Jan/Feb 2023 by californiaveterinarian

Your Vetcation Awaits! PacVet 2023 in Long Beach page 28 CVMA 2022 Economic Survey Report—Part 2 page 18 VOLUME 77 NUMBER 01 | JANUARY–FEBRUARY 2023 THE PUBLICATION OF THE CALIFORNIA VETERINARY MEDICAL ASSOCIATION VETERINARIAN California

2 California Veterinarian | January–February 2023 ®

Features

CVMA President: Creating and Maintaining a Positive Workplace —and Profession!

Departments

Member Profile: Larry Correia, DVM

Record Keeping—But There’s More!

Let Us Give You a Hand: CVMA Member Benefits

White Saviorism in Veterinary Medicine and How to Avoid It

CVMA 2022 Economic Survey Report—Part 2

Immune-Mediated Diseases in Dogs and Cats: When Are Steroids Not Enough?

Compliance Corner: Cal/OSHA Requirements for Veterinary Practices

Ensuring a Safe Driving Program

CDFA News: New Animal Confinement Laws in 2023

CVMA Board of Governors Openings

Make a Healthy Start to the New Year with the CVMA’s Member Assistance Program

Upcoming CE

3 cvma.net/publications CONTENTS

CE Calendar Director’s Corner First-Year Veterinarian News & Now CVMA Remembers Something to Wag About Student News University News Classifieds Ad Index Spring Seminar in Yosemite 2023 Pacific Veterinary Conference in Long Beach 8 4 13 10 5 28 12 6 14 7 16 36 18 39 26 40 34 44 41 35 46 37 38 42 6 18 28 41

NEW LAWS FOR 2023

January 25, 2023 | 5:30 PM–6:45 PM (1 CEU)

FREE for CVMA members! Registration closes January 18.

CVMA SPRING SEMINAR IN YOSEMITE

March 3–5, 2023 | 12 CEUs for veterinarians, RVTs, and CVMA CVAs

For more information, see page 13.

How Far We’ve Come

By Anne Chiruvolu, DVM

Throughout vet school, we were warned that fourth year was a big learning curve but that the toughest curve of all would be our first year in practice. My first six months as a DVM have felt at times like a roller coaster, from an initial “I can’t do this! I’m not ready!” to “I guess I know more than I thought I did…” to “Wow, I still have so much to learn.” I watch my mentors who seem to know the answers to nearly any question at the drop of a hat, and the gulf between their level of expertise and mine sometimes seems insurmountable.

Yet, does the owner of the husky with refractile chronic diarrhea know that I spent 40 minutes researching next steps before returning her phone call? Does the owner of the pit bull with the mast cell tumor know it was my first time diagnosing one myself on cytology? Does the owner of the cat that presented on urgent care with difficulty breathing know I had never performed a thoracocentesis before I tapped their cat’s pleural space? No, they didn’t— they just thanked me for my help. And I’ll be able to help the next pet with the same condition even more efficiently.

In the course of a busy clinic day I learn and implement many new things, but I was also recently fortunate enough to spend four days at a continuing education conference specifically designed for new graduate veterinarians to build our skills. We spent long days soaking in as much knowledge as we could. We studied anesthesia and dermatology with a renewed fervor; now that we have actual cases of our own to manage, the concepts were

no longer abstract, and we peppered the specialists with questions ranging from management of arrythmias during anesthetic induction, to where to biopsy a footpad, to the preferred skincare regimen for hairless cats. Then we spent a day practicing dental nerve blocks and extractions on cadaver heads, dreading the snap that heralded a broken tooth root. During our final, whirlwind day of surgery, we learned a dozen new surgical techniques over the course of eight hours. At the end of the day, after sweating through our first resection and anastomosis on cadaver bowel that had grown soft and rather “fragrant” after a full day out in the surgical suite, my colleague and I sat on the bus back to our hotel reflecting on our progress.

“I’m so slow—and my sutures kept failing the leak test.”

“I kept perforating my gingival flap while I was trying to elevate it off the periosteum.”

“The specialists make it look so easy!” “But think of what our selves from three years ago would think of where we are today…”

We reflected on those past versions of us, bleary-eyed from late nights studying anatomy and physiology. In those days, when I had the opportunity to shadow fourth-year students, I was amazed at how much they could do and how much knowledge they had at the ready. At that time, the ability to formulate a strong list of differential diagnoses or perform surgery felt impossibly out of reach. And yet, by trusting the process (and working really hard), we got there, right on schedule. So if we just keep putting in the effort, I expect that in a year (or two, or three), we’ll be amazed at how far we’ve come since that conversation on the bus.

6 California Veterinarian | January–February 2023 FIRST-YEAR VET

“My first six months as a DVM has felt at times like a roller coaster, from an initial ‘I can’t do this! I’m not ready!’ to ‘I guess I know more than I thought I did…’ to ‘Wow, I still have so much to learn.’”

JANUARY 24–26, 2023

Veterinary Medical Board Meetings

FEBRUARY 12, 2023

CVMA RVT Committee Meeting

FEBRUARY 28, 2023

CVMA Finance Committee Meeting

MARCH 1–2, 2023

VISC Board Meetings

News Now & CVMA

Cal/OSHA Form 300A Posting Requirement

Cal/OSHA Form 300A is a summary of specific job-related illnesses and injuries that have been reported by businesses in 2022. Businesses must post this form for employee review between February 1, 2023 and April 30, 2023.

Visit https://www.dir.ca.gov/dosh/doshreg/apndxb300afinal.pdf to access this form.

New Nametag Requirement

Effective January 1, 2023, registered veterinary technicians and veterinary assistants are required to wear nametags when interacting with the public. To help satisfy this requirement, the CVMA offers our members a 10% discount on nametag printing and a variety of printing services through The Castle Press. To access this member benefit, log in to cvma.net and go to the Membership section, then select Member Benefits and Services.

Share Your Good News with the CVMA!

MARCH 25, 2023

CVMA Board of Governors Meeting

JUNE 9, 2023

Joint CVMA Board of Governors/House of Delegates Meeting

= HYBRID OR VIRTUAL EVENT

The CVMA likes to spotlight the accomplishments and good news of our members and/or their practices—whether that includes purchasing a new practice or house, retiring, getting married, starting a family, or any other significant and positive event—on our “Something to Wag About” page of California Veterinarian. We would love to hear from you! To submit your good news for consideration in an upcoming issue, please contact the CVMA’s Publications Manager, Taryn DeOilers, at tdeoilers@cvma.net.

Contributions

to California Veterinarian

California Veterinarian is now accepting reader contributions for publication. Please send letters, story ideas, and editorial pieces for consideration to comments@cvma.net. All material is published at our discretion and we reserve the right to edit all submissions.

California Minimum Wage Increase

As of January 1, 2023, all California employers are subject to a $15.50/hr minimum wage rate. For more information visit dir.ca.gov.

7 cvma.net/publications NEWS & NOW

UPCOMING

MEETINGS

Creating and Maintaining a Positive Workplace—and Profession!

By Keith Rode, DVM, CVMA President

However, it is erroneous to think of “workplace negativity/positivity” as just one topic. There are so many different things that affect how content we are at work. When I recently posed a question about how to combat veterinary workplace negativity on a prominent veterinary Facebook group, I received a wide variety of responses, ranging from improving communication and firing abusive clients to paying a living wage and actually supporting (and not just talking about) work/life balance.

life philosophies, among many other circumstances. As a small example, I personally prefer to leave the office for at least a short time during lunch (which definitely does not always happen), while other colleagues prefer to work straight through their lunch times. Hopefully, we can all realize that there is no single way to do the job, and that we should not judge people who go about their work differently than we do.

An unofficial theme that I am striving to promote during my term as this year’s CVMA president is “celebrate the good”—that we are part of a fantastic profession, and sometimes we need to remind ourselves of that.

I imagine that I, like many of you, initially wanted to become a veterinarian to pursue a rewarding career helping animals and the people who care for them. Along a veterinary professional’s journey, we find that things are a bit more complicated than that, and sometimes the joy and idealism get a little lost.

Workplace negativity is one topic that I have heard colleagues mention as a reason that they sour on the profession. Many of those who have expressed this sentiment are in clinical practice, but this issue is by no means exclusive to any one type of veterinary workplace. A toxic or unduly onerous work environment is not healthy for anyone; conversely, a positive work environment can be uplifting and fulfilling, allowing us to more easily find joy in what we do.

One of my associates saw the post and commented, “Cheez-It dispensers.” It is true—we do in fact have a Cheez-It dispenser at work, and it is amazing how much positivity that gadget spreads.

I certainly do not claim to be an expert on creating a positive workplace, and I know that there have been times when the atmosphere at my own veterinary hospital was not what I would have liked it to be. The intention to provide a positive space certainly exists though, and my business partner and I always work toward that end.

Here are a few lessons and observations I have found along the way, which I have discovered to be equally as relevant to me when I was an associate as they are now that I am a practice owner.

• People have individual motivations and priorities that affect the way that they work. Sometimes those motivations change due to a person’s position within the business, longevity within the profession, relationships within the workplace, relationships outside of the workplace, generational norms, and personal

• Similarly, not everyone communicates in the same way. Communication is so important in any workplace, and it can easily lead to problems when done poorly. One person may prefer face-to-face talks whereas another may prefer email communication in order to better process information before responding. I can be very blunt with some of my coworkers, while others require a more indirect approach. Learning these differences not only shows the other person that they matter to you, but also helps promote better outcomes overall.

• A culture of respect comes from the top down. Owners and managers are not to blame for all the ills in a workplace, but toxicity at the top breeds toxicity throughout the rest of the workforce. Associate veterinarians and support staff need to be supported by their management. Performance issues certainly come up but can be dealt with in a professional and supportive manner. Recognition of staff achievements goes a long way toward showing that management does not only care when something goes wrong. Management should never tolerate clients being verbally (or otherwise) abusive toward their staff. And workplace leaders should never be so proud as to not apologize and change course when a decision of theirs does not work out.

8 California Veterinarian | January–February 2023 FROM THE PRESIDENT

• Workplace cliques and gossip can make people feel like outsiders. Friendships naturally form within a work environment but they should never become an exclusionary mechanism. All employees within a workplace—whether longstanding fixtures or new hires, whether highly skilled or entry-level—need to feel a sense of belonging; anything short of that creates negativity and leads to high staff turnover. Many of us are so busy at work that we may look at team-building exercises and experiences as expendable in the pursuit of output and efficiency. Yet I have found that some of our just-for-

fun group activities have significantly improved morale, which in turn increases efficiency as a silver lining benefit.

• A technician of mine talked with me about the difference of a veterinarian at the end of their shift saying, “Thank goodness that is over with; I can’t wait to go home,” as opposed to, “Thank you all for helping me get through a busy day.” Our colleagues and staff pick up on those differences, and the way we collectively perceive our workplace experience can hang in the balance. Sure, we may be excited to go home at the end of a shift. But we can still make the decision to play our own part in promoting a workplace culture that makes people excited to come back for the next shift.

Improving workplace positivity takes intentional efforts, and it does not happen overnight. We are individually complex people with complex emotions, and the additional complexity of social interactions both inside and outside of the workplace can be difficult to navigate. There are any number of

external forces that may drag us down, but we each have the personal capability to bring ourselves back up. And when we are riding higher, we tend to bring our colleagues up with us.

Does the veterinary profession have some legitimate problems? Yes. Do some workplaces have toxic management, employees, clientele, and/or overall culture? Also yes. Hopefully, we can all continue to address and solve these issues. We need to advocate for each other and for our profession just as we advocate for our patients.

