keystone
veterinarian
OFFICIAL PUBLICATION OF THE PENNSYLVANIA VETERINARY MEDICAL ASSOCIATION
VOLUME III, 2013
www.pavma.org
pvma
pennsylvania veterinary medical association
advancing animal welfare and human health while ensuring the vitality of the profession
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pvma
pennsylvania veterinary medical association
pennsylvania veterinary medical association
8574 paxton street hummelstown, pa 17036
advancing animal welfare and human health while ensuring the vitality of the profession
phone: 888.550.7862 fax: 717.220.1461 email: pvma@pavma.org website: www.pavma.org
what’s featured 14
Increase Patient Visits With Monthly Payment Plans
20
6th 3 Rivers Veterinary Symposium Returns to Pittsburgh
in this issue
2013 EXECUTIVE COMMITTEE Kenton Rexford, VMD President Sherrill Davison, VMD, MS, MBA, DACPV President-Elect James Holt, VMD Vice President Ronald M. Kraft, DVM Secretary-Treasurer
5
PVMA Announces Newly-Elected Officers 2014 Leaders
7
Seize the Opportunity to Spread Veterinary Medicine at the 98th Pennsylvania Farm Show
11
Inside VetGirl ‌ An Interview with Dr. Justine Lee
16
Customized Patient Care: Putting Your Plans Into Practice
17
An Inside Look at 2013 Business Behaviors in the Mid-Atlantic Region
22
Meet the Winners the PVMA's 2013 Member Awards
25
PVMA Fact Sheet: Preventive Care
26
A Look Back at 2013's Legislative Day and Friends of Veterinary Medicine
Robert P. Lavan, DVM, MS, MPVM, DACVPM Immediate Past President Mary A. Bryant, VMD AVMA Delegate Charlene Miller Wandzilak Executive Director
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Quarterly Columns 6
Observations
“Are There Too Many Schools and Not Enough Jobs?”
8
The President’s Two Cents
"Brushing Up on Changes in the Rabies Law”
10
12
18
by Heather Berst, VMD
by Kenton Rexford, VMD
From Where I Sit
by Charlene Wandzilak
“Creating a Wellness Plan for Your Practice ”
Practice Pearls
by By Sherry Everhart BS, RVT, and David McCormick, MS
"Top Five Costliest Business Mistakes”
Inside PADLS
by Deep Tewari BVSc, PhD, DACVM
28
Penn Vet News
30 38 40
"Bovine Viral Diarrhea (BVD) in Cattle: PADLS Testing Options”
"New Acupuncture Services Available at Penn Vet's New Bolton Center”
Member News "Practice Spotlight: Hope Veterinary Specialists”
What’s Happening “Events and Education”
The Grand Finale “A Dog's Daily Routine”
Advertising Index
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37
Allied Veterinary Cremation
27
AVMA-PLIT
24
BenefitHub
35
Burzenski & Company, PC
15
Communication Solutions For Veterinarians
IRC
Highmark
37
Nate Lynch & Associates, LLC
4
On-Hold Specialists
7
Pet Memorial Services
3
PNC Bank
IFC
pvmaAssure Insurance Agency, Inc.
29
Simmons Veterinary Practice Sales and Appraisals
28
Standard Process Veterinary Formulas
RC
Total Practice Solutions Group
39
VetCor
7
VeterinaryLoans.com
5, 7
Veterinary Management Consultation
33
Zoetis
36
Classifieds
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keystone
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2013 Board of Trustees
(A= Alternate Trustee, T=Trustee)
District I
Adam Hoover, VMD, Trustee Beth Piersol, DVM, Alternate
District II
Editor: Heather Berst, VMD Staff Editor & Graphic Designer: Lori Raver Staff Editor: Charlene Wandzilak Editorial Correspondence Letters to the Editor should be sent to PVMA, Attn: Lori Raver, 8574 Paxton Street, Hummelstown, PA 17036, fax 717.220.1461, or by email at lraver@pavma.org.
District III
Advertising keystone veterinarian is published quarterly by the Pennsylvania Veterinary Medical Association. Inquiries about display advertising should be directed to Lori Raver at the address and phone number listed above. Advertising information is also available on our website, www.pavma.org. Contracts and insertion orders should be sent to the address listed above by the appropriate submission deadline.
District IV
Submission Deadlines All articles, classifieds, and display advertisements must be received by the deadlines listed to be considered for inclusion in the respective issue:
Lloyd Reitz, Jr., DVM, Trustee Stacia McMahon Gilbert, DVM, Alternate
Mary-Lynn McBride, DVM, Trustee Dawn Fiedorczyk, VMD, Alternate
Michael Q. Bailey, DVM, DACVR, Trustee John Showalter, DVM, Trustee Amanda Glass, DVM, Alternate Sean Smarick, VMD, DACVECC, Alternate
District V
Dan Zawisza, VMD, Trustee Alternate—Vacant
District VI
Andrea Honigmann, DVM, Trustee John Simms, VMD, Trustee Nathan Kapp, VMD, Alternate Jeff Steed, DVM, Alternate
District VII
Heather Berst, VMD, Trustee Christina Dougherty, VMD, Trustee Casey Lynch Kurtz, VMD, Trustee Theodore Robinson, VMD, Trustee Kimberley Hershhorn Galligher, VMD, Alternate Kim Kovath, VMD, Alternate Steven Prier, VMD, Alternate Tom Garg, VMD, Alternate
Volume IV, 2013—October 1, 2013 Subscriptions keystone veterinarian is mailed to all PVMA members at no charge as a member benefit. Subscriptions are available to non-members for $30 a year or $10 for a single issue. Notice to Readers Neither this publication nor PVMA assume responsibility for material contained in articles and advertisements published, nor does publication necessarily constitute endorsement or approval of the advertiser, product, service, or author viewpoint by the keystone veterinarian, its editors and publishers, or the Pennsylvania Veterinary Medical Association. In addition, neither this publication nor PVMA guarantee the accuracy, reliability, or completeness of any facts, views, opinions, recommendations, information or statements contained within this publication. Reproduction in whole or in part is prohibited without the permission of the Pennsylvania Veterinary Medical Association. Copyright 2013: Pennsylvania Veterinary Medical Association.
District VIII
Susan Ackermann, DVM, Trustee Ferdinand Visintainer, VMD, Trustee Meg Alonso, VMD, Alternate Carlos Hodges, DVM, MS, PC
AVMA Alternate Delegate
Mike Topper, DVM, PhD, DACVP
Academic Veterinarian At-Large Colin Harvey, BVSc, ACVS
Veterinary Student At-Large Vacant
Production Animal Practice Veterinarian At-Large Darcie Stolz, VMD
Equine Veterinarian At-Large Vacant
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PVMA Announces Newly-Elected 2014 Leaders
O
n August 17, the Pennsylvania Veterinary Medical Association announced the results of the 2014 election for the organization’s officers. These individuals will take office on January 1, 2014, in their new capacities.
Sherrill Davison, VMD, MS, MBA, DACPV
Sherrill Davison, VMD, MS, MBA, DACPV, of Kennett Square, Pennsylvania, currently serves as the President-Elect and will automatically assume the Presidency. Dr. Davison received a Bachelor of Arts in Biology from the University of Pennsylvania in 1979, a veterinary degree from the University of Pennsylvania in 1983, a Master of Science degree from the University of Pennsylvania in 1988, and a Master of Business Administration from the Wharton School in 2004. She is currently Resident Director of the New Bolton Center Pennsylvania Animal Diagnostic Laboratory System, Director of the Laboratory of Avian Medicine and Pathology, and an Associate Professor of Avian Medicine and Pathology, University of Pennsylvania. Prior to her Associate Professorship, she held the positions of Assistant Professor, Lecturer and Resident at the Veterinary School’s Laboratory of Avian Medicine and Pathology. Prior to her work at the university, she was a practitioner in a small animal hospital. Dr. Davison also holds a specialty certificate as a Diplomate of the American College of Poultry Veterinarians. She is a member of the Legislative and Regulatory Affairs Committee and Secretary-Treasurer of the pvmaAssure Insurance Agency, Inc.
of Rutgers University with a Bachelor of Science in Animal Science, Dr. Michael Bailey was a USDA extension agent with the state of New Jersey prior to attending Tuskegee University, School of Veterinary Medicine where he received his veterinary degree in 1982. Dr. Bailey completed a medical surgical internship and then a diagnostic and therapeutic radiology residency at Michigan State University, College of Veterinary Medicine. He was on faculty at Michigan State University, Tuskegee University and was tenured faculty at The Ohio State University prior to leaving academia to enter private radiology practice. Dr. Bailey has authored more than 32 articles in referred journals, has presented at numerous veterinary and human health care professional meetings, and was an AVMA/AAAS congressional fellow where he worked as a legislative aide to a senior member of Congress in the areas of healthcare, agriculture, and education. He is the head radiologist for Banfield Pet Hospitals. Dr. Bailey is currently the District IV Trustee on the PVMA Board of Trustees. Dr. Bailey’s wife, Terri, is a pediatric nurse practitioner, and they have two sons, Jon, a paramedic firefighter and Quinton, a police officer. Ron Kraft, DVM, of Norristown, Pennsylvania, will continue as the Secretary-Treasurer and Dr. Kenton Rexford of Pittsburgh, Pennsylvania, will succeed to Immediate Past President. Congratulations to the newly elected officers! l
Jim Holt, VMD
Jim Holt, VMD, of Glenmoore, Pennsylvania, was elected to serve as the President-Elect. He currently serves as Vice-President. Dr. Holt showed an interest in animals beginning at an early age and has been an avid horse rider since he was 9-years-old. While riding hunters and jumpers, the highlight of his riding career was when he rode in a Grand Prix at age 16. Dr. Holt attended the University of Pennsylvania and graduated in 1991. Upon completion of his education, he was hired on at Morgantown Veterinary Clinic, a mixed equine/bovine practice that serviced northern Chester, Lancaster, and Berks Counties. In 1993, Dr. Holt decided to open his own mixed practice called Brandywine Veterinary Services which he still owns today. Currently, he works three days per week as the veterinarian for New Holland Sales Stables in New Holland, PA, working predominantly with cows and horses. The rest of Dr. Holt’s time is spent in a more typical mixed equine/ bovine practice doing pre-purchase exams, treating equine lameness, offering second opinions, overseeing imports and exports, and dealing with animal welfare issues as they relate to how animals are treated at sales and equine rescue facilities. Dr. Holt has served as the Trustee for the Brandywine Veterinary Medical Association and as a District VII Trustee. He has also served as the Equine Chair on the Scientific Program Committee and a member of the Coalition for the Care, Custody, and Welfare of the Unwanted Horse. He currently serves on the Legislative and Regulatory Affairs Committee and is a member of the Board of Directors of pvmaAssure Insurance Agency, Inc.
Michael Q. Bailey, DVM, DACVR
Michael Q. Bailey, DVM, DACVR, of Export, Pennsylvania, was one of two candidates for the position of Vice-President. He won the 2014 election and will assume the Vice-Presidency on January 1. A graduate WWW.PAVMA.ORG
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observations
Are There Too Many Schools and Not Enough Jobs? By Heather Berst, VMD, Editor
A
s a veterinarian, if you haven’t read it or heard about it, you must be living under a rock. I saw it first posted by a classmate of mine on Facebook. It was the February 2013 New York Times article titled “High Debt and Falling Demand Trap New Vets”. I had multiple non-veterinary friends forward this to me. The article was disturbing and has started many lively discussions about the veterinary profession including many about the newly accredited veterinary schools. If you haven’t read it, the article highlights the fact that there are too many veterinarians and not enough jobs. The new graduates are carrying a high debt load. Here is a key quote from the article: "Class sizes have been raising at nearly every school, in some cases by as much as 20 percent in recent years. And the cost of vet school has far outpaced the rate of inflation. It has risen to a median of $63,000 a year for out-of-state tuition, fees and living expenses, according to the Association of American Veterinary Medical Colleges, up 35 percent in the last decade. But starting salaries have sunk by about 13 percent during the same 10-year period, in inflation-adjusted terms, to $45,575 a year, according to the American Veterinary Medical Association." The article also highlights some struggling new veterinary school graduates. I think there is a tendency to "blame" the newly accredited veterinary schools by bringing this subject up. keystone veterinarian may get a slew of letters to the editor. My opinion (not PVMA’s) is that no matter how much people fight or oppose the accreditation of new veterinary schools, they will continue to be accredited. It is inevitable. I believe the profession needs to adapt rather than wasting energy opposing them. The American Veterinary Medical Association (AVMA) does have a response to what is going on in the profession. AVMA's website highlights the National Research Council’s 2012 report that expressed concerns about the sustainability of the veterinary profession and a need for the profession to evolve to meet changing societal needs. The AVMA states that it wants to be proactive to improve the well-being of veterinarians in the United States. What should be done? The majority of my classmates at the University of Pennsylvania, School of Veterinary Medicine (Penn Vet) in the graduating class of 2000 were interested in small animal private practice. We graduated, hung out our nameplates, and started working. Those days are gone. The profession needs to highlight and select for incoming students that are interested in alternative career paths. I think there are some steps to move the profession forward. A veterinary degree is very versatile. You can be involved in a career with public health, research, military, industry, academia, teaching, or government. Penn Vet has the One Health Initiative that can really open young veterinarian’s minds to think more globally. So, if you are mentoring a prospective veterinary student as many of us do, why not mention the versatility of a veterinary degree and all the routes that your career can take? My own personal career has taken a few twists and turns. I ended up in a place in my career that I am extremely happy in but never where I imagined to be when in veterinary school. l
Letter to the Editor In Volume 2, 2013, in The President's Two Cents, Dr. Rexford says licensees should complete at least 16 hours of continuing education. That is the correct number of hours for certified veterinary technicians. The correct number of continuing education hours required for biennial renewal of the license of a veterinarian is 30. Teresa Lazo, Assistant Counsel, Pennsylvania Department of State, Bureau of Professional and Occupational Affairs, Harrisburg, PA
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WWW.PAVMA.ORG
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th
98
ania Farm S v l y s n n e P how
Seize the opportunity to teach the importance of veterinary care to a huge audience!
W
e invite you to help represent veterinary medicine by helping to staff the PVMA/PVTA/PVF booth during the 98th Pennsylvania Farm Show to be held January 4-11, 2014, at the Farm Show Complex in Harrisburg. The farm show, renowned for its high-quality animal exhibitions and delicious food, attracts hundreds of thousands of visitors each year. What better way to impress upon the public the importance of veterinarians in Pennsylvania, not just for food animals and livestock, but for companion animals too, than to be there greeting people and answering questions. Because of the public nature of the show, many guests have questions about getting a pet or about a pet they already have.
How do I sign up?
Visit http://doodle.com/etdsxbatkywqmadm or scan the QR code at the bottom of the page with your mobile device. Simply click the button to expand all selections and just click on the shifts throughout the week which suit your schedule. We need 2-3 people per shift so don't skip one just because its already been chosen.
What do I get?
Volunteers will receive directions to the farm show complex, an exhibitor parking pass, and other materials related to your shift. Meal expenses are covered during your shift.
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Who can I bring?
