Keystone Veterinarian Volume IV

keystone

veterinarian

OFFICIAL PUBLICATION OF THE PENNSYLVANIA VETERINARY MEDICAL ASSOCIATION

VOLUME IV, 2013

www.pavma.org

pvma

pennsylvania veterinary medical association

advancing animal welfare and human health while ensuring the vitality of the profession

13_Vol_4_cover.indd 1

1/8/2014 11:27:46 AM

13_Vol_4_cover.indd 2

1/8/2014 11:27:48 AM

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

Plan to Succeed in 2014

20 10th Annual Winter Conference 26

Mentorship: A Two Fold Look at Veterinary Mentorship Today

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

7

Laparoscopic Cholecystectomy—A New Minimally Invasive Option

16

Veterinary Medicine Online—What Sites Can You Trust

17

The Internet's New Go-To Place For Pet Owners

25

PVMA Fact Sheet: Licensing Your Dog is the Law

28

Setting the Stage for the New Year—Creating the Client Experience for Dentistry

30

Introducing a Wellness Program Into Your Practice

34

Senator Judith Schwank Receives a 2013

35

PVMA Hosts White Coat Ceremony for Penn Vet's Third Year Students

38

Thank you to our 2013 donors, sponsors, and volunteers

Robert P. Lavan, DVM, MS, MPVM, DACVPM Immediate Past President Mary A. Bryant, VMD AVMA Delegate Charlene Miller Wandzilak Executive Director

13_Volume_4.indd 1

1/8/2014 3:34:38 PM

Quarterly Columns 6

Observations

“'Dr. Google' and Social Media—Friend or Foe?”

8

The President’s Two Cents

"One Hour Can Make a Difference”

10

From Where I Sit

“10 Takeaways From 2013”

12

by Heather Berst, VMD

by Kenton Rexford, VMD

by Charlene Wandzilak

Practice Pearls

by Denise Tumblin

18

Inside PADLS

"Chronic Wasting Disease Program Changes”

22

"Strategic Planning—Driving Excellence in Your Practice”

by David Zellner

Foundation Cornerstone "A Look Back at Bark in the Park”

33

Member News

35

Penn Vet News

39

What’s Happening

40

The Grand Finale

"PVMA Remembers Dr. Richard Vaclavik, Dr. Don Reeser, and Dr. Matthew Murphy” "Penn Vet Receives Grand Challenges Explorations Grand for Groundbreaking Research in Global Health and Development” “Events and Education” “Dogs Mobilize Against Terrorist Threat”

Advertising Index 31

Allied Veterinary Cremation

15 AVMA-PLIT 5

Burzenski & Company, PC

15

Communication Solutions For Veterinarians

IRC Highmark 34

Nate Lynch & Associates, LLC

4

On-Hold Specialists

7

Pet Memorial Services

3

PNC Bank

19

pvmaAssure Insurance Agency, Inc.

17

Simmons Veterinary Practice Sales and Appraisals

13

Standard Process Veterinary Formulas

IFC SurePayroll RC

Total Practice Solutions Group

31 VetCor

13_Volume_4.indd 2

5

Zoetis

36

Classifieds

1/8/2014 3:34:39 PM

13_Volume_4.indd 3

1/8/2014 3:34:40 PM

keystone

veterinarian

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 I, 2014—February 1, 2014 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

Public and Corporate Practice Veterinarian At-Large Jules Benson, BVSc, MRCVS

Veterinary Technician At-Large JOY ELLWANGER, CVT, BS, AAS

13_Volume_4.indd 4

On-Hold Specialists We specialize in customized veterinary on-hold messages starting at just $79.

We are proud to be the only on-hold provider for PVMA! Is your current on-hold program outdated? Need a complete system? Visit our veterinary section online at www.onholdspecialists.com and click on “place an order” to create your script.

Ask about group, multi-location, and PVMA member discounts.

No contracts, no monthly fees.

Call us today!

1.888.546.3949

1/8/2014 3:34:40 PM

13_Volume_4.indd 5

1/8/2014 3:34:41 PM

observations

"Dr. Google" and Social Media—Friend or Foe?

By Heather Berst, VMD, Editor

A

re social media and veterinarians friends or foes? I've heard both sides of the story. Some veterinary hospitals are successful at promoting their hospitals on social media websites while some hospitals receive negative remarks from pet owners on social media. Some employees say inappropriate things on social media. I occasionally read veterinary hospitals' Facebook pages. I find many of them have Facebook pages, but they frequently aren't updated. These factors may lead to veterinarians' trepidation of social media. What is the answer to the veterinary profession’s relationship with social media?

Veterinarians have been slow to embrace social media, but pet owners have not. I recently came across an article in USA Today regarding small business and social media. The article said, “This year, average digital media usage among US consumers is estimated at nearly 15 hours per week, according to researcher PQ Media. By 2017, it's expected to hit 19.30 hours per week.” Pet owners spend a lot of time looking up things such as flea preventative, vaccines, veterinary services, and pet foods online. The same article also states: “Even as digital media use grows, there are firms staying on the sidelines. One in 10 small businesses doesn’t have a website according to the National Small Business Association's 2013 Technology Survey. Nearly 30% don't use social media.” I suspect those statistics hold true for veterinary practices. Where does that leave our profession?

The concern is that pet owners are getting veterinary advice from the internet, and it may not be what your hospital recommends. They may even be going to “Dr. Google” before they call your practice. We veterinarians has changed over the past 10 years must have a social media presence to interact with pet owners online.

Organized veterinary medicine such as the American Veterinary Medical has to do with the amount of non-veterinarians Association (AVMA), the American Animal Hospital Association (AAHA), and the Pennsylvania Veterinary Medical Association (PVMA) are blogging about veterinary medicine. We need to be there, but each practice needs a presence to reach out to their clients.

I wonder if one of the reasons that the perception of veterinarians has our own advocates. changed over the past 10 years has to do with the amount of non-veterinarians blogging about veterinary medicine. We need to be our own advocates.

I wonder if one of the reasons that the perception of

Are you still uncomfortable with Twitter? Take a course. There are CE offerings, online courses, and companies offering to help veterinarians learn about social media. Consider posting about topics related to veterinary medicine or allowing owners to send in veterinary questions digitally. The Veterinary Economics team wrote Facebook posts and tweets for your team to use to raise awareness of key health care issues with your clients and to help you encourage clients to visit and get the care their pets need. Better yet, leverage those new graduates’ skills to handle your social media program!

I believe the answer to the question of the veterinary profession’s relationship to social media is currently somewhere in the middle of the spectrum. Veterinarians need to embrace social media, promote our profession, and use our skills to increase pet owners' knowledge about our special skill set and enhance our profession. l

6

VOLUME IV 2013

13_Volume_4.indd 6

keystone veterinarian

WWW.PAVMA.ORG

1/8/2014 3:34:41 PM

Laparoscopic Cholecystectomy—a New Minimally Invasive Option

By David A. Puerto, DVM, Diplomate, American College of Veterinary Surgeons, Center for Animal Referral and Emergency Services (CARES), Langhorne, Pennsylvania

M

issy is an 11-year-old female spayed miniature schnauzer. She was happy, active, and to the owners appeared normal. However, she was had a ticking time bomb inside. Her veterinarian had examined her regularly and they had noted progressive increases in her liver enzymes. Missy was referred to CARES radiologist Dr. Jessica Basseches for an abdominal ultrasound. Her scan revealed that she had a fulminant gallbladder mucocele with no active evidence of inflammation.

Missy was then referred to Dr. David Puerto for a surgical consultation.

He examined Missy and recommended a laparoscopic cholecystectomy.

Preoperative workup was performed through Missy’s veterinarian and Missy was diagnosed with pituitary dependent Cushing’s disease by her primary veterinarian and started on therapy prior to her cholecystectomy to reduce perioperative risks. Ursodiol therapy was also started at the initial surgical consult. Missy’s ultrasound was repeated a month later and the mucocele was unchanged. We decided that it was best to remove Missy’s gallbladder before it developed cholecystitis and possible rupture. We were very excited to offer this as a laparoscopic cholecystectomy to shorten Missy’s recovery and reduce her pain.

Missy returned to CARES and was admitted for her laparoscopic cholecystectomy. Dr. David Puerto and Dr. Brian Bretz performed her procedure during the minimally invasive surgery clinic in May. The gallbladder was successfully removed through tiny incisions. Specialized instruments were used to dissect the gallbladder, and remove it from the liver. The gallbladder was then emptied within a specimen retrieval bag and extracted from the abdomen. Missy’s recovery from surgery was exceptional and rapid. She was discharged to home in two days.

Laparoscopic cholecystectomy is one of the most commonly performed laparoscopic surgeries in humans and has become the standard of care.

ized effusion may indicate cholecystitis and possible gallbladder rupture. Non-surgical management with choleretics, such as ursodeoxycholic acid, has been anecdotally reported to have some success and may be tried in patients without clinical signs. The treatment of choice in dogs with clinical signs, elevation of liver enzymes or evidence of gallbladder inflammation or rupture is cholecystectomy.

We feel that having the option of a less painful surgical treatment with laparoscopic cholecystectomy offers promise for earlier treatment of this gallbladder disease before development of complications and mortality associated severe cholecystitis and gallbladder rupture. l CARES is a full service, specialty referral, 24-hour emergency and critical care veterinary hospital with one clear goal: to provide a gold standard of care for your pet. CARES ensures the latest, most advanced and best treatments available.

Specialty and referral services include: Anesthesiology, The Cancer Center at CARES, Cardiology, Clinical Pathology, Emergency and Critical Care, Internal Medicine, Neurology, Ophthalmology, Radiology and Surgery. CARES’ emergency service operates 24/7. For more information, visit www.vetcares.com. You can also find CARES on Facebook at www.Facebook.com/CARESvet.

Laparoscopic cholecystectomy is a new procedure in veterinary medicine. Mayhew et al recently published a series of six patients that underwent laparoscopic cholecystectomy in veterinary surgery in 2008.

All patients had the surgery completed successfully and recovered. The study showed laparoscopic cholecystectomy can be performed safely in dogs with uncomplicated gallbladder mucocele such as in Missy.

Gallbladder mucocele is a condition in dogs where there is accumulation of mucus in the gallbladder. This condition has recently been reported as the most common cause of canine extrahepatic biliary duct obstruction.

It is most commonly seen in older small to medium sized dogs. Cocker spaniels, Shetland sheepdogs and miniature schnauzers appear to be predisposed to the condition. There has been a weak association reported with hyperadrenocorticism (Cushing’s disease) and gallbladder mucocele.

Gallbladder mucocele may be incidental finding but can be clinical in about 75% of patients diagnosed. Inflammation and necrosis of the gallbladder may result in gallbladder rupture and bile peritonitis.

Clinical signs may be vague in milder cases, but in more severe cases, vomiting and abdominal discomfort are often noted. Elevations of liver enzymes and bilirubin are common.

The diagnosis of gallbladder mucocele is typically made by ultrasound.

There is a characteristic appearance to the gallbladder termed Kiwi gallbladder. Thickening of the gallbladder wall, edema of wall, or localWWW.PAVMA.ORG

13_Volume_4.indd 7

keystone veterinarian

VOLUME IV 2013

7

1/8/2014 3:34:42 PM

the two cents the president’s president’s two cents

One Hour Can Make a Difference

By Kenton Rexford, VMD, President

S

erving on the PVMA Executive Committee has afforded me the opportunity to see how important PVMA’s role in advocacy is to our profession. PVMA is the voice of our profession in Harrisburg, and since our numbers are relatively small—approximately 4000 veterinarians in the state—we want our communication to be as effective as possible. I have also had the privilege of meeting many members of our state legislature. The resounding message I have heard from them is that they want to hear from their constituents, and that the form of communication influences their response. So I’m asking you to take one hour out of your year and meet with your state senator and/or your state representative.

Be a face, not just a name

I understand, you’re busy. It would be easier not to communicate with your legislator at all or just fire off an email. Why am I asking you to schedule a face-to-face meeting? Legislators tell me over and over that: • They value face-to-face communication most highly.