At the same time, it is up to each of us to “celebrate the good” and promote the positive when we achieve it. This can help reunite us with the initial joy we felt for the veterinary profession, and it will help continue to make the profession an attractive option for the workforce of tomorrow. I know that we can rise to the occasion

9 cvma.net/publications

“We need to advocate for each other and for our profession just as we advocate for our patients.”

PHOTO: SHUTTERSTOCK

I AM THE

Members are the heart of the CVMA

Larry Correia, DVM

c Medical Director and Partner of VCA Asher Animal Hospital

c Practice type: Small animal general practice

c Washington State University

My best professional moment was when I pulled a foxtail out of the ventricle wall of a dog’s heart and the dog survived!

Do you have any words of wisdom for new veterinary professionals? Expect to work hard and continue lifelong learning, and you will never be bored.

The most adventurous thing I’ve done is climbing Mount Fuji in the dark during a torrential rainstorm with my wife and daughters.

My role models are my parents.

If I could have dinner with any famous person in history, it would be Walter Cronkite.

What five adjectives best describe you? Hardworking, honest, determined, compassionate, and adventuresome.

I am a CVMA member because I like to be aware of legislation that may affect our profession. The CVMA keeps its members informed of these issues and helps protect the future of veterinary medicine.

10 California Veterinarian | January–February 2023 MEMBER PROFILE

One in-clinic dose of ZorbiumTM provides 4 days of continuous post-op pain control

for at-home comfort.

The only FDA-approved long-acting transdermal buprenorphine for cats.

Incorporate Zorbium into your postoperative pain protocol today.

Indication: Zorbium is indicated for the control of postoperative pain associated with surgical procedures in cats.

Important Safety Information: Before using ZORBIUM (buprenorphine transdermal solution), read the entire package insert, including the Boxed Human Warning. Call 1-888-545-5973 for full prescribing information. ZORBIUM contains buprenorphine, an opioid that exposes humans to risks of misuse, abuse, and addiction, which can lead to overdose and death. Use of buprenorphine may lead to physical dependence. The risk of abuse by humans should be considered when storing, administering, and disposing of ZORBIUM. Serious, life-threatening, or fatal respiratory depression may occur with accidental exposure to or with misuse or abuse of ZORBIUM. ZORBIUM should only be administered by veterinarians or veterinary technicians who are trained in the handling of potent opioids. Accidental exposure to even one tube of ZORBIUM, especially in children, can result in a fatal overdose. ZORBIUM is for topical application in cats only. Following application to the cat, allow a minimum drying time of 30 minutes before direct contact with the application site. Do not administer to cats with a known hypersensitivity to buprenorphine hydrochloride, any inactive ingredients of ZORBIUM, or known intolerance to opioids. Most common adverse reactions during anesthesia were hypothermia, hypotension, and hypertension, and after anesthetic recovery were hypothermia, hyperthermia, and sedation. The safe use of ZORBIUM has not been evaluated in debilitated cats, those with renal, hepatic, cardiac or respiratory disease, pregnant, lactating, breeding, in cats younger than four months old or <2.6 lbs or >16.5 lbs. See safety summary on page X for additional safety information.

NEW

Zorbium, Elanco and the

diagonal

Record Keeping —But There’s More!

By Stephen Marmaduke, Wilke Fleury LLP

Title 16, California Code of Regulations, Section 2032.3 sets forth the minimum recordkeeping requirements that are enforced by the Veterinary Medical Board (VMB). Comprehensive medical records that go beyond the minimum standards are a key component of protecting practitioners from civil liability. Further, detailed documentation may be an effective liability shield for the practitioner. In the last issue of California Veterinarian, we discussed recordkeeping standards relative to questions of ownership, phone logs, and counter notes. In this edition, we will address record keeping regarding informed consent, treatment options, and denial of treatment.

Informed Consent

In simple term, informed consent means that information is made available to an owner to permit them to make the best decision within the limitations of the animal’s health and economic realities. Informed consent is dictated by the standard of care and is a fundamental element of the contract between the veterinarian and the owner to provide and pay for veterinary services.

Interestingly, 16 CCR Section 2032.3 requires that medical records reflect assessments, diagnoses, and treatment plans, but does not specifically address informed consent. Nonetheless, a veterinarian is required to provide services in accordance with the standard of care, which does include informed consent. Given the importance of informed consent, the information-gathering process and the consent should be well-documented.

Practice areas of particular concern are anesthesia and euthanasia, in part because of the risks and finality of the procedures, but also due to emotional responses of owners. Each veterinarian should consider the risks of the procedures and treatment, and assess whether the risks are being adequately explained. This assessment should include pharmaceutical products, as in many instances the veterinarian is assuming the role of both prescriber and pharmacist.

Again, informed consent should be documented. For repetitive procedures and prescriptions, a consent form setting forth benefits and risks may be efficient and well-indicated. These forms should be executed by the owner and incorporated into the medical records.

Exhaustive warnings and disclosures are part of the human medical system. Although many consumers may not fully read these advisements, they generally understand that they

will be governed by the information contained therein, even the “fine print,” and that these disclosures are part of the contract. Veterinarians should adopt the same approach.

Treatment Options

Overlapping “informed consent,” which focuses on risk, is the documentation of treatment options and the cost of the respective options. Part of the agreement to provide services should include the cost of the service, as cost is a fundamental aspect of a caregiver’s contract with the owner.

The standard of care requires that the owner be provided the treatment options available. Cost may be a critical factor in the decision-making process, and failure to empower the owner with all reasonably available options may leave the provider vulnerable to liability claims. When a fixed cost cannot be provided, a range can be relied upon. Ideally, the owner will provide written approval (initials are better than nothing). In the real world, a verbal agreement may be the best that can be achieved but the medical records should contain a contemporaneous entry memorializing the authorization, the time and date it was given, and who provided it.

Denials of Treatment

Not all animal owners are willing or able to authorize treatment due to cost. Obviously, a total denial of care should be documented in the records. Frequently, however, denials come in the form of a refusal to authorize a lab test or to leave the animal for observation to assist in the development of a treatment plan. These refusals can leave the veterinarian open to claims that (1) they did not properly diagnose the issue; or (2) they charged for improper treatment. All too often, veterinarians are second-guessed for a bad result when they were not permitted to take appropriate steps to treat the animal.

When an owner chooses a more limited treatment plan or option, the medical records should accurately reflect that the owner understood the necessity for a more extensive treatment plan, the risk of not authorizing it, and that they assumed responsibility for that risk.

Conclusion

The minimum standards of record keeping established by Section 2032.3 focus on the care provided to the animal. Compliance with these standards protects the practitioner from VMB scrutiny. To additionally protect the veterinarian from liability, the medical records should document the relationship with the consumer. Was the care properly authorized? Were treatment care options and costs provided? Was informed consent obtained? After an owner tells their story of blame and makes accusations of liability, the veterinarian should be able to point to the medical records and assert—but there’s more!

12 California Veterinarian | January–February 2023 LEGAL

Legal Services sponsored by

Enjoy Excellent CE from World-Class Speakers

at the

CVMA Spring Seminar!

2023 SPRING SEMINAR SPEAKERS

Infectious Diseases

JANE SYKES, BVSc (Hons), Ph.D., MBA, DACVIM (SAIM)

Dr. Jane Sykes is a Professor of Small Animal Medicine at the UC Davis School of Veterinary Medicine with an interest in small animal infectious diseases. She obtained her veterinary degree and Ph.D. in veterinary microbiology at the University of Melbourne, Australia, completed a residency in small animal internal medicine at the University of Minnesota, and received her MBA from the University of Georgia. She is board-certified with and the current president of the American College of Veterinary Internal Medicine, as well as the founder and first president of the International Society of Companion Animal Infectious Diseases (ISCAID).

Immune-Mediated Diseases

Drs. Dana LeVine and Austin Viall will be co-presenting on Immune-Mediated Diseases.

DANA LEVINE, DVM, Ph.D., DACVIM (Int. Med)

Dr. Dana LeVine is an Associate Professor of Small Animal Internal Medicine at Auburn University. A 2004 graduate of Cornell University’s College of Veterinary Medicine, Dr. LeVine completed a rotating small animal internship at the University of Georgia and the Clinician Investigator Program at North Carolina State University with a Ph.D. focusing on the pathogenesis of immune thrombocytopenia. She recently coauthored the American College of Veterinary Internal Medicine’s (ACVIM) Consensus Statements on the Diagnosis and Treatment of Immune-Mediated Hemolytic Anemia and is co-chair of the current ACVIM Consensus Panel for Diagnosis and Treatment of Immune Thrombocytopenia. Dr. LeVine serves as president of the Association of Veterinary Hematology and Transfusion Medicine and secretary of the Veterinary and Comparative Clinical Immunology Society.

AUSTIN VIALL, DVM, MS, DACVP

Dr. Austin Viall is an Associate Professor of Clinical Pathology at the University of California, Davis. Dr. Viall is a veterinary graduate of Washington State University and completed his clinical pathology training at Oregon State University. Dr. Viall previously worked at Iowa State University as the Clinical Pathology Laboratory Director, until very recently joining the clinical pathology team at UC, Davis. Dr. Viall is heavily involved in clinical pathology training at the specialty level, serving in various education-associated and trainee certification roles for the American College of Veterinary Pathologists (ACVP) and American Society for Veterinary Clinical Pathology (ASVCP). He is also actively engaged in advancing the veterinary pathology discipline through his role as the current president of the ASVCP.

Veterinarians, RVTs, and CVMA CVAs are invited to attend the CVMA Spring Seminar on March 3–5, 2023!

Earn up to 12 CEUs on topics that can be immediately applied in your everyday practice. This is an in-person event.

Continuing Education Information Student

Special Member pricing on CE offered inperson at vacation destinations or online from the comfort and convenience of your home or office. Visit the Continuing Education tab at cvma.net.

Manage your continuing education records through the CVMA’s website and receive a reminder letter from the CVMA six months before your license renewal date. Visit the Continuing Education tab at cvma.net.

The CVMA’s Certified Veterinary Assistant Program increases your veterinary assistants’ education, experience, and skills. Visit the Resources tab on cvma.net.

Immediate access to critical information through California Veterinarian magazine, the CVMA’s Weekly e-newsletter, and the CVMA’s website, press releases, and action alerts.

The CVMA App allows access to instant legislative updates, CE offerings, regulatory information, and more—all in the palm of your hand.

The Summer Work Experience Program (SWEP) connects students from UC Davis and WesternU with veterinary practices for summer employment.

Veterinary Insurance Services Company (VISC) offers UC Davis and WesternU student members complimentary professional liability insurance.

Savings on Products and Services Wellness

CareCredit healthcare financing helps families manage veterinary costs through monthly payments.

Free legal consultation for member veterinarians. Take advantage of 30 minutes of free legal consultation each month with attorneys specializing in employment law, contract and business law, and administrative law, including the Veterinary Medical Board (VMB) and other regulatory agency issues.

One-stop regulatory consulting resources help you stay in compliance with everchanging laws and regulations.

The CVMA InLine Program assists with workplace safety, legal issues, and laws and regulations affecting the profession. Visit cvma-inline.net.

The Relief Veterinarian Directory provides contact information for locum tenens veterinarians.

The Find-a-Veterinarian online listing allows potential clients to find you by name, city, and practice type. Visit the Resources tab on cvma.net.