If you have children who are interested in veterinary medicine or animals and who like to interact with the public, we encourage you to bring them along. Likewise, we encourage you to bring your pet if they are good with people. We'd like to have at least one animal each day.
Questions?
Contact Lori Raver at lraver@pavma.org or 888.550.7862. l
WWW.PAVMA.ORG
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www.veterinaryloans.com 877.288.VETS (8387) keystone veterinarian
VOLUME III 2013
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the two cents the president’s president’s two cents
Brushing Up on Changes in the Rabies Law By Kenton Rexford, VMD, President
R
abies is a topic that generates much concern and many questions. I will address some of these issues in this article.
Prevalence
As of August, 238 animals have tested positive for Rabies in PA – 109 Raccoons; 55 Bats; 25 Foxes; 24 Cats; 17 Skunk; 4 Groundhogs; 3 Cows; 1 Deer. Rabies positive animals have been identified in all regions of the state. As veterinarians, we have an appreciation for the significant public health risk Rabies represents. Our Legislature also recognizes this risk - as is evidenced by the passage of Act 65 of 2013 (previously Senate Bill 155), this Act is an amendment to the 1986 Rabies Act all of which is in effect as of September 7, 2013.
New Rabies Law Highlights
Some of you may have heard about the recently signed new Rabies Act, a.k.a PA Senate Bill 155. There will be new rabies regulations to accompany the new Act, but they have not yet been completed. At this time, you should just be aware that there will be some significant changes to the Pennsylvania Department of Agriculture’s rabies regulations for the first time in several decades, so stay tuned for those additional upcoming changes. I will try to give you the key points of the new Rabies Act, most of which took effect on September 7, 2013. One section of the new Rabies Act took effect back in July, and it relates to boarding kennels, so if you own or operate one, this may be of interest to you (paraphrasing from the new act): You must now require the owner of each dog you are boarding to provide proof of up-to-date rabies vaccination when the dog enters the kennel. The proof of vaccination must be kept on file at the kennel for 7 days after the dog leaves the kennel. If there is a dog attack at a boarding kennel, all rabies vaccination records and owner contact information must be provided to the owners of all dogs injured in the attack. Here are some of the other “highlights” of the new Rabies Act: a. Dogs and cats (no change in the definition of cat—they still are only required by law to be vaccinated if they spend time inside an inhabited residence) will be required to be vaccinated against rabies for the first time within 4 weeks after they attain 12 weeks of age (i.e. between 12 and 16 weeks of age). This is a helpful change since the way the old Act was worded, these animals were required to be vaccinated at 3 months old with no window of time in which to get that done. b. Dogs and cats must receive a subsequent rabies vaccination between 12-14 months after the date of the initial rabies vaccination, regardless of the age of the animal at first vaccination unless the label instructions specifically direct otherwise. That does NOT mean that you cannot administer additional rabies vaccinations sooner if you wish to do so. c. Ongoing rabies vaccination will then be according to label instructions. This is good because it allows for the Act to remain flexible as new vaccines or new label instructions are approved. For example, if you use the rabies vaccine labeled for every 4 year administration in cats, you can write a certificate for 4 years. d. Rabies vaccination medical exemption is now permitted in Pennsylvania. All this exemption means, however, is that the owner of an exempt dog or cat would not be a criminal (not able to be cited) for having their cat or dog not vaccinated. These exempt animals are, of course, still unvaccinated and would therefore not be able to be boarded in a licensed kennel, and would still have a 6 month quarantine if exposed to rabies, etc. To be able to grant an exemption for a dog or cat, a licensed veterinarian must examine the animal and determine that it would be medically contraindicated to vaccinate. The veterinarian must write an exemption statement and sign it and have the animal owner sign it. There is no official form for this statement, but it must contain the following information: • The signature and license number of the veterinarian • The date • The name and address of the vet practice/office/clinic • An explanation of the medical reason contraindicating vaccination against rabies • A description of the dog or cat including: breed, sex, age, color and markings, whether or not the animal is intact, neutered or spayed, and the current license number of the dog including any permanent identification if applicable (e.g. tattoo or microchip) • The signature of the owner and their address. If there are multiple owners with separate addresses at which the animal may be housed, then both/all owners must sign and provide addresses
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As veterinarians, we have an appreciation for the significant public health risk Rabies represents. These exemptions will last one year only and the animal must be re-examined and a new certificate of exemption issued each year if appropriate. The signed exemption form stays in the medical record of the animal and two copies of it are made by the veterinarian and provided to the owner. The owner must save one copy and send the other copy to the PDA—Office of Dog Law Enforcement, 2301 North Cameron St, Harrisburg, PA 17110 (yes, even for cats). Licensed Veterinarian—Rabies vaccination must be administered by a licensed veterinarian or under the direct supervision of a licensed veterinarian. "Direct veterinary supervision" occurs when a veterinarian is on the premises and has given either oral or written instructions to a certified veterinary technician or noncertified employee and is easily and quickly available to assist the certified veterinary technician or the noncertified employee. Rabies Certificate and tag—Veterinarians are required to provide the pet owner with a Certificate of Vaccination and a metal Rabies tag bearing the year of vaccination. The Certificate must be signed by a licensed veterinarian and must provide all of the information recommended by the National Association of Public Health Veterinarians (NASPHV) (www.nasphv.org). Exception for Kennels—Certain approved Licensed Kennel Owners may vaccinate animals that are owned by and housed at the kennel. If an animal is sold or given away, it must be revaccinated immediately by a licensed veterinarian or under his/her direct supervision.
Review of Rabies Situation Protocols
Some of these may change when the new regulations come out.
Wild Animals
Wild animals showing abnormal behavior should be reported to the PA Game Commission. If humans or domestic animals are in danger, contact Police or Animal Control.
Human Exposure
Concerns about potential human exposure to rabies should be referred to the human health department (either the Pennsylvania Department of Health or the municipal health department for the person’s jurisdiction), or a physician. If you are dealing with an animal that has BITTEN a person: • If a person is bitten by a domestic animal not suspected of having Rabies: 1. Report the bite to the Health Department 2. Confine animal for 10 days for observation—at home or at practice 3. If animal dies or is euthanized within 10 days, test for Rabies • If the animal is showing signs of Rabies and has bitten or otherwise exposed a person, then it must be euthanized and tested for Rabies.
Rabies Suspects and Suspected Exposures
2. Euthanasia and Rabies testing OR PDA quarantine (location of quarantine varies depending on circumstances) If you are dealing with a domestic animal that has been or is suspected of having been exposed to Rabies: • Domestic animal with current Rabies vaccine exposed to confirmedknown Rabid animal 1. 90 day PDA quarantine to owner’s property OR euthanasia if owner chooses 2. If quarantine is chosen, then additional Rabies vaccinatione may be administered at the discretion of the practitioner • Domestic animal with expired, extra-label, or very recent first Rabies vaccination exposed to known Rabid animal 1. 180 day PDA quarantine to owner’s property OR euthanasia—the choice is the owner’s 2. If quarantine is chosen, one or more Rabies vaccinations may be administered at the discretion of the practitioner (for dogs and cats required to be vaccinated, one vaccination is required to bring them into compliance with the vaccination requirement) • Domestic animal with unknown vaccination status exposed to known Rabid animal 1. Euthanasia is recommended OR 180 day PDA quarantine to owner’s property—the choice is the owner’s 2. If quarantine is chosen, one or morea Rabies vaccinationse may be administered at the discretion of the practitioner • Domestic animal of any vaccination status believed to have been exposed to Rabies but without confirmatory testing (e.g. dog seen fighting with raccoon, but raccoon got away) 1. Veterinarian must report Rabies exposure to PDA 2. Rabies vaccine may be administered 3. Or Euthanasia may be recommended, depending on the circumstances. continued on page 27
• If you are dealing with a domestic animal suspected of having Rabies 1. Must be reported to PA Department of Agriculture (PDA) Regional Office if the animal is not immediately euthanized and submitted for testing. WWW.PAVMA.ORG
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from where I sit
Creating a Wellness Plan for Your Practice By Charlene Wandzilak, Executive Director
T
his issue is dedicated to wellness plans and the importance of preventative care for pets. I would encourage you and your practice to adopt this same approach when examining how you practice as a team and the client and patient experience you provide. As we get ready for the holiday season which quickly leads into 2014, I recommend you reevaluate how you are doing things and resolve to do things that aren’t working well differently. In today’s world, people have different expectations. The economy has made people more careful with expenditures, the explosion of technology has made them more technologically savvy and they have more options for knowledge and purchases. This requires a different approach to how you choose to go about doing business “as usual” and it requires veterinary practices to take charge of their success. Here are some examples of ways that you can start making a difference on how you approach your team, your clients, and your practice’s success.
Consider Introducing Wellness Plans Into Your Practice
The 2011 Bayer Veterinary Care Usage Study1 stated that one of the most effective ways to increase client visits is to introduce pet wellness plans. They provide a variety of preventative care and encourage clients to get the care they need for their animals. They come in all shapes and sizes and can be tailored to your practice’s needs. There are examples of approaches in this issue. Wendy Myers offers advice on increasing patience visits with monthly payment plans on page 14. According to the Bayer Veterinary Care Usage Study, 44% of pet owners said veterinarians could increase patient visits if they provided wellness plans with monthly billing. On page 28, Animal Hospital of Dauphin County illustrates what they have done to create a wellness plan for their practice, and on page 16, Andy Burstein gives you pointers on the “How To’s” and things to consider. The Partners for Healthy Pets website, www.partnersforhealthypets.org, has a number of resources and examples on Preventative Healthcare Plans for Pets too and other valuable information.
Market, Market, Market
Long gone are the days where you can be guaranteed that clients will return to you or that new clients will be banging down your doors. Low cost services, internet pharmacies, big box stores, and the sluggish economy make practice challenging to say the least. It is incredibly crucial to market your practice effectively. There are numerous resources that can assist you with this. PVMA’s new partnership with Community Veterinary Partners’ (CVP) Affiliate Member Network offers practices a great opportunity to have an expert help you accomplish your marketing goals online. Social media is an excellent way to develop your practice’s marketing abilities and to generate buzz about what’s going on in your practice, put a caring “face” to what you do by showing pictures of patients, welcoming new patients and staff, recognizing accomplishments, and educating your clientele on animal health and preventative care. CVP also offers assistance with website development for its Affiliate Members. It is said that your website is the new “front door” of your business. Websites are often overlooked as important and this is a disservice to your practice. Take the time to invest in making your website attractive, user-friendly, and beneficial to keep people coming back and to make a great first impression when people are shopping for veterinary services.
Evaluate How You Are Doing
Later this month, PVMA will be unveiling its new benchmarking service. This service will help your practice evaluate your fee structure, the client experience, and benchmark your practice against other practices in the state. However, even if you don’t use our service, I highly recommend you incorporate some type of benchmarking and client satisfaction evaluation tools into your business to make sure you are where you need to be to ensure success and profitability.
Utilize Technology to Improve Client Relations
Use the vast array of technological advancements to allow you to connect with your clients more easily. Utilize blast, customizable emails to offer a monthly or quarterly e-newsletter to build rapport with clients. Use it as a way to promote specials, events, pet health topics that are seasonal, and preventative care guidelines as a reminder that they should be scheduling to come see you! Utilize email and text to send reminders of appointments to increase compliance. Allow clients to schedule appointments online or order products for home delivery. Today’s customer is about convenience, use technology to help make life easier for both of you!
Invest in Your Team
One of the things that I do every year is have a staff retreat. This is a great way to get out of your normal environment and discuss what you have accomplished and figure out where you need to go as a team in the new year. continued on page 32 10
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Inside VetGirl …
An Interview with Dr. Justine Lee By Andrea Honigmann, DVM, Lititz, Pennsylvania
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f you have been to a national veterinary meeting in the past few years, you may have seen Justine Lee’s name on the scheduled list of speakers. Her lectures are generally focused on emergency and critical care or toxicology. I was more than a bit “star-struck” to have made contact with her in the summer of 2012 and secure her as a speaker for the PVMA’s Keystone Veterinary Conference (KVC) in Hershey. I previously heard her speak at the North American Veterinary Community Conference (NAVC) in Orlando and remembered her as being a very dynamic, engaging, and informative speaker. As the chair of PVMA’s small animal section of the Scientific Programming Committee, securing her for this meeting was a huge achievement and a win for the attendees of the conference. A couple weeks before heading to the Hershey meeting, I emailed her to see if she would be up for an interview during the lunch break. I wanted to discuss her newest endeavor, VetGirl, a subscription-based podcast service that offers up to 16 hours of RACEapproved veterinary continuing education (CE). She was fully on-board with the idea; cue again my amazement. I was actually going to sit down and chat with Justine Lee, DVM, DACVECC, DABT! It was the second day of the meeting, and after picking up our lunch items, we found a spot outside to talk. The first question, of course, was what exactly is VetGirl? Dr. Lee and her partner, Dr. Garret Pachtinger, DACVECC—who practices in Levittown, PA, and is a PVMA member—designed VetGirl to be a way for veterinarians to receive high quality CE in a format that is portable, convenient, and quick (see the sidebar for the two types of membership options). The cartoon drawing of VetGirl shows a veterinarian with running sneakers on, and that reflects some of the background of the start-up (e.g., being able to “learn on the run,” while running around busily in clinics!). The name? Dr. Lee admits that she’s “VetGirl” and the voice behind it. While VetGirl is run by a female veterinarian, the name is actually inspired from a similar site offering podcasts called GrammarGirl, offering quick and dirty tips to improve one’s writing. Dr. Lee came up with the idea approximately 10 years ago when she was studying for her emergency and critical care board exam. She WWW.PAVMA.ORG
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felt guilty for going for a dog walk or a run, and felt that she needed to be studying all the time. She had dreams of being able to study and take in the information she needed through her Walkman, while pounding the pavement. She felt that there had to be a better way to do this and wanted to leave the guilt behind that came with taking time away from her stacks of journals and books. With that in mind, VetGirl is designed for veterinarians, veterinary students, and veterinary technicians who want to learn “on the run,” whether it is while you’re running outside, walking the dog, or at the gym. Pop a pair of headphones into your iPhone, Droid, or other internet capable device, and off you go! Instead of sifting through the piles of journals on your desk, some gathering dust or serving as a place to set your coffee mug, you can stream podcasts that provide up-to-date, relevant clinical information in minutes. With VetGirl ELITE ($199/year), members receive an additional 12 hours of RACE-approved webinar CE also, for a total of 16 hours per year. This gives you a great option if you’re looking to save yourself some expenses and travel time to a conference. Dr. Lee feels that VetGirl is definitely aimed at anyone with a smartphone, especially generation X and Y veterinarians. In addition to VetGirl, I posed some other questions to Dr. Lee (outside of the typical biography questions: she’s a 1997 graduate of Cornell University’s College of Veterinary Medicine and finished her residency and fellowship at University of Pennsylvania) during our lunch to allow our members to get to know her better. Although I am no longer considered a new graduate, I asked her what her best advice was for new graduates. She responded by saying that it is important to find a good mentor and work hard. She feels that the early stages of one’s career are when you are most impressionable and want to develop strong medical habits. In those formative years of one’s veterinary career, Dr. Lee emphasizes that it is important to establish a work/life balance while simultaneously working to build yourself and your clinical skills as a veterinarian.
PVMA Members Receive a Discount on a VetGirl Supscription PVMA Members can use discount code PVMAVETGIRL15 to receive a 15% discount. VetGirl Standard subscription: • Over 50-60 podcasts/year (ranging from 3- 5 minutes long) that provide clinical tips and updates in veterinary literature • Up to 4 hour of RACE-approved CE • $99/year VetGirl ELITE subscription: • Over 50-60 podcasts/year • An additional 12 hours of RACEapproved webinars • Up to 16 hours of RACE-approved CE • $199/year
Being double-boarded in emergency medicine/critical care and toxicology, I asked Dr. Lee about her most memorable ER case. She continued on page 35 keystone veterinarian
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practice pearls
Top Five Costliest Business Mistakes By Sherry Everhart BS, RVT, and David McCormick, MS, Simmons Mid-Atlantic, Boalsburg, Pennsylvania
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very year the top business publications print their top 8, 10, 15 or more factors that have contributed to small businesses faltering in today’s economy. Although these are based on the broad spectrum of small business, there are common themes that do relate to the veterinary profession. Here are the top factors that we believe can contribute to veterinary practice failure or at least significant problems and headaches if you are not paying attention to them.
Failure to actively manage personnel
This should not be a surprise to anyone. What does surprise many practice owners is how challenging it is to manage a staff ‘well’. It is too easy to underestimate the time, resources and management skills necessary to keep employees productive and satisfied. Research studies show that being poorly managed remains one of the top reasons for employee resignations. It often ranks higher than salary dissatisfaction. Below are key areas that, when left unresolved, can result in high costs associated with employee turnover, poor performance, inadequate client service and sometimes legal issues. Inadequate structure Sometimes this is a conscience choice by the owners who, in favor of a more relaxed ‘family’ environment for their employees, resist implementing many personnel policies. In reality, most employees 12
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today strongly desire structure in the form of employee manuals, job descriptions, training materials, performance reviews, etc. They are happier knowing the employer’s expectations, the rules, and the rewards right up front. Lack of continual investment The majority of employees want the opportunity to grow professionally. While many practice owners plan for the required continuing education needed by doctors and technicians, they sometimes overlook the importance in providing professional development opportunities for their reception, assistant and kennel staff. This results in a large portion of the staff feeling unsatisfied and at a stand still. Without growth, there is stagnation. Assuming an open door policy will keep you fully informed of personnel issues. This is not likely to happen. Too often by the time an employee gets the nerve to approach their employer about an issue, it has already escalated to a level where the resolution is destined to consume excess time and resources that could’ve been spent focusing on client and patient needs. The most effective administrators manage by walking around and engaging with employees at every level providing them the opportunity to intervene quickly when they sense problems among staff.
Failure to budget or plan
Many practice owners fail to budget, not because they don’t know how, but because they don’t see the tremendous value in creating one.
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A well-developed budget is a one year profit plan. It involves assessing all the financial needs of the practice and creating a strategy to make sure all bills get paid, all the employees get paychecks, and the business meets it earnings target. Including the profits in the budget is quite simply, planning to be successful. A budget is not a “one time” forecast that gets filed away after its completion. Its effectiveness lies in continually comparing it against actual income and expenses allowing early detection of trouble areas or adjustments for unforeseen circumstances. This allows owners and mangers to keep the earnings level intact rather than discover at tax preparation time that the business hadn’t performed as well as hoped.
Too Immersed in Industry
One of the most common mistakes business owners make is to focus only on ideas that have been created from within their industry. Unfortunately, this results in little means of differentiating their service and client experience from the competition (who are using the same ideas!) This creates a culture of just “keeping up”. Great ideas can come from anywhere and from anyone. Challenge yourself and your staff to be aware of and identify elements in any business you frequent that make that business stand out and inspire customer loyalty. It could be a hotel, a car repair shop, an online retailer, the local farmer’s market, anything. See if you can bring those elements into your practice for your clients.
Lack of Self Promotion
Generally speaking, we have found that many practices are highly uncomfortable with the idea of self-promotion. Instead, they assume (or desperately hope) that great work will result in satisfied and loyal customers who will actively tell all their friends. This relies on the assumption that the client actually perceived that there was great work done. Unfortunately, there are many studies that show a gap between the service providers’ and the clients’ perceptions. They have different perceptions of the value of the actual service provided. As a result, reliance on word of mouth advertising as a sole marketing strategy becomes a risky venture. It is not new news that you need to be participating in digital marketing. At a minimum, all practices today should have a website. The next step is a Facebook presence. When employed correctly these can be both a conduit for new clients and a means to build your bond with current clients. WWW.PAVMA.ORG
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Still, simply having a digital presence is not a complete and effective marketing strategy. It’s best to utilize multiple methods to reinforce current relationships and reach the potential new ones. Here are a few additional methods of promotion that are often overlooked or undervalued. Answering the telephone, properly Having a well trained, courteous, genuinely caring individual answering your telephone (and not putting the caller directly on hold!) is one of the most effective ways of promoting your practice and its services. If practice owners and managers disregard the staff’s role in promoting the practice, so will the staff. Community participation Think of this as an easy way of cold calling. It might be sponsoring a children’s sports team, having a booth at a local community event, hosting an informative talk on pet health issues at a local venue, or having a community website blog. Community members will often reward businesses active in their community with their patronage. Email marketing and communication It continues to be surprising how many practices do not collect and use client email addresses. Most practice management software can help organize client and patient data so that specific groups can be targeted for informative e-mailings such as a note about medical advancements, new equipment, or new services. A simple click allows your clients to pass these emails on to a friend that might not yet know what a valuable resource you are.
feline friendly, or revamping current preventive care protocols to those that cater more specifically to different age groups, species or breeds. Practice owners need to be proactive in monitoring the shifting needs of their clients using customer surveys, discussions in the exam room, or through the simple observance of client behaviors and an awareness of changes in the acceptance of services. Too many practice owners wait for income to decline before taking action. Savvy business owners will also take notice of which clients aren’t coming to see them. If your practice’s business model has been tailored to meeting the demands of baby boomers, there may be an entire segment of consumers that have not realized you exist. Knowing the demographics of the consumers and pet owners in your surrounding community should play a key factor in the practice’s ongoing business model. This includes its marketing initiatives, communication style, services available and quite possibly even the hours the practice is open.
Conclusion
Most if not all, small businesses struggle with the above issues. The solutions are not “one size fits all.” If they were, every business in every market would be succeeding. Making the time to learn about how these may be impacting your practice would be time well spent. l Sherry Everhart and David McCormick are veterinary practice appraisers and practice management consultants at Simmons Mid-Atlantic. They can be reached at 888.881.7084 and by email at SEverhart@ TMcCG.com and DMcCormick@TMcCG.com.
And don’t forget to cross promote! Advertise events and programs on your website and Facebook. Advertise your website at your events and on all printed communication materials. Link your website and your Facebook.
Clinging to a Shrinking Market Niche
Offering “only what’s expected” isn’t working any more for the general veterinary practitioner. Large portions of revenues from spay/ neuter services, the pharmacy, and over the counter sales are going to outside competitors, not all of whom are other veterinarians. A renewed focus on expanding services is a must for many practice owners today to remain financially healthy. Knowing what changes will best benefit the practice’s bottom line is a real challenge. Areas to explore might include the addition of alternative therapies, expanding services to include exotic patients or specialty care, becoming more keystone veterinarian
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Increase Patient Visits With Monthly Payment Plans By Wendy S. Myers, Owner, Communication Solutions For Veterinarians, Highlands Ranch, Colorado
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t age 12, Kodi was diagnosed with cancer, adding to his multiple medical problems. When veterinarians at Union Lake Veterinary Hospital in Waterford, Mich., wanted to perform ultrasound, blood work, and x-rays, Kodi’s family easily said yes. Kodi has been enrolled in a senior preventive care plan for four years, which has unlimited exams, vaccines, heartworm test, intestinal parasite screens, deworming, EKG, blood pressure check, tonometry, abdominal ultrasound, chest and abdominal x-rays, and senior preventive blood work (www.unionlakepets.com/ about-us/pet-wellness-plans.html). Because core medical services are on monthly payments, Kodi’s family could afford the level of cancer treatments that their dog needed.
Early adopters of wellness plans are seeing increases in patient visits while also boosting compliance. Here are benefits that hospitals have discovered during the kickoff years of wellness plans: Increase patient visits. More than 44% of pet owners said veterinarians could increase patient visits if they provided wellness plans with monthly billing, according to the 2011 Bayer Veterinary Care Usage Study.1 At Union Lake Veterinary Hospital, doctors strive to see patients twice a year for exams. Plan holders exceed the standard, averaging three to five exams per year, Engler says. Improved patient visits at Union Lake Veterinary Hospital echo results that Banfield found, which has 1.4 million pets on wellness plans. Among Banfield plan holders, cats averaged 3.67 veterinary visits per year while dogs had 2.86 visits annually.2 Plan holders visited twice as often as non-plan users. “Preventive care plans give clients a way to receive unlimited exams while also increasing value and compliance,” Engler says. Eliminate “Do you want?” conversations. During 20-minute exams, how much time do you spend negotiating which services and products clients will accept? “There is no back and forth because we do what we recommend for the pet,” says Harold Pearce, DVM, owner of Leesville Animal Hospital in Raleigh, N.C., who has been offering wellness plans for one year through Partners in Wellness (www.partners-n-wellness. com/clinic). “Most senior patients need blood work and dentistry. Senior patients need care now, and wellness plans are a way clients can say yes now.” Clients pay $47 per month plus a one-time $50 enrollment fee for a senior dog wellness plan with a routine dental cleaning. If purchased separately, clients would pay $783 for the same services, a savings of $169. As an added perk, plan holders are rewarded with a 10% discount on microchips and flea/tick and heartworm prevention. “Smart clinics add items to their plans that cost them very little—such as nail trims—but have high value to clients,” says David Goodnight, DVM, MBA, president and chief operating officer of Partners in Wellness, an AAHA preferred provider in San Antonio, Texas. “People love unlimited exams because they’re not afraid to come in.”
“Kodi is probably surviving cancer much better because we diagnosed it early,” says Annette Engler, LVT, CVPM, CCRP, hospital administrator. Over four years, Kodi’s preventive care plan has saved the family an estimated $1,000 and cemented their loyalty to the nine-doctor practice nestled in the heart of the Big Three—General Motors, Ford and Chrysler. Decades of economic downturn in the Detroit area often had clients requesting monthly payments, Engler says. Now preventive care plans deliver the standard of care that veterinarians want, while giving clients financial solutions. After four years, 600 clients have enrolled with numbers swelling higher each year. Revenue is up 10% thanks to increases in spays, neuters and dentistry covered by plans. 14
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When employees sell plans at Powell Boulevard Veterinary Clinic & Dental Center in Portland, Ore., they compare costs for today’s visit with wellness plan payments. Staff may ask clients, “Instead of spending $430 today, would you like to sign up for a wellness plan? You would pay $99.90 today and then monthly payments of $29.95.” Clients pay a one-time enrollment fee of $69.95 per pet and monthly payments of $29.95 for the adult wellness plan. The plan includes up to four exams, core vaccines, monthly nail trims, anal gland expression, deworming, two intestinal parasite tests, and preventive blood work (www.powellvet.com/online-forms). “Make your adult plans the same price as pediatric plans or a little less,” advises Denise Saxon, hospital manager, who has offered plans for two years. “Make sure your plans auto renew every year with a 60day cancellation period.” continued on page 15
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Payment Plans
continued from page 14
Plan holders can graduate from puppy/kitten to adult plans, and then onto senior plans. At Union Lake Veterinary Hospital, 70% of plan holders renew. Perform more dentistry. Leesville Animal Hospital offers plans that include routine dentistry. When advanced oral disease is present, clients pay for extractions, dental x-rays and other services at the time of the procedure. “No question, dentistry is an easy sell,” Dr. Pearce says. Finances may limit some clients from accepting dentistry. At Powell Boulevard Veterinary Clinic & Dental Center, having wellness plans with dental add-ons has increased compliance. “We practice great medicine but a lot of people can’t pay $600 to $700 for dentistry,” says Saxon. “Splitting it into 12 payments gives us more potential for extra earnings while also improving patient care. Now clients can afford extractions, dental x-rays and advanced care.” Provide more diagnostics. When structuring plans, most hospitals include preventive
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blood work for adult and senior patients. “Our plans include work-ups for early detection,” says Engler. “We want to address medical conditions before they become serious problems.”
Free Webinars on Wellness Plans Here are links to my two free webinars on wellness plans:
At Leesville Animal Hospital, its senior dog plan includes diagnostics of heartworm/tick test, intestinal parasite screen, blood work, thyroid test, urinalysis, tonometry, and bloodpressure screening. Bundling diagnostics into wellness plans has upgraded patient care, Dr. Pearce says. When deciding whether wellness plans are right for your clinic, have a goal in mind. Union Lake Veterinary Hospital had four goals for its plans: 1) Bond clients to the practice, 2) Increase spays and neuters being lost to low-cost providers, 3) Increase Grade 1 dentistry, and 4) Increase diagnostics for senior patients. “Before you try to implement preventive care plans, ask what are you trying to achieve by offering them?” advises Engler. “Are you doing wellness plans because everyone else is? That’s not a good reason. My main goal was to provide better patient care. As a result of wellness plans, we also grew revenue.” l
“Promoting Preventive Care With Wellness Plans,” AAHA web conference on-demand at www.aahanet.org/Education/WebConference.aspx?key=A993724D-F687-4E599CF2-9ECAC211CDDC “Introducing Wellness Plans to Your Clients,” sponsored by Partners in Wellness, www.dvm360.com/wellnesswebinars
1
2011 Bayer Veterinary Care Usage Study conducted by the National Commission on Veterinary Economic Issues, Brakke Consulting and Bayer Animal Health. http://avmajournals. avma.org/doi/full/10.2460/javma.238.10.1275
2
AVMA, Sep. 15, 2011. Burns K. “Reversing the Decline in Patient Visits,” https://www.avma.org/ News/JAVMANews/Pages/110915o.aspx
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Customized Patient Care
Putting Your Plans Into Practice By Andy Burstein, CEO, VetJump, LLC, Bala Cynwyd, Pennsylvania For any program to work effectively, we must take the time to communicate them in the right forum and to the right people. In any meeting that introduces change into the practice, it’s always helpful to have the pre-existing support of a few key team members already in place (staff doctors, lead technical staff, program coordinator). Introduce your program in person, at a time when all team members can attend and questions can be addressed as a team. Take the time and fully introduce the idea, the program, and the path for putting your ideas into everyday practice.
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here is no shortage of articles, conference workshops or websites making the argument for custom patient care plans and/or wellness programs and putting these programs into practice can be challenging. Every hospital has different patient demographics, varying protocols, and individual opinions about what is and what isn’t the best standard of medicine. But once a practice team has made the decision to adopt special pricing or plans for preventive care, the job is not over… in fact, our experience shows that the hardest work is just beginning. You can choose the perfect program for your practice, but if you don’t find a way to effectively create staff support and communicate to your clients, your efforts won’t succeed. There is a method for introducing something new into a practice and this method can be applied to many initiatives including wellness plans, referral programs, new medical services or even billing procedures. By taking your time and walking through each of the eight operational steps listed below, you can increase the likelihood of any program being embraced by your staff and your clients.
Step 1: Identify a Program Coordinator and Find a Simple Message
Identify a program coordinator in your practice who can take ownership of this project – someone outgoing and respected by the rest of the staff with at least a base of technical knowledge. The Coordinator can serve as a single point of contact for implementing each step of the process along with functioning as the key resource for staff and client questions. Once you have decided on the best program for your practice, work with your program coordinator to create a “Platform Document” that can succinctly communicate the structure of your wellness program - bullet points of key features, prices, and client messaging points. Don’t forget to keep the message simple and to the point. The Bayer Study on Veterinary Medicine concluded that only 53% of practice clients agree with the statement “My veterinarian communicates with me in language I understand” The more we layer on additional technical messaging, the higher the likelihood of our key points being lost in the message.
Step 2: Involve The Entire Team
Many practice programs and initiatives are rolled out in the lunchtime staff meeting where there is often distraction or incomplete attention. 16
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Assume that any questions your team may have will also be shared by your clients. It’s not uncommon for a Platform Document to undergo several revisions from the time it’s first authored until it’s officially accepted as the standard communication document. Dennis McMichael, Practice Manager of the Animal Hospital of Dauphin County, says “the biggest challenge with introducing any initiative, like a wellness program, is making sure to get buy-in from the entire staff. Even the slightest hesitation will undermine the efforts.”
Step 3: Training
One of the simplest and most often unused ways to train your staff about the new program (or any new offer that you have) is through role-play of common scenarios. This can be easily accomplished through the Program Coordinator or a doctor creating a scenario in an exam room where each staff member is challenged to effectively describe the program and answer common client questions. Create a bullet point script that your staff can use. They will ultimately choose to say it in their own words, but you’ll have the confidence that they are all keeping to the same basic script. Practicing common scenarios reinforces the importance of each idea to your staff as well as creates an opportunity for staff development. Role-play enables staff that may be shy or uncomfortable to feel more secure communicating key message points, and identify creative ways of explaining messaging points.
Step 4: Learn from your clients
We all have long-term clients who would jump at the opportunity to support our practices. Once you’ve established a consistent message within your staff, reach out to 3 or 4 good clients and invite them in to review your in room messaging and marketing tools. Most clients love the opportunity to have their voices heard and to feel part of the practice.
Step 5: Have Your Systems in Place
While we may use different software and techniques for our record keeping, it’s important to have a system in place to support your program roll out. Ensure the processes and procedures are established for patient records, reminders, invoicing and billing, as well as regular compliance reporting from your Practice Management System.
Step 6: Communication and Marketing
Marketing Communications will play a prominent role in supporting your in clinic and phone messaging. Your messaging shouldn’t only list the components of the program, but it should also focus on how the client & pet benefit from this program. Physical tools can range from a brochure to a simple flier. Online, the messaging should be shared on your website, Facebook, Google+, Twitter as well as emailed to all continued on page 38 WWW.PAVMA.ORG
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An Inside Look at 2013 Business Behaviors in the Mid-Atlantic Region By Travis Meredith, DVM, MBA, DACT, Community Vet Partners, Royersford, Pennsylvania The 2013 Business Behaviors Survey is made possible through the sponsorship of Community Veterinary Partners, and the support of the Delaware Valley Academy of Veterinary Medicine, DC Academy of Veterinary Medicine, Pennsylvania Veterinary Medical Association, and the Northern Virginia Veterinary Medical Association.
this year, while 19% feel growth will continue to stagnate. Only 4% of respondents anticipate their practices will see a decline in revenue in 2013.
Pharmacy Under Threat
The in-house pharmacy and the pending challenges to this segment of the business continue to be a hot topic. Pharmacy (59%) was cited far and away as the most threatened segment of practice. Surgery (15%) and annual preventive care (17%) were also cited. The veterinary pharmacy will experience continued pressure from online channels, traditional pharmacies, as well as large retail chains.
Growing Competitors
When asked to consider the most significant outside competitive threats to their practice, 33% of respondents cited online pharmacies while non-profit veterinary facilities were cited 22% of the time. In addition, practices acknowledge the growing competitive impact of Big Box retailers (16%) as well as increased competition from existing practices (15%).
Management Challenges
When asked about the most significant operational challenges affecting hospital operations, responses varied widely between segments. Three of the top four operational challenges cited were related to communication channels. Most respondents (26%) cited patient compliance as a key challenge, followed by staff issues (23%), acquiring new patients (16%), and marketing (12%).
Introduction
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any studies have been published in recent years describing the challenges facing the veterinary profession. However, most fail to capture economic issues related to specific geographic areas. In an effort to address this lack of information, the 2013 Business Behaviors study was designed with the goal of providing practitioners in the MidAtlantic region a more detailed view of the prevailing issues and best practices among our peers.
Respondent Demographics
Surveys were received from more than 200 practices in the region with Eastern Pennsylvania and Northern Virginia being the highest represented local markets. Data distribution by practice size (by number of doctors) is consistent with previously reported studies with 47% of respondents coming from practices with 2 or less full time doctors.
Opportunities for Growth
Most respondents cited growth actions as the most significant opportunities to improve the financial health of their practices. Adding new clients (65%) and new services (21%) were mentioned most frequently while cost control practices on functions such as inventory (8%), staff (5%), and benefits (1%) were mentioned significantly less often. These findings suggest that most respondents believe they are effective in controlling key operational costs.
Hospital Operations Operational Practices and Policies
Respondents were asked to comment on their practices and policies in managing specific day-to-day tasks. For tasks related to human continued on page 34
Market Outlook Positive Growth in 2012
Most respondents reported observing mild to moderate revenue growth during 2012. Sixty three percent (63%) reported growth above the pace of inflation while 27% reported flat or no changes. Only 10% of respondents reported a decline in revenues for 2012. Overall, these findings are encouraging as practices are looking to return to a pattern of growth following several years of unpredictable financial performance.
Optimism in 2013
Most respondents look to 2013 to continue the growth observed in 2012. Seventy seven percent (77%) are planning on growth above 2% WWW.PAVMA.ORG
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inside padls
Bovine Viral Diarrhea (BVD) in Cattle: PADLS Testing Options By Deep Tewari BVSc, PhD, DACVM, Pennsylvania Veterinary Laboratory, Harrisburg, PA, and Dave Wolfgang VMD, DABVP, Penn State University Veterinary Extension, State College, Pennsylvania
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ovine viral diarrhea (BVD) is an important cattle disease and causes significant economic losses to both the dairy and beef industries. The disease is caused by a pestivirus within the Flaviviridae family and results in clinical signs ranging from subclinical to severe or fatal mucosal disease. Viral infections, resulting in acute disease, often manifests as transient episodes of diarrhea or pneumonia. In many cases, clinical signs may go unrecognized. Infections of pregnant cattle can cause
early embryonic death, abortions, still births, congenital defects, or apparently normal calves. A proportion of calves born to infected dams become persistently infected (PI). Symptoms in PI animals can range from being unthrifty and weak to showing no symptoms at all. PI animals act like “Typhoid Mary’s” in spreading the infection to susceptible animals. They are a risk to herd mates and can spread the infection very efficiently through the herd. Transmission of BVD virus mainly occurs from contact with excretions and secretions of infected animals either by ingestion or inhalation. One of the most important methods for reducing BVD incidence is identification of the PI animals in the herd. Other important control methods include the implementation of good biosecurity and an effective vaccination plan to protect against the infection challenge. For identifying BVD infections, the Pennsylvania Animal Diagnostic Lab System (PADLS) offers several test choices (See accompanying Table). Availability of test options include pooling of serum or ear notches and use of bulk tank milk testing, thereby offering affordable test choices to our clients. Once BVD infections have been identified both acute and persistent cases of the infection require identification and monitoring. To eliminate the virus from a herd all positive PI calves must be identified. Along with this, rigorous testing should be conducted to find any or all other sources of infected animals. Routine surveillance should be implemented to check newborns and other entrants into the herds. This typically involves testing the entire crop of calves following an outbreak over the next 9 to 12 months.
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BVDV is classified into two main genotypes BVDV types 1 and 2. Some strains of BVDV type 2 have been found to be very virulent causing hemorrhagic syndromes, enteric disease, high fevers and sudden death. However, other BVDV-2 strains cause less obvious disease and behave more like the classic subclinical BVDV-1. Available laboratory assays can detect both BVDV genotypes successfully. PADLS currently does also offer BVD genotyping. Many vaccine labels claim to offer cross-protective immunity for both the genotypes. Practitioners should carefully evaluate labels and label claims as part of their vaccine protocol in herds experiencing BVD problems. Besides offering testing services, PADLS through its outreach services also provides access to a network of field investigators. These veterinarians are available for consultation with private practitioners for assistance in dealing with the difficult herd health problems related to management, vaccination and biosecurity issues. Listed below are some of the important suggestions from the National BVD working Group for BVD elimination: • Determine if your herd is at high or low risk for having persistently infected (PI) cattle. • Identify and eliminate any PIs from your herd. • Prevent other PIs from entering your herd. • Vaccinate to reduce the risk of the disease. • Monitor your herd for the presence of the BVD virus. • Don’t sell PI animals except for slaughter. • Don’t mix purchased pregnant cattle with your herd until they and their calves have been tested for existence of PIs. • Don’t buy bred heifers unless they test PI-negative and are properly vaccinated. • Don’t use animals of unknown BVD status as embryo transfer recipients. • Don’t rely on vaccination alone for BVD control. l
PADLS Laboratory Locations Penn State University Animal Diagnostic Laboratory Orchard Road, University Park, PA 16802 Phone: (814) 863-0837; Fax: (814) 865-3907 adlhelp@psu.edu Pennsylvania Veterinary Laboratory 2305 North Cameron Street, Harrisburg, PA, 17110 Phone: (717) 787-8808; Fax: (717) 772-3895 pvl@pa.gov New Bolton Center Veterinary Laboratory 382 West Street Road, Kennett Square, PA, 19348-1692 Phone: (610) 925-6211; Fax: (610) 925-6822 nbccontact@padlsnbc.vet.upenn.edu
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PADLS TEST CHOICES FOR BVD TESTING Test/TAT/Lab
Fee*
Advantages
Disadvantages
Specimens
Virus Isolation or Microplate-PI test
$5.00
• The Gold standard for BVDV diagnosis • High specificity • Virus is available for study at a later date
• Slow lab turnaround • Labor-intensive • Specimens must be shipped on ice to keep virus viable • Potential false negative from interference by maternal antibodies • To distinguish between PI and transient infections (TI), must retest positives
• 1 ml sterile (red top) serum • Send in insulated container with cold packs • Age: calves >3 mo
$5.50
• High sensitivity • Usually identifies persistent infections (PI) only
• Labor-intensive • Formalin usage • Will generally not identify transiently infected animals
• Skin samples (1/4-1/2”) usually taken with an ear notcher • Send in 10% neutral buffered formalin • Samples can be held in formalin for several weeks
$5.50
• High sensitivity
• Potential false negative due to interference by maternal antibodies • To distinguish between persistent and transient infections, must retest animal in 3 weeks
• Serum 1 ml or milk 10 ml • Send in insulated container with cold packs • Age:calves >3 mo
$5.50
• High sensitivity • Usually identifies persistent infections (PI) only – transiently infected animals test negative
• Will generally not identify transiently infected animals. Retesting is advised in 3 weeks.
Skin–(1 cmx1cm) • usually taken from ear with an ear notcher. • Send in insulated container with cold packs in red top tube. • Do not allow to dry out – can freeze samples if necessary.
• To distinguish between PI and TI, must retest positive cattle in 3 weeks. • If vaccinating with modified live vaccine avoid submission for 3 weeks due to false positives.
• Serum (2-3ml) or tissue, Whole blood (7-10 ml), or tissue Send in insulated container with cold packs.
• If vaccinating with modified live vaccine avoid submission for 3 weeks due to false positives. • If suspect/ positive, all animals in the pool must be individually tested to find infected animals.
• Clean Skin samples – usually taken from ear with ear notcher. (1cm x1cm) • Send in insulated container with cold packs. • Do not allow to dry out – can hold samples by freezing
• If vaccinating with modified live vaccine avoid submission for 3 weeks due to false positives. • If positive, all animals in the string must be traceable and individually tested or with pools to find infected animals.
• 100 ml sent on ice • Recommended herd size-200 animals for a bulk tank or a string sample.
5-12 day TAT (set on Monday) (send directly to PSU with next day delivery number)
Immunohistochemistry (IHC) of skin 5-10 day TAT (available through PVL and NBC) Antigen – capture ELISA for serum 1 – 5 day TAT (available through PSU and PVL) Milk testing at PVL Antigen – capture ELISA for skin or ear notch 1-5 day TAT (available through PSU and PVL)
Polymerase chain reaction (PCR) 1-5 day TAT
• High sensitivity $35 for single serum sample blood, or tissue
Individual serum, pooled serum, and individual ear notch (available through PSU and PVL)
$60 for pooled testing of serum up to 30 samples ($20 for pooling 10 sera)
Polymerase chain reaction (PCR)-Ear notch
$20 for pooled • High sensitivity ear-notch testing for up to 20 samples
1-5 day TAT Ear notch pooled testing (available through PVL) Polymerase chain reaction (PCR)- Milk 1-5 day TAT Bulk Tank Milk (BTM) testing (available through PVL).
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$35 for BTM
• Good sensitivity
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6
th 3 Rivers
Veterinary Symposium November 2-3, 2013 Omni William Penn Hotel Pittsburgh, PA
12 hours approved continuing education credit
Featured Speakers
Dentistry John Lewis, VMD, FAVD, DAVDC Sponsored by
COMPANION ANIMAL Surgery Michael Conzemius, DVM, PhD, DACVS Sponsored by
• • • •
Professional Dental Cleaning Interpreting Dental Radiographs Complications of Extractions and Avoiding Them Feline Extraction Techniques Wet Lab
• Canine Cruciate Disease-New Diagnostics, Treatments and Evaluation Methods • Diagnosis and Treatment of Perioperative Pain • New Treatments for Osteoarthritis • Elbow Dysplasia – Review of Recent Treatments
Krista Mendoza, DVM, DAVDC
Emergency/Critical Care
Internal Medicine
Daniel Fletcher, PhD, DVM, DACVECC • • • •
Shock: Pathophysiology and Diagnostic Approach Shock: Treatment Traumatic Brain Injury Management of Severe Acute Seizures Respiratory Distress – An Approach for Rapid Diagnosis and Treatment • CPR – What Every Veterinarian and Technician Should Know About the New 2012 Guidelines • CPR Wet Lab
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• • • •
Common Oral Pathology Feline Dentistry Extraction Techniques in Dogs and Cats Feline Extraction Techniques Wet Lab
Robert Washabau, VMD, PhD, DACVIM • G.I. Motility Disorders: Pathogenesis, Diagnosis, and Therapy • Difficult Vomiting Disorders: Pathogenesis, Diagnosis, and Therapy • Canine Inflammatory Bowel Disease: The Eight Components of Therapy • Feline Exocrine Pancreatic Disease: A Diagnostic & Therapeutic Challenge • Feline Hepatobiliary Disease: What’s New in Diagnosis and Therapy? • Feline Diarrheal Syndromes: Common and Not-So-Common Disorders
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PRACTICE MANAGEMENT
EQUINE
Wendy Myers
Harold Schott, II, DVM, PhD, DACVIM • Old Shaggy Horses: Diagnosis of Pituitary Pars Intermedia Dysfunction • Pituitary Pars Intermedia Dysfunction: Management and Treatment • Fat, Foundered Horses: What is Equine Metabolic Syndrome? • Equine Metabolic Syndrome: Management and Treatment • Equine Thyroid Disease: Fact or Fiction? • Equine Endocrine Case Discussion
Sponsored by • • • • •
Creating the Client Experience: Before, During and After the Exam Phone Skills for Veterinary Teams How to Say It: Talking With Phone Shoppers Reminder Systems That Get Clients Back Promoting Preventive Care with Wellness Plans
Donald Shandler, PhD • Turning Generational Conflict into Collaboration • Turning Generational Conflict into Collaboration Workshop • Transitioning Into Technical Leadership: Helping Technical Experts • Become Effective Leaders
Menno Jager, DVM Topics to be announced
Emergency/Critical Care Amy Butler, DVM, MS, DACVECC • Practical Transfusion Medicine Practical Coagulation Testing • A Practical Approach to Head Trauma • Intralipids for Acute Toxicity Critical Care Monitoring—A Clinical Signs Based Approach • Anesthetic Death – What to Do When the Worst Happens
Exotics Care
HOW TO REGISTER
Register online at www.pavma.org or scan the code below with your mobile device. Prefer to register by mail? Download a printable copy of the registration form at www.pavma.org.
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USDA NVAP REACCREDITATION MODULES Sponsored by Enzo Campagnolo, DVM, MPH • Module 10: Personal Protective Equipment for Veterinarians • Module 4: Preventing Disease Introduction and Spread Michael Kornreich, DVM • Module 9: Interstate and International Health Certificates for Category 1 Animals • Module 21: Animals’ Fitness to Travel
Jenni Jenkins-Perez, LVT, CVT, AA, BAS(VT) • Reptile and Avian Hematology • The Reptile Physical Exam • Reptile Nursing Care • Reptile Parasitology
• Top notch continuing education (up to 12 hours available) • Admission to the exhibit hall • Reception in the exhibit hall on Saturday afternoon (complimentary hors d’oeuvres and drink provided) • Continental breakfast, refreshment breaks, and lunch on Saturday and Sunday • Online lecture notes
David Moran, PhD Topics to be announced
BOVINE
VETERINARY TECHNICIAN
WHAT DOES YOUR REGISTRATION INCLUDE?
SMALL RUMINANT
Karen Martin, VMD • Module 3: Foreign Animal, Program, and Reportable Diseases • Module 13: Aquatic Animal Health Regulations and Health Certification l
HOTEL RESERVATIONS
A block of discounted rooms is available at the Omni William Penn Hotel for 3 Rivers Veterinary Symposium attendees. To make your online reservation, please visit www.pavma.org, or call the hotel directly at 1.800.THE.OMNI and reference PVMA to obtain the discounted rates. Room reservations are made on a firstcome, first-served basis until October 4, 2013, after which rooms may be reserved on a space and rate availability basis only. The discounted rates are: $169 – Single/Double Occupancy $189 – Triple Occupancy $199 – Quadruple Occupancy For a map and directions to the Omni William Penn, visit www.omnihotels.com/ Pittsburgh or scan the code at the right with your mobile device.
HANDS-ON WET LABS CPR Wet Lab
This is a highly interactive CPR lab, allowing participants to practice basic and advanced life support skills, based on the recently published, evidence-based RECOVER veterinary CPR guidelines. Participants will perform and discuss crucial patient management, crisis decision-making, and team communication skills in a realistic, real-time, high-stakes simulation environment.
Feline Extraction Techniques Wet Lab
Feline extractions don’t need to be difficult. Dr. Lewis and Dr. Mendoza will teach basic tenets of oral surgery in cats that will allow you to formulate an appropriate diagnosis and treatment plan, followed by skillful extraction of feline teeth through open oral surgical techniques using feline cadavers.
WET LAB ATTENDANCE IS LIMITED—SO REGISTER TODAY! keystone veterinarian
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Meet the Winners of PVMA's 2013 Member Awards
E
ach year during the Keystone Veterinary Conference in August, PVMA honors some of its outstanding members with PVMA Member Awards. The awards, which honor service to the public and/ or veterinary community highlight the broad range of talents which our members possess. Here is a look back at the 2013 winners.
Dr. A. Wayne Mountan Memorial Media Award
Public Service Award of Merit Nikki Wright, V’14
Newspaper Category: Deborah Weisberg
The 2013 recipient of the Dr. A. Wayne Mountan Memorial Media Award is Deborah Weisberg in In recognition of her talented contributions to the Pittsburgh Tribune-Review in which she educates the public on advances in veterinary care and innovative treatment options. Deborah writes extensively about wildlife and the environment, as well as pets and the human-animal bond. In 2003, she was honored to receive the Dr. A. Wayne Mountain Memorial Award for an article about feline kidney transplants that was published in the Pittsburgh Post-Gazette, and was honored to receive this year’s award for her Pittsburgh Tribune-Review story about laser therapy.
The Wodan Animal Hero Award K-9 Zeke
The Wodan Animal Hero Award was created in 2001 to recognize the courageous and heroic acts of Pennsylvania animals in the preservation and protection of animal or human life. The 2013 Wodan Animal Hero Award is presented to Zeke, a K-9 Officer from the City of Harrisburg, in recognition and appreciation of his selfless act of bravery and heroism by placing himself in harm’s way to protect and save the lives of fellow police officers on March 15, 2013. Zeke was shot and seriously injured in the neck, including his jugular vein, when a suspect who was being chased by police shot him. Zeke was airlifted by Penn State Hershey Medical Center’s Life Lion helicopter to Rossmoyne Animal ER/ Trauma Center in Lower Allen Township where Dr. Mark Meyerhoff and his team saved his life. Zeke is now fully recovered.
Veterinarian of the Year Award Mark Meyerhoff, DVM
The Veterinarian of the Year Award is presented annually to a member of the Pennsylvania Veterinary Medical Association for an outstanding achieve22
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ment in veterinary medicine within the past year. The 2013 recipient is Mark Meyerhoff, DVM, in recognition of the lifesaving measures he provided to Zeke, the Harrisburg City K-9 officer, and for his creation of the Animal Emergency Fund to help pets get the care they need. Dr. Meyerhoff stabilized Zeke upon arrival to his clinic and performed lifesaving surgery which repaired his damaged jugular vein.
The Public Service Award of Merit is presented annually to a member of the Pennsylvania Veterinary Medical Association for an outstanding act or achievement outside the veterinary profession. The 2013 recipient is Nikki Wright, V’14, in recognition of her work with Pou Sante: Amar Haiti and her dedicated efforts to improve animal health and welfare and increase the knowledge, productivity, and profitability of the people of Haiti. Nikki first visited Haiti with a World Vets team in an effort to provide livestock production consulting and medical care to rural village in Haiti. She was struck by the dichotomy between the beauty of the country and its profound culture, and began working with the iF Foundation as well as her Penn Vet classmates and faculty mentors to build a sustainable relationship that would enable American veterinary professionals to provide technical training and veterinary consulting to smallholder farmers to enhance production and provide opportunities for economic growth and independence.
Distinguished Veterinary Service Award Donald Caslow, VMD
The Distinguished Veterinary Service Award is presented annually to a member of the Pennsylvania Veterinary Medical Association for an outstanding act or achievement to the veterinary profession over a period of years. The 2013 recipient of the Distinguished Veterinary Service Award is Donald Caslow, VMD, in recognition of his many years of dedicated and caring service to patients and their owners and his commitment to the betterment of the profession through mentorship, externships, and job shadowing. Dr. Caslow has done countless tours of his hospital with childrens groups from local schools, Cub Scouts and Girl Scouts. He has allowed everyone who has asked to spend time shadowing him and has done many career days at the local high school. At least ten of his former employees have become veterinarians.
Animal Welfare Advocacy Award Larry Gerson, VMD
The Animal Welfare Advocacy Award recognizes a PVMA member who has demonstrated outstanding compassion and/or developed prokeystone veterinarian
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grams for the welfare of animals. The 2013 recipient of the Animal Welfare Advocacy Award is Larry Gerson, VMD, for his extensive work to improve the lives of deserving animals in need through the Allegheny Abused Animal Relief Fund (AAARF) and The Last Chance Fund (TLC) of the Pennsylvania Veterinary Foundation (PVF). Larry currently is the Chair of the Pennsylvania Veterinary Foundation (PVF) which is the charitable arm of PVMA. He is active in the Foundation and works to generate money for veterinary student scholarships as well as PVF’s other endeavors. Dr. Gerson also is the President of the Allegheny Animal Abuse Relief Fund (AAARF!) which has raised over $1,000,000 for abused and neglected animals.
Lifetime Achievement Award Robert Orsher, VMD, DACVS
Veterinary Industry Partner Award Charles Godfrey, Ceva Animal Health
The Veterinary Industry Partner Award is presented to a Veterinary Industry Partner member to recognize his or her steadfast commitment to ensuring the vitality of the Pennsylvania Veterinary Medical Association and the veterinary profession. The 2013 recipient of the Veterinary Industry Partner Award is Charles Godfrey of Ceva Animal Health in recognition of our appreciation for his years of commitment to the PVMA and the veterinary profession as a whole. Charles developed his sales territory from the ground up, working to build close relationships with veterinarians, distributors, as well as state VMAs.
PVTA Veterinary Technician of the Year Award
The PVMA Lifetime Achievement Award is given to a member of the Pennsylvania Veterinary Medical Association who has demonstrated a lifetime of selfless dedication to veterinary medicine, the health and welfare of animals, and the betterment of the profession. The 2013 recipient of this award is Dr. Robert Orsher. Dr. Orsher designed and built VSEC’s first location in Langhorne. His vision was to bring board certified specialists form multiple disciplines together under one roof to practice as a cohesive group. This vision, along with a strong commitment to excellent patient care, education, and service, provided the framework for sustained practice growth. Expanding this vision in February 2013, VSEC opened its sister hospital, bringing the VSEC brand of unwavering commitment to pets, pet owners and primary care veterinarians to South Philadelphia.
Cindy Esgro, CVT
George B. Wolff Legislative Leadership Award
Carolyn Lawrence
Robert Graybill, VMD
The George B. Wolff Legislative Leadership Award is given to a PVMA member veterinarian or veterinary student who has shown dedicated leadership in legislative advocacy at the state or federal level. The 2013 recipient is Dr. Robert Graybill in sincere appreciation and recognition of his dedicated efforts as a steadfast leader and passionate advocate for Pennsylvania’s veterinary and agricultural communities during his many years of service as Vice-Chair and member of the Animal Health Diagnostic Commission, past Chair and current member of the PVMA Legislative and Regulatory Affairs Committee, and veterinary representative to numerous organizations.
The Veterinary Technician of the Year Award of the Pennsylvania Veterinary Technicians Association is presented annually for outstanding achievement in veterinary technology. The 2013 recipient of the Veterinary Technician of the Year Award is Cindy Esgro, CVT, in recognition of her committed efforts to continually improve her knowledge and expertise in her field and for being a champion for the veterinary profession. She thinks of work as her play time; she loves what she does! Her husband tells everyone “he never saw someone truly enjoy wanting to go to work”. She’s a patient person, having learned to be even more patient with because of her two sons and dog.
PVTA Veterinary Technology Scholarship The Veterinary Technology Scholarship of the Pennsylvania Veterinary Technicians Association is awarded annually to assist a student during their education to become a certified veterinary technician. Criteria for the scholarship is based on cumulative GPA, academic achievements, plans for the future, and financial need. The 2013 recipient of the scholarship is Carolyn Lawrence. Having grown up on a dairy farm, she has worked with animals her whole life. Carolyn attended the veterinary assistant program at Lancaster County Career and Technology Center. This is what prompted her to attend Wilson College to become a certified veterinary technician.
PVMA President’s Award
The President’s Awards are given to honor and recognize an achievement or activity of any individual or company that deserves more than a letter of commendation but does not qualify for any existing PVMA award.
continued on page 39
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pvma fact sheet
Preventive Care Many dogs and cats in the United States do not get the regular preventive care check-ups they need to stay healthy. This trend began long before the recent economic downturn. Pets should receive a veterinary examination at least annually and—for some animals—more frequent visits may be appropriate.
What is Preventive Care About? Preventive care, or a general wellness visit, is a proactive approach to healthcare. Just like changing the oil in your car can prevent additional problems, regular check-ups with your veterinarian for your pet can catch problems early or prevent them altogether. Depending on the age and health of your pet, your veterinarian may even create a customized plan of preventive care which is tailored to your pet’s specific needs. Regular check-ups are also important because your pet can’t tell you when it doesn’t feel well. Unlike humans, animals hide pain, so there may not be any outward signs that something is wrong. Regular check-ups allow you to be sure that your pet is in good health.
examinations, etc.) • Parasite control (heartworms, external parasites, and intestinal parasites) • Vaccinations (rabies, canine distemper, canine parvovirus, etc.) • Identification (microchipping) • Reproductive counseling (spay/neuter) • A plan for follow-up and the next scheduled visit
What Are the Benefits of a Preventive Care Plan? • Pets get better, more comprehensive care instead of a hit-or- miss approach. The pet owner and the veterinarian both commit to the healthcare plan and pets get the care they need when they need it. • Pet owners like having a plan with payments they can work into their budget. People want to take good care of their pets, but not everyone understands that pets get better care and live healthier lives when they go to the veterinarian regularly, not just when something is obviously wrong. • Regular visits also provide your veterinarian with a better knowledge of your pets habits, general health and temperament, and can reduce the stress of an office visit on your pet.
Check-ups normally begin with a general health evaluation. This includes a thorough history about a pet’s breed, age, lifestyle, behavior, and diet. There is also a physical examination to check weight, temperature, pulse, and breathing. All of this information is gathered to assess whether a pet might be sick. The mouth is also examined to see if there is any gum disease or oral problems. The veterinarian will also ask the owner questions about the pet since its last visit. What are you feeding Fido? Has he been eating and drinking normally? Is Fido still as active as normal? Has he recently lost or gained weight? The remainder of a wellness visit is usually dedicated to preventive care which can be broken down into a few main categories: • Diagnostics (heartworm testing, FELV/FIV testing, fecal
The Pennsylvania Veterinary Medical Association (PVMA) is an Associate Member of Partners for Healthy Pets. Partners for Healthy Pets is the face of the Partnership for Preventive Pet Healthcare™, a committee of the non-profit American Veterinary Medical Foundation that was created to ensure that pets receive the preventive healthcare they deserve through regular visits to a veterinarian. This alliance of more than 20 leading veterinary associations and animal health companies is committed to a vision of improved overall health for pets.
pvma
pennsylvania veterinary medical association advancing animal welfare and human health while ensuring the vitality of the profession WWW.PAVMA.ORG
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A Look Back at 2013's Legislative Day and Friends of Veterinary Medicine Reception
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VMA once again held its annual Legislative Day which invites PVMA members to travel to Harrisburg to learn more about advocacy and how PVMA is working for Pennsylvania's veterinarians at the Capitol. During the first part of the day, PVMA lobbyist Stacy Gromlich spoke on the best way of building a relationship with your legislator and why it's important to do so. Afterward, PVMA Legislative and Regulatory Affairs Committee Chair Dr. Tom Garg gave an update on current legislation, and Teresa Lazo, Esq., counsel to the State Board of Veterinary Medicine, got the attendees caught up on the current hot topics in the profession, and Minority Chair of the Senate Agriculture and Rural Affairs Committee Senator Judith Schwank graciously took time out of her busy day to speak about the importance of the veterinary profession and agriculture in Pennsylvania and what it meant to her. Following the lectures, PVMA members headed to the Capitol to make scheduled legislative visits to Representatives and Senators from their respective home districts. Some PVMA members already had an existing relationship with their legislators and some were making visits for the first time, but all expressed the desire of PVMA to be a go-to resource when issues arise to help provided a scientifically-balanced view. Following the visits, PVMA members and state representatives, sena-
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tors, and staff attended the Friends of Veterinary Medicine Reception—co-hosted by the University of Pennsylvania, School of Veterinary Medicine (Penn Vet)—which was held in the Capitol Rotunda. Here, guests were able to mingle in a casual environment. During the reception, Louis Sallie, Pennsylvania Farm Bureau Administrative Secretary, received the Distinguished Service Proclamation from both PVMA and Penn Vet for his life's dedication to representing and leading agriculture in Pennsylvania and for championing the veterinary profession. Legislative Day is a great way to keep your relationship with your repResentatives and Senators going or to get your feet wet if you haven't begun. We encourage PVMA members to learn about the issues facing veterinary medicine in Pennsylvania and to get involved, either at home or in Harrisburg. If you would like to join the PVMA Legislative and Regulatory Affairs Committee, contact Executive Director Charlene Wandzilak at cwandzilak@pavma.org. l Top left photo: from l-r are Bill Evans, Executive Director for the Democratic Members of the Senate Ag Committee, PVMA Legislative and Regulatory Affairs Committee Chair Dr. Tom Garg, Minority Chair of the Senate Agriculture and Rural Affairs Committee Senator Judith Schwank, and PVMA President Dr. Kenton Rexford. Top right photo: from l-r are Penn Vet Dean Joan Hendricks, Distinguished Service Award winner Louis Sallie, and PVMA President Dr. Kenton Rexford.
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Rabies
continued from page 9
Testing
PDA Regional Offices
Specimens can be taken to the following regional Department of Agriculture offices for shipment to our laboratory but you must call ahead to ensure that someone will be available to receive the specimen: Meadville, Altoona, Montoursville, Tunkhannock, and Gibsonia. In many cases, it is easier and faster for veterinarians to submit the specimens from their office by using the courier or another method of submission.
Laboratories in the Commonwealth Performing Rabies Diagnostic Work Pennsylvania Department of Health, Bureau of Laboratories 110 Pickering Way, Exton, Pennsylvania 19341 610.280.3464 Specimens are accepted 7 days a week 24 hours a day.
They can only accept very small animals whole (bats, kittens—up to 3 lbs). Medium sized animals such as raccoons, skunks, dogs and adult cats must be decapitated with only the head submitted. Livestock must have the brain removed prior to submission to Lionville (or of course they can be submitted to the Pennsylvania Veterinary Lab instead). Preferred for all human exposure specimens except Philadelphia and Allegheny County. (see below)
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Human and Non-Human Exposure Specimens From Anywhere in Pennsylvania Pennsylvania Department of Agriculture, State Veterinary Laboratory 2305 North Cameron Street, Harrisburg , Pennsylvania 17110 717-787-8808 Preferred for all human exposure specimens except Philadelphia and Allegheny County. (see below) Human Exposure Specimens From Within Philadelphia Philadelphia Department of Health Laboratory 500 South Broad Street, Philadelphia, Pennsylvania 19170 215-685-6740 or 215-685-6748 Specimens originating from within the city limits of Philadelphia can be submitted to this laboratory or to the Pennsylvania Veterinary Laboratory or the Pennsylvania Department of Health Laboratory. Human And Non-Human Exposure Specimens From Within Allegheny County Allegheny County Department of Laboratories 3441 Forbes Avenue, Pittsburgh , Pennsylvania 15213 412-578-8070 This laboratory provides rabies diagnostics services for Allegheny County only.
Resources
Contact your regional Regional PDA Veterinarian • www.agriculture.state.pa.us • www.cdc.gov • www.portal.health.state.pa.us l keystone veterinarian
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penn vet news
New Acupuncture Services Available At Penn Vet’s New Bolton Center
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cupuncture can be used on all species treated at the University of Pennsylvania's New Bolton Center, although it is most commonly used in horses. The service can be helpful in treating back pain, laminitis, nerve problems, reproductive problems, and many other medical conditions. Michelle Harris, VMD, DACVIM, an Emergency and Critical Care specialist, completed acupuncture training at the Chi Institute of Chinese Medicine in Florida and will perform acupuncture services at the hospital. “Many clients of New Bolton Center are familiar with acupuncture and want to try different treatments for their hospitalized animals,” said Corinne Sweeney, DVM, Associate Dean of New Bolton Center. “We are excited to offer this new service.” For the past three years, Meagan Smith, DVM, DABVP (Equine Practice), has offered acupuncture to New Bolton Center’s Equine Field Service clients. Liz Arbittier, VMD, CVA, who joined the Field Service last month, adds to the team’s ability to offer acupuncture. Drs. Smith and Arbittier also were trained at the Chi Institute. “Acupuncture is especially useful for pain management, to help get the horse through the worst of times,” Dr. Smith said. “It can be a great adjunct to any therapy to increase comfort and lessen recovery time.” At New Bolton Center, acupuncture is not used to cure a disease or replace Western treatment, but to provide additional therapy that
can ease pain and improve the animal’s quality of life. In some cases, acupuncture can decrease the need for certain medications. Acupuncture dates back thousands of years in China. The techniques used on animals are similar to those used on humans. New Bolton Center will offer dry needle therapy, aquapuncture, electroacupuncture, and moxabustion. Penn Vet is one of the world’s premier veterinary schools and is the only school in Pennsylvania graduating veterinarians. Founded in 1884, the school was built on the concept of Many Species, One MedicineTM. The birthplace of veterinary specialties, the school serves a distinctly diverse array of animal patients at its two campuses, from companion animals to horses to farm animals. The large-animal facility, New Bolton Center, in Kennett Square, PA, includes the George D. Widener Veterinary Hospital for large animals; diagnostic laboratories serving the agriculture industry; and research facilities to determine new treatment and diagnostic measures for large-animal diseases. In Philadelphia, on Penn’s campus, are the Matthew J. Ryan Veterinary Hospital of the University of Pennsylvania (Ryan Hospital) for companion animals; classrooms; research laboratories; and the School’s administrative offices. For more information, visit www.vet.upenn.edu. l
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member news
Practice Spotlight: Hope Veterinary Specialists By Dennis Burkett, VMD, PhD, DACVECC, DACVIM (Cardiology), Hope Veterinary Specialists, Malvern, Pennsylvania
I
n November 2004, the Animal Critical Care and Specialty Group, Inc., doing business as Hope Veterinary Specialists (HopeVS) since 2012, joined the Veterinary Referral Center (VRC) and opened the first 24-hour emergency and critical care facility in the area staffed by board certified specialists in emergency and critical care medicine. Due to space and capacity constraints and seeking a more simplified and unified approach to patient care, HopeVS decided to leave VRC at the end of December 2012 and operate from a newly-constructed, state-of-the-art facility located within the Three Tun Business Park at 40 Three Tun Road, East Whiteland Township, Chester County, PA.
Hope Veterinary Specialists 24/7 Emergency & Patient Care 40 Three Tun Road Malvern, PA 19355 610-296-2099 PH 610.296.2444 FX http://hopevs.com
At the present time, the HopeVS Emergency/Critical Care department consists of three American College of Veterinary Emergency and Critical Care (ACVECC) diplomates who assist with emergency receiving and oversee the emergency staff. They also have primary case responsibility and offer consultation on other in-house specialty cases. We currently employ three full-time emergency clinicians in addition to our diplomates. The Emergency/Critical Care department is also supported by certified technicians, many with advanced training and certification in emergency and critical care nursing. HopeVS is the region’s leader in advanced veterinary medical care for dogs and cats. Our other specialties include anesthesia and pain management, cardiology, dermatology, internal medicine, neurology, oncology, radiation oncology, radiology, and surgery. Including our six emergency and critical care doctors, our total number of doctors is 21. Our team of specialists and experienced doctors work closely with each other and our referring veterinarians to ensure that we can consistently offer the highest level of care to each and every patient. HopeVS provides emergency and critical care services to area veterinarians on a referral basis and the general public on a walk-in basis. By emphasizing education, investing in cutting-edge technology and focusing on the total client experience, HopeVS is developing into a renowned
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member news
specialty practice that will continue to expand in the future. Our practice not only features state-of-the-art technologies but also an absolute dedication to the art as well as the science of veterinary medicine. We are committed to excellence in veterinary medicine, blending the latest technology with good old-fashioned patient care. HopeVS currently employs approximately 80 full-time and part-time staff. HopeVS is open to receive patients in need 24 hours a day, 7 days a week, and 52 weeks a year (24/7/365). HopeVS believes “the veterinary emergency and critical care centers of the future will be composed of veterinary care teams. These teams will be composed of outstanding veterinarians, veterinary nurses, and managers who will set the standard for compassion and excellence, armed with the right tools and information to meet the challenges of our patients and clients.” More than just competent medicine and patient care, people need hope and encouragement from compassionate and caring staff. HopeVS recognizes this and is committed to providing it to every patient and every client, every time. Our philosophy, simply stated here, will hopefully provide insight regarding the level of care we strive to offer and the degree of commitment to which we aspire.
Questions & Answers
What prompted you to create Hope Veterinary Specialists? As I approached my retirement from the pharmaceutical industry, I yearned to get back into clinical medicine for the pet owning public. From this small desire and an opportunity that presented itself, it just seemed like the right thing to do. Surrounding myself with the right people and staff seemed to me to be the key challenge in this new endeavor. After assembling a key team of individuals, most of whom are still with HopeVS today, pursuing my (really, our) dream just seemed like the logical next step—and here we are today still pursuing that dream. How did you come up with the layout/design for your state-of-the-art building? This turned out to be a labor of love but a lot of work too. Before actually starting the actual planning of the new hospital, I visited literally hundreds of veterinary hospitals and veterinary schools across the country. Everywhere I traveled, if there was a veterinary school or a specialty practice nearby, I visited it. I also perused as many books on hospital design and floor planning as I could get my hands on, but probably the most important part regarding our floorplan was interactions with my peers and staff regarding what we thought would work best for our new hospital. This was critical to our mission and I think we went through 10-15 floorplan designs before we finally settled on the one we have. This was the key ingredient in my opinion, getting input from our staff as to how they actually use the space. What flows more naturally, what aids efficiency and—basically—how do we work. Nothing new, just often overlooked, form follows function, not the other way around. Oh yes, and get yourself a good architect. What is your vision for the practice as you continue to grow? This is best exemplified by our vision and mission statements: Vision: Where the hopes for tomorrow reside today (the meaning behind our name). Mission: Improving the quality of life and health of our community, our clients, our patients, our staff, and ourselves. Since we all recognize that it is easy to put words on paper, we decided to outline just how we plan to work toward making this a reality each and every day for ourselves, our clients, our patients, and by default, our hospital. To live out our vision, HopeVS has identified the following to focus on and to demonstrate to the best of our ability daily. • Leadership: lead by example, be mindful of what you leave behind (wake effect). WWW.PAVMA.ORG
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• Change: embrace change when appropriate, become a “change merchant” when needed (flexibility). • Possibilities: consider all, recognize they are limitless (openness). • Expectations: reach high, challenge yourself and others (embrace knowledge, keep learning and growing). • Communication: “connect” with others. • Relationships: create, nurture, develop and cherish. This is the throughway for effective communication (honesty, trustworthiness and compassion). • Teamwork: 1 + 1 > 2 (sometimes known as synergy) (collaboration). • Develop Peripheral Vision: learn to see around corners, become more aware of your actions and what is going on around you, anticipate what “could” happen based on your actions (awareness). • Choose happy: if you are happy, happy things will happen to you. l keystone veterinarian
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member news
Welcome New Members
p
VMA welcomes the following new members and thanks them for joining PVMA! (July 31, 2013–September 23, 2013)
Active-Recent Graduate
Zachary Goodrich, VMD, Monroeville, PA Jennifer Burroughs, DVM, Lititz, PA Casey Pawl, DVM, Reedsville, PA
Industry Partner
Daniel Luchansky Chesapeake Waste Solutions, Inc., Manheim, PA Leeann MacWilliams, Medical Dental Bureau of York & Adams Counties, York, PA
Practice Manager
Suzanne Krause, CVT, New Holland Veterinary Hospital, New Holland, PA
Academic Active
Ann Barr, CVT, Penn Foster College, Scranton , PA Eugene Lengerich, VMD, Hershey, PA
Active
Kelly Longenecker, VMD, The Village Veterinarian, Bangor, PA Brady Beale, VMD, Veterinary Referral Center, Malvern, PA Danielle Young, DVM, St Francis Animal Hospital, Tamaqua, PA David Krehl, DVM, Martinsburg, PA Elena Shockman, VMD, York, PA Sadf Mnbvcxz, Col, OH
Associate
James Dorney, DVM, Summit Dog & Cat Hospital, Summit, NJ Ronald Tyler, DVM, American Veterinary Pathology Associates, PLLC, Blacksburg, VA Roberto Torres-Diaz, DVM, Patrick Springs, VA
Government
Student
Katharine, Sharon, Landenberg, PA Michele Dickey, Philadelphia, PA Elizabeth Antzis, Philadelphia, PA Gretchen Landin, Philadelphia, PA Ashley Moyer, Philadelphia, PA Alexandra St. Pierre, Philadelphia, PA Caitlin Hunter, Philadelphia, PA Kristen Koepsell, Phoenixville, PA Emily Shea, Philadelphia, PA Caroline Maguire, Philadelphia, PA Julianne Sangimino, Philadelphia, PA Aidan Chambers, Philadelphia, PA Lizzy Bairstow, Philadelphia, PA Han Chia, Glen Burnie, MD Sarah Colmer, Neptune, NJ Jonathan Ferrari, Ambler, PA Fiona Inglis, PhD, Philadelphia, PA Meredith Lancaster, Philadelphia, PA Matthew Lanza, Philadelphia, PA Samantha Lauro, Philadelphia, PA
Megan Longstreet, Mechanicsburg, PA Rachael Nelson, Philadelphia, PA Caroline Neville, Philadelphia, PA Roger Rengert, Philadelphia, PA Noelle Schoettle, Philadelphia, PA Marvin Schuldenfrei, Philadelphia, PA Rachael Sirois, Philadelphia, PA Luigi Topacio, Philadelphia, PA Alyssa Codes, Philadelphia, PA Samantha Fanelli, Philadelphia, PA Gregory Kaiman, Philadelphia, PA Jennifer Masucci, Philadelphia, PA Resa McLellan, Philadelphia, PA Meghana Pendurthi, Philadelphia, PA Jared Risser, Blacksburg, VT Benjamin Donati, Philadelphia, PA Katina Pangakis, Philadelphia, PA Zachary Smith, Philadelphia, PA Ashley Cherry, Philadelphia, PA Kristen Conniff, Philadelphia, PA Caitlin Doran, Easton, PA Eva Jacobs, Philadelphia, PA Grace Nebzydoski, Philadelphia, PA Joseph O'Hara, Kingston, PA Annelise Myers, Clarksville, MD Rachel Sclarsky, Philadelphia, PA Nathan Squire, Philadelphia, PA Christina Montalbano, Philadelphia, PA Katherine Very, Philadelphia , PA Jessica Mitchell, Philadelphia, PA Sarah Bye, Holicong, PA l
Anil Thakur, BVSc, Mandi, India
PVMA Says Goodbye to Dr. Matthew Murphy
We want to know!
M
atthew Murphy, DVM, born January 15, 1958, passed away September 22, 2013. He was a resident of Scotland, PA, and owner the Keystone Mobile Veterinarian Service. He is survived by his wife, Brenda; his children Matthew (spouse Susan), Jarred (spouse Lindsey), and Anna; as well as grandchildren McKenna, Matthew, Jacob, Emma, Abriel, and Katelyn. Friends were received at Open Door Church, 600 Miller Street, Chambersburg, PA, on September 28. In lieu of flowers, donations may be made to Chambersburg Baptist Church Building Fund. PVMA wishes the Murphy family its deepest sympathies. l
Do you have a marriage, a birth, or other event in your life or practice you want to share? Tell us! We love to share member news within the PVMA family. Email Lori Raver at lraver@pavma.org. 32
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From Where I Sit
as you identify goals, look at strengths and weaknesses, and develop a plan.
Staff value the time away together and the fact that you let them have a role in creating a great practice. Another way to invest, is to do strategic planning so that you have clearly defined goals and action steps to ensure that it is done. This is another great thing to do with your team because for a plan to be successful, everyone must be on board and support it. It is also beneficial to have a facilitator to help you have an objective perspective
If PVMA can assist you with any of these topics, please contact me at cwandzilak@pavma. org. No matter what you do, it is important to resolve to do things differently. That’s a great first step to any wellness plan. l
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2011 Bayer Veterinary Care Usage Study conducted by the National Commission on Veterinary Economic Issues, Brakke Consulting and Bayer Animal Health. http://avmajournals.avma. org/doi/full/10.2460/javma.238.10.1275 1
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Nathan Kapp, VMD, & Valerie Bollinger PVMA member Nathan Kapp, VMD, and Valerie Bollinger tied the knot on June 29, 2013, in Lititz. Congratulations Nathan and Valerie!
Š Orange Rose Photography
Lauren Aldinger, VMD, & Yoon Chay, VMD PVMA members Lauren Aldinger, VMD, & Yoon Chay, VMD, tied the knot on July 20, 2013, at Trinity Memorial Church in Center City Philadelphia. Congratulations Lauren & Yoon!
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Staff Management
Business Behaviors
continued from page 17
resources, including new hire paperwork, administering employee benefits, and employee handbooks, most respondents manage these tasks internally. Other than bookkeeping, most practices utilize outside providers to manage financial tasks such as payroll and accounting. For many practices, the day-to-day tasks related to marketing still fall on the practice team to complete. Outside of website hosting, the majority of respondents still internally manage tasks related to patient reminders, website content creation, and social media communications.
Operational Efficiency
Employee Benefits
Participants were asked what benefits they provide to practice staff. More than 70% of respondents offer staff at least partial funding of health insurance benefits and participation in a 401k or retirement plan. Thirty three percent (33%) of those surveyed offer disability insurance and 21% offer life insurance for staff.
Training Staff
Only 20% of those surveyed have an established protocol for training new hires at each position within the hospital. Fifty two percent (52%) train new employees by shadowing protocol and 18% admit to training new employees through learning on the job.
Respondents were then asked to assess how effective their practice teams were at completing the operational tasks referenced in previous questions. The majority of those surveyed felt their teams were effective in managing tasks related to supply costs, staff, and payroll. Conversely, 50% or more of respondents cited marketing activities as a burden or source of frustration.
Managing Performance Issues
Financial Behaviors
Marketing
When it comes to staff development and conflict, 48% of respondents acknowledge that the responsibility falls primarily on the practice manager. In 23% of practices, the practice owner retains responsibility for managing these issues. In 11% of those surveyed, conflict management is not proactively managed.
The Role of Marketing
Pricing
While variation did exist in the frequency of price changes (43% once yearly vs. 23% twice yearly), most respondents referenced selectively increasing service and product prices compared to “across the board” changes. Of specific interest were the 10% of respondents who have not increased prices in more than 1 year.
As also referenced in other studies, practices that are active in marketing to pet owners tend to be more successful than those who do not engage their client base. Of those surveyed, 44% of practices are proactive in marketing in multiple channels. Of those who are less active, 15% still engage in word of mouth only and 12% don’t actively market their practice.
Tracking Customer Satisfaction
Measuring customer satisfaction is a key marketing tool that is often overlooked. Only 24% of respondents use an outside provider for tracking customer satisfaction while 30% use print surveys at or shortly following discharge. Most practices track customer satisfaction primarily to identify unhappy clients. Sixty percent (60%) of practices reach out to known disgruntled clients and 55% regularly monitor online review sites.
Competing in a New Online World
Thirty one percent (31%) of practices surveyed have evolved to prioritize online communication with clients while 25% see having a website as sufficient to meet their marketing needs. Thirty one percent (31%) of respondents acknowledge the importance of online communications, but don’t have the time to effectively manage these tasks. Surprisingly, 13% of practices in this survey still do not have an online presence of any kind.
Making Social Media Work Financial Transparency
Contrary to other business environments, financial transparency is still uncommon in most veterinary practices. Only 21% of respondents share practice financial information with associate doctors, while 33% regularly review practice performance metrics with the practice manager. Twenty one (21%) percent of respondents share financial information with the entire staff. In addition, 51% of respondents say that the dissemination of financial information is an infrequent behavior in their practice.
What Budget?
One surprising finding of the study is how few practices utilize a budget in the management of their business. Only 27% of respondents utilize a formal budget that they monitor regularly while 19% make an attempt to limit expenses to that of the previous year. Of significant note is that 37% of respondents don’t operate off of a budget and 17% of respondents don’t even know if their practice has a budget. 34
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Successful application of social media as a marketing tool continues to be an enigma to many practices. Twenty eight percent (28%) of respondents see social media marketing as important and dedicate significant internal resources to managing. Thirty eight percent (38%) acknowledge social media as a useful but don’t have the time or resources to effectively manage. Nine percent (9%) of practices acknowledge taking the time to create a Facebook page but are not active and 16% don't utilize social media at all.
Conclusion
Challenges and Optimism
The regional veterinary climate appears to be a combination of cautious optimism and concern over growing competitive threats to the average veterinary practice. Most respondents see their practices growing in 2013 and believe the greatest opportunities for growth will come from expanding their services and client base. The pharmacy continues continued on page 35 WWW.PAVMA.ORG
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Business Behaviors
continued from page 34
to be perceived as the most significant revenue source that’s under attack from online pharmacies and retailers, although non-profit entities have emerged as a growing source of concern. The survey revealed numerous observations that should be of interest to today’s practice owner/manager. • While most respondents depend on their practice teams to manage the daily tasks related to marketing, more than 50% cite marketing as a frustration or burden. • Fewer than 1/3 of survey respondents readily share financial performance information with all or even part of their practice team.
Dr. Justine Lee
continued from page 11
relates that she examined a dog named “Stoli,” a 13-year-old black Labrador Retriever. He was given a single therapeutic dose of ketoprofen, but that single dose was enough to send him to the ER as he developed a severe gastric ulcer which resulted in cardiopulmonary arrest and hemorrhagic shock. After being revived in the ER and failing to respond to medical management, he went to surgery. Through his stay in the hospital, he received 40 units of blood products! To this day, Dr. Lee is still in touch with those owners.
• Only 27% of respondents utilize a formal budget that they monitor regularly while 19% make an attempt to limit expenses to that of the previous year. • Only 20% of those surveyed have an established protocol for training new hires at each position within the hospital. • Most practices track customer satisfaction primarily to identify unhappy clients. • Surprisingly, 13% of practices in this survey still do not have an online presence of any kind. • Nine percent (9%) of practices acknowledge taking the time to create a Facebook page but are not active and 16% don't utilize social media at all. l
women in veterinary medicine, she’d love to see more women take on a leadership positions or small business ownership within the profession. Now being a small business owner herself, she understands the importance of continuing to emphasize the work/life balance, and hopes that more women will learn to be better negotiators and seek out leadership roles. Outside of her very busy life of lecturing and running VetGirl, Dr. Lee is active in playing ultimate Frisbee, ice hockey, running, and hiking. Dr. Lee shares her home with three rescued pets: a pit bull, Milo, and two cats, Lily and Seamus. l
Dr. Lee recognizes that the face of the profession has changed in the course of the last two decades. She notes that with the increase in
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Classified Ads Veterinarians FULL-TIME OR PART-TIME veterinarian: Emancipate yourself! Be your own boss! Be appreciated! Compassionate Heart is dedicated to the provision of gentle, humane euthanasia for terminally ill companion animals in the comfort of home. We are looking to work with compassionate, empathetic veterinarians who are interested in nurturing the human animal bond in Pennsylvania. This is a great opportunity to free yourself from a clinical setting! In-home euthanasia is a highly valued, personal service. Flexible part-time hours (or full-time, if motivated). If interested, please contact Dr. Alicia Harris. We look forward to working with you! Email: dralicia@mycompassionateheart.com. Website: www.mycompassionateheart.com. HUMANE SOCIETY Management Services, headquartered in Reading, Pennsylvania, seeks veterinarians to join the expanding veterinary practices managed by our organization in Berks, Chester and Lancaster Counties. Full and part-time positions are available and offer the best of both the private practice and animal welfare worlds. All positions offer competitive salary and benefits, and new graduates are welcomed. Humane Society Management Services, LLC is an Equal Opportunity Employer (EOE.) Please forward cover letter, resume and salary requirements to: Karel Minor, President/ CEO, Humane Society Management Services, LLC, 1801 N 11th St, Reading PA 19604, fax 610.921.5833, or email kminor@shelterservices.org. PART-TIME ASSOCIATE needed for small animal hospital in southern Chester County. We have terrific clients and a very devoted staff. Help is needed for 3 afternoons (2 to 6pm) and 2 evenings (4 to 8pm) per week along with 2 Saturdays (8am to 12noon) per month. Total hours are approximately 20 to 24 per week. Please visit our web site: www.pennanimal. com to learn more about us. Please contact our office manager Russ by phone at 610.869.3033 or email at vets@pennanimal.com. FULL-TIME ASSOCIATE veterinarian—buy-in potential. 3-doctor, full-service small animal hospital in scenic Berks County. Practices high-quality standard of care. Exceptional doctor/support staff ratio. Excellent benefit and compensation package. Visit www.antietamvet.com. Email resume to avah@ dejazzd.com or fax to 610.779.6079.
Practice Consultant PRACTICE SALES and appraisals—Why pay 8-10% in commissions to help you sell your practice? Our company has the knowledge and experience to produce significant savings for you. Call to inquire about our rates. No obligation. Practice valuations starting at $2500. Ark Business Consulting. Alan Glassman, VMD; David Cherst, CPA, MBA. 610.283.3476.
Veterinary Technicians WE CURRENTLY have an opening for an experienced veterinary technician. The practice includes 2 busy offices with up-to-date equipment. The practice is strictly small animal—primarily cats and dogs. The focus of the practice is preventive and general medicine and general and orthopedic surgery. Experience in surgery/anesthesia is a plus. Must be 36
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willing to work some nights and weekends. Schedule will involve some hours in both offices. You may email your resume to wsahvmc@ptd.net or mail it to Jeni Cleveland 12043 Route 287, Middlebury Center, PA 16935. No phone calls please.
Central PA. We are currently a one Doctor practice who is seeking a Relief Vet for about 6 months beginning in September 2013. If interested please contact us at 717-573-4569 or email your CV to needmorevet@frontiernet.net.
ANIMAL HOSPITAL of Mount Pocono and All Pets Dental Care and Oral Surgery is looking for a certified veterinary technician or equivalent. We are a one doctor general small animal/exotic practice plus a veterinary dental referral practice. Candidate must be experienced in the typical duties of a veterinary technician with a special interest in learning and excelling in dentistry. We are a small practice with a pleasant, low pressure work environment. Compensation DOE , plus vacation, 401K, production bonus, health insurance, CE and other benefits, plus no emergency shifts. All candidates please email Jennifer at ahmp@verizon.net.
S. RAE BRAUDAWAY, DVM. OSU 2007, internship trained (University of Minnesota), 4+ years in small animal referral emergency practice. Available for relief and part-time work in small animal clinics within 100 miles of the Wilkes-Barre/Plains area. Competent medical and surgical skills, practices progressive high-quality medicine. 517.599.1221, rae.braudaway@gmail.com.
CENTRAL ANIMAL Hospital, a small animal AAHA hospital located in Scarsdale, NY, seeks an experienced licensed veterinary technician to complement our veterinary healthcare team. Seeking an individual who enjoys speaking with clients, working with others and independently utilizing all their technician skills like dentistry, venipuncture, catheter placement, ultrasonography, cystocentesis, radiology, anesthesia monitoring, patient assessment, surgical preparation, assisting patient recovery, and more. Offering competitive compensation, comprehensive benefits package including medical insurance, 2 weeks paid vacation, paid professional dues/licenses, profit sharing/401K plans, uniforms, and generous personal pet care courtesies. Meet our healthcare team/visit our hospital. Forward resume to CentralAH@aol.com and/or call Cookie Woltz at 914.723.1250. www.bestvets.net.
Relief Veterinarians RELIEF VETERINARIAN needed for busy, state-ofthe-art, 6-doctor small animal general practice in Bucks County, PA. Practice has digital radiographs, ultrasound, full in-house laboratory, electronic medical records, and experience support staff. Practitioner must be a skilled small animal clinician with excellent communication skills and be licensed in the state of Pennsylvania and carry AVMA-PLIT insurance. Please contact Dr. Wood at dr.wood@ newtownvet.net for more information. INTERNSHIP-TRAINED VETERINARIAN available in Pittsburgh and the surrounding area. Experience in a specialty hospital and emergency setting for 5+ years. Available for one time or short term relief work as well as extended periods if needed. Please email zwn47@yahoo.com. ENERGETIC VETERINARIAN relocated to the area looking for part-time or relief work in small animal practices in Lancaster, Berks, and Lebanon areas, as well as portions of Dauphin, York, Schuylkill, and Lehigh counties. Comfortable providing both routine and emergency care to small animals, including birds and pocket pets. Available anywhere in PA for one week to longer periods to cover vacations, illness, and short term needs. Experienced, integrity, detailed. I treat your practice like I own it! Recent references available. Please contact David J. Henzler, DVM, PhD, at 717.341.4357, henzlerdvmphd@aol.com. SMALL ANIMAL relief veterinarian needed for our small animal practice located in beautiful South
keystone veterinarian
RAJU KACHAM BVSc, veterinarian with 5 years of experience in small animal medicine and surgery. Licensed and available for relief veterinarian services in both Pennsylvania and New Jersey states. Please contact me at 484.560.7714 (cell) or by email at rajunaveen@yahoo.com. SAFI CHAND, DVM. Compassionate, productive small animal veterinarian, strong interpersonal, medical and surgical skills, >5 year experience in referral/ ER,exotics, available weekends, weekdays and nights. 413.636.9209; safi_c2000@yahoo.ca. EXPERIENCED, SURGICALLY-COMPETENT veterinarian available for relief employment. York, Adams, Lancaster, Dauphin, Cumberland, and Franklin Counties. Allan Hill, VMD, 717.723.6559. BONNIE J. MILLER DVM. Veterinarian with 25+ years experience in small animal, pocket pets, avian, reptile and exotics. Licensed in MD and PA. APHIS certified and have a current DEA certification. Proficient in surgery as well. York, Lancaster, Gettysburg, Harrisburg, and surrounding areas in PA. Northern Baltimore County and some parts of Hartford and Frederick Counties. 717.739.8400. DONALD W. STREMME, VMD. Experienced veterinarian (35+ years) available for small animal and exotic (birds, pocket pets, reptiles) relief work in Philadelphia area and South Jersey. Will consider other areas where licensed, too. Licensed (including DEA and USDA-APHS) in PA, NJ, NY, FL and CA. Email to CCACDWS@aol.com. KATHRYN WEST, DVM, UF ‘94. Small animal and exotic/non-traditional pet work, including sx. Central and SE PA. kswdvm@comcast.net. EXPERIENCED VETERINARIAN, 1987 Penn grad seeks part-time employment within 30-45 minutes of the Pottstown/Quakertown area. Special interests in surgery, diagnostic imaging, exotics. Professional, reliable, neat appearance. Call Jacqueline Burke, VMD at 610.754.1155 or email jacquib@dejazzd.com. LOOKING FOR relief: Veterinarian needed for Tuesday and or Thursday evenings. Approximate hours are 4 hour weekly with opportunity for further relief (vacations) Contact: Providence Veterinary Hospital, Chester, PA. 215.620.2407.
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Classified Ads
continued from page 36 MJ POTTER, UP 97. Experience in small animal internal medicine, critical care, oncology, and general surgery. Available for long or short term relief in Delaware, Chester, Lancaster, and surrounding counties. 610.357.5275 or drmjpotter@hotmail. com. WILLIAM KEER, DVM, Wisconsin ‘99 Providing veterinary relief services and improving colleagues’ quality of life in eastern Pennsylvania. Please contact me via email at bkeer@ptd.net or phone at 484.560.4338 for more information. THE VISITING VET! Experienced relief veterinarian available for quality coverage in Chester County, Northern Delaware, southern Lancaster County and southern New Jersey. Small animal and pocket pets. Soft tissue surgery and emergency coverage. Licensed three states and DEA current certificate. One day or regular short-term part-time. References available. Contact: Sandra Fargher, VMD '91, at 610.299.8593 or sandraatmillrd@aol.com. HOW DO you spell relief? Jerry Godfry, DVM! I have been a veterinarian for 38 years and have owned my own practice in Chester County for the past 30 years. I have sold my practice recently and I am currently available to work as a relief veterinarian in Philadelphia and the surrounding areas. I am an experienced, reliable doctor that would fit your needs. My experience ranges from cats and dogs to birds and reptiles. I am licensed and accredited in PA as well as federallyaccredited. I work well with new staff and am able to work a busy schedule. Available for day and evening shifts in addition to Saturdays and some holidays. Will travel 45-1 hour if needed. Please contact if interested. 610.506.6494.
Equipment For Sale CENTRAL BUCKS COUNTY: new 56-stall equine training/rehab facility on 58 unpreserved acres with indoor and outdoor riding arenas, ADA compliant main barn with $300K sprinkler system and 7 drive-in, roll-up doors for easy access. Features include multiple paddocks, 1 acre pond, 1.5 mile training track along continued on page 38 WWW.PAVMA.ORG
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what’s happening
Events & Education october 2013 October 27, 2013 4th Annual Bark in the Park 5k Run & 1 Mile Dog Walk City Island, Harrisburg, PA Fetch your sneakers, dog, and dog leash or come alone and run! If you and your dog are both able to comfortably go the distance, dogs are welcome to join their owners on the 5k run. Get pledges prior to race day to benefit The Last Chance Fund (TLC) of the Pennsylvania Veterinary Foundation. The TLC Fund provides funds for the care of abused or neglected unowned companion animals. Full details and online registration will be available at www.pavetfoundation.org/BITP.aspx.
november 2013 November 2-3, 2013 6th 3 Rivers Veterinary Symposium Omni William Penn Hotel, Pittsburgh, PA 12 HOURS OF CONTINUING EDUCATION CREDIT 3 Rivers Veterinary Symposium will return to Pittsburgh in November. The program will include the following tracks: companion animal dentistry, critical care, orthopedic, surgery, internal medicine, bovine, equine, veterinary technician, and practice management. Full details and online registration will be available at www.pavma.org.
december 2013
Classified Ads
continued from page 37 perimeter, wash bays, tack rooms, offices, additional outdoor stalls and pastures. Other uses could include rescue operation, camp, boarding. Land is sub-dividable or can be preserved. Website: http://4506newhope.epropertysites.com/indexGo2. htm. For more details contact Linda Emerson, Coldwell Banker Hearthside, Realtors, 186 Main Street, Hellertown, PA 18055. Office: 610-838-0440; Cell: 610.291.3841; or l.emerson@cbhearthside.com.
Practices For Sale BUILT IN 1919, the Werntz Memorial Animal Hospital is the oldest continuing operating veterinary hospital in the Pittsburgh area. It is situated on 1.7 acres and was recently professional appraised for $100K. While the facilities currently serve adequately, renovation or rebuilding would enhance the capabilities of the practice. Working a 25 to 30 hour week with ample time away, the practice grossed $400K in 2012. Our dedicated clientele have a 99.9% pay rate and deserve a veterinarian to whom they can transfer their loyalty. Being semi retired, I am willing to make this practice available for a very reasonable figure to the right individual. 412 243-2401. SMALL ANIMAL practice for sale in northwestern PA. 2400 sq. ft. with room to expland. Located on approximately 2 acres—nice facility designed and built as a veterinary hospital. Owner has limited open hours and services. Large animal potential (some equipment). Practice, equipment, inventory, computer system and real estate offered. Please contact Brian Langdon, DVM, at 814.333.1313. PRACTICES FOR SALE nationwide: Covington County, AL: SA, 3,000sf on +1 acre; Collier County, FL: SA, 2-exam rooms w/room to grow; Manatee County, FL: Wellestablished, Solo SA w/RE; Northwest Florida: SA on lake. 3,500sf w/RE; Dawson County, GA: SA, 3,200sf w/RE. 2-exam rooms; York County, ME: SA 2,600sf w/ RE. 3-exam rooms; Onondaga County, NY: Profitable ER 3-exam rooms; Piedmont Area, NC: SA, 4,000sf w/RE, 4-exam rooms; Winston Salem, NC: Start-Up. 5,500sf w/RE; Oklahoma County, OK: SA, 4,500sf w/RE. 2-exam rooms; ElPaso County, TX: SA, 2,500sf w/RE, 3-exam rooms; Cabell County, WV: SA. 3-exam rooms w/RE; PS BROKER, INC. 1.800.636.4740, PSBROKER.COM.l
Friday, December 6, 2013, 1:00-2:00pm Managing the New Workforce Presenter: Donald Shandler, PhD
Customized Patient Care
Four generations now characterizes the workforce. They represent a cohort of people born within a particular period of time—usually during an interval 20 years in length. And while each generation [Traditionals-b.(1925-1942); Baby Boomers (b.1943-1960); Generation X (b.1961-1981); Generation Y/Millennials (b.1982-2002] bring their unique values, needs, preferences and behaviors to workplace they also bring challenges. The challenges are often unresolved. The four generation workforce has different expectations on how they are managed, motivated, rewarded, trained and educated. And, often these expectations are not met and conflicts develop between multigenerational teams and between each generation and their managers. Organizations, managers and professionals have an opportunity to develop responsive strategies to turn generational conflict into collaboration. Webinars are free to PVMA members. Register at http://www.cvent. com/d/fcqtn7/4W.
of your clients. Assume that you will need to reinforce the message periodically through seasonal emails or practice newsletters.
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february 2014 Saturday, February 8, 2014 10th Annual Winter Conference ACE Conference Center, Lafayette Hill, Pennsylvania 9 HOURS OF CONTINUING EDUCATION WILL BE OFFERED The 10th Annual Winter Conference will return to the Philadelphia area in 2014. Multiple tracks will be offered, including companion animal, equine, practice management, bovine, veterinary technician, and more! Full details and online registration will be available at www.pavma.org.l
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Step 7: The Ask
To be successful your message must reach every client, every visit, every time. From the time a client schedules an appointment, to the front desk check in, in the exam room, and through discharge, the entire team must be able to “Ask” for the client’s business. Making the “Ask” mandatory sometimes creates a discomfort, but after a few times, the message will become easier and easier. It is important make the “Ask” with confidence— if you don’t believe in what you’re communicating, neither will your client.
Step 8: Review & Revise
Track your progress through periodic compliance reporting from your Practice Management system and make changes to your protocols and procedures as necessary to make the program more effective. Continue to add questions and modify the answers on your FAQ page. At staff meetings make it mandatory for few of your staff members to share a story about a client who has signed up as well as a client who has passed on the information. Some staff members will be more successful in getting the clients to participate so let them proudly share their approach so that the staff can learn from each other.
In Conclusion
Customized Patient Care is a unique opportunity to build your practice while helping your clients and their pets. By using the steps above to operationally support and market your program, not only will your program be more successful, you’ll be developing a methodology for the future introduction of other programs, promotions and services. l WWW.PAVMA.ORG
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PVMA Member Awards continued from page 23
Bash Halow, LVT, CVPM
The first recipient of a 2013 President’s Award is the Bash Halow in recognition of the enthusiastic partnership he has cultivated with PVMA and his passionate commitment to empowering veterinary practices across Pennsylvania. Mr. Halow is regularly recruited by Merial, Vetstreet, Zoetis, Merck, and Antech Diagnostic Laboratories to provide helpful seminars in effective communication and basic veterinary practice financial oversight. He is a proud member of the Innovation Committee of the VHMA, and a member of the American Animal Hospital Association (AAHA), PVMA, New Jersey VHMA, and the New Jersey Veterinary Medical Association (NJVTA).
Teresa Lazo, Esq.
The second recipient of a 2013 President’s Award is Teresa Lazo, Esq., in recognition of the dedicated commitment she has demonstrated in her significant role with the State Board of Veterinary Medicine and her valued partnership with PVMA to improve Pennsylvania’s veterinary profession. Ms. Lazo has served as legal counsel to the Pennsylvania Board of Veterinary Medicine since 1999 and is also counsel to the State Board of Medicine. As counsel to the Board of Veterinary Medicine, she presides at disciplinary hearings, writes opinions as directed by the Board, defends Board actions on appeal, drafts regulations and recommendations on proposed legislation, and serves as a liaison to other state agencies and the General Assembly on issues related to the Board.
The Honorable Judith Schwank
The third recipient of a 2013 President’s Award is The Honorable Judith Schwank in recognition of her willingness to partner with PVMA and her tireless work to raise awareness about agricultural and animal issues within Democratic Caucus and the Pennsylvania General Assembly. Judy Schwank recognizes that the needs and concerns of residents of the 11th Senatorial District are not limited by its boundaries. Her achievements in government, education and nonprofit realms reflect her interest in and advocacy for sustainable growth and prosperity, both locally and statewide. A former Berks County Commissioner, Judy has been committed to serving the people of Berks County. Her passion for promoting sustainable growth, prosperity and preserving agricultural integrity has been exemplified through her many accomplishments in public service. l
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the grand finale
Laughter Is the Best Medicine A Dog's Daily Routine II. Everything Else
The day is divided into two important sections: the all-important mealtime, and everything else.
I. Mealtime
1. Just because there does not seem to be anything visible around to eat certainly does not mean there is nothing around to eat. The act of staring at the underside of a table or chair on which someone else is eating sets in motion a chain of events that eventually results in food. 2. It goes without saying that you should carefully check the lower third of any space for edibles. Mouth-sized things which cannot be identified by sight or smell are considered gum. 3. When you actually receive a meal, submerge your head into it as you would a shower. Never, never look up again until a minimum of at least fifteen minutes after the obvious food is gone. This is important. Just because your dish is empty does not mean that it is time to stop eating. 4. Remember that all food is potentially yours up until the time that it is actually swallowed by another. The lengthy path a piece of food will take from a plate to a mouth via a hand is as good a time as any to stake your claim to it. 5. When it comes to selecting an appropriate beverage, location and packaging mean nothing. There are absolutely no exceptions to this rule. 6. If you really see something you want, and all your other attempts at getting it have failed, it is only right to grovel shamelessly. As a second tactic, stare intently at the object of your desire, allowing long gelatinous drools to leak like icicles from your lower lip.
1. There are really only two important facial expressions to bother with: complete and overwhelming joy and nothing at all. 2. Any time that is not meal time is potentially nap time. The best time to take a nap is when you hear your name being called repeatedly. The best location for a nap is dead center of any street or driveway. The most relaxing position is on your side, all four limbs parallel. 3. The most practical way to get dry is to shake violently near a fully clothed person. A second effective method is to stand on a lightcolored piece of furniture. 4. Personal Safety • At the first hint of any irregular noise, run from room to room barking loudly. If someone actually comes into the house, rush over to them whether you know them or not. Then kiss them so violently that they lose their balance or have to force you away physically. • The greatest unacknowledged threat to life as we have come to know it is squirrels. No matter what you must do, make sure there are none in your yard. 5. Recreation and Leisure • Ball: There are two equally amusing sets of rules you will want to know. The Common Form, in which you receive a thrown ball and return it. The Preferred Form, in which you receive a thrown ball and eat it. • Car: As you know, any open car door is an invitation to get in. Once inside, your only goal is to try to get out. 6. Health: In the event of a trip to the doctor, always be on your guard. If you are vaccinated, urinate on the physician. l
final words of wisdom If at first you don't succeed, try to hide your astonishment."
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—Harry Banks, Scottish soldier
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