• They believe a constituent who takes the time to schedule an appointment is serious.

• They believe there are many constituents (perhaps thousands) who share the opinion of someone who takes the time to meet in person.

Be prepared

I suggest you review the current proposed legislation that is relevant to our field. If PVMA has your email address, then you should be receiving VetBytes, PVMA's e-newsletter which reviews upcoming events and current legislation. Summaries can also be found on the PVMA website under the “Advocacy” tab, or you can use this link to go directly to the summaries at http://www.pavma.org/members/13_LeaveBehind.pdf. I suggest you take along a copy of the proposed legislation for yourself and your legislator so you can refer to it by number.

If you don’t already know who represents you in Harrisburg, you can find it at our state’s website: http://www.legis.state.pa.us and use the Find My Legislator tools located on the left hand bar of the homepage.

There is also a link under the “Advocacy” tab on the PVMA website at http://www.pavma.org. Then call or email to schedule an appointment at their district (local) office.

Be a giver, not a taker

Most people who communicate with their legislator want something. I suggest that you offer them something.

Tell them that you want to be a resource for them any time a proposed bill is related to animals/veterinary medicine/agriculture. Remember that these are men and women like you and me. They aren't experts in every field; they want to learn from the experts to make sure they do their job to the best of their ability.

Be honest and reasonable

Be truthful about your opinions and why you hold them. If you don’t know the answer to a question, just say so.

Don’t exaggerate the situation—this could compromise your credibility.

If PVMA does not have your email, we would love to have it. We send important updates about CE opportunities and other information as well as our weekly e-newsletter, Vet Bytes. To give us your preferred email address, you may add it to your member profile or email it to vmiller@pavma.org.

8

VOLUME IV 2013

13_Volume_4.indd 8

Be brief

Organize your thoughts before you meet with your legislator. Be respectful of their time.

Be thankful

Send a thank you note. It shows that you appreciate their time, and it is a reminder of your meeting. An extra “touch.”

Be present

Meet with your legislator at least once a year (twice a year would be great). Try to attend community events and fundraisers. If you see your legislator, re-introduce yourself. He or she will appreciate knowing that you are involved in the community.

Other options

Can’t find the time or feel uncomfortable with a face-to-face meeting? The next most effective form of communication is a handwritten letter. Why? Because the legislators recognize that this takes an honest effort on the part of the constituent. What about email? I would put this in the “better than nothing” category. Mass emails? I have been told that they don’t carry a lot of weight.

Everything helps. Any form of communication with your legislator can be beneficial. Please remember that we belong to a small professional community. Anything we can do to make our voice heard can benefit us. Again, please take one hour out of your year and meet with your senator or representative. l keystone veterinarian

WWW.PAVMA.ORG

1/8/2014 3:34:44 PM

WWW.PAVMA.ORG

13_Volume_4.indd 9

keystone veterinarian

VOLUME IV 2013

9

1/8/2014 3:34:45 PM

from where I sit

10 Takeaways From 2013

By Charlene Wandzilak, Executive Director

A

s we look forward to a new year filled with new opportunities, it has been customary for me to share some of PVMA’s accomplishments with you. So, let me begin this Year in Review with a big thank you to each of you, our members, for your support of PVMA and the entire veterinary profession. Each one of you counts and your investment in what we do on your behalf is greatly appreciated. Thank you.

Legislative Victories

Perhaps one of the most necessary things we do is also one of the least recognized. PVMA advocates and lobbies on the profession’s behalf to ensure there is veterinary expertise at the table when contemplating bills which can have unintended consequences to the profession, your practice, and animals. We monitor legislation daily and the Legislative and Regulatory Affairs Committee reviews and determines if we should take a position on legislation. We also spend a lot of time cultivating relationships with legislators and their staff to ensure that we are the experts that they turn to when they have questions on bills or issues. This year alone we have participated in over 100 visits with legislators and reviewed over 40 legislative proposals, taking positions on 19. Some examples of bills we have weighed in on and consider successes are Act 65 of 2013, the revised Rabies Prevention and Control in Domestic Animals and Wildlife Act. This bill revises the rabies law to bring the vaccine requirements to current standards and also provides for a medical exemption for cats and dogs if the veterinarian feels it is not in the best interest of the animal to be vaccinated. This exemption is valid for up to one year and then can be recertified. PVMA worked with Senator Stewart Greenleaf and the Senate Ag Committee on this bill and supported the medical exemption for cats and dogs based on a veterinary recommendation. We also advocated for expansion of the law to include all cats—including feral and outside cats—to help curtail the spread of rabies. Although the law revisions did not include all cats (only ones that spend a portion of a 24-hour period indoors with humans), we were able to raise awareness of the need to address the issue of rabies vaccination for all cats, especially outdoor cats. PVMA was promised a hearing on this issue in the near future.

We have also been successful in keeping changes to the Veterinary Medicine Practice Act from moving forward.

Senator Michael Stack reintroduced Senate Bills 949 and 950 which would add conditions to the VeterinarianClient-Patient Relationship requiring you to provide a client information sheet for every prescription you provide and would mandate that you provide any blood prescreening test required by a drug manufacturer before you prescribe the medication, regardless of veterinary medical judgment or necessity. We have worked with Senator Stack and his staff to educate them about what is already done to ensure standards of quality veterinary care through the State Board of Veterinary Medicine and the veterinary regulations. These bills are likely not to move forward because of our efforts.

Over the course of the year, four bills—House Bill 317, Senate Bill 423, Senate Bill 611, and Senate Bill 1180— have been introduced in the Pennsylvania General Assembly which would expand the state’s ability to track dispensing of controlled substances to patients through a Pharmaceutical Accountability Monitoring System (PAMS). These PAMS bills, aimed at addressing prescription abuse and pharmacy shopping, would take the existing efforts of the Attorney General to track up to Level 2 controlled substances and expand it to a comprehensive system which would track all controlled substances up to Level 5. Pennsylvania is the only state that does not have an expansive PAMS system for monitoring pharmaceutical use. Why does this matter to you? It matters because three of the bills included veterinarians in the group of dispensers and/or prescribers that would need to report any time a medication was dispensed in any of these covered categories. Throughout the process, PVMA advocated for you advising the legislature that veterinarians do not have the complex technology available to human pharmacies and doctors’ offices or the financial and staff resources to track and report for this purpose.

Nor do they have access to the private personal HIPAA information about their clients. Their patients are animals, not the humans potentially misusing medications. In two of the four bills, we were able to negotiate for language that would require veterinarians to report every six months, and we also removed the huge expense and burden of buying the computer system for reporting. In the most recent bill, Senate Bill 1180 introduced by Senator Pat Vance, we were able to have veterinarians completely eliminated from the bill. This is the bill which will most likely pass and through our lobbying efforts, we successfully stopped the veterinary profession’s inclusion.

In addition to monitoring bills, another major area of advocacy is funding for the Pennsylvania Animal Diagnostic Laboratory System (PADLS), the Animal Health and Diagnostic Commission (AHDC), and the University of Pennsylvania, School of Veterinary Medicine (Penn Vet). Each year, we spend time educating legislators on the importance of having PADLS in responsive disease detection to prevent outbreaks which are costly to producers, the Commonwealth, and to animal and sometimes human lives. We also educate the General Assembly on all the ways that Penn Vet helps the Commonwealth and its citizens through supporting the farming community, research with both animal and human implications, and training the next generation of veterinarians. This year, the stakeholder organizations, including PVMA, celebrated the success of these efforts as the legislature passed a

continued on page 11

10

VOLUME IV 2013

13_Volume_4.indd 10

keystone veterinarian

WWW.PAVMA.ORG

1/8/2014 3:34:45 PM

From Where I Sit

continued from page 10

budget which provided $5.3 million for PADLS and AHDC and $28 million for the veterinary school.

For a complete list of bills we are monitoring and our positions, please visit www.pavma.org or contact me at cwandzilak@pavma.org.

Inclusion of the Entire Veterinary Team

During this summer at our Keystone Veterinary Conference, PVMA’s membership voted to create two new membership categories for Certified Veterinary Technicians and Veterinary Assistants. These new categories were created in response to a decision of the Pennsylvania Veterinary Technicians Association to dissolve as an independent organization. As you know, we created a category for practice managers in 2011, and we are excited to bring CVTs and veterinary assistants into PVMA in 2014 so we can be inclusive of the entire veterinary team. In the coming year, we are also looking at models for practice memberships to reward practices that pay for PVMA membership for their team members.

Responding to Issues

This year, PVMA began work on the issues of illegal practice of veterinary medicine and non-profit shelter/veterinarian relations. Both of these issues are heated ones that have real impact on the day-to-day operations and success of veterinary practices. The Scope of Practice Taskforce met once in September and as a follow up action item, our lobbyist and I met with the Attorney General’s office to determine where the breakdown is on enforcement of fines when someone is charged with practicing veterinary medicine without a license. From the meeting, we gained a better understanding of the fine process and are now moving onto the Department of State to figure out what role they play in making sure that violators do pay their fines. We will also be launching a survey of our members to determine what violations you see in practice so we can continue our conversation with the State Board of Veterinary Medicine to determine what can be done.

The Non-Profit Shelter/Veterinarian Relations Taskforce has met twice this year and is beginning to look at models for better collaboration and education between these communities. We have evaluated what other states have tried via legislation and legal action and neither path has yielded favorable results for the profession. We will continue looking at this issue over 2014 and will be surveying our members and shelters on perceptions from each community’s point of view to WWW.PAVMA.ORG

13_Volume_4.indd 11

determine where the areas are for improvement. Through our newly formed taskforces on these issues, we hope to bring balanced discussion and real solutions to our members.

We also recognize the importance of understanding and proactively addressing the needs of our newest veterinary graduates.

This year, we created our Recent Graduate Advisory Council, a think tank of veterinarians who have graduated within the last 10 years, to help us develop our portfolio of services for this career stage and identify ways we can have a meaningful impact on their lives as veterinarians.

Professional Development

In 2013, we moved our Winter Conference to King of Prussia to increase our presence in the southeastern part of the state. Over the year, we provided 55 hours of approved continuing education credit across the Commonwealth at our four in-person programs—Winter Conference, Spring Clinic, Keystone Veterinary Conference, and 3 Rivers Veterinary Symposium. Without leaving the state and with minimal costs, you can receive quality education from the top experts. We also hosted four webinars on topics such as emergency medicine, rabies, and healthcare reform and held our exclusive quarterly practice manager webinar series. In addition, we offered eight district dinner meetings, one in each of our eight geographic districts. Our district meetings are our way of getting out locally to meet our members and provide an update on our activities. It is also a way for us to gain feedback from you. In addition, we offer 1-2 hours of CE at each of these dinners.

New Practice Tools to Save You Time and Increase Profitability and Productivity

For practice managers and owners, we are launching a number of new services that will help improve the bottom line of your practice. Our new online payroll service through SurePayroll provides an affordable, easy option for payroll processing with added human resource and legal resources. You can check out information on this new service on the inside front cover of this issue. Our upcoming benchmarking tools will provide you diagnostics on your own practice and team to gain insight on what changes you can make to increase your profitability and improve customer service. Practices who have utilized these services have saved thousands and improved their team’s functionality by leaps and bounds. Information on this service will be available soon. As an added bonus, the first 25 practices are free! That’s a great value of $250 not to mention potential additional profitability for your practice.

New Online BenefitHub to Save You Money

For all our members, our new BenefitHub offers discounts on thousands of name brand services, vendors, and stores for both home and business. Plus, by using this free member benefit, you not only save money, you help PVMA. PVMA receives 4 cents per click through on the website, so your everyday purchases can pay for your yearly dues many times over and help reinvest money into PVMA.

Pennsylvania Veterinary Foundation

Our charitable, non-profit organization, the Pennsylvania Veterinary Foundation (PVF), has undergone major strategic planning this year and has hired a fundraising consulting firm to assist us with increasing our support.

We are excited about this opportunity to grow the Foundation and encourage you to learn more and donate to PVF at www.pavetfoundation.org.

One of our main initiatives, The Last Chance Fund (TLC), is a fund which provides veterinary practices reimbursement for the care they provide to unowned animals which are presented to them for treatment. Our Bark in the Park 5K Run is our main fundraiser for the TLC fund, and I am happy to report that we raised approximately $14,000 for this cause at our race on October 27 at Harrisburg's City Island. Check out the great photos of the event on page 22.

Associated Marketing Partners

At our last board meeting of the year, the Trustees approved a partnership with Associated Marketing Partners. This marketing firm will be assisting us with doing an inventory of all we do to assess what improvements can be made in how we communicate and interact with you. As part of this assessment, they will be reaching out to some of our members to do one-on-one interviews. If you are called upon, please give them your feedback so we can grow and improve. They will also be helping us to identify what our priority areas should be in the areas of marketing, communication, and technology in 2014 and beyond.

We are very excited to work with them and improve PVMA.

pvmaAssure Insurance Agency

We just completed our second full year with our insurance agency, pvmaAssure. This year brought lots of changes with healthcare reform and much of our time and resources were spent understanding and educating our members on the ramifications of Obamacare on their

keystone veterinarian

continued on page 39 VOLUME IV 2013

11

1/8/2014 3:34:45 PM

practice pearls

Strategic Planning …

Driving Excellence in Your Practice

By Denise L. Tumblin, CPA, Owner and President, Wutchiett Tumblin and Associates, Columbus, Ohio

W

e’ve all heard it—strategic planning is a must for businesses to excel and move forward. In order to determine where the practice is going, you need to know exactly where it stands, then determine where you want to go and how to get there.

Strategic planning puts you in the driver’s seat—firmly in control of your direction rather than reacting to the next bump or curve in the road. Yet in spite of good intentions, too often the year slips away and the new one begins without practices taking this critical step. Why? Reasons include lack of time, lack of clarity about who is involved and how to conduct the meeting, and lack of follow through with the decisions made. So sit back and follow the road map of Hope Veterinary Center (composite practice) to reach your strategic planning destination.

Hope Veterinary Center (HVC) is a seven doctor practice co-owned

by Drs. Linzell and Davis. They hold their annual, two-day strategic planning conference in November facilitated by their management consultant at a local hotel and conference center. The owners and the management team, consisting of the practice manager, the financial and compliance manager, the IT manager, and the reception and technician team leaders attend, along with future owner, Dr. Rose.

Results from the 2013 strategic planning conference follow:

The Agenda

Review Vision Statement and Mission Statement.

• The existing vision statement resonated and will remain, “Happy, healthy pets and cheery, satisfied clients.”

• Modify the mission statement to incorporate a client focus. The revised mission is “We preserve and protect our patients’ health and nurture our client relationships.”

Accomplishments in 2013 Each segment of the management team presented their list of accomplishments (see Hope Veterinary Center 2013 Accomplishments on page 13).

Results of 2013 operations The Financial Manager presented the results of operations (see Figure 1).

SWOT Analysis HVC developed a list of strengths, weaknesses, opportunities and threats and then developed the goals and action plan for 2014 based on the SWOT. Goals and Action Plan for 2014 The consultant facilitated the discussion about the practice goals for 2014 and assisted in developing the action plan to accomplish the goals. The group settled on the following goals and action plan: Goal #1: Update the HVC Operating and Shareholder Agreements Action Plan:

12

VOLUME IV 2013

13_Volume_4.indd 12

• Drs. Linzell and Davis will review the current agreements and meet January 10 to discuss possible changes • The owners will meet with the attorney on January 20 to discuss and seek input on the changes • The attorney will update the documents by March 15 Goal #2: Plan for Dr. Rose’s buy-in with a target date of 2015 Action Plan: • Continue to mentor Dr. Rose. Include a discussion of “Building Blocks that Create Successful Owners” and “Topics to Discuss before Becoming Partners” from Benchmarks 2010: A Study of Well-Managed Practices®. Assign medical development to Dr. Rose; explain the responsibilities, resources available, time allotment, and compensation. She will receive 10% of the management fee, or $10,000, for her management responsibilities • Value practice at 12/31/13 for planning purposes and work with consultant to identify opportunities to improve profit and value Goal #3: Review and approve 2014 Budget presented by Financial Manager (see Figure 1).

Action Plan • Fee increase of 3% on non-shopped services (projected revenue: $100,000) • Recapture of missed charges (projected revenue: $50,000) • Focus on improved healthcare compliance with six-month exams, wellness lab work, fecal testing, and dentistry (projected revenue: $200,000) • New services—see Goal #4 (projected revenue: $100,000) • Reduce inventory cost (projected savings: $70,000) • Reduce the amount of outsourced IT support (projected savings: $13,000) • Pay increases for existing staff; hire two additional receptionists and two additional technicians (projected cost: $198,100) • Budget approved Goal #4: New services for 2014 Action Plan • Laser therapy (Dr. Rose) • Rehabilitation therapy (Dr. Davis) • Acupuncture (Dr. Linzell) Goal #5: Hold quarterly Strategic Planning Conferences in 2014 Action Plan • Schedule one day conferences in March, June, and September • Discuss progress with implementation of annual action plan and make adjustments as necessary • Hold annual SP conference in November If you’re not yet taking the time to plan the trip for your practice, now’s the time to start. Any road will get you somewhere. Make sure you’re firmly in control of the road map for your practice, so you end up where you intend. And remember to celebrate your successes along the way! continued on page 13

keystone veterinarian

WWW.PAVMA.ORG

1/8/2014 3:34:45 PM

practice pearls Strategic Planning

continued from page 12

Hope Veterinary Center 2013 Accomplishments Owners • Weekly management team meetings • Received certifications in Acupuncture and Rehabilitative Therapy (Drs. Linzell and Davis) • Started the business mentorship program with Dr. Rose Dr. Rose • Participated in the weekly management team meetings • Participated in developing a plan to reduce 2014 inventory cost • Working through the management reading list provided by Dr. Linzell Practice Manager • Updated the HVC employee manual • Developed customized training and education schedules for the staff based on the results of evaluations; mapped out the 2014 CE plan • Participated in preparing the 2014 budget • Participated in developing a plan to reduce 2014 inventory cost Financial Manager • Successfully met the 2013 budget in all categories except inventory cost • Participated in developing a plan to reduce 2014 inventory cost • Developed the 2014 budget • Compiled a monthly financial management workbook for the owners’ use IT Manager • Set up an internal e-mail account for all doctors and staff to improve communication • Upgraded the network server and hardware • Installed the latest updates for the practice management software

WWW.PAVMA.ORG

13_Volume_4.indd 13

Figure 1—Results of Operations for 2013 and Budget Projections for 2014 Annualized 2013

Budget Projections 2014

Revenue

$4,900,000

$5,350,000

Variable Fixed Staff Facility Total Operating

$1,274,000 $441,000 $1,313,200 $441,000 $3,469,200

26% 9% 27% 9% 71%

$1,284,000 $428,000 $1,511,300 $450,000 $3,673,300

Amount Available for Doctor Comp.

$1,430,800

29%

$1,676,700 31%

Doctor Comp.* Management Comp.

Total Doctor Comp.

$733,200 $98,000 $831,200

15% 2% 17%

$800,500 $107,000 $907,500

15% 2% 17%

Owner Return on Investment

$599,600

12%

$769,200

14%

Reinvestment

$147,000

3%

$100,000

2%

Remaining to Owners

$452,600

9%

$669,200

12%

24% 8% 28% 8% 69%

* Medical revenue represents 85% of total revenue, and doctors generate 85% of the medical revenue. Doctors receive 19% of doctor-generated revenue.

• Established additional internal control protections Reception team leaders • Participated in developing the 2014 reception training and CE education plan • Terminated a receptionist who wasn’t happy in her position; successfully hired replacement • Developed a receptionist CE program to market to area practices • Submitted a request to hire two additional receptionists in 2014 to further strengthen customer service including the estimated cost and summary of how the new people will be utilized to improve customer service

Technician team leaders • Participated in developing the 2014 technician training and education plan • Terminated two technicians who weren’t happy in their positions; successfully hired replacements • Participated in the development of the technician CE programs marketed to area practices • Submitted a request to hire two additional technicians to assist with the new services for 2014 including the estimated cost and summary of how the new people will be utilized • Participated in developing a plan to reduce 2014 inventory cost. l

keystone veterinarian

VOLUME IV 2013

13

1/8/2014 3:34:46 PM

Plan to Succeed in 2014

By Brenda Tassava, CVPM, CVJ, Halow Tassava Consulting, Indianapolis, Indiana

I

find myself waking up each morning with one aspect or another of the strategic planning process on my mind these days.

Why? It’s nearing the end of the year, and our company has facilitated roughly a dozen strategic planning sessions in the past two weeks, and we have many more to do in the coming months! It’s gratifying to see so many practice owners and managers see the need for a plan and take the reins of their practice by stopping what they’re doing in the day-to-day long enough to take a breath, brainstorm with their team, and outline a plan forward.

Planning for the future can feel overwhelming. The way we’ve wrapped our heads around strategic planning is to break it down into six steps. Each step builds a foundation for the next and ultimately sets your team up for success in achieving the vision of your practice’s future.

Step 1: Mission and Core Values Statement

Remember that mission statements are more than just words. They sweep up employees and clients alike in their reach, ambition, and the reasons for why your company’s service is relevant to the world. The best mission statements are crafted when more time is spent on what your mission is, rather than worrying how to say it. With the help of your team, think about and articulate what your practice is trying to accomplish when it comes to serving your clients, caring for your patients, caring for the practice’s employees, cultivating a workplace culture, and delivering veterinary medicine.

Once you’ve answered these questions, it’s a good time to reflect on the shared core values of your practice team. Core values are the way in which we carry out our mission, and are the fundamental tenets that shape our culture. Hiring to your core values goes a long way toward workplace harmony, better communication, and employee engagement.

Step 2: Vision Exploration

In preparation for your vision work, reflect upon the future as it pertains to you, the economy and other forces important to your business. Discuss what is happening in your community, what the future might look like 14

VOLUME IV 2013

13_Volume_4.indd 14

with regards to pet care, the pet population, and what service means to you and your team. Discuss other similar businesses that deliver patient and/or client care, and what the most famous brands deliver that set them apart in people’s minds. Discuss how these companies achieve levels of extreme success.

To help you get started, we’ve created an online worksheet you can use. Go to www. halowtassava.com and take the HTC Vision Quiz.

Step 3: Vision Goals

Brainstorm ideas on what your practice will look like in the future. Then, sort your ideas based on the following categories: • Clients/Patients • Veterinary Services/Medicine • Image/Marketing/Business Model • Management/Leadership Lifestyle • Recruiting/Staff Development • Financial Position

Step 4: SWOT

Before you can plan for where you want to go, you need to take a look at where you are now. A SWOT analysis is a look at your company’s strengths, weaknesses, opportunities, and threats. Internally, you should look at your practice’s strengths and weaknesses in areas like client and patient care, workplace culture, etc. Opportunities and threats

keystone veterinarian

are external to your practice and look at your community and the veterinary profession.

Think about each of the six categories above and make note of where you are with these areas today, both internally and externally.

Step 5: Brainstorm a list of Strategic Goals

These are specific milestones the practice must pass to transition from now to your practice vision five years from now. After looking at where you are now and where you want to go, your team should brainstorm goals that will help move towards your mission and reach your vision along a five year timeline. When determining your goals, make sure they are smart goals! Ask yourself: Are they specific, measurable, attainable, relevant to your mission, and timely?

Step 6: Strategic Plan

This is a plan that guides you through the completion of each of the above goals. Once you and your team have brainstormed your list of goals, take time to prioritize them in a logical order. It’s easy to get excited and want to try to accomplish everything at once, but taking one goal at a time and working on a step-by-step action plan assigning someone in charge of each goal is the best course to follow. When we try to do too much at once, or

continued on page 37 WWW.PAVMA.ORG

1/8/2014 3:34:46 PM

13_Volume_4.indd 15

1/8/2014 3:34:47 PM

Veterinary Medicine Online—What Sites Can You Trust?

By Dr. Jim Humphries, Certified Veterinary Journalist, Veterinary News Network, Colorado Springs, Colorado

I

t’s not hard to find pet health information on the Internet. But, the challenge is finding advice and information from sources that you can trust. What can you do to make sure that the recommendations and opinions you find will actually help? And … what about those review sites? Can they help you find a veterinarian when you need one?

From new toys and comfy beds for your pets to medications, designer sweaters and even recommendations for “pet friendly” vacation destinations, animal lovers can find just about anything for their four legged furry family online.

Unfortunately, it’s far too easy to find a lot of mis-information and even potentially dangerous advice when it comes to your pet’s health care.

Since the very first website was created, anyone with the time, creativity and access to a web hosting service can post their opinions about almost any subject. This has led to a wide variety of non-veterinarians who claim to be “experts” in pets providing advice and recommendations. Sadly, pets have been harmed or even died when owners followed the counsel provided by these individuals.

When searching for helpful information about animal health, you should trust sites that have a veterinarian who either writes or over-

sees the content. HealthyPet.com from the American Animal Hospital Association is a great place to start. You can also look at your state’s veterinary medical association website or even their Facebook page for pet owner resources.

A new organization, the American Society of Veterinary Journalists, has been created to help both the media and the public find trustworthy professionals providing advice through any sort of media. Look for the Seal of Approval from ASVJ. The popularity of veterinary blogs is hard to ignore and bloggers like Pawcurious.com or PetHealthCareGazette.com can provide general suggestions and opinions about veterinary care. The added bonus to following these well-liked sites is that they are often a lot of fun and give the reader a personal viewpoint that is lacking from other sites.

Just remember, none of these bloggers can diagnose or treat your pet’s specific problem.

Another fashionable trend is the use of review sites to find service providers, restaurants or almost any other type of retail outlet. The question here is, should you rely on these review sites when you are looking for a veterinarian?

According to SearchEngineLand.com, almost 80% of online users say they trust online reviews as much as personnel recommendations.

There is no doubt that sites like Yelp, YP.com and Angie’s List can have a significant impact on a person’s decision to use a specific provider.

These experts do recommend that you follow some easy guidelines when reading online reviews.

First, find sites that present a balanced set of reviews and look for at least ten to twelve postings before you can say you spot a trend for that particular business.

Next, look beyond the reviewer’s words. Is there a genuine concern over poor service or are emotions and a focus on money obscuring the real issue? Let’s face it … some people are very hard to please or are often simply grumpy.

Conversely, avoid relying on reviews that are excessively positive and seem too good to be true. While there are people who are always happy and never have a bad word to say, companies do exist that pay individuals to write positive reviews for a wide variety of organizations.

Finally, look at the reviewer’s profile. Has this person reviewed other businesses? Do they seem to be objective or are they using the same “cut and paste” language on all their reviews? If their evaluations seem too similar, they may be working for one of the review writing companies. Another red flag is to watch out for reviewers who constantly try to send you to look at their own profile … odds are, they are trying to sell something and they are using the review sites as marketing opportunities.

It’s been said before, but veterinarians (and their websites) will always offer you the best and most trusted source of information. With a good relationship, you can have confidence that your veterinary professionals are eager to help and offer the correct advice! l

16

VOLUME IV 2013

13_Volume_4.indd 16

keystone veterinarian

WWW.PAVMA.ORG

1/8/2014 3:34:48 PM

The Internet's New Go-to Place For Pet Owners

By Sarah Rumple, American Animal Hospital Association (AAHA)

L

ooking for a fun, reliable place to send your clients to read about pet health, news, and more? Look no further than the American Animal Hospital Association (AAHA)'s new PetsMatter. Previously a bimonthly e-newsletter for pet owners, AAHA has given the publication a complete makeover, transitioning it into an engaging, fun blog.

Why the change? As social media expands our reach to more pet owners, we see the need for us to provide more timely pet health information to our followers. With this new format, we can provide pet-related news, like recalls, so pet owners are notified as soon as possible. In addition to timely information and news, we'll provide fun articles for pet owners (looking for a great dog-friendly patio for happy hour or a cat fashion show for your feline friend?), as well as the same pet-health articles you've come to rely on from AAHA. What does this mean for your practice? If you currently have PetsMatter sent to your clients, you will still be able to do so, and on a more frequent basis! A monthly e-newsletter containing teasers of the month's posts will be distributed to pet owners, using the same distribution options we have used in the past. Additionally, we have created a widget that can be placed on your website—a "ticker" that includes photos and headlines of the latest PetsMatter blog posts. If you choose to embed the widget on your practice's website, your website could become the go-to place for your clients to find the latest pet health and news stories, all with no work on your part—let AAHA do it for you!

WWW.PAVMA.ORG

13_Volume_4.indd 17

All of these changes will be taking place in January 2014. You'll be able to read blog posts at aaha.org/petsmatter and embed the new widget on your website at that time.

Our fresh new logo and layout are signs of the direction we're going with PetsMatter. We hope you and your clients enjoy it as much as we think we will. If you have questions or concerns about this new direction for PetsMatter, please contact us at marketing@aahanet.org or 800-883-6301. l

keystone veterinarian

VOLUME IV 2013

17

1/8/2014 3:34:48 PM

inside padls

Chronic Wasting Disease Program Updates

By David Zellner, Epizootiology Programs Manager, Bureau of Animal Health and Diagnostic Services, Pennsylvania Department of Agriculture, Harrisburg, Pennsylvania

highlights for both programs but additional information is available through PDA. • Any person or business that has blacktailed deer, elk, moose, mule deer, red deer, sika deer, white-tailed deer, or any hybrids thereof must enroll in either the voluntary HCP or the mandatory HMP. • The HCP has multiple status levels which entails at least five years to demonstrate that CWD does not exist in the herd before being designated as a fully Certified herd.

Previously enrolled HCP herds will not lose their current status if all program requirements are met.

C

hronic Wasting Disease (CWD) is one of a group of diseases called Transmissible Spongiform Encephalopathies (TSEs), or prion diseases. These diseases are believed to be the result of an infectious, self-propagating prion protein whose shape can be transformed to cause disease. CWD is closely related to, but different than, other TSEs, including Scrapie in sheep, Bovine Spongiform Encephalopathy in cattle, and CreutzfeldtJakob disease and variant Creutzfeldt-Jakob disease in humans. Clinical signs include staggering, drooling, weight loss, or unusual behavior eventually resulting in death.

Chronic Wasting Disease affects the brain and nervous system of infected cervids (deer, elk and moose) in portions of North America including Pennsylvania. In October 2012, CWD was detected in two animals on a captive whitetailed deer farm in Adams County. Later, the Pennsylvania Game Commission announced three CWD positive wild white-tailed deer harvested during the 2012 firearms season from Bedford and Blair Counties. The identification of CWD in Pennsylvania initiated the CWD response plan which multiple state and federal agencies are involved in controlling CWD. The Pennsylvania CWD response plan can be seen on the websites listed at the end of this article.

In October 2013, the Pennsylvania Department of Agriculture (PDA) published revised requirements for the CWD Herd Certification Program (HCP) and the Herd Monitoring Program (HMP). These revisions will meet the standards established by the United States Department of Agriculture, Veterinary Services for the HCP and also to aid in identifying animals that are infected with CWD thus preventing further spread. Listed below are the

18

VOLUME IV 2013

13_Volume_4.indd 18

• Cervids that have clinical signs compatible with CWD including staggering, drooling, weight loss, or unusual behavior are considered “suspects” and must be reported to PDA. • All cervids 12 months of age or older that die for any reason, including harvest and slaughter must be tested for CWD. This applies to animals from both HCP and HMP herds.

• CWD test samples are to be collected within 72 hours from all adult animals which die. Animals which are found dead and in an advanced stage of decomposition are to be reported to the nearest PDA regional office. A determination regarding feasibility of test sample collection must be made by a PDA official before carcass disposal can occur.

• Official identification must be in place prior to movement of any live animal from its current premises. HCP herds must have official identification on all cervids 12 months of age or older plus a tamperproof second form of identification that is unique within the herd.

• The inventory of all live cervids in an HCP herd must be routinely verified by an accredited veterinarian. There are two options: an annual visual inventory which is performed by the visual recognition and recording of the number on the visible secondary ID device for every adult animal in the herd. The second option is a complete physical “hands-on” inventory and recording of both official and secondary ID numbers. This verification is performed once every three years. The “hands-on” inventory requires physical restraint or chemical immobilization to allow the ac-

keystone veterinarian

tual reading of all identification devices on each animal in the herd in order to verify the accuracy of the herd records and to perform the inventory audit.

• All animals received by or leaving an HCP herd shall be reported to PDA on a movement form obtained from the Department within 10 business days. HCP participants must report all deaths occurring in the herd within 10 business days, as well. HMP participants need to meet the movement reporting requirement only when receiving animals from an HCP herd.

• Both HCP and HMP participants are required to submit several documents annually. Forms must be submitted which list all animals that were born on the premises, all animals which have moved onto or off of the premises, all those which died, any which escaped, and also a current inventory of all cervids that are on the premises. For HCP participants, the list of cervids must include both of the individual animal’s identification devices.

• Bill of Sale documents shall be created and maintained by the participant for any live animal business transactions.

• PDA must be notified immediately of cervids that have escaped or have been stolen.

A written report must also be submitted to the Department within 10 business days.

Free-ranging cervids which have gained entrance to an enclosure must also be reported immediately.

• HCP herds shall be inspected annually by PDA staff. HMP herds may be inspected at the discretion of the Department, but it is not an annual requirement.

• All premises must have a fence that prevents ingress and egress of cervids and is a height of at least 8 feet, but a 10 foot fence is recommended.

• New program participant premises are to be inspected by a PDA official prior to enrollment and prior to obtaining any cervids. No transfer of a cervid or cervids may occur until it has been determined that the receiving party is enrolled in one of the two CWD programs and that the premises has been inspected and approved by the Department. Both parties involved in the movement of cervids will be held accountable if this requirement is not met. continued on page 37 WWW.PAVMA.ORG

1/8/2014 3:34:49 PM

pvmaAssure’s dental plan gives you something to smile about Affordable Rates and Great Coverage!

You can’t help but smile with pvmaAssure’s dental plan! We offer a statewide dental program through United Concordia which offers excellent coverage at affordable rates.

For under $400 a year or approximately a $1.00 a day, you can enjoy comprehensive individual dental coverage which includes some of these benefits: • 100% coverage for all diagnostic and preventive services including cleanings, X-rays, and exams • 100% coverage for basic services like fillings, simple extractions, endodontics, and oral surgery • 70% coverage for major surgical and non-surgical services • 50% coverage for inlays, crowns, prosthetics, and repairs • 50% coverage for orthodontics In addition, there is no medical underwriting or waiting period for benefits to become effective.

To check out more information on specific coverages and rates, scan the QR code with your mobile device or go to www.pvmaassure.com and click on “Products” and select “Dental Insurance.”

To talk with one of our representatives about getting started on a quote or to answer any questions, please contact info@pvmaassure.com, call 1.888.612.7659, or visit www.pvmaassure.com and click on “Request for More Information.”

pvmaAssure Insurance Agency, Inc. is the official in-house, full-service insurance agency created by the Pennsylvania Veterinary Medical Association (PVMA) to serve its members. pvmaAssure is

pvma

Assure

our promise

13_Volume_4.indd 19

an integral part of PVMA’s continuing promise to deliver the highest level of service and loyalty to our members and the veterinary profession.

your health

1/8/2014 3:34:50 PM

10 Annual Winter Con ference th

February 8, 2014 . ACE Conference Center, Lafayette Hill, PA Faculty

Arlene Buchholz, DVM USDA APHIS, Harrisburg, PA

Alison Gottlieb BS, CVT, VTS (ECC) Four Paws Consulting LLC, Cedar Grove, New Jersey

Charlotte Lacroix, DVM, JD Owner, Veterinary Business Advisors, Whitehouse Station, New Jersey

Ricardo Loinaz, VMD Equine Surgeon, Unionville Equine Associates, Oxford, Pennsylvania

Mark Russak, DVM Immediate Past President, American Animal Hospital Association, Berlin, Connecticut

Howard B. Seim, III, DVM, DACVS Professor of Small Animal Surgery, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado Kurt Selberg, DVM, MS, DACVR Assistant Professor, Diagnostic Imaging, The College of Veterinary Medicine, The University of Georgia, Athens, Georgia

Aliza Simeone, VMD Region VII Veterinarian, Bureau of Animal Health and Diagnostic Services, Pennsylvania Department of Agriculture, Collegeville, Pennsylvania

Ann B. Weil, MS, DVM, DACVA Clinical Associate Professor of Anesthesiology, Anesthesia Section Chief, Small Animal Hospital Chief of Staff, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana 20

VOLUME IV 2013

13_Volume_4.indd 20

keystone veterinarian

WWW.PAVMA.ORG

1/8/2014 3:34:52 PM

Friday Equine Schedule: Unionville Equine Associates Lecture and Hands-On Wet Lab 8:30–9:00am

Registration & Continental Breakfast (provided)

9:00–11:00am

Anatomy and Imaging of the Equine Neck and Back—SELBERG

11:00–11:15am

Break

11:15am–12:15pm Tips and Tricks for Imaging the Equine Axial

Spine—SELBERG 12:15–1:00pm

Lunch (provided)

1:00–4:00pm

WET LAB: Targeting Treatment: Ultrasound Guided Injection Techniques for the Equine Neck and Back—SELBERG

What Does Your Registration Include?

• • •

• • •

Top notch continuing education (up to 8 hours available) Admission to exhibit area Reception on Friday evening (complimentary hors d’eouvres and drinks provided) Continental breakfast on Saturday Refreshment breaks on Saturday Lecture notes provided online

How to Register

Register online at www.pavma.org or scan the QR code below with your mobile device. Prefer to register by mail? Download a printable copy of the registration form found at www.pavma.org.

Hotel Reservations

A block of discounted rooms is available at the ACE Conference Center on Friday, February 7, and Saturday, February 8. Please call the ACE Conference Center directly at 610.825.8000, or visit www.aceconferencecenter.com and use discount code pavma14 to obtain the discounted rates.

Reservations are made on a first-come, first-served basis until January 10, 2014, after which rooms may be reserved on a space and rate availability basis only. Rates: $129—Single/Double—$149 Triple/Quad

Companion Animal

Howard Seim, III, DVM, DACVS • Visceral Organ Biopsy • Principles of GI Surgery • Anal Sacculectomy: A Novel Approach • Surgical Management of Uroabdomen • Surgical Repair of Diaphragmatic Hernia • Surgical Management of Brachycephalic Syndrome and Surgical Treatment of Salivary Mucocele • Optional Happy Hour CE—Managing the Difficult Calculi in Male Dogs

Ann B. Weil, MS, DVM, DACVA • Post Anesthetic Cortical Blindness in Cats • New Analgesic Techniques • Overview of Anesthetic Equipment • Situation Normal • Myths and Misconceptions in Small Animal Anesthesia • Alpha-2s and Anesthesia: What Have We Learned?

Equine

Kurt Selberg, DVM, MS, DACVR • Anatomy and Imaging the Equine Upper Body (Neck, Back & Pelvis) • A Review of the Equine Stifle: Anatomy, Imaging, and Diagnosis of Disease • Approaches to Diagnosing Disease in the Hind Proximal Suspensory

Ricardo Loinaz, VMD • Update on Medical and Surgical Treatment of Proximal Suspensory Desmitis • Update on Medical and Surgical Treatment of Dorsal Spinous Process Impingement

WWW.PAVMA.ORG

13_Volume_4.indd 21

Hands-on Equine Wet Lab—Friday, Feb. 7 Tips and Tricks for Imaging the Equine Axial Spine and Targeting Treatment

Ultrasound Guided Injection Techniques for the Equine Back and Neck. A handson wet lab will be offered on Friday, February 7, 2013 at Unionville Equine Associates in Oxford, PA, with Kurt Selberg, DVM, MS, DACVR. Participation is limited to 15 people and registration will be accepted on a first-come, first-served basis. Discounted registration will be available to practitioners who attend both the wet lab on Friday and the Winter Conference sessions on Saturday.

Veterinary Technology Alison Gottlieb BS, CVT, VTS (ECC) • Anesthesia Plain and Simple • Anesthesia 3 Steps • Anesthetic Emergencies • CPR – Anything is Better Than Dead • ECG Made Easy • Feline Focus Practice Management

Arlene Buchholz, DVM, MPH, DACVPM

• Module 11: Sheep and Goats: Disease Awareness and Health Certificates • Module 18: Avian Influenza and Exotic Newcastle Disease • Module 19: Animal Health Emergency Response

Aliza Simeone, VMD

• Regulating Rabies -What Does the Practitioner Need to Know?

• Regulating Rabies – Scenarios & Questions • Health Certificate Help – Who Can Write Them, When Are They Needed, and What Do You Need to Do?

Student/Young Graduate Mark Russak, DVM

Charlotte Lacroix, DVM, JD • Hire Right … Not Often • Mysteries of Compensation • Establishing Expectations for Performance Improvement or Discipline • Breakfast with the Expert—Compounding Drugs and Extra-Label Drug Use? Watch Your Step!

SPONSORED BY

National Veterinary Accreditation Program and Regulatory Issues

• Not So Trivial Pursuit: Evaluation of Student and Recent Graduate Management/ Financial Knowledge • Developing the Million Dollar Plus Practice • Mastering the Exam Room: Increasing Compliance/Adherence • Successful Practicing in ANY Economy

FULL DETAILS CAN BE FOUND AT WWW.PAVMA.ORG!

keystone veterinarian

VOLUME IV 2013

21

1/8/2014 3:34:53 PM

foundation cornerstone

A Look Back at

k r a P e h t n i k r a

B

Over 250 runners, walkers, and dogs participated in Pennsylvania Veterinary Foundation's (PVF) fourth annual 5k race and 1 mile walk

O

n Sunday, October 27, over 250 people—and dozens of dogs— gathered on Harrisburg's City Island for the 4th Annual Bark in the Park 5k Run & 1 Mile Dog Walk. The weather was cold, so it was a perfect day to run or walk to warm up. Though there were winners in each age category, the overall winner was Miguel Murrieta from Hershey, PA, with a race time of 19:16.0. Congratulations, Miguel! There was also a Halloween Costume Contest which drew some really creative costumes and earned some great prizes. The event also raised more than $13,000 for TLC. Thank you to all who participated!

22

VOLUME IV 2013

13_Volume_4.indd 22

keystone veterinarian

Monies raised through Bark in the Park registrations and donations go to benefit the Pennsylvania Veterinary Foundation (PVF)'s The Last Chance Fund (TLC) which provides funds for the veterinary care of neglected or injured unowned companion animals. Without the availability of these funds, animals might not receive the care and treatment that they need to feel better or even survive. To see who TLC has helped or to make a donation, visit http://www.pavetfoundation.org/ whatistlc.aspx. You may also make a donation by scanning the code on page 31 with your mobile device.

WWW.PAVMA.ORG

1/8/2014 3:34:56 PM

foundation cornerstone

The TLC Fund is an official program of the Pennsylvania Veterinary Foundation (PVF).e Internal Revenue Service as a 501(c)(3) non-profit, charitable organization. PVF’s tax identification number and financial information can be obtained by contacting the PVF office. The official registration and financial information of the Pennsylvania Veterinary Foundation may be obtained from the Pennsylvania Department of State by calling toll free, within Pennsylvania, 1.800.732.0999. Registration does not imply endorsement.

WWW.PAVMA.ORG

13_Volume_4.indd 23

keystone veterinarian

VOLUME IV 2013

23

1/8/2014 3:35:00 PM

Special Thanks to Our Bark in the Park Sponsors Great Dane—$2,500 Hoffer Properties

Labrador Retriever—$1,000

Cocker Spaniel—$500

Chihuahua—$250 The Orsini Family

Teacup Poodle—$100 Donegal Mutual Insurance Group Eastern Insurance Holdings, Inc. Minnie and Rosebud Pennsylvania State Animal Response Team (PaSART)

24

VOLUME IV 2013

13_Volume_4.indd 24

keystone veterinarian

WWW.PAVMA.ORG

1/8/2014 3:35:02 PM

pvma fact sheet

A Dog License Isn't Just Bling, It's the Law

D

ogs are an important part of our families as loyal companions, protectors and playmates. Few things beat coming home after a long week to a dog who's happy to see you, wagging his tail. Dogs bring a lot of joy, but also a lot of responsibilities. Ensuring he has a current license is at the top of the list.

It’s the Law

All dogs three months or older must be licensed by January 1 of each year. Dog owners who do not license their dogs can be cited with a maximum fine of $300 per unlicensed dog plus court costs.

Dog wardens canvass neighborhoods across the state looking for unlicensed dogs and fine any dog owners who break the law. Wardens issued more than 900 fines for failing to license a dog in 2013. The cost of a license is far less than the penalty for being caught without one.

Get a License

Dog licenses are available from your local county treasurer. Some counties offer online licensing. Licenses may also be available through registered agents in certain counties, including retail businesses and veterinary offices.

An annual dog license is $8.45 or $6.45 if the animal is spayed or neutered. Lifetime licenses are available for dogs that have permanent identification like a microchip or tattoo. Older adults and people with disabilities may be eligible for discounts. The dog license application is simple and only requests owner contact information and details about the dog being licensed, like name, age, breed and color.

Ticket Home

If you’ve ever walked or driven your neighborhood calling out your lost dog’s name with the hope you’ll see him running toward you or visited your local animal shelter and registered your pet as missing, you know the importance of a dog license.

Pets run away for a variety of reasons. Big, strong dogs can run five miles or more from their homes. Along the way, they encounter dangers like moving vehicles and wildlife.

If your dog is found, someone may take him to a local veterinarian, groomer, pet store, or animal shelter. If your dog has a current license, it makes his return home easy. But if your dog doesn’t have a current license, it becomes harder to ensure he can make his way back to you.

Your best friend’s ticket home is a license because it helps animal control and shelters identify your dog and get him home safely.

Support Animal Control

Dog license fees support animal control. The annual fee you pay to license your dog helps keep shelters running and supports the work of the Dog Law Enforcement Office, which is responsible for ensuring the welfare of dogs, regulating dangerous dogs and overseeing annual licensing and rabies vaccinations.

Vaccinate Against Rabies

In addition to being licensed, all dogs three months or older must be vaccinated against rabies. Rabies is a fatal viral infection of the central nervous system that is spread by infected animals.

Lost dogs can easily encounter wildlife. Rabies in wildlife accounts for more than 90 percent of the reported rabies cases in the United States with raccoons making up more than half of this total.

Rabies vaccination boosters must be given by your veterinarian to maintain your dog’s immunity every three years. Failure to vaccinate your dog can result in a maximum fine of $300 per unvaccinated dog violation plus court costs.

For more information about dog licensing, visit www.licenseyourdogPA.com. l

INFORMATION PROVIDED COURTESY OF THE PENNSYLVANIA DEPARTMENT OF AGRICULTURE WWW.PAVMA.ORG

13_Volume_4.indd 25

keystone veterinarian

VOLUME IV 2013

25

1/8/2014 3:35:02 PM

Mentorship

Two PVMA members, recent gradaute Dr. Caroline Cantner and Past President Dr. Larry Gerson lend their thoughts on mentorship from each side of the coin.

Making the Most of Your Mentorship Network

By Caroline Cantner, VMD, Recent Graduate Advisory Council

M

entorship.

It is a buzzword in many circles, from early and high school education straight through to graduate programs and Fortune 500 companies. Interviews of successful people feature the “who was your mentor” segment leaving the rest of us wondering, how do we get such a magical person in our lives?

Know what you want

Take the time to write out what you are looking for in a mentor. For example, are you a new graduate looking for someone to help you review cases or are you thinking about purchasing a practice and looking for ownership guidance? Are you frustrated or anxious about your particular career juncture and looking for someone to provide emotional guidance and encouragement? Are their specific skills you would like to develop and are those veterinary skills or business skills?

Identify the tangible versus the intangible

Specific veterinary or business skills and specific professional goals are tangible whereas emotional support and encouragement during times of frustration or insecurity are intangible. Which area is the most important to you at this moment? Creating a mental space between the professional skills and advice and the personal challenges each of us faces will help you to identify where to go for the support you need.

It’s a network, not a person

While there are people who manage to find that all-in-one mentor, chances are you will find greater success if you focus on developing

a network of resources rather than pursue a single-minded quest for one individual. You may find that you look to veterinarians who have more experience for the professional skills but that your veterinary contemporaries or even your non-veterinary friends or family are the best resource for the frustrations and challenges of day-to-day practice.

Expand your horizons. If you are looking into a new career direction or a business opportunity, your network may need to expand beyond the veterinary community.

Ditch the terminology

If you are getting the advice, information, and support you need, does it matter what you call the person providing that for you? Free yourself from an idea of what a mentor should be and the worry that you may not have one. Look at your network and develop a strategy for continually expanding your network. Rather than coming into a professional relationship asking someone for a vague chance at “mentorship,” you may find that if you’ve developed clear goals and specific areas of interest or concern, there may be several people within your network who are willing and happy to help you.

Be grateful

Acknowledging what you have is much more rewarding than worrying about what you are missing. If someone can provide the informational support—as in the additional skills or training you want—but is falling short of your expectations on emotional support, be thankful for the additional skills and turn to another avenue in your network for the emotional support. Make the most of the resources you have and develop a plan for expanding those resources in a targeted way. It is a much more pro-active and rewarding approach than speed-dating for a mentor or trying to fit one person into an all-encompassing role they may not be prepared for. Most of all, celebrate your mentorship network: chances are, it can offer you more than you think! l

PVMA's Recent Graduate Toolkit We offer members access to our Recent Graduate Toolkit. The toolkit is specially-designed to help those just out of veterinary school deal with the financial strain, job concerns, and life balance that most new grads struggle with. Multiple topics are available under each of these categories:

Communication Strategies

Practicing in Pennsylvania

Connections & Networking

Job Search

Financial Planning

Transitioning Into Practice

https://www.pavma.org/members/graduateToolkit.aspx 26

VOLUME IV 2013

13_Volume_4.indd 26

keystone veterinarian

WWW.PAVMA.ORG

1/8/2014 3:35:04 PM

Mentorship is About More Than Just Veterinary Medicine

By Larry Gerson, VMD, Past President, Pennsylvania Veterinary Medical Association and Chair, Pennsylvania Veterinary Foundation

M

ost veterinarians remember their first contact with the profession, often at their hometown veterinarian’s office. These early memories can last forever—our first mentor showing us the compassion and healing of our profession.

In college and in veterinary school, we had favorite professors who imprinted upon us the love of learning, who taught us to study and work hard to realize our lifetime goals.

Leaving veterinary school and entering the real world is a significant transition. Professional growth and development is still in its adolescence during the first few years of practice. Being solely responsible for the care of patients can be difficult if there is no one with whom to consult.

The first job, be it an internship or private practice, is critical. The techniques, skills, ethics, and thought processes learned and reinforced early in our career are likely to influence our entire career. Ideally, every new graduate would have a mentor to help bridge the gap between functioning as a student and functioning as a doctor.

A disconnect exists between the expectations of new graduates and employers. In 2009, the Canadian Veterinary Journal reported only 28.4% of survey respondents had remained with their first employer.

More than a third (38%) of respondents left their position solely due to lack of mentorship and support.

A veterinary mentor is more than an employer. A mentor takes the time to teach and support the recent graduate. Many topics are bypassed in formal education but necessary for the new graduate to understand to be successful. One such example, client communications—especially on a case that did not go as expected—takes time to develop. Many complaints that go to the state board are due to poor communication. New graduates also have to learn the limits of their personal friendship with hospital staff and co-workers. Relationships outside of business hours can complicate the work week. Having a mentor to discuss the varied aspects of human resources issues is critical to their development.

New graduates also need a mentor to guide them to network within the greater veterinary community. Having relationships with other veterinarians, for example with emergency coverage or referring out exotic pets, makes for an easier time in a busy office.

In the short term, this requires an investment of the employer’s time.

In the long term, this investment pays dividends. The recent graduWWW.PAVMA.ORG

13_Volume_4.indd 27

ate develops confidence and expertise and becomes a more valuable part of the practice team than if they had not been provided guidance. Mentorship benefits both parties in the long run; nonetheless, there are aspects of mentorship that both parties need to discuss and understand.

Early phase of mentorship (first 6 months) 1. The mentor may be less productive than normal.

2. The recent graduate will be minimally/moderately productive.

3. The practice will likely not benefit economically.

4. Compensation may be lower during this time.

Transition phase of mentorship (6 to 12 months) 1. The mentor should return to normal productivity.

2. The recent graduate will be moderately productive.

3. The practice will start to benefit economically.

4. Compensation should be re-evaluated.

Long-term 1. The mentor should enjoy an improved quality of life.

2. The recent graduate should become integral to the practice.

3. The practice will provide superior service to clients and patients.

4. Compensation should be re-evaluated periodically.

My first employer taught me that the Pennsylvania Veterinary Medical Association (PVMA) is important to the profession. Not only did he insist that I had an obligation for membership to the Western Pennsylvania Veterinary Medical Association (WPVMA), PVMA and the American Veterinary Medical Association (AVMA), he insisted that I went to the meetings and covered those costs for me. Thirty-eight years later, I still consider him a friend, colleague, and mentor.

Years later, as president of the WPVMA, our group had legal issues with the city of Pittsburgh wanting to enter the practice of veterinary medicine. With help from a state and national leader in our profession, we were able to provide testimony and ultimately start a voucher system to control pet overpopulation. I was amazed at the dedication and passion one veterinarian, whom I had not previously met, could have in coming to our aid. He also became a friend and mentor for life.

Mentors help other veterinarians in many different ways. They teach the ethics and morals to make every veterinarian a complete professional. l keystone veterinarian

VOLUME IV 2013

27

1/8/2014 3:35:05 PM

Setting the stage for the new year …

Creating the Client Experience for Dentistry

By Wendy S. Myers, Owner, Communication Solutions for Veterinarians, Highlands Ranch, Colorado

A

lthough your team recommends the best medical care for pets, sticker shock may prevent some clients from accepting dental treatments.

The average dental case is $427, according to the American Animal Hospital Association (AAHA) Veterinary Fee Reference, 8th edition (see Table 1).1 To get more clients to accept dentistry, we must communicate its value.

“Clients want optimal dental care—a higher quality service,” says Dr. Ed Eisner, Diplomate AVDC, at Animal Hospital Specialty Center in Highlands Ranch, Colorado. “We must offer competence, service and value for dentistry.

When we communicate value, clients will appreciate our dental services, pay their bills, tell friends, and return for annual or semiannual dental care.”

Here’s how you can create a great experience for dentistry that makes clients smile: Create photo books or slideshows. Most pet owners have never seen an animal’s dental procedure from start to finish. Create dental photo books using websites such as Shutterfly, Walgreens, or Costco. Place photo books in each exam room and your lobby.

AAHA offers a book to use in exam room conversations, Healthy Mouth, Healthy Pet: Why Dental Care Matters (www.aahanet.org).

Dr. Jan Bellows, Diplomate AVDC, of All Pets Dental Clinic in Weston, Florida, has a series of five smile books that can be viewed on his website at www.dentalvet.com. Veterinary Information Network members can download his books at no charge at www.vin.com.

For a digital option, create slideshows on digital photo frames, tablets or exam room computers. When the computer hibernates, your slideshow becomes the screen saver.

Describe anesthesia safety protocols. “Once an animal reaches age 10, more clients are afraid of anesthesia,” says Kathy Pershing, CVT, a dental technician at Animal Hospital Specialty Center. “I explain that three people are actively involved in the pet’s dental procedure: two certified veterinary technicians and Dr. Eisner. We also use sevoflurane, monitoring equipment and warming blankets.”

Present service first, price last. When recommending dental treatments, avoid saying “estimate,” which centers on price. “Treatment plan” emphasizes needed medical care.

Stand at the end of the exam table, forming L-shaped body language, or position yourself shoulder-to-shoulder with the client. This is collaborative body language, compared to a confrontational posture of talking across the table with a physical barrier between you and the client.

Above: Share dental x-rays with clients to show value for professional services.

IDEXX I-Vision MobileTM Application allows you to show radiographs on tablets and iPads as well as email them to clients or specialists.

28

VOLUME IV 2013

13_Volume_4.indd 28

keystone veterinarian

Because clients need to understand service first, cover prices with an educational brochure such as Virbac’s dental report card (brochure #VP028) or preanesthetic testing brochure. Explain each item, pointing to the left column that lists medical services.

After you’ve shared photos and discussed medical services, reveal the price.

Educating clients before showing prices helps them make informed decisions. Clients may jump to judgment if they see the price first without understanding the comprehensiveness of professional dental care.

Schedule admission appointments. Avoid using the term “drop off,” which implies the admission process takes seconds. Schedule a 15-minute admission appointment with a technician or veterinarian. In the privacy of an exam room, you can have the client sign consent forms, collect contact phone numbers, answer questions and explain when you will call following the procedure. If technicians admit patients, make sure a veterinarian is available in case the client has additional questions.

When client care coordinators make confirmation calls, they would explain fasting instructions and then tell clients, “Your dental admission appointment is scheduled for 7:45–8:00am with a technician who will spend 15 minutes reviewing the consent form, answering your questions and getting phone numbers where we can reach you on the day of the procedure. Please allow at least 15 minutes for your pet’s admission to the hospital. If you have questions, please call us at 555.555.5555.”

Give clients your business card. During the admission appointment, give clients business cards of the veterinarian and technician who will perform the procedure. This instills confidence and communicates your professionalism. A technician would say, “We will call you after 1pm when we have finished your pet’s dental procedure. If you have questions before then, here’s my business card and the doctor’s.” Clients also may use the business card if they have questions about home care instructions after the patient is discharged.

Watch my video on using business cards at www.YouTube.com/csvets.

Use a dental consent form. Once the pet is under anesthesia, a comprehensive oral exam and dental x-rays may reveal additional care.

In addition to the anesthesia consent form, have clients sign to authorize additional dental services if necessary. Always call to update the client on any additional services and prices. If you can’t reach the pet owner, this consent form tells you whether to perform continued on page 29 WWW.PAVMA.ORG

1/8/2014 3:35:06 PM

Dentistry

continued from page 28

all necessary dental procedures, add services up to a specific dollar amount, or if the client declines any unforeseen dental procedures.

Text clients after dental patients are awake. Add this statement to your anesthesia consent form: “How would you like to hear from us when your pet wakes from the procedure?” Then list text, email or phone call. If a complication occurs, always call the client. Expect up to half of clients to choose text notification.

Never use a practice cell phone to text clients because you can’t print the text to document it in medical records. Another danger: Clients may expect you to answer the practice’s cell phone 24/7. Google Voice and Gmail Chat offer free texting services that time and date stamp conversations, which you could print for paper medical records or save as PDFs in electronic medical records. Gmail Chat also allows you to attach photos. Dental technicians would log into Google Voice or Gmail Chat as patients are recovered to update clients and remind them about discharge appointments.

Take before and after dental photos. Few clients look at the back of their pets’ mouths. Photos often show dramatic improvements and communicate value for dental services. Incorporate photos and x-ray images into discharge instructions.

Provide a dental report card. “Write a pictorial case summary report with photos and x-rays,” advises Dr. Eisner. “Create a template in Word so it’s easy to format and revise.” In addition to showing value, a dental report card helps family members who were not present understand the procedure. See my book, The Veterinary Practice Management Resource Book & CD, for a dental report card (www.csvets.com/books.htm).

Share dental x-rays. The 2013 AAHA Dental Care Guidelines for Dogs and Cats recommend taking radiographs of the entire mouth, which are necessary for accurate evaluation and diagnosis. Intraoral radiographs revealed clinically important pathology in 28% of dogs and 42% of cats when no abnormal findings were noted during initial exams.2 AAHA also offers a dental radiology poster to help educate clients about the importance of dental x-rays (www.aahanet.org).

Discharge first, pay last. Clients need to understand all of the services that were performed before they see the final bill. During discharge, explain the procedure and potential complications such as vocalization, bleeding, coughing or signs of pain to watch for at home. Discuss any prescribed antibiotics and medication for inflammation and pain. Also demonstrate home-care products.

When you offer a product in the exam room, it’s medicine. When it’s sold at the front desk, it’s retail. Because a dental diet may be part of ongoing therapy, bring the therapeutic diet into the exam room. Tell the client, “Because your pet was treated for dental disease today, he needs to eat this therapeutic diet to maintain his oral health. Let me explain how to transition to the new food and also tell you how much to feed.” Put a prescription label on the diet, which has the pet’s name, how much to feed and where to get refills.

“Release consults can be delegated to well-trained staff, but clients are even more impressed if the doctor takes time to explain what was done,” Dr. Eisner advises. Call clients after dental patients have been discharged.

Depending upon the discharge time, call the pet owner later that evening or the next morning. Ask about the pet’s condition, ability to give dispensed medications, use of home-care products, and answer questions.

In dental group codes in your practice-management software, automatically turn on a callback for one day later. Whenever this service is invoiced, a callback will be generated. Have the technician who performed the procedure call the client. The employee already has a faceWWW.PAVMA.ORG

13_Volume_4.indd 29

Top photo: When presenting the dental treatment plan, use collaborative body language. Stand at the end of the exam table to form L-shaped body language or stand shoulder-to-shoulder next to the client. Bottom photo: Because clients need to understand service before price, place a dental or preanesthetic testing brochure over the total. After you share step-by-step photos of a dental treatment and describe services, reveal the price so the client can make an informed decision.

Dental reminder intervals Service Grade 1 dental treatment Grade 2 dental treatment Grade 3 dental treatment Grade 4 dental treatment

Reminder cycle 12 months 9 months 6 months 3 months

to-face relationship with the client, knows details of the procedure and can answer questions the client may have. Just as you use doctor ID codes to track production, create staff ID codes so each employee who delivered care for a specific patient is linked to that medical record.

This will keep callbacks organized and give staff accountability. continued on page 37 keystone veterinarian

VOLUME IV 2013

29

1/8/2014 3:35:07 PM

Start the new year right …

Implementing a Wellness Program in Your Practice in the New Year Benefits Clients and Patients

By Jennifer Fletcher, DVM, Associate Veterinarian, Animal Hospital of Dauphin County, Hershey, Pennsylvania

A

s veterinarians, we have two main goals: keeping pets healthy and their owners happy. We examine animals and administer vaccines to protect them from infectious disease, but all too often we find ourselves treating dogs and cats for chronic conditions that require lifelong medications and monitoring. The move toward preventive medicine is becoming more imperative as the cost and standard of care rises. The cornerstone of moving your practice towards preventive medicine is a wellness program. By

creating a comprehensive plan and thorough training of our staff to embrace “wellness,” we now have a foothold in moving our practice towards preventive medicine. We implemented our program two years ago at the Animal Hospital of Dauphin County and have seen many benefits of transforming the way we approach wellness in our patients.

Establishing a comprehensive plan

The first step in establishing our wellness program was determining the components of the program. Every practice may take a different approach but we elected to streamline the wellness exam, provide stage-specific blood panels at a discounted price, administer lifestyle specific vaccines, discuss current diet, and

recommend year-round flea/tick and heartworm prevention. We tried to keep it as simple as possible for our clients so they would not feel overwhelmed or confused by the choices that we offer. With time being a limiting factor in the exam room, becoming efficient with recommendations and discussion of wellness was one of our greatest challenges.

For the wellness exam, we utilized our electronic medical record to start our recommendations before the client even enters the hospital. Our veterinarians will research the medical record of each wellness patient on the schedule that day and pre-load the patient list with the vaccines, blood testing and

preventive products they recommend based on the patient’s lifestyle and medical history.

We also created Feline Wellness and Canine Wellness exam templates. These templates include questions our technicians ask our clients in the exam room. These questions cover current problems or concerns, diet (what brand of food and how much they are feeding), flea/tick/heartworm prevention if they currently use it, at home dental care, lifestyle of the pet (boarding, grooming, etc. for dogs and indoor only, indoor/outdoor, outdoor only for cats), and infectious disease testing (heartworm, tick-borne, FIV/FeLV). Through training and discussions at staff meetings, the technicians transformed these questions into a dialogue with clients rather than peppering

them with questions. Finally, the technician opens the computer invoice and discusses wellness bloodwork and other recommendations the veterinarian has made.

For wellness bloodwork, we created a set of blood panels that include a CBC, chemistry, and a fecal float but may also include thyroid testing and a urinalysis based on the age of the patient. We are able to offer these panels at a discounted price to our clients through an agreement with our external laboratory.

We propose annual wellness bloodwork for all patients and infectious disease testing yearly in dogs and based on lifestyle of the cat.

Changing your message—vaccines to wellness

The next aspect we changed about the way we practiced was our message to our clients.

We no longer ask owners to set up their “vaccine appointments,” but instead, to have them schedule their “wellness exams.” The word wellness definitely alerted a change in our clients. The most commonly asked question was, “What do you mean by wellness?”

Through interactive staff meetings based on communication techniques, we trained our staff to use this opportunity to explain that we want to not only administer vaccines but also ensure their pet's overall health status by discussing weight, diet, parasite preventives and any other concerns the client may have. About one year after instituting our program, our clients now call to set up their wellness exams. By changing one word, we also changed how our clients saw the value of their annual or semi-annual appointment.

Staff participation

First and foremost, everyone on the staff must be on board with the program and believe in the value of wellness and preventive care. The best way for staff to feel a part of the program is to be participants themselves.

We encouraged our staff members to have wellness bloodwork performed on their own cats and dogs. We embraced the “practice what you preach” mentality.

We also used the opportunity of our staff pets’ bloodwork to educate receptionists and technicians about what the values mean. The

continued on page 31

30

VOLUME IV 2013

13_Volume_4.indd 30

keystone veterinarian

WWW.PAVMA.ORG

1/8/2014 3:35:08 PM

Wellness Plans

continued from page 30

more your staff knows about their own pets’ health, the more they can convey this to the client. Our clients especially take what we do for our own pets into consideration when making decisions for their animals.

There is no stronger recommendation than one you would make for your own dog or cat.

Introducing the wellness program to the clients

For the most part, our hospital had always been recommending preventives and lifestyle-based vaccinations. With the introduction of the wellness program, we made it more visible to the client with visual aids and a consistent message. Our emphasis on wellness to our client starts with the receptionists scheduling and confirming the appointment; it is then reiterated in the exam room by the technicians and doctors, and is again reinforced by the receptionists and technicians with follow up calls. By doing this, the client feels the entire practice is on board with recommendations and is more likely to participate.

When our receptionists schedule and call to confirm the appointment, they remind the owner to bring a fecal sample (as all of our wellness bloodwork panels include a fecal float). In the exam room, we have posters explaining wellness bloodwork and show what each panel includes, the cost of the panel and the discounted savings to the client. It’s a great visual tool and shows the client the value they are receiving. Finally we use our EMR system to our advantage to create callback reminders for vaccines (if starting a series and needing boosters) and dental recommendations. The receptionists call owners reminding to set up their technician appointment for the booster vaccine or to ask them if they would like to set up the dental cleaning procedure that the doctor recommended at their exam. The follow up calls have increased client compliance and show our clients are commitment to wellness in their pets.

Especially in the first year of our wellness program, our clients felt slightly overwhelmed or unprepared for the cost of the wellness bloodwork.

Because of this, we allow clients to set up appointments with our technicians within three months of the wellness exam to take advantage of the blodowork prices and to have infectious disease testing performed without another exam by a doctor. Many clients enjoy this option as it allows them to discuss it with family members at home or to spread out cost over two visits.

Showing clients the value—sharing stories of success

Our hospital has certainly seen the value of the wellness program along with our clients. Not only have we established “baseline” bloodwork values for patients who appear healthy, we have also detected early or subclinical disease in a number of patients. We have diagnosed early stage chronic renal failure where a diet change is the only treatment needed instead of discovering it when the patient is severely azotemic and clinically ill. Additionally, we have revealed hyperthyroidism and diabetes mellitus before patients have developed hypertension, heart murmurs, weight loss and ketosis. By far one of the most rewarding examples of the success of wellness bloodwork was a case in which we diagnosed thyroid cancer in a dog whose only clinical sign was a three pound weight loss. We relay these stories of success with all of our clients in the exam room. We emphasize how animals can “hide” disease and that early detection is the key in the management of most chronic conditions. By detecting disease early, we can increase a patient’s quality of life for longer and most likely for a lower cost to the client as well.

Overall, the wellness program at our hospital has been a win-win situation. Our patients are receiving a higher standard of care and their owners are becoming an active participant in their pet’s health. Many hospitals already recommend and perform many components of a wellness plan, but making it visible and valuable to the client is the key.

A straight-forward comprehensive plan will help move your practice towards success with preventive medicine. l WWW.PAVMA.ORG

13_Volume_4.indd 31

keystone veterinarian

VOLUME IV 2013

31

1/8/2014 3:35:08 PM

member news

Welcome New Members

p

VMA welcomes the following new members and thanks them for joining PVMA! (September 24–December 31, 2013) Active-Recent Graduate Emily Lantzsch, DVM, Shippensburg, PA Daniel VanSteenkiste, DVM, Hometown Veterinary Hospital, Veterinary Hospital, North East, PA

Risa Hanninen, DVM, Utica, PA Lynn Cartee, DVM, Cochranton Veterinary Hospital, Cochranton, PA Kelley Collins, DVM, Keystone Veterinary Emergency and Referral, Havertown, PA Nicole Drummond, DVM, Drummond Animal Hospital, New Bethlehem, PA Valerie Heartsfield, VMD, Bristol, PA R. Dubensky, DVM, Milford Animal Hospital, Milford, PA Benjamin Orozco, DVM, Center Valley, PA Angelee Gerovasiliou, VMD, Kennett Square, PA Allison Braun, DVM, Cranberry Township, PA Tiffany Clarke, DVM, Plains, PA Megan Minchin, VMD, Plains, PA Susan Ivy, VMD, Lowe Burrell, PA Victoria Kabakjian, DVM, Oxford, PA Jennifer Hamilton, DVM, Hubbard, OH Joanelle Hernandez-Lopez, VMD, Philadelphia, PA Nicholle Hebert, DVM, Woodlands Animal Care Center, Farmington, PA Darrick Yamaguchi, DVM, Plains, PA Eric Pienschke, DVM, Leader Heights Animal Hospital, York, PA Academic Active Joshua Henry, DVM, University of Pennsylvania, Maple Shade, NJ Christine Cain, DVM, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, PA Jeffrey Runge, DVM, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, PA Jantra Saran, University of Pennsylvania, School of Veterinary Medicine, Philadelphia, PA Meghann Pierdon, VMD, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA Active Jennica Smith, Bryn Athyn, PA Laura Dobrowolski, Animal Hospital of Richboro, Richboro, PA Richard Roseberry, DVM, Anna Equine Clinic, Albion, PA Heather Balmer, VMD, Animal Hospital of Dauphin County, Harrisburg, PA Rachel Morris, DVM, Animal Care Center, PC, Danville, PA Celeste Blumerich, DVM, Greenville, PA Reginald Royster, Jr., DVM, Haverford Animal Hospital, Haverford, PA Kyle Horn, Andover, NJ Denise Nickodemus, DVM, Altoona, PA

Maria Wakefield, Standard Process of PA, Inc. Middletown, PA

Zack Beresin, Philadelphia, PA Christiana Fischer, Howell, NJ Kristen Robinson, Philadelphia, PA Alexandra Shailor, Philadelphia, PA Monica Smetts, Philadelphia, PA Ashley Power, Philadelphia, PA Michael Timko, Columbus, OH Bernadetta Bernatowicz, Jefferson Twp, PA Caroline Kiorpes, Philadelphia, PA Nathaniel Sotuyo, Philadelphia, PA Arielle Thomas, Pittsburgh, PA Carl Toborowsky, Philadelphia, PA Cassandra Tuttman, Philadelphia, PA l

Practice Manager Jackie Jozwiak, Lansdowne, PA Cheryl Butya, Chartiers Animal Hospital, Heidelberg, PA Student Grace Zhang, Philadelphia, PA Devon Graham, Easton, PA Brett Shorenstein, Philadelphia, PA Melanie Boretsky, Columbus, OH Tierney Roche, Philadelphia, PA

Charlene Wandzilak & Todd Witmer PVMA Executive Director Charlene Wandzilak and Todd Witmer tied the knot on September 27, 2013, at the Cameron Estate in Mount Joy, PA. Congratulations, Charlene and Todd! Also pictured, Olivia Wandzilak and Tristan Witmer.

Adam Hoover, VMD, & Jessica Rae Moon PVMA Member and District 1 Trustee Dr. Adam Hoover and Jessica Rae Moon tied the knot on September 27, 2013, at White Point Barn in Prospect, PA. Congratulations, Adam and Jessica!

Associate Marla Hall, DVM, Western Reserve Animal Clinic, Pierpont, OH Sandra Hickey, DVM, Creature Comforts Veterinary Clinic, Eaton , OH Julie Sanders, DVM, Lawrenceville, NJ

Tom Munkittrick, DVM, & Naomi Peters PVMA Past President Dr. Tom Munkittrick and Naomi Peters tied the knot December 22.

Congratulations, Tom and Naomi!

Industry Partner Jessi Coleman, VetMatrix, San Diego, CA John Kegley, North Lima, OH 32

VOLUME IV 2013

13_Volume_4.indd 32

keystone veterinarian

WWW.PAVMA.ORG

1/8/2014 3:35:10 PM

member news

PVMA Remembers Dr. Don Reeser Donald Reeser, DVM, 87, died Sunday, September 29, 2013. He practiced small animal medicine in Pittsburgh for 10 years, Allison Park, PA, for 15 years, and Bakerstown, PA, for nine years. Dr. Reeser was the first veterinarian to teach the animal technology course at the Median School for Health Sciences in Pittsburgh and he developed the original course curriculum. For five years he did relief work within a 50 mile radius of Pittsburgh. He was the first chairman of the Pennsylvania Veterinary Medical Association's Continuing Education Committee, and in 1973 he received the PVMA Veterinarian of the Year award, as a result. He served on the Pennsylvania Board of Examiners for a four year term. He and his wife, Helen, who predeceased him, retired to NC. He was an avid woodcarver and donated many dozens of carvings to charities in addition to selling many. He is survived by his wife, Nancy; daughters Kathrine of Columbus, OH, and Susan of Chapel Hill, NC; son David of Greensboro, NC; four grandchildren and eight great-grandchildren. For further information and to view family photos, please visit www.donreeser.com. Memorials may be made to Hospice and Palliative Care Center, 101 Hospice Lane, Winston Salem, NC 27103.

PVMA Remembers Dr. Matthew Murphy Dr. Matthew John Murphy, born January 15, 1958, went home to be with the Lord September 22, 2013. He was a resident of Scotland, PA, and owner of the Keystone Mobile Veterinary Service.

He is survived by his wife, Brenda; his children, Matthew Adam

Murphy (spouse Susan), Jarred Luke Murphy (spouse Lindsey), and Anna Murphy Lovett; and grandchildren, McKenna, Matthew, Jacob, Emma, Abriel and Katelyn. In lieu of flowers, donations may be made to Chambersburg Baptist Church building fund.

PVMA Remembers Past President Dr. Richard Vaclavik Dr. Richard A. Vaclavik, age 82, of Millersburg, Pennsylvania passed away in his home on March 18, 2013. Dr. Vaclavik, the son of the late Paul and Anna (Snyder) Vaclavik, was born in Rosedale, Pennsylvania. He did his undergraduate studies at West Virginia University and graduated from the University of Pennsylvania, School of Veterinary Medicine in 1956. During his years at West Virginia University, Dr. Vaclavik was a member of ROTC, and during veterinary school he was a member and officer of the Alpha Si fraternity.

Dr. Vaclavik opened the Upper Dauphin Animal Hospital in Millersburg in 1960, where he practiced for the past 53 years.

He also served as a veterinarian for the Commonwealth of Pennsylvania, Department of Agriculture. Dr. Vaclavik attended the Peace United Church of Christ in Berrysburg, was a member of the American Veterinary Medical Association (AVMA), and was a member and Past President of the Pennsylvania Veterinary Medical Association (PVMA).

His surviving family members are his wife of 56 years, Patsy (Kipp) Vaclavik; his son, Steven Vaclavik, and daughter-inlaw, Cheryl (Sweigard) Vaclavik, of Dallastown; his daughter, Kathryn Vaclavik, and son-in-law, Alfonso Moreno, of Pacific Palisades, California; his daughter, Jennifer Keeler, and son-in-law, Jonathan Keeler, of Hummelstown; his six grandchildren, Alexander Vaclavik, Sarah Vaclavik, Nathaniel Moreno, Sofia Moreno, Anna Keeler, and Sydney Keeler; his sister, Evelyn and brother-in-law, Harry Pepe, of Uniontown, Pennsylvania; and his brother, Dr. Charles Vaclavik and sister-in-law, Katie Vaclavik, of Chico, California.

In lieu of flowers, donations can be made in Dr. Vaclavik's memory to the University of Pennsylvania, School of Veterinary Medicine, New Bolton Center, 382 West Street Road, Kennett Square, PA 19348; the American Cancer Society , 2 Lemoyne Drive, Suite 101, Lemoyne, Pennsylvania 17043; the American Heart Association , 1019 Mumma Road, Wormleysburg, Pennsylvania 17043; or Hospice of Central Pennsylvania, 1320 Linglestown Road, Harrisburg, Pennsylvania 17110.

WWW.PAVMA.ORG

13_Volume_4.indd 33

keystone veterinarian

VOLUME IV 2013

33

1/8/2014 3:35:11 PM

Senator Judith Schwank Receives a 2013 PVMA President's Award

P

ennsylvania Veterinary Medical Association today bestowed its prestigious “President’s Award” to state Sen. Judy Schwank (D-Berks).

PVMA picked the Berks County Democrat because of her “tireless work to raise awareness about agricultural and animal issues” in Pennsylvania.

“I have been a life-long advocate for farmers, agriculture professionals and animals because all of them—separately and together—impact our quality of life in Pennsylvania, the United States and throughout the world,” Schwank said. “Agriculture continues to be one of the commonwealth’s biggest economic generators and it would not survive without the help of dedicated veterinarians.

“I am extremely pleased and honored to receive the Pennsylvania Veterinary Medical Association’s President’s Award,” the senator said.

PVMA presented its 2012 President’s Award to the Pennsylvania State Animal Response Team for its work to safeguard animals through disaster preparedness and response, and to create public awareness throughout the commonwealth. The response team, also known as PaSART, helps counties build local teams of volunteers who jump into action when needed.

Congratulations to Senator Judith Schwank, Minority Chair of the Senate Agricultural and Rural Affairs Committee, on receiving the 2013 PVMA President's Award! Also pictured is Senator Elder Vogel, The committee's Majority Chair (left) and PVMA President Dr. Kenton Rexford (right).

34

VOLUME IV 2013

13_Volume_4.indd 34

keystone veterinarian

Agriculture is the number one industry in Berks County, which is why Schwank has brought fellow senators to the region to better understand how local farming and food prices work together.

Sen. Schwank is the Democratic chair of the Senate Agriculture and Rural Affairs Committee. l

WWW.PAVMA.ORG

1/8/2014 3:35:12 PM

Penn Vet Receives Grand Challenges Explorations Grant for Groundbreaking Research in Global Health and Development

T

he University of Pennsylvania School of Veterinary Medicine (Penn Vet) announced that it is a Grand Challenges Explorations winner, an initiative funded by the Bill & Melinda Gates Foundation. Robert M. Greenberg, PhD, will pursue an innovative global health and development research project, “Helminth ABC transporters as targets for combination therapy.”

Grand Challenges Explorations (GCE) funds individuals worldwide to explore ideas that can break the mold in how we solve persistent global health and development challenges. Dr. Greenberg’s project is one of more than 80 Grand Challenges Explorations Round 11 grants announced by the Bill & Melinda Gates Foundation.

To receive funding, Dr. Greenberg and other Grand Challenges Explorations Round 11 winners demonstrated in a two-page online application a bold idea in one of five critical global heath and development topic areas that included development of the next generation condom, agriculture development, and neglected tropical diseases.

Parasitic worms such as schistosomes and filarial and soil-transmitted nematodes infect as many as a billion people worldwide and have

devastating effects on human health and economic development. Dr. Greenberg and Dr. Bernadette Ardelli of Brandon University in Manitoba will explore ways to enhance the effectiveness of drugs against these infections. They will test whether the potency of current drugs can be enhanced by co-administration of compounds that block protective mechanisms the worms use to transport the drugs out of cells and tissues. This approach could potentially increase drug effectiveness and prevent the emergence of drug resistance.

About Grand Challenges Explorations

Grand Challenges Explorations is a US$100 million initiative funded by the Bill & Melinda Gates Foundation. Launched in 2008, over 850 people in more than 50 countries have received Grand Challenges Explorations grants. The grant program is open to anyone from any discipline and from any organization. The initiative uses an agile, accelerated grant-making process with short two-page online applications and no preliminary data required. Initial grants of $100,000 are awarded two times a year. Successful projects have the opportunity to receive a follow-on grant of up to $1 million. l

PVMA Hosts White Coat Ceremony for Penn Vet's Third Year Students

O

n Monday, September 30, staff and officers of the Pennsylvania Veterinary Medical Association met at Hill Pavilion to help the third year students celebrate the receipt of their white coats. Christine Gacono, Director of Education and Events; Dr. Kenton Rexford, President; Dr. Sherrill Davison, President-Elect; Dr. Mary Bryant, AVMA Delegate; and Dr. Susan Ackermann, Alternate Trustee, and Dr. Nate Harvey, Member, hosted a reception for the students on behalf of PVMA to celebrate this milestone, in preparation for the White Coat Ceremony, which was held in November. l

WWW.PAVMA.ORG

13_Volume_4.indd 35

keystone veterinarian

VOLUME IV 2013

35

1/8/2014 3:35:12 PM

Classified Ads

Veterinary Technicians

Veterinarians 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.

SHELTER VETERINARIAN/MEDICAL DIRECTOR needed—full or part time—Pennsylvania. The Chester County SPCA, the only open-access animal shelter in Chester County, Pennsylvania, is seeking a PT/FT medical director who is energetic, innovative, passionate about welfare and willing to assist in movement towards ‘no kill’. Our mission is promoting the welfare and humane treatment of animals in Chester/Delaware counties and advocate on their behalf. Medical director will manage the delivery of required routine, onsite veterinary/ emergency care, infectious disease control measures, and work with Humane Law Enforcement officers as needed. Veterinary licensure in Pennsylvania is/will be required. Salary competitive and negotiable. Contact Emily Simmons, Executive Director (emily@ccspca.org). Chester County SPCA is an equal opportunity employer.

A GREAT opportunity for experienced veterinarian desiring ownership wanted to manage/operate.

4-year-old growing, well-equipped, solo small animal practice in central Pennsylvania. Excellent opportunity and growth potential for ambitious person. No after-hours emergency duty.

Compensation and benefits are competitive and flexible scheduele. Fax resume to 717.620.8173 every resume received will be answered.

MOUNTAIN VIEW Pet Hospital seeks experienced part-time or full-time associate veterinarