learned to control.
The simplest factor controlling a population is its fecundity. This is something that we, as veterinary surgeons, have learned to control on an individual basis by spaying and neutering. While we may not yet have mastered the intricacies of human behavior and animal survival rates based on neutering prevalence in a community that in turn affect the population size, we do understand the basis for population growth in companion animals.
And in fact, the past several decades have witnessed a decline in shelter euthanasias nationally, from an estimated 13.5 million cats and dogs in 1973, to 4-5 million in 1991, (Scarlett 2004) to 3-4 million currently (HSUS 2010).
2. This isn't the place for an exposition on procreation, but you won't find a single well-documented study that shows significant decrease in animal populations anywhere in this country. Those few studies that exist show essentially flat shelter fill and euthanasia rates.
Some studies have already shown effects from spay and neuter programs on shelter intake and euthanasia. White (2010) studied the impact of the Animal Population Control Program in New Hampshire and demonstrated a significant decrease in cat intake and euthanasia in shelters during the years after program onset. Austin-based EmanciPET Free Spay/Neuter Program produced a significantly lower rate of increase for dog and cat intake and euthanasia in the municipal shelter for animals from the program areas. Shelter intake and euthanasias in Asheville, N.C have decreased by 75% since Humane Alliance established their low-cost high-volume spay neuter program.
Indeed, more studies are needed to prove the effects of high volume spay and neuter programs on animal populations. Several such studies are in the process of being completed and await publication. In addition, spay and neuter programs and animal shelters have come to understand the necessity of accurate and thorough data collection. Geographic Information Systems (GIS) are being studied for use as tools to track risk for animals coming into shelters and to focus spay and neuter resources on highest risk neighborhoods (Patronek, 2010; Weiss, 2010). Studies such as these will help us better understand the effectiveness of spay and neuter programs and how we can use our resources most effectively.
It would be a mistake to view inconclusive evidence as proof of failure. Evidence-based medicine is, by its nature, based on evaluation of the results of experimentation. If we, as scientists, are not allowed room to form hypotheses and test them, then we can have no evidence-based medicine.
3. If what we said would work were working, we'd see it by now.
In Joshua Frank’s 2004 mathematical model of neutering for animal population control, neutering programs were found to be effective at reducing shelter euthanasia. However, the model also predicted that the full impact of a one-time permanent increase in the neutering rate may not be felt for as much as 40 years (Frank, 2004). In addition, many of the spay and neuter clinics now in existence have been opened within the past five years (Humane Alliance, 2010). Thus, we are only now beginning to see the effects of a movement that began several decades ago.
4. Approximately 40 percent of pets in this country are sexually intact. Apparently we can't sway this population of owners with cost.
Cost is the reason most often cited by owners for not having their cats neutered (Patronek, 1997 and New, 2004). With unowned, feral cats, the percent of caretakers attempting to have feral cats neutered (Levy 2003) or taking feral cats to a veterinarian for any reason (Lord 2008) is small, ranging from 11% to 22%. Cost is likely to be even more of a factor with these cats than with owned cats. Thus, providing reduced cost or free spay and neuter services addresses one of the most common reasons for failure to spay and neuter cats.
Low-cost or free subsidized spay and neuter surgery is the only way to reach certain segments of our country’s companion animal population. In the United States, 14.3% of people live below the poverty line (Bishaw, 2010). People with low incomes are nearly as likely to own pets as are people with high incomes (AVMA, 2007), indicating that large numbers of animals live in households that simply cannot afford full-service veterinary care.
5. Feral cats are so fecund that even if we leave one pair unneutered, we'll soon see the population restocked naturally.
One population model of feral cat populations show that population control can be achieved by ongoing spaying of at least 75% of the fertile female population. (Anderson 2004). While this approach does take ongoing effort and monitoring, the number of surgeries required to maintain a greater than 75% spay and neuter rate is low after the initial, first-year trapping and neutering. Indeed, removal-and-euthanasia strategies, sometimes touted as an alternative to Trap Neuter Return (TNR) programs, also require ongoing monitoring and euthanasia, making them no less effort than TNR. In addition, euthanasia of ferals is often unsupported by the general public and by colony caretakers, and may be morally untenable for the humane agents or veterinarians who would be asked to perform the procedure.