Business Advocacy

Increased awareness and understanding of the impact of legislation on your profession through effective policy analysis and membership advisories. Visit the CVMA Legislative Action Center at cvma.net under the Advocacy tab.

Protecting your license by continually monitoring and reporting unlicensed veterinary activity in all areas of practice.

A full-service member assistance program (MAP) with LifeWorks provides confidential consultations, information and resources, connections to community agencies and supports, and referrals to counseling (by video or in-person). CVMA members and their families have access to the program 24/7 via phone, online, and the free mobile app—all at no additional cost.

NEW! Discounts on over 30 home health tests with LetsGetChecked, including COVID-19 with RT-PCR/TMA lab analysis and 24-72-hour online test results. Additional tests include cancer screening, cholesterol, diabetes, female fertility and health, male hormone, thyroid, vitamin and minerals, and more!

NEW! Discounted membership to over 11,600 national fitness centers through Active&Fit Direct with no long-term contract and the ability to switch between gyms, ensuring members find the one that best suits their needs.

Insurance Coverage

Veterinary Insurance Services Company (VISC) provides personal and professional lines of coverage tailored for the needs of veterinary professionals. Learn more at visc-ins.com.

Delta Dental Insurance plans to cover the needs of your personal and staff needs.

Vision Service Plan (VSP) provides affordable, high-quality eye care plans.

Career

The CVMA Career Center allows you to post and view classified employment ads and practice sales ads.

Network with colleagues and specialists through our members-only online CVMA Directory.

The Castle Press offers discounts on printing services and products, including controlled substance security prescription pads, regular prescription pads, name tags, stationery, appointment cards, and more.

CheckmarcUSA provides free check recovery services.

Epicur Pharma offers discounts on its 503B product line for in-house use and administration as well as secondary dispensation to clients.

GlobalVetLINK offers discount pricing for electronic prescriptions, health certificates, feed directives, and other products to help veterinary practices manage records.

HireRight provides discounted employee background screening.

i3 Merchant Solutions lowers your credit card processing rates.

NEW! National Pharmaceutical Returns offers discounts on mail-back disposal services for unwanted prescription and over-the-counter drugs, as well as reverse distribution of unwanted controlled substances.

Entertainment

California Academy of Sciences provides a discount to its planetarium, aquarium, and natural history museum…all under one roof.

Car Rental savings through Alamo, Avis, and National.

TicketsAtWork provides discounts for theme parks, including Disneyland, Disney World, Universal Studios, Great America, Sea World, Six Flags, and more.

15 cvma.net/publications CVMA MEMBER BENEFITS

Unity

A Lens into Diversity, Equity, and Inclusion in the Veterinary Profession

White Saviorism in Veterinary Medicine and How to Avoid It

By Valerie Marcano Gomez, DVM, Ph.D., ACPV, Chief Executive Officer, Pawsibilities Vet Med

White saviorism in veterinary medicine starts with the assumption that there is an easy fix to increasing diversity, equity, and inclusion (DEI) in the veterinary profession by simply increasing recruitment of individuals from underrepresented communities. If I got a dollar for each time someone told me Black and Indigenous people of color (BIPOC) are simply not interested in food animal medicine, or that recruiting more BIPOC people is the primary way to fix DEI in the veterinary profession, I would have paid my student loans by now. Oversimplifying these issues ignores the socioeconomic and cultural barriers to the profession that disproportionately affect recruitment and retention of talent.

For years, my Dominican blood cringed whenever people I met told me about their mission trips to the Dominican Republic. This visceral reaction, I have come to learn, stems from colonialism. Writer Teju Cole describes the WhiteSavior Industrial Complex as dominant or majority groups seeking to do good while satisfying their emotional needs. Cole outlines a three-step process where

these groups (1) introduce practices that perpetuate injustices, (2) heroically aim to fix them, and (3) ultimately garner recognition for those efforts. The Dominican Republic has a long history of colonization, involving the indoctrination into Spanish culture via the Roman Catholic Church, the use and abuse of slaves of African and Taino descent, and the annihilation of the Taino Native population. Based on Cole’s definition, colonialism is step one. The mission trip itself is step two. Going out of your way to tell me about it? Step three.

White saviors are often well-meaning white westerners who believe they are better equipped to address the challenges of communities with a history of colonialism than the actual members of those communities. While I am all about using white privilege to empower BIPOC individuals, white saviors lack the cultural competency to solve structurally complex, multi-generational issues, at best placing a Band-Aid on the problems.

A few weeks ago, I met with a group that was given generous funds to address a particular veterinary desert, a geographic area where reasonable access to a veterinarian is limited. During our meeting I noted

Dr. Valerie Marcano Gomez is the CEO of Pawsibilities Vet Med, a 501(c)3 nonprofit seeking to increase recruitment and retention of individuals from underrepresented communities to the veterinary profession. Dr. Marcano is the chair of the Diversity and Inclusion Committee of the American Association of Avian Pathologists and a member of the Commission for a Diverse, Equitable, and Inclusive Veterinary Profession of the American Veterinary Medical Association and Association of American Veterinary Medical Colleges. Dr. Marcano received her B.S. from Cornell University and her DVM and Ph.D. degrees from the University of Georgia.

16 California Veterinarian | January–February 2023

the false narrative that there are no veterinarians from these types of communities, a lack of understanding about the specific challenges of BIPOC individuals in veterinary medicine, and a lack of input from community members. I also noted a general defensiveness after I pointed out these shortcomings. I was horrified as one of the group members described someone as being “of some nationality” because their “ skin is brown.” Their bias, paired with closedmindedness to the shortcomings of their initiative, tainted their seemingly good intentions. They should have researched the challenges specific to the community and received input in the form of a committee, board, or task force empaneled with individuals from that community and similar ones.

Good intentions, privilege, and funding are powerful—but alone, they do not fix systemically discriminatory practices. Veterinary recruitment initiatives must have practices that foster inclusion and belonging at their

forefront. The debt, lack of worklife balance, and burnout we face in veterinary medicine are real to the point that individuals in our profession are actively discouraging others from joining. Imagine pairing all of that with the burden of racism, sexism, and ableism—as well as extra debt. Black veterinarians who graduated in 2020 had approximately $100,000 more in debt compared to their white and Asian counterparts, while Hispanic and Latino veterinarians had approximately $50,000 more debt (Larkin, 2021; Mattson, 2021). Recruiting BIPOC people into a profession in which their mental and financial health are disproportionately affected without understanding the challenges hindering their retention, and without counseling and safeguards to ensure their success, is irresponsible.

I write this article as an Afro-Latina cis-female with a chronic health condition. I also write this article as the CEO of Pawsibilities Vet Med. Our mission is to diversify all roles within the veterinary profession by providing mentorship, professional development, and resources to all intersecting identities including but not limited to:

• Ability

• Ethnicity

• Gender identity

• Non-traditional paths

• Race

• Sexual orientation

• Socioeconomic background

• Religion

• Veteran status

I am not part of every demographic I wish to serve and empower. Our team has recruited a diverse board of directors, advisory board, and group of partners and collaborators to help us grow and develop long-term, effective initiatives for diversifying the profession. Representation matters. If

you are involved in a project aimed at helping a particular group and there are no members of said group present, that is a warning sign!

This article is not meant to stop you from helping others. It is meant to remind you to educate yourself on the history of those around you, acknowledging your privilege and how your ancestors’ colonialism contributed to extreme socioeconomic discrepancies. If you intend to support communities with less privilege than your own, start by doing the work in educating yourself, and check your biases. Do not task your BIPOC friends to educate you; there are plenty of resources out there—articles, books, movies, podcasts. Consult with leaders and members of those communities on strategies that support communities in finding solutions that work. Making decisions that impact underserved and underrepresented communities without their input is largely counterproductive. It is the responsibility of allies to speak up and ensure representation. Finally, remember that the narrative is to improve the world around you, not to promote BIPOC people as people in need of saving, or yourself as a hero.

Sources

1. Anderson, Knee, & Mowatt, 2021. “Leisure and the ‘White-Savior Industrial Complex.’” Journal of Leisure Research, 52(5), 531-550.

2. Cole, 2012. “The White-Savior Industrial Complex.” The Atlantic. https:// www.theatlantic.com/international/ archive/2012/03/the-white-saviorindustrial-complex/254843/

3. Larkin, 2021. “Increase in veterinarians’ starting salaries long overdue, economist says.” JAVMA News https://www.avma. org/javma-news/2021-12-01/increaseveterinarians-starting-salaries-longoverdue-economist-says

4. Mattson, 2021. “Veterinary educational debt varies by sector, race.” JAVMA News. https://www.avma.org/javmanews/2021-05-15/veterinary-educationaldebt-varies-sector-race

17 cvma.net/publications UNITY

“Good intentions, privilege, and funding are powerful—but alone, they do not fix systemically discriminatory practices. Veterinary recruitment initiatives must have practices that foster inclusion and belonging at their forefront.”

CVMA 2022 Economic Survey Report—Part 2

The CVMA’s Economic Task Force was convened to study and report on economic trends facing the veterinary industry in California. The Task Force first partnered with EMC Research in 2013 to conduct an online survey of California veterinary professionals and has conducted surveys every three years since to follow trends in the industry over time. The fourth iteration of the survey was conducted in July and August of 2022 and received 1,333 total responses, including 923 responses from veterinarians and 410 responses from RVTs.

Responses from veterinarians can be compared to the 2019, 2016, and inaugural 2013 studies conducted by EMC Research and the CVMA Economic Task Force, and responses from RVTs can be compared to the 2019 and 2016 studies. Due to rounding, or some questions allowing multiple responses to be selected, percentages may not add up to exactly 100%.

This is the second article in a series exploring the results of the survey. It will cover ownership and revenue among California veterinary professionals,

pay and benefits among veterinarian associates and owners as well as RVTs, and shifts in attitudes towards practice ownership since 2019.

All respondents were asked to report their current pre-tax salary or income, including bonuses but not including other benefits like health care plans. Veterinarian owners were also asked to include profit sharing and exclude rental income.

*As used herein, “DVM” is shorthand for licensed veterinarians, recognizing that different schools use different designations for their veterinary degrees.

This survey was administered and aggregated by EMC Research.

18 California Veterinarian | January–February 2023 ECONOMIC SURVEY

Salary and Benefits

DVMs—both owners and associates—and RVTs have reported increased salaries since 2019.

Among DVMs

For the first time since the inaugural survey, a majority (62%) of non-owner DVMs reported earning more than $120,000, with a full third (35%) reporting earning $160,000 or more—more than double the number of non-owner DVMs who reported making more than $160,000 in 2019. The lowest income range, less than $80,000 annually, also saw a drop from 17% in 2019 to 12% in 2022. The percentage of non-owner DVMs reporting income in this range has dropped by nearly two-thirds since 2013, when 38% of non-owners reported income under $80,000.

While earnings are driven largely by hours (part-time non-owners primarily make under $120,000 per year while full-time non-owners make more than $120,000) salary increases are evident for both full-time and part-time nonowners. The percent of full-time, non-owner DVMs who reported salaries over $160,000 rose from 18% in 2019 to 43% in 2022. While there was a smaller increase among part-time non-owners, the percentage reporting income between $81,000 and $120,000 annually rose from 28% in 2019 to 39% in 2022.

Practice owner salaries have also increased, though not quite to the same extent. For the first time since 2013, more than half of practice owners (53%) reported income over $160,000, up from 38% in 2019. The proportion of non-owners who reported income under $80,000 annually dropped by half from 17% in 2019 to 8% in 2022.