Several studies have demonstrated the success of ongoing TNR programs for free-roaming and feral animal management. A TNR program in Jaipur, India sterilized and rabies vaccinated 24,986 dogs between 1994 and 2002. Direct observational surveys of the local dog population indicated that 65 per cent of the females were sterilized and vaccinated, and that the population declined by 28 per cent (Reece, 2006). A study of a cat colony on a university campus in Florida saw a 66% decrease in the resident cat population after the onset of a TNR program, and concluded that a comprehensive long-term program of neutering followed by adoption or return to the resident colony can result in a sustained reduction of free-roaming cat populations in urban areas (Levy, 2003).
6. We've cheapened the entire profession with bargain-basement spays. We've taught the public that we don't consider ourselves worth much.
Human medicine offers many examples of professionals providing care at low or no cost to individuals who cannot or will not otherwise seek care. Rather than cheapening the medical profession, these services demonstrate compassion while enhancing human welfare and public health. Similarly, veterinary medical services provided to enhance animal welfare and public health by providing services to those who could not, or would not, otherwise afford them demonstrate compassion and enhance the value of the veterinary profession.
7. We've set the standards of care at the level of herd medicine, not something most small animal practitioners want.
Indeed, many small animal practitioners are not accustomed to or comfortable with approaching animal health on a population basis. However, veterinary epidemiology and population medicine is a central part of the veterinary curriculum in our veterinary schools. While private practitioners may not, in day to day practice, think about veterinary epidemiology and animal populations, much of the medicine that veterinarians practice today is based on epidemiological evidence. Evidence-based clinical veterinary medicine relies heavily on the results of epidemiological analyses (Thrusfield, 2007), and veterinarians in clinical practice must use probability-based information to make decisions about individual patients in day-to-day practice. (Pfeiffer, 2010).
Standards of care in high volume surgical settings need not compromise animal health and welfare. The Association of Shelter Veterinarians veterinary medical care guidelines for spay-neuter programs, published in JAVMA on July 1, 2008 (Looney et al 2008), provides practical standards for high-quality, humane, and efficient care of veterinary patients in high-volume spay and neuter programs.
8. And we've exercised our seemingly unbounded ability to take blame for situations that are not of our making.
Taking action does not equate to taking blame. Veterinarians are in a unique position to take action, not because we are at fault, but because we have the skills that can actually change the population dynamics of our cat and dog populations.
9. We've also wasted a lot of time and money sending people to school for four years to perform a simple procedure that takes three months to master.
While a spay or neuter surgery is, in itself, a simple procedure, it is of course false to assume that “cutting and sewing” is all that is involved in spay and neuter practice. Spay and neuter surgeons must know current anesthesia and analgesia protocols that maximize patient comfort and welfare, while being attentive to cost. They must be familiar with patient monitoring techniques and emergency procedures. They must be able to perform efficient physical examinations in order to aid in patient selection and in the modification of treatment protocols. They must know common and uncommon reproductive anatomical anomalies and understand how to address them surgically. They must learn to practice efficient surgical techniques that minimize tissue trauma.
10. Many practices are now feeling the effects of these misguided efforts. Clients who don't understand why real surgery costs 10 to 20 times the price of a spay bristle at the idea of paying us a living wage. Young doctors whine about their student debt yet gladly debase the very profession that should be supporting them.
Efficient, high quality spay and neuter programs need not underpay their veterinary staff. Spay and neuter clinics can and should offer competitive salaries and benefits (Weedon, 2007).
Furthermore, the advent of spay and neuter programs need not imply a decrease in procedures performed by private practitioners. In an analysis of five communities with targeted spay and neuter programs, Frank (2007) demonstrates that low-cost neutering programs are effective at increasing the total number of neuters in the program community, including in private practices, rather than simply causing a substitution of sources for neutering services as some practitioners might fear.
In conclusion, I, as a member of the Association of Shelter Veterinarians Veterinary Task Force to Advance Spay Neuter, feel that High-Quality, High-Volume Spay and Neuter programs have a vital place in our profession and are an essential component to decreasing cat and dog overpopulation and shelter euthanasia. While more data needs to be collected, preliminary research does show a reduction in shelter intake and euthanasias associated with high-volume spay neuter programs. And, finally, compassionate activities directed towards animal welfare and public health enhances the value of the veterinary profession as opposed to cheapening the profession.
Editor's note: Click here to join the cheap-spay discussion online right now on the dvm360 Community message board.
References:
American Veterinary Medical Association (2007) U.S. Pet Ownership & Demographics Sourcebook. Published by AVMA, available at www.avma.org
Bishaw, A, and Macartney, S. (2010) Poverty: 2008 and 2009, American Community Survey Briefs. U.S. Census Bureau. Available at www.census.gov/prod/2010pubs/acsbr09-1.pdf
Frank, J.M., Carlisle-Frank, P.L. (2007). Analysis of programs to reduce overpopulation of companion animals: Do adoption and low-cost spay/neuter programs merely cause substitution of sources? Ecological Economics,62,740-746.
Frank, J.M. (2004). An interactive model of human and companion animal dynamics: the ecology and economics of dog overpopulation and the human costs of addressing the problem. Human Ecology, 32,107-130.
Humane Alliance (2010). Accessed 12/18/10. Available at www.humanealliance.org/index.php/about-us
Humane Society of the United States (2010). Accessed 12/18/10. Available at www.humanesociety.org/issues/pet_overpopulation/facts/overpopulation_estimates.html
Levy J.K., Gale D.W., Gale L.A. (2003) Evaluation of the effect of a long-term trap-neuter-return and adoption program on a free-roaming cat population. J Am Vet Med Assoc, 222, 42–46.
Looney , A. L. et al. (2008) The Association of Shelter Veterinarians veterinary medical care guidelines for spay-neuter programs. Journal of the American Veterinary Medical Association, 233, No. 1, Pages 74-86.
Lord, Linda K. (2008). Attitudes toward and perceptions of free-roaming cats among individuals living in Ohio. Journal of the American Veterinary Medical Association, Vol 232, No. 8. pp 1159-1167.
New, J.C., Jr., Kelch, W.J., Hutchison, J.M., Salman, M.D., King, M., Scarlett, J.M., and Kass, P.H. (2004). Birth and Death Rate Estimates of Cats and Dogs in U.S. Households and Related Factors. Journal of Applied Animal Welfare Science. 7(4), 229–241.
Patronek G .J., Beck A. M., Glickman L. T. (1997) Dynamics of dog and cat populations in a community. Journal of the American Veterinary Medical Association. 210(5):637-42.
Patronek, G. J. (2010) Mapping and measuring disparities in welfare for cats across neighborhoods in a large US city. American Journal of Veterinary Research Vol. 71, No. 2, Pages 161-168
Pfeiffer, D. (2010) Veterinary Epidemiology: An Introduction. 152 pages.Wiley-Blackwell.
Reece, J.F. & Chawla, S.K. (2006). Control of rabies in Jaipur, India, by the sterilisation and vaccination of neighbourhood dogs. The Veterinary Record, 159, 379-383.
Scarlett, J. M. (2004) Pet Population Dynamics and Animal Shelters. In Shelter Medicine for Veterinarians and Staff, Blackwell Publishing, pages 11-23.
Thrusfield, M. (2007). Veterinary Epidemiology, 3rd Edition. 624 pages. Wiley-Blackwell.
Weedon, J. (2007) Strategies for Recruiting and Retaining Spay/Neuter Veterinarians. Available at http://www.sheltermedicine.vet.cornell.edu/working/RecruitingVets.pdf
Weiss, E. (2010). ASPCA website. Accessed 12/18/10. Available at http://www.aspcapro.org/blog/2010/05/are-we-hitting-our-target/
White, S. C., Jefferson, E. & Levy, J. K. (2010). Impact of Publicly Sponsored Neutering Programs on Animal Population Dynamics at Animal Shelters: The New Hampshire and Austin Experiences. Journal of Applied Animal Welfare Science, 13(3), 191-212.
Congratulations! You joined the community. But right now, when you or anyone else goes to look at your profile—which they will—it says “Sorry. YourNameHere hasn’t written anything yet. You can change that in a jiffy. Here’s how:
1. Go to http://www.dvm360.com and click on “community” in the blue navigation bar.
2. Click “community log in.”
3. Fill in your user name and password to log in.
4. Click “edit my profile.”
To get started, fill in a few words that describe you or your interest in the “tags” field, like your role in the practice or your hobby. For example: manager, Washington, skiing, small animal, poodles …
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In the “about me” field write a short description about yourself and your role in veterinary practice and your interests to let other community members get to know you better.
The next field “What is your role in the veterinary community?” gives you a chance to expand that description for people who want to learn more about you.
5. When you’re done, click “update profile.”
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