19 cvma.net/publications CNA

$160k+ $81k-$120k $121k-$160k $0-$80k Salary Among Non-Owner DVMs 2022 12% 23% 27% 35% 2019 17% 42% 24% 15% 2016 50% 27% 15% 8% 2013 38% 42% 12% 7% 43% 4% 31% 10% 5% 40% 20% 39% 18% 4% 28% 8% 8% 58% 45% 28% $160k+ $160k+ $121k-$160k $121k-$160k $81k-$120k $81k-$120k $0-$80k $0-$80k 2022 2022 2019 2019 Salary Among Non-Owner DVMs Full-time Part-time $160k-$200k $200k+ $81k-$120k $121k-$160k $0-$80k Salary Among Practice Owners 2022 40% 8% 17% 13% 15% 2019 17% 11% 16% 27% 20% 2016 23% 10% 15% 29% 23% 2013 27% 11% 19% 22% 22%

2019 Combined Owner/Non-Owner Salary Among DVMs

Salary by Gender

Looking at salary by gender, a pay gap persists but has decreased among DVM non-owners/ associates more than it has among practice owners. In 2022, 71% of male associates reported salaries over $121,000 per year compared to 65% of women, while in 2019, 54% of male associates reported salaries over $121,000 compared to just 33% of women.

2022 Combined Owner/Non-Owner Salary Among DVMs

2022 Salary by Years of Experience Combined Owner/Non-Owner Salary Among DVMs

Among DVM practice owners, 80% of male owners in 2022 reported salaries over $121,000 compared to 55% of women in the same range, while in 2019, 62% of male owners reported salaries over $121,000 compared to 48% of women. This marks a 25-point gap in 2022, compared to a 14-point gap in 2019.

Among associates, pay equity improves with years of experience. Among those making more than $161,000 per year, there is only an eight-point gap between the percentage of male associates with more than twenty years of experience (45% of whom are in this salary range) and female associates with the same level of experience (37% of whom are in this range). Among owners, the gap is fairly consistent regardless of years of experience.

20 California Veterinarian | January–February 2023 ECONOMIC SURVEY

Overall Male Owner (13%) Female Owner (15%) Male Associate (10%) Female Associate (44%) 17% 36% 22% 22% 4% 11% 23% 11% 16% 18% 22% 34% 50% 12% 19% 30% 22% 50% 29% 24% 11% 8% 7% 1% 2% $161k+ Refuse $81k-$120k $121k-$160k $0-$80k

Overall Male Owner (18%) Female Owner (20%) Male Associate (11%) Female Associate (51%) 8% 21% 24% 43% 4% 2% 13% 9% 6% 11% 23% 21% 28% 14% 16% 25% 32% 66% 39% 46% 33% 7% 8% 0 $161k+ Refuse $81k-$120k $121k-$160k $0-$80k 1%

Overall Male Associates <20 Years (6%) Female Associates <20 Years (36%) Male Owner 20+ Years (11%) Female Owner 20+ Years (10%) 8% 4% 5% 21% 18% 23% 24% 25% 33% 43% 53% 38% 1% 4% $161k+ Refuse $81k-$120k $121k-$160k $0-$80k 13% 2% 22% 9% 14% 17% 68% 6% 39% Male Owner <20 Years (3%) Female Owner <20 Years (6%) 13% 16% 25% 13% 15% 61% 10% 40% 8% Male Associates 20+ Years (8%) Female Associates 20+ Years (19%) 10% 17% 27% 20% 23% 17% 45% 1% 37% 3% 8%

Salary Among RVTs

More than two-thirds of RVTs (71%) still report salaries under $61,000 annually, though this number has steadily decreased since the first RVT survey in 2016 (down from 85% reporting salaries less than $61k annually in 2019, and 90% reporting that in 2016). The $41,000 to $60,000 annual income range is now the most commonly reported among RVTs, with 39% saying their salary falls within this band.

Benefits Among DVM Associates

Benefits Among DVM Owners

Salary Among RVTs

Benefits

Benefits have remained fairly consistent for DVMs since the 2019 survey. Continuing education registration fees remain the most reported common benefit, with 80% of non-owner DVMs saying they receive this benefit and 74% of owners saying they receive it.

Non-owner DVMs reported a small increase in benefits like vacation, health, dental, and vision insurance, and particularly in 401(k)s, where the percentage reporting this benefit increased from 59% in 2019 to 72% in 2022. Owner DVMs remained slightly more consistent, but there was also an increase among owners who reported maintaining a 401(k)—from 30% in 2019 to 49% in 2022.

21 cvma.net/publications CNA

$61k-$80K $80k+ $21k-$40k $41k-$60k $0-$20k *Asked for the first time in 2022. 2022 2019

Continuing education registration fees Vacation Health insurance License fees* 401 (k) Association membership dues Paid time off for continuing education Dental insurance Vision insurance Uniform allowance* Disability insurance Life insurance Other retirement plan 80% 78% 76% 70% 74% 68% 74% 72% 59% 69% 60% 62% 56% 59% 51% 54% 44% 42% 39% 34% 38% 30% 13% 12% *Asked for the first time in 2022. 2022 2019

Continuing education opportunities Association membership dues Professional liability and license defense insurance* Health insurance Vacation Ownership "perks" that are expensed through the practice 401 (k) Dental insurance Disability insurance Vehicle expenses Life insurance Vision insurance Other retirement plan Rental income associated with the practice 74% 75% 72% 77% 66% 66% 71% 56% 56% 52% 55% 48% 30% 39% 31% 36% 34% 33% 29% 35% 38% 30% 23% 29% 27% 13% 16% 2016 2% 7% 10% 36% 44% 2022 8% 8% 18% 39% 24% 2019 10% 4% 38% 38% 9%

Benefits Among RVTs

Benefits

Among

RVTs

Benefits have also remained consistent among RVTs, with vacation being the most common (77%), followed by health insurance (75%) and continuing education registration fees (71%). RVTs have also reported increases in receiving benefits like licensing fees being paid (70%, up from 58% in 2019) and the availability of retirement funds like 401(k)s (67%, up from 56% in 2019).

Revenue and Profits

Veterinary practice owners in California have reported increased revenue in 2022 compared to the 2019 survey. This year, 33% of practice owners reported annual gross revenue of more than $2 million dollars per year, a seven-point increase since 2019 (26%). Only a quarter of practice owners reported gross annual revenue under $800,000 per year, while the percentage reporting income between $801,000 and $2,000,000 remained consistent with 2019 at 37%.

Percentage of Owners Reporting Increased Profitability

The percentage of practice owners who reported a profitability increase over the last two years has also improved since 2019, with nearly two-thirds (63%) reporting increased profitability compared to 57% in 2019.

22 California Veterinarian | January–February 2023 ECONOMIC SURVEY

Gross Annual Revenue Among Practice Owners 2022 2019 2016 2013 $801,000$2,000,000 per year Less than $800,000 per year More than $2,001,000 per year 40% 34% 22% 37% 38% 22% 34% 37% 26% 26% 37% 33%

63% 57% 50% 36% 2022 2019 2016 2013

*Asked for the first time in 2022. 2022 2019

Vacation Health insurance Continuing education registration fees License fees* 401 (k) Dental insurance Uniform allowance Vision insurance Life insurance Paid time off for continuing education Disability insurance Association membership dues Other retirement plan 77% 79% 75% 73% 71% 71% 70% 58% 67% 56% 63% 59% 55% 60% 55% 52% 40% 35% 36% 32% 33% 30% 27% 26% 19% 14%

Hiring and Job Seeking

While there was a small decrease in the number of DVMs who say they hired a DVM within the last 12 months (down to 51% from 56% in 2019), half of the DVM respondents still say they hired a DVM within the last 12 months (51%) or are looking to hire in the next 12 months (52%).

Reported RVT hiring levels remained identical to 2019, with 77% of RVTs saying their practice has hired an RVT in the last twelve months. The percentage of RVT respondents who say their practice is likely to hire in the next twelve months increased slightly, up to 74% from 69% in 2019.

However, despite no significant decrease in hiring outlook and increases in salaries and benefits offered, more DVMs say it has been difficult for their practice to find candidates for open roles. Eightyfour percent of DVM respondents agree it has been difficult to find candidates, the highest number since 2013 and an increase of 11% since 2019 (when 73% agreed).

Reported job seeking has remained stable since 2019. Only 13% of DVMs say they have been looking for a new role, while RVTs continue to job hunt at a higher rate of 24%. These numbers are consistent with results from 2019, when the question was first asked.

In recent hiring decisions, our practice has had difficulty finding an adequate number of qualified candidates interested in our open positions.

23 cvma.net/publications CNA

2022 2019 DVM

you been actively seeking a new position? 12% Yes 13% RVT Have you been actively seeking a new position? 2022 2019 23% 24%

Have

46% 51% 51% 56% Yes

2022 2019 2016 2013 25% 41% 52% 50% Yes, likely

74% 77% 77% Yes 66% 69% 74% Yes, likely Is

2022 2019 2016

Has your practice hired a veterinarian within the past 12 months?

your practice looking to hire a veterinarian in the next 12 months? Has your practice hired a registered veterinary technician or veterinary assistant within the past 12 months? your practice likely to hire a registered veterinary technician or veterinary assistant in the next 12 months?

Agree

Among DVMs

2022 2019 2016 2013 84% 73% 71% 46%

Practice Ownership Outlook and Trends

Corporate-Owned Practice Growth

The number of DVMs and RVTs who report working in corporateowned practices has increased since 2019. More than a third of DVMs (35%) and RVTs (38%) report working in a corporateowned practice. While 40% of DVMs still report working in a single-owner practice, corporateowned practices are now the more common employer for RVTs. Thirty percent of RVTs report working in a single-owner practice, down from 37% in 2019.

DVMs who work at a corporate-owned practice report slightly higher salaries than those at other practices, with multiple-owner practices closest in terms of salary. Among RVTs, those who work at multiple-owner practices continue to report slightly higher salaries than other types of practices.

2022 Combined Owner/Non-Owner Salary Among DVMs

2022 Salary Over $41k Among

The growth of corporate veterinary practices is good for the veterinary industry

However, fewer than a quarter of both DVMs and RVTs agree that the growth of corporate practices is good for the industry. Even among those who work at corporate-owned practices, only a third of DVMs (32%) and slightly more RVTs (42%) say they agree the growth of corporate practices is good for the industry as a whole.

24 California Veterinarian | January–February 2023 ECONOMIC SURVEY

40% 45% 35% 29% 13% 17% 9% 7% 3% 1% Single owner Corporate owner Multiple owners Public or non-profit Other 2019 2022 DVMs 30% 37% 38% 31% 13% 17% 15% 11% 4% 5% Single owner Corporate owner Multiple owners Public or non-profit Other 2019 2022 RVTs

Overall Corporate-owned practice (35%) Public or non-profit (9%) Single owner (40%) Multiple owners (13%) 8% 21% 24% 43% 4% 3% 13% 11% 8% 18% 23% 25% 20% 29% 27% 17% 26% 47% 34% 42% 43% 3% 2% 6% $161k+ Refuse $81k-$120k $121k-$160k $0-$80k 2% 64% 71% 73% 46% 73% Overall Corporate-owned practice (38%) Public or non-profit (15%) Single owner (30%) Multiple owners (13%) More than $41k

RVTs 17% 24% 9% 13% 11% 13% 32% 42% 9% 18% Overall Overall Single owner (40%) Single owner (40%) Multiple owners (13%) Multiple owners (13%) Corporate owner (35%) Corporate owner (35%) Public or non-profit (9%) Public or non-profit (9%)

% Agree Among DVMs % Agree Among RVTs

Practice Ownership

While DVMs may not agree that the growth of corporate practices in the industry is a positive, interest in owning their own practice continues to decrease. Only 19% of the DVM respondents say they are interested in owning a practice, down from 31% in 2019 and nearly halved since the inaugural survey in 2013.

The potential for practice ownership is not an important factor for DVMs when they are choosing a job. On a scale of 1 to 10, where 1 is not at all important and 10 is extremely important, only 12% of DVMs report potential for practice ownership is “extremely important” with a mean of 3.89. While the overall percentage is consistent with 2019 (11% extremely important) the mean has decreased from 4.47 in 2019, indicating lower enthusiasm for practice ownership.

Private Practice Ownership Demographics

When looking at who owns veterinary practices, more private practice DVMs than ever report at least one female practice owner at their practice, and for the first time, female and male owners are being reported at similar levels (compared to more male owners in previous years). Fifty-two percent of private practice DVMs report at least one female owner, up from 44% in 2019. Only 32% reported no women owners in 2022, compared to 42% in 2019 and 54% in 2016.

25 cvma.net/publications

2022 2019 2016 2013 19% 31% 38% 44% Practice Ownership Interest Interested Among non-practice owners only 2022 2019 2016 2013 12% 11% 8% 13% 2% 3% 4% 6% 5% 5% 6% 8% Importance of Potential for Practice Ownership when Choosing a Job Among DVMs 10- Extremely Important 9 8 Mean 3.89 4.47 4.19 4.85 Number of Male Practice Owners Number of Female Practice Owners 2022 2019 2016 None 54% 42% 32% None 39% 35% 37% 1 37% 44% 52% 1 47% 48% 48% 2 5% 7% 9% 2 8% 8% 9% 3+ 5% 7% 7% 3+ 7% 9% 6% Among private practice DVMs Among private practice DVMs

Immune-Mediated Diseases in Dogs and Cats: When Are Steroids Not Enough?

By Andrew Woolcock, DVM, DACVIM (SAIM)│ 2023 Pacific Veterinary Conference Speaker

Immune-mediated diseases pose diagnostic and therapeutic challenges for small animal veterinarians. There are many inciting factors, be they disease-related or environmental, which can act as triggers to the immune system and lead to an exaggerated or deleterious response and subsequent immunemediated disease. Diagnostically, it can be very difficult to identify these triggers, and therefore these diseases are most often determined to be idiopathic in origin.

Without a clear cause, the choice of treatment for these diseases can be unclear. While it is accepted that most patients will benefit from pharmacologic suppression of the immune system, there is no consensus about the best regimen to achieve this suppression. Additionally, without identifying an underlying cause, it can be difficult to have confidence that immune suppression should be the sole mechanistic approach to treatment, making the monitoring of patients on therapy that much more important.

Prednisone, and other systemic corticosteroids, have long been the gold standard of treatment for immune-mediated diseases

in dogs and cats. In addition to the ease of accessibility and low cost, corticosteroids have a broad mechanism for immune suppression, including inhibitory effects on aspects of the innate and adaptive immune system. Corticosteroids reduce the function of neutrophils and complements, while also causing apoptosis and decreased proliferation of lymphocytes. In addition to these broad effects, corticosteroids have a rapid onset of action. When used at appropriate doses, corticosteroids can be suppressive to these immune responses within about 3-5 days. For these reasons, corticosteroids will likely remain the gold standard for immune suppression in dogs and cats, especially for severe immunemediated diseases for which rapid therapeutic effect is necessary, like immune-mediated hemolytic anemia (IMHA), immune-mediated thrombocytopenia (ITP), and systemic lupus erythematosus (SLE).

Prednisone and other corticosteroids are catabolic in nature. Over time, these effects can lead to a number of adverse effects. In addition to the expected polyuria, polydipsia, polyphagia, and panting, long-term use of high-dose corticosteroids can lead to significant dermatologic issues like alopecia, thin skin, and calcinosis cutis. Corticosteroids also lead to muscle atrophy and ligament/tendon laxity,

PACVET SPEAKER California Veterinarian | January–February 2023 26

which can lead to musculoskeletal issues like weakness and injury. These effects on muscle mass and mobility can be especially severe in large and giant breed dogs, who tend to have a lower tolerance for high-dose corticosteroids when compared to smaller breed dogs and cats.

Adjunctive immune-suppressive agents have been used for decades, but the indication for their use, the choice of drug, and the approach to concomitant corticosteroid therapy have no clear guidelines. The most common adjunctive immune-suppressive agents used presently include azathioprine, cyclosporine, leflunomide, and mycophenolate. These medications each have their own unique mechanism of action but, in general, their effects

are primarily on lymphocytes and the adaptive immune response. While their utility in veterinary medicine has been documented for years, the logistics of their use including optimal dosage, expected side effects, time to onset of immune suppression, and therapeutic drug monitoring are still active areas of discovery.

In general, the use of these drugs should be guided by patient factors including size and expected side effects, and disease factors including severity and response to corticosteroids. Patients with a lifethreatening disease like IMHA, or who have not demonstrated a response to corticosteroids within the first week or so of treatment, might require a more aggressive therapeutic regimen, including an adjunctive immunesuppressive agent. Other patients may respond readily to corticosteroids, but due to size or sensitivity to steroid side effects, they may benefit from an adjunctive immune-suppressive medication in order to allow a more rapid tapering of steroids and ameliorate adverse effects.

Developing an understanding of these immune-suppressive medications and the clinical scenarios for which more than one medication is indicated can help clinicians achieve more rewarding outcomes in these challenging cases.

The focus of Dr. Woolcock’s presentations at the 2023 Pacific Veterinary Conference will be on immune-mediated diseases in dogs and cats, as well as on common immune-suppressive medications and their use.

Andrew Woolcock, DVM, DACVIM, is an associate professor of small animal internal medicine at Purdue University. His interests include immune-mediated diseases, endocrinology, and the scholarship of teaching and learning. He has published several articles and book chapters, given lectures throughout the United States and internationally, and has received several awards for teaching and mentorship in the profession. His research program investigates the role of oxidative stress in inflammatory disease states of the dog and cat.

27 Visit the Pacific Veterinary Conference online at PacVet.net

“Without identifying an underlying cause, it can be difficult to have confidence that immune suppression should be the sole mechanistic approach to treatment, making the monitoring of patients on therapy that much more important.”

PHOTO: SHUTTERSTOCK

Plan your Vetcation! June 9–12, 2023 Long Beach, CA #PacVet2023 20 23 PacVet 4 Days | 200+ Sessions | 15 In-Person Tracks 3 Virtual Tracks | 2 Day Vet Expo | 1 Vacation Destination Hosted by the California Veterinary Medical Association

Topics by Track

HOT TOPICS WITH WORLD-CLASS SPEAKERS

Keynote Presentation

Attend In-Person or Online

Kwane Stewart, DVM

Small Animal Medicine

Attend In-Person or Online

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John Rush, MS, DVM, DACVIM, DACVECC Sponsored by Boehringer Ingelheim

Dermatology

Allison Kirby, DVM, DACVD

Emergency Critical Care

Robert Goggs, BVSc, Ph.D., DACVECC, DECVECC

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Katie Tolbert, DVM, Ph.D., DACVIM (SAIM)

Immune-Mediated Diseases

Andrew Woolcock, DVM, DACVIM (SAIM)

2023 TOPICS BY TRACK CONTINUED

Avian/Exotics

Avian

Heather Barron, DVM, DABVP (Avian), CertAqV

Poultry, Game Birds, and Waterfowl

Teresa Morishita, DVM, Ph.D., DACPV

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Mark Mitchell, MS, DVM, Ph.D., DECZM (Herpetology)

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Angela Lennox, DVM, DABVP (Avian), ECM, DECZM (Small Mammal)

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Suzie Kovacs, MSc, Ph.D.

Equine

Internal Medicine

Michelle Barton, DVM, Ph.D., DACVIM (LAIM)

Legal/Business Issues Related to Equine

Ky Mortensen, JD, MBA

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Kyla Ortved, DVM, Ph.D., DACVS, DACVSMR

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Scott Morrison, DVM

Hobby Animal

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Andrea Mongini, DVM, MS

Over 200 sessions in 15 tracks

Integrative Medicine

Cannabis and Cancer: Emerging Science in Two Dynamic Veterinary Fields

Trina Hazzah, DVM, DACVIM (Oncology), CVCH

Practice Management

Cannabis Law

Stephen Marmaduke, Wilke Fleury

Wellness

Well-Being and Fulfillment Through Knowledge and Action

Alex Miller, VMD, MSMSL, CCFP

30 California Veterinarian | January–February 2023 PACVET SPEAKER

CONFERENCE HOTEL AND VENUE

The Pacific Veterinary Conference will be held at the Long Beach Convention Center, conveniently located in the heart of downtown Long Beach.

Venue

Long Beach Convention Center 100 South Pine Avenue

Long Beach, CA 90802

Host Hotel

Hyatt Regency Long Beach 200 South Pine Avenue

Long Beach, CA 90802

Phone: 562.491.1234 | Reservations: 877.803.7534

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Airports Long Beach Airport lgb.org

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YThank ou

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32 California Veterinarian | January–February 2023 PACVET SPEAKER

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CAL/OSHA Requirements for Veterinary Practices

By Grant Miller, DVM, CVMA Director of Regulatory Affairs

All California businesses with employees are subject to Cal/OSHA regulation and oversight. Cal/OSHA regulations require every employer to have a written safety plan created specifically for their business. In addition, Cal/OSHA requires an active safety program that includes ongoing self-inspections, continual employee training, documentation and record keeping, as well as certain workplace postings. No two safety programs or written plans will be exactly the same, but certain core components should be addressed in all veterinary practices.

The Written Illness and Injury Prevention Program

California Code of Regulations, Title 8, Section 3203 requires that all California employers have a written Illness and Injury Prevention Program (IIPP) available for employees. The written program must include the following components:

• Responsibility—the employer’s written IIPP must provide the name and/or job title of the person(s) with the authority and responsibility for its implementation

• Compliance—a system must be set forth in writing to ensure that employees comply with safe and healthful work practices

• Communication—a system for communicating with employees about safety and health matters in a form easily understood by and accessible to employees

• Hazard assessment—procedures for identifying and evaluating workplace hazards, such as periodic inspections performed by a competent observer

• Accident/exposure investigation—a procedure to investigate workplace injuries or illnesses

• Hazard correction—methods and procedures for correcting all existing workplace hazards and unsafe or unhealthful work conditions or work practices in a timely manner

• Training and instruction—an effective training program to instruct employees on general safe work practices and hazards specific to each job assignment

• Keeping records—there must be adequate written documentation of the steps taken to establish and maintain the employer’s IIPP

Due to the unique nature of veterinary practice, certain additional components of an IIPP will be necessary. Below are other required sections:

• Hazard Communication Program (HCP)

• Fire Prevention Plan

• Emergency Action Plan

• Heat Illness Prevention Program (only applicable to businesses with outdoor workers)

• Log 300 records and Log 300A posting if applicable (businesses with 10 or fewer employees are exempt from both requirements)

• Zoonotic Disease Control Program

• Hearing Conservation Program

• COVID-19 Protection Program

• Wildfire Smoke Inhalation Protection (for situations in which practice employees are exposed to prolonged smoke)

• Anesthetic Gas Monitoring Program

• Emergency eyewash and shower stations

Workplace Safety Training Program

Workers must be trained on the written policies listed above. Training should take place not only for all newly hired employees as a component of job orientation, but should also be provided on an ongoing basis for all employees. Documentation of training, including proof of employee attendance, is helpful. In lieu of live interactive teaching, training can be offered as online or printed materials for self-guided study, but should always provide workers with a person who can answer questions.

Workplace Postings

In California, all employers must meet workplace posting obligations. Cal/OSHA requires over two dozen postings for employees relating to wages, hours, sick leave, protections afforded to workers under the law, and working conditions, to name a few. The notices must be posted in an area frequented by employees where they may be easily read during the workday.

All Cal/OSHA required postings are included in the CVMA Employee Poster set, available for purchase in the CVMA online store at cvma.net by clicking "Products" under the Resources tab at the top of the homepage.

For more information about complying with Cal/OSHA workplace requirements in veterinary practices, visit cvma-inline.net and click “Practice Safety.”

This article is for informational and general educational purposes only. It is not intended to take the place of legal advice nor should it be considered as a legal interpretation. Although significant effort has been made to ensure the accuracy and completeness of the information at the time of publication, the CVMA is not responsible for any errors or omissions, or any agency’s interpretation, application, or enforcement of the information presented herein.

34 California Veterinarian | January–February 2023 COMPLIANCE CORNER

Helping to Ensure a Safe Driving Program

By Katie Stryker, CNA Assistant Vice President of Risk Control

Over the past few years, there has been a steady increase in the number of auto accidents and related fatalities due to risky driving behaviors.1 This is a stark reminder to businesses on risks associated with not employing safe drivers. Review the steps below to help ensure you are managing your practice’s auto risk.

Identify and Qualify Your Drivers

Have a company policy that makes it clear to all employees that they are responsible for driving safely during business-related travel. Furthermore, under your policy, it should be clear that anyone who drives a vehicle while conducting business is considered a driver, whether they drive a companyowned or personal vehicle and even if driving is not their sole responsibility or a regular job task.

To qualify drivers, as permitted by law, conduct a prior review of each individual’s motor vehicle records (MVRs) outlining their driving history and record of violations. Ideally, these MVRs should be periodically reviewed throughout the term of employment to ensure that no new violations have occurred.

Recognize Unique Risks

Organizations must consider their unique operational activities when evaluating their auto risk, including whether they transport animals, customers, supplies, or hazardous waste. Accounting for these factors—in addition to planning the safest route—helps drivers prepare for conditions like poor weather, high traffic, and driving in remote areas.

Technology like GPS, navigation, cameras, and telematics systems have increased in sophistication over the past decade, and can help drivers determine

the safest route to their destination while limiting unsafe driving behaviors.

Educate Your Staff

Educate all employees who may drive for company-related purposes on the basic risks and responsibilities of driving. Individuals with a higher level of risk based on their driving tasks, such as transporting animals or utilizing trailers, should receive specific training centered on those exposures.

All individuals within an organization have a responsibility to drive safely when engaging in business-related travel. Following these steps will help establish a foundation from which your organization can continue to build a successful auto safety program.

Sources

1. https://injuryfacts.nsc.org/motor-vehicle/ overview/introduction/

2. https://www.iii.org/article/social-inflationhard-to-measure-important-to-understand

3. verisk.com/insurance/visualize/the-rise-ofnuclear-verdicts-and-how-to-rein-them-in/

The information, examples, and suggestions presented in this material have been developed from sources believed to be reliable, but they should not be construed as legal or other professional advice. CNA accepts no responsibility for the accuracy or completeness of this material and recommends the consultation with competent legal counsel and/or other professional advisors before applying this material in any particular factual situations. This material is for illustrative purposes and is not intended to constitute a contract. Please remember that only the relevant insurance policy can provide the actual terms, coverages, amounts, conditions, and exclusions for an insured. All products and services may not be available in all states and may be subject to change without notice. “CNA” is a registered trademark of CNA Financial Corporation. Certain CNA Financial Corporation subsidiaries use the “CNA” trademark in connection with insurance underwriting and claims activities. Copyright © 2022 CNA. All rights reserved.

Trending Terms to Know

Juries may hold employers accountable when employees are involved in auto accidents. The awards paid to plaintiffs may increase when an employer is found to not adhere to basic auto safety elements. These terms will aid in understanding the importance of auto safety at your practice.

Social Inflation

Social inflation is a term that refers to the rising litigation costs to defend a claim.2 While there are several contributing factors to social inflation, such as corporate distrust and juror sympathy towards plaintiff’s claims, one key element is the drastic increase in “nuclear verdicts” awarded.

Nuclear Verdict

A Nuclear Verdict is a jury award that surpasses $10 million. The period between 2010 to 2019 saw a 300% increase in verdicts of $20 million or more when compared to prior years.3 Causes for such large award amounts are attributed to elements like corporate mistrust, litigation funding, and negligent entrustment.

Negligent Entrustment

When a company entrusts an individual to operate vehicles for company purposes, it has a responsibility to ensure that the individual is a qualified and responsible driver. When a company fails to adequately discharge this responsibility and an incident occurs, the company may be found to have negligently entrusted the individual, thereby providing leverage for plaintiffs to demand higher damages.

35 cvma.net/publications VISC/CNA

Dr. John Theodore Hollister, a CVMA Life Member, passed away on March 29, 2022. Dr. Hollister graduated with a veterinary degree from UC Davis in 1955, after which he served in the U.S. Air Force. He established the Peninsula Animal Hospital in Pacific Grove, a small animal medicine practice where he worked until his retirement in 1995. Later, Dr. Hollister volunteered at a spay and neuter clinic in Greenfield. He served on the board of directors of the Society for the Prevention of Cruelty to Animals, Monterey County.

Dr. David McClun, a CVMA Life Member, passed away on September 9, 2022. Dr. McClun received his DVM degree from Kansas State University in 1959. After serving in the U.S. Navy during the Korean War, Dr. McClun spent almost 50 years of his career practicing small animal medicine at El Cerrito Pet Hospital in El Cerrito.

In memory of deceased members, the CVMA makes a donation to the California Veterinary Medical Foundation, whose mission statement reads: “Nurturing kindness, education, and well-being for all animals, people, and the environment.”

The FDA recently finalized GFI #256, regulatory guidance for compounded animal medications from bulk drug substances for use in non-food producing animals. This new guidance impacts both office stock in veterinary practices and individual animalpatient prescriptions. It’s important your daily practice operations are compliant!

36 California Veterinarian | January–February 2023 CVMA REMEMBERS ®

You Know What’s In A Compound? New FDA Guidance Says You Should. UNDERSTANDING GFI #256

Use our free resources to learn more about GFI #256 and how to minimize risk in your practice! 888.508.5032 | EPICURPHARMA.COM

The CVMA extends our sympathy to the friends and family of those remembered.

New Animal Confinement Laws in 2023

By Liz Cox, MS, DVM, CDFA Animal Care Program Manager

requirement is that shipping documents accompanying covered product, eggs, pork, and veal meat being transported into or within California must have required markings for the respective covered product. In addition, distributors selling covered product to an end-user in California were required to register with the CDFA by January 1, 2023. Please visit this link for the Distributor Registration Application: https://www.cdfa.ca.gov/ AHFSS/pdfs/acp-73-002.pdf.

We know there are a lot of questions, including those regarding who is a “distributor,” registering, and the

minimum confinement standards for covered animals. The Animal Care Program website has guidance documents to answer stakeholder questions, or you can email animalcare@cdfa.ca.gov.

ANIMAL CARE PROGRAM

The California Department of Agriculture (CDFA) Animal Care Program (ACP) implements and enforces animal confinement laws related to covered animals raised in the state and in-state sales of covered product from covered animals. On November 6, 2018, California voters approved Proposition 12, the Farm Animal Confinement Initiative (FACI), which amended requirements in Chapter 13.8, sections 25990 through 25994, of the Health and Safety Code (HSC) that were previously enacted via 2008’s Proposition 2. The FACI established minimum confinement standards for California farms raising egg-laying hens, breeding pigs, and veal calves and made it illegal to engage in a commercial sale of covered product from covered animals if they were not raised according to the minimum standards of confinement. For pork meat, this includes meat from immediate offspring of a covered animal (breeding pig).

As of September 1, 2022, animal confinement regulations were finalized and went into effect via Title 3, California Code of Regulations, section 1320 et seq. An immediate regulatory

37 cvma.net/publications CDFA

REGULATORY FRAMEWORK:

1 EGG PRODUCER *CDFA ACCREDITED CERTIFYING AGENTS CDFA accredits private thirdparty certifying agents to certify producers and distributors. 3 BORDER STATIONS Check shipping documents of shell eggs and liquid eggs coming into California for required markings 5 Retail location (no further distribution) 2a. 2b. SHELL EGG BREAKING PROCESSING PLANT 4 REGISTERED EGG DISTRIBUTORS • Selling shell egg and liquid eggs to and end-user Register annually with CDFA • Certiﬁed as compliant annually END-USERS Consumer Restaurant (Personal or Food consumption) Facility Food Safety and Inspection Service CERTIFIED OPERATIONS • Egg producers and egg distributors Certiﬁed by one of the following: (1) CDFA, (2) an accredited certifying agent*, or (3) other government entity • Includes an annual on site inspection for renewal Food Processing Facility or Cottage Food Operation Regulatory Framework: eggs Animal Health and Food Safety Services | 1220 N Street, Sacramento, California 95814 Telephone: 916.900.5000 Fax: 916.900.5332 | www.cdfa.ca.gov/ahfss 1

EGGS

Dr. Liz Cox, Animal Care Program Manager

CALLING ALL MEMBERS:

Get Involved with the CVMA!

The CVMA Board of Governors is composed of 16 governors consisting of 11 geographic representatives and five At-Large members. The following terms on the CVMA Board of Governors expire on June 30, 2023.

Geographic District Governors

District II—Counties of Los Angeles, Orange, and the Antelope Valley portion of Kern County

• Dr. Peter Vogel, not eligible for another term

District III—Counties of Riverside, San Bernardino, Imperial, and Kern (excluding the Antelope Valley portion of Kern County)

• Vacancy

District VI—Counties of El Dorado, Placer, Sacramento, and Yolo

• Dr. Keith Rode, not eligible for another term

District IX—Counties of San Mateo and Santa Clara, and the City and County of San Francisco

• Dr. Julia Lewis, not eligible for another term

Governors-At-Large

• Dr. Peter Bowie, eligible for another term

• Dr. Teresa Morishita, eligible for another term

Geographic District Representation

Any eligible CVMA member may become a candidate for a geographic district governorship by submitting a written petition of intent signed by 10 CVMA members who reside in or maintain a principal office for the practice of veterinary medicine within the district to be represented.

Download the petition by visiting cvma.net and clicking on Get Involved under the About Us tab, or contact Dan Baxter at dbaxter@cvma.net. Completed candidate district petitions must be returned to the CVMA office by March 24, 2023.

At-Large Representation

Applicants must be a voting member of the CVMA for three preceding years and must reside or maintain a principal practice office in California. After receiving letters of interest and applications from qualified CVMA members, the CVMA’s Leadership Development Committee shall evaluate candidates for the open At-Large positions. Applicants for At-Large Board positions shall not simultaneously run for an elected district board position. Existing At-Large governors must complete an application for a second term.

To view the At-Large position description and to download an application, visit cvma.net or contact Dan Baxter at dbaxter@cvma.net. Completed At-Large applications must be returned to the CVMA office by February 1, 2023.

38 California Veterinarian | January–February 2023 CVMA BOARD OF GOVERNORS OPENINGS

Something to About Wag

THE CVMA CONGRATULATES…

Patrick Connolly, DVM, for hiking the Inca Quarry Trail to Machu Picchu while in Peru for the World Small Animal Veterinary Association meeting. The hike took a total of 2.5 days to complete and peaked at an altitude of approximately 15,000 feet. Just four months short of 70, Dr. Connolly was told he was the oldest hiker to have been guided through the Quarry Trail. Congratulations on this accomplishment, Dr. Connolly!

Bernadine Cruz, DVM, for helping bring a new veterinary clinic into reality in 2022. After four decades in veterinary medicine, Dr. Cruz was ready to hang up her stethoscope until she was offered an opportunity at the Paw Sweet Paw-Spectrum in Irvine, where she achieved her goal of providing concierge care to animal clients. She is also celebrating one year of being a solopreneur, having launched her online luggage company in August of 2021. The CVMA wishes you another successful year in 2023, Dr. Cruz!

Encino Veterinary Center, for celebrating its two-year anniversary. Co-owned by Dr. Julio Lopez and Dr. Christine Fabregas-Arnau, Encino Veterinary Center has blossomed into a prosperous practice with a team of seven doctors, four RVTs, one assistant, three assistants in RVT school, and three pre-vets. Congratulations to the whole team at Encino Veterinary Center for the practice’s substantial growth within just two years!

Dane Whitaker, DVM, for receiving the PrideVMC Leadership Award, given in recognition of individuals who actively support the PrideVMC’s mission to create a better world for the LGBTQ+ veterinary community. Dr. Whitaker, the past president of the PrideVMC and a member of the CVMA Inclusion & Diversity Committee, received this award for his longtime advocacy for the LGBTQ+ community, his role in the expansion of the PrideVMC’s reach and funding, and his exemplary leadership during the COVID-19 pandemic. Fantastic work, Dr. Whitaker!

Got any good news?

The CVMA likes to champion the many accomplishments of our members and their practices, whether a professional development or a personal milestone. Don’t hesitate to contact us! To be considered, please send in your good news and a fun photo to Taryn DeOilers, the CVMA’s Publications Manager, at tdeoilers@cvma.net.

39 cvma.net/publications SOMETHING TO WAG ABOUT

STUDENT SCHOLARSHIP AWARDS

Applications Available

Every year, the California Veterinary Medical Foundation (CVMF) offers two scholarships to veterinary students. Descriptions and criteria for both awards are listed below.

CVMF/VISC Student Scholarship Award

The CVMF/Veterinary Insurance Services Company (VISC) Student Scholarship Award is given each year by the CVMF in partnership with VISC. This scholarship is made possible with donations from VISC and the CVMF and is part of VISC’s ongoing commitment to support the

1, 2023 gatto-half-horiz.pdf 1 9/29/22 9:11 PM

state’s veterinary profession. The CVMF will award $1,000 scholarships to third- and fourth-year veterinary students in good standing at the University of California, Davis, School of Veterinary Medicine, the Western University of Health Sciences, College of Veterinary Medicine, and California residents attending out-of-state AVMA-accredited veterinary medical colleges.

Ron Faoro, DVM, Student Scholarship Award

The Ron Faoro, DVM Student Scholarship Award was established in memory of former CVMA president Dr. Ron Faoro and administered by the CVMF. This award presents recipients with $2,500 scholarships for their role in leadership. Second-, third-, and fourth-year veterinary students in good standing at the UC Davis School of Veterinary Medicine and Western University College of Veterinary Medicine are eligible to apply.

How to Apply

Recipients will be selected by the CVMF/VISC Student Scholarship Fund Subcommittee and the Ron Faoro, DVM Student Scholarship Fund Subcommittee based on their submitted application materials.

Applications for both scholarships must be received by April 15, 2023 to be considered. For eligibility requirements and application information, please visit the CVMF website at cvmf.net, call the CVMA at 800.655.2862, or email staff@cvmf.net. Recipients will be notified of their award by June 2023.

40 California Veterinarian | January–February 2023 STUDENT NEWS

February C M Y CM MY CY CMY K

UC Davis Offers Veterinary Business Course

and combines self-paced online modules on general business principles with three live, interactive Saturday Zoom sessions covering practical, veterinaryspecific business concepts. The program is designed for practice owners, prospective owners, practice leaders, and hospital administrators who want to take their understanding of business to the next level.

veterinary practice data, and present their findings in the final Zoom session. The online modules are taught by GSM business experts, and the live Zoom sessions on June 17, July 15, and August 12 are taught by veterinary industry experts.

The UC Davis School of Veterinary Medicine and UC Davis Graduate School of Management (GSM) will once again offer the Foundations of Veterinary Business certificate program in 2023. The popular summer online program runs from May 15 to August 12

The program provides veterinary working professionals with a timeand cost-efficient way to further their understanding of business basics, including managerial accounting, finance, marketing, strategy, and more. Attendees work in small teams on an online Capstone Project analyzing actual

John Tegzes Named Interim Dean at WesternU as Phillip Nelson Retires

Upon successful completion of the program, graduates receive a certificate from GSM as well as approximately 16 hours of California CE credit in the area of practice management. Registration is $2,599, with an early bird special of $2,449 if registered by February 15. Space is limited to 42 participants, and the event has sold out previously, so register early. Zoetis has generously supported this program since its inception in 2019.

Registration and more information can be found at: gsm.ucdavis.edu/executiveeducation-programs/foundationsveterinary-business.

Academic Officer. “Dr. Tegzes’ years of experience in interprofessional education and student-centric training, coupled with his nationally recognized expertise in team building, will serve him well as we go through this leadership transition.”

Western University of Health Sciences has named John Tegzes, MA, VMD, Dipl. ABVT, as the interim dean for the College of Veterinary Medicine (CVM). Dr. Tegzes succeeds Dean Phillip Nelson, who retired after 15 years in the role.

Dr. Tegzes is a CVM professor of toxicology and the director of WesternU’s Interprofessional Practice and Education (IPE) program. He earned his veterinary degree from the University of Pennsylvania, as well as a master’s in applied psychology from the University of Santa Monica and a bachelor’s in nursing from Thomas Jefferson University, where he graduated magna cum laude. He is a licensed veterinarian and a registered nurse in the state of California.

“I would like to thank Dr. Tegzes for stepping into this leadership role at a pivotal time for CVM and the veterinary medicine profession,” said Paula Crone, WesternU Interim Provost and Chief

Dr. Tegzes joined CVM in 2003, the year of the inaugural CVM class. Over the course of his 19-year career, he has taught numerous courses and served on many different committees. He is the author of hundreds of peer-reviewed publications and is a national leader in the veterinary medicine profession.

Dr. Nelson became Dean of WesternU’s CVM in 2005, taking over for founding dean Dr. Shirley Johnston. He led the college through a period of growth and was instrumental in diversifying both the student body and faculty. He served as the president of the Association of American Veterinary Medical Colleges from 2017–2018.

41 cvma.net/publications UNIVERSITY NEWS

WESTERN U NEWS

UC DAVIS NEWS

John Tegzes (left); Phillip Nelson (right)

Welcome to LifeWorks

Make a Healthy Start to the New Year with the CVMA’s Member Assistance Program

LifeWorks, the CVMA’s Member Assistance Program, provides the tools and resources you need to become a healthier you—mentally, physically, and financially. CVMA members have free 24/7 access to resources to help navigate family, health, life, money, and work issues.

Resources include:

Confidential counseling and referral services

Online wellness tools and personalization recommendations, such as assessments, digital clinical programs, and challenges to help you reach your mental and physical health goals and keep you on track

Perks to help you save money on daily essentials and life events

Trusted, expert-led online audio, video, and article content on a variety of vital topics

Legal and identity theft resource center

Child care and elder care locator

And more!

CVMA members were emailed an invitation to join LifeWorks. If you have not received your invitation, contact Jennifer Smith at jsmith@cvma.net.

Brokers and Appraisers Practice and Real Estate Sales Transition Specialists Practice Valuations

Ellie Wattles, DVM, President, Broker Beka Herrera, Vice President, Broker

SAN DIEGO, EAST COUNTY Suburban, affluent community with strong economic base offers an exceptional lifestyle. Reputable & very organized practice located in a diverse business plaza. ~3,500 sq. ft. leased facility w/ 3 exam rooms, in-house lab, ultrasound, digital dental X-Ray, digital X-Ray & class iv medical laser. Computerized, full-service hospital with experienced staff. 2022 Projected Gross ~$1.2 million produced with limited DVM hours. Current available income after all debt service is ~$417,000. Owner open to remaining post-sale, if desired. Excellent turn-key opportunity. . NEW LISTING! PRACTICE PRICE: $950, 000.

SAN BERNARDINO COUNTY, INLAND EMPIRE: Popular community with new residents because of its affordable and upscale housing. The community is only 45 minutes from Palm Springs & close to all the Southern CA’s attractions. PX is conveniently located in a high activity shopping center. Leased 2,100 sq. ft. facility includes 2 exam rooms as well as a large treatment area. Well-equipped practice includes digital X-Ray, digital dental X-Ray, ultrasound and IDEXX lab equipment. 2022 Projected Gross ~$1.2 Million. N NEW LISTING! PRACTICE PRICE: $960, 000

VENTURA COUNTY: Nestled in a flourishing valley boasting spacious mountain views and a perpetual vacation climate. The community itself is just less than 1-hour drive to Los Angeles or Santa Barbara. Spacious, organized leased practice underwent recent upgrades. The practice consists of 2,700 sq. ft with 2 exam rooms. Equipment includes digital X-Ray, digital dental X-Ray & ultrasound. 2022 Projected Gross ~$806,000 produced with limited services and hours. Multiple opportunities for growth, including a facility redesign, with a new energetic owner operator. N NEW LISTING! PRACTICE PRICE: $655, 000

MADERA COUNTY: Slip away from the hustle and bustle to this enchanted covenant area of nature and wildlife situated in the San Joaquin Valley. This community is centrally located between Fresno and Yosemite National Park. Full service practice is located within a free- standing ~1,680 sq. ft. facility with a favorable lease rate. The facility includes 2 exam rooms, 20 cages & IDEXX lab equipment. 2022 projected gross ~$536,000 produced with very limited DVM hours, which still provides exceptional cash flow of about 39%. Buyer’s after debt income expected to be approximately $225,000. Minimal competition and significant growth opportunities with a new energetic owner. N NEW LISTING! PRACTICE PRICE ONLY: $451, 000

SAN DIEGO, EAST COUNTY: Near perfect climate. Leisurely drive to beaches and downtown. Growing population & highly rated school districts, along with endless outdoor activities, easy access to retail and commercial areas offers a highly desirable area in which to live and have a business. Well- established & very organized practice located in an active, popular shopping center. ~1,600 sq. ft. leased facility with 2 exam rooms, digital X-Ray and new ultrasound. 2022 projected gross~$874,000. Exceptional cash flow of approximately 39%. M MAJOR PRICE REDUCTION! MOTIVATED SELLER! PRACTICE PRICE: $600, 000

SANTA CRUZ COUNTY, SCOTTS VALLEY: Located about six miles north of the City of Santa Cruz and 26 miles southwest of San Jose. Historic downtown, ideal weather & various amenities. Well established practice situated along a major thoroughfare. Free-standing facility is ~ 2,000 sq. ft. with 2 exam rooms. Equipment includes DR X-Ray & IDEXX lab. 2021 Gross $968,000. M MAJOR PRICE REDUCTION! SELLER MOTIVATED, MAKE US AN OFFER! PRACTICE PRICE ONLY: $300, 000

SUTTER COUNTY: Turn-key opportunity! Located within an hour’s drive from Sacramento. The community provides convenient shopping & amenities. The practice is located adjacent to a major thoroughfare with excellent street visibility & ample parking. Spacious ~2,700 sq. ft. free-standing facility offers 3 exam rooms, 20+ cages & 20+ runs. Equipment includes newer digital X-Ray, ultrasound unit, dental X-Ray & CO2 Laser. 2022 Projected Gross ~$1.2 Million. Currently operated as a 1 DVM practice with great staff. Exceptional profitability. P PRACTICE PRICE: $950, 000

REAL ESTATE PRICE: $560, 000

NORTHERN CA, NORTH VALLEY: Pastoral, quaint community located just a few hours from Sacramento & Tahoe. Beautiful 3,000 sq. ft. free-standing facility. Well maintained hospital built in 2005. Reputable, full service PX, well equipped with leased IDEXX lab & digital X-RAY. Gross increases year over year. Great profitability and excellent staff. 2021 Gross ~$1.3 Million produced with 1 DVM/day and limited doctor hours, only 5 days/week. Seller open to remaining for a transition post-sale, as desired by buyer PRACTICE PRICE: $1,100, 000 REAL ESTATE PRICE: $625, 000

KERN COUNTY: Situated in a growing community located ~1 hour North of LA with a strong agricultural, oil & general broad economic base including a new Amazon fulfillment center. There are many nearby amenities & affordable housing. This general Small Animal practice offers an ~3,000 sq. ft. facility with 3 exam rooms, 60+ cages and 10 runs. Equipment includes ultrasound & digital X-RAY. 2021 Gross ~$1,260,000. Potential to significantly increase hours of operation to grow productivity. P PRACTICE PRICE: $667, 000

REAL ESTATE PRICE: $425, 000

MENDOCINO COUNTY: Wanna getaway? Just 2 hours north of the San Francisco Bay Area & west of Sacramento. This area boasts spectacular scenery & distinctive wineries. Hundreds of miles of hiking trails, verdant hills & secluded lakes residents can easily find solitude & beauty. 1 PT DVM PX. ~1,500 sq.ft leasehold facility located in a small strip-center. 2021 Gross~ $556,000 produced with very limited hours. P PRACTICE PRICE ONLY: $120, 000. HAPPY NEW

545 Sespe Avenue Fillmore, CA 93015 Phone: 805.524.3195 Fax: 805.524.3192

E-mail: PacProInc@aol.com Website: www.pacificproinc.com

43 cvma.net/publications AD

WISHING YOU A PROSPEROUS 2023! Visit us at the 2023 WVC in Las Vegas. Booth #1173

YEAR!

Placing a Classified Ad

Place your ad in the Career Center at cvma.net. There are two options for classified advertising:

1. Online advertising

2. Online and in one issue of the California Veterinarian CVMA Members NonMembers

Online only

30 days online $169 $249

60 days online $269 $349

90 days online $369 $449

Online and in one issue of the California Veterinarian

60 days online + one issue of the California Veterinarian $319 $399

90 days online + one issue of the California Veterinarian $419 $499

Post an Anonymous Resume or Ad Resume—Post a confidential resume. Go to cvma.net. Click on the Resources tab then Classifieds in the right menu to get started.

Ad—Place a confidential ad by creating an anonymous email address and using it when posting your ad.

Print Display Advertising

The CVMA’s California Veterinarian magazine is mailed bi-monthly to all CVMA members and licensed California veterinary practitioners, reaching veterinarians of all practice types. The magazine is also sent to veterinary academia, including veterinary school faculty, researchers, and veterinary students. CVMA members receive discounts on all advertising.

Print Insertion Order Deadlines:

Jan/Feb November 1

March/April January 1

May/June March 1

July/Aug May 1

Sept/Oct July 1

Nov/Dec September 1

Digital Display Advertising

The CVMA offers two digital print advertising opportunities. The CVMA’s Weekly e-newsletter, distributed every Wednesday to all CVMA members, includes the most up-to-date information about issues

*Price includes the first six lines of text. Each additional line is $10/$11 for non-members. A line consists of approximately 50 characters.

**If you wish to place a print ad only, contact Laura Phillips at 916.649.0599 or classifieds@cvma.net.

If you have any questions, please contact customer service at 860.437.5700, clientserv@yourmembership.com, or classifieds@cvma.net.

Deadline dates for ad submissions in the California Veterinarian:

Issue

Deadline

Jan/Feb December 5

March/April

May/June

July/Aug

Sept/Oct

Nov/Dec

February 5

April 5

June 5

August 5

October 5

If your ad is received after the deadline, it will go into the following month’s California Veterinarian. After the deadline, the CVMA cannot alter or cancel ads. The CVMA reserves the right to edit copy and does not assume liability for contents of classified advertising. Prices subject to change without notice.

relevant to the veterinary profession. Advertisements in the Weekly e-newsletter are banner ads that are hyperlinked to the company website.

The CVMA’s monthly Upcoming CE e-blast provides information regarding currently scheduled CVMA continuing education events. Advertisements for the Upcoming CE e-blast can include a logo and text (up to 70 words), which may include contact information and is hyperlinked to the company website.

For more information on rates, deadlines, specifications, and more, and to view our Media Kit, contact Taryn DeOilers at tdeoilers@cvma.net, or click Resources > Display Advertising Opportunities at cvma.net.

All advertising is subject to the publisher’s approval. The publisher reserves the right to reject advertising which it feels is not in keeping with the advertising standard. The publisher reserves the right to reject, discontinue, or omit any advertising or any part thereof.

44 California Veterinarian | January–February 2023 CLASSIFIED/DISPLAY ADVERTISING

Issue Deadline

POSITIONS OFFERED

Northern California

Veterinarians

Join our team! Acacia Pet Clinic is seeking a great associate to join our experienced team. Our neighborhood hospital is located in the heart of San Jose and we are proud of our roots in the community. The hospital is located next to fantastic restaurants, quaint shops, and “San Jose’s Local Treasure” - the Willow Glen Neighborhood. Our family-like culture is created within our team and every day is both fun and productive. Our team genuinely cares about each other’s well-being and happiness. Medical quality paired with client partnership are the cornerstone of the practice. Our neighborhood-based clientele appreciate that we strive to create long lasting and positive relationships. We build those relationships with mutual trust and respect. Because of our commitment to client care, we have a high level of compliance with recommended diagnostic and treatment plans. The practice offers to our doctor team in house laboratory (IDEXX), digital radiographs, dental radiographs, and ultrasound imaging. The case load is general practice, but we will accommodate emergencies and advance surgery if possible. This position offers a flexible schedule with many options to fit your quality of life. No afterhours or weekends required. Requirements: Client focused communication; Team Driven Attitude; High Level of Medical Quality; Excellent physical exam skills; Strives for complete diagnostic work-ups including imaging; Comfort advocating for pets with the best treatment plans; Non-restricted California License; Eligible for DEA licensure; Eligible for USDA accreditation; Greater than 2 years of experience.

**Basic surgical knowledge a plus but not required. Compensation and Benefits include: Salary starts at $200k/year and 22% production, paid quarterly, no negative accrual; $20k Signing bonus; 401k with 3% match; 100% of Health, Dental, and Vision covered; 4 weeks PTO; $3500/year towards CE; Professional licenses and memberships paid; Discounted pet care75% off services, inventory items at cost + 10%.

Email rajvirgillon@gmail.com.

Belmont Pet Hospital, a family-owned, longestablished, vet clinic in Silicon Valley seeks associate veterinarian. Looking for a person who relates well with others, enjoys working with small animals, and is compassionate with care, with clients and with staff. This is a great opportunity for a vet to step into a high-functioning clinic with a 4-day work week, a great environment with excellent staff support. You will be busy and well-rewarded as you apply your knowledge. Production-based pay is 21% of gross with ability to grow over time. Your experience treating exotic animals is not required, but is a plus. Benefits: Established, busy vet clinic; Upgraded facilities; Seasoned, friendly, helpful supportive staff; Full Time work immediately available; 4-day work week; Production-based pay: 21% of total gross (Above market-rate); 401K, IRA, Health Care, Dental, Vision. We have consistently gained up to double the amount of 'new clients' a 'healthy' practice averages per month! As a practice, we have an 'overall' client experience rating of 91.13% satisfaction: Phone wait time: 86.72% satisfaction; Timeliness of visit: 91.5% satisfaction; Questions/concerns addressed during visit/attentiveness/ caring staff: 93.65% satisfaction; Knowledgeable, friendly, and efficient staff: 93.39% satisfaction; Likelihood of referring us to friends/family: 90.39% satisfaction. Email MyrnaSrouji@outlook.com.

45 cvma.net/publications CLASSIFIED ADVERTISING

Southern California

Veterinarians

We are a well-established private small animal practice in Spring Valley looking to add a full-time or part-time Associate Veterinarian to our team. Our clinic provides affordable care to the community, works with several rescue groups, as well as providing wellness care and routine surgery/dentals. We offer a healthy work-life balance, excellent support staff, a flexible schedule, and no on-call requirements. Work 8-hour days, 6-hour days, or 10-hour days! You decide! Salary is commensurate with experience and would be a base/commission-based package (ProSal formula). Email szs777@aol.com.

HOSPITALS—SALES/LEASE/BUY

Well established practice for sale after 39 plus years of ownership near Long Beach, CA on free standing 2000SF renovated corner lot building on a very busy avenue. Working 30 hours/week (besides travel times off) in last few years with projected 2022 gross $840K plus. RE lease with option to buy later negotiable. Only principal buyer with cash for quick sale of practice or including negotiable RE sale. Please contact mashiq@aol.com.

1+ Dr. SA practice in So. Sac. County, Central Valley wine country. Small town QOL. Leasehold with 30yrs in same location, excellent community reputation. Digital X-ray and dental x-ray, well equipped dental suite. >420,000 gross w/4day work week and small staff. 15% margins, opportunity to increase revs with added staff and/or hours. Asking $315,000. Offers considered. Contact: LD_LIDEN@SBCglobal.net.

CORRECTION:

In the article "Congratulations to the 2022–2023 Donald G. Low/CVMA Practitioner Fellows!" published in the September/October 2022 issue of the California Veterinarian, we mistakenly omitted one of the six 2022–2023 Donald G. Low/CVMA Practitioner Fellows: Dr. Anna DeVincenzi, who practices relief work in San Francisco. Her specialty area during the program is in Emergency/Critical Care. We sincerely apologize to Dr. DeVincenzi for this oversight.

46 California Veterinarian | January–February 2023 CLASSIFIED ADVERTISING

Elanco …...................................................................... 11 Epicur Pharma …........................................................ 36 Gatto McFerson …...................................................... 40 LASERRIFFIC …........................................................... 38 Pacific Professionals Inc. …........................................ 43 Preferred Employers Insurance …................................ 2 Simmons …................................................................. 47 Veterinary Insurance Services Company ..........…...... 48 ADVERTISING INDEX

www.simmonsinc.com Byron Farquer, DVM, CVA pacific@simmonsinc.com Dardalee Bussell, DVM (209) 845—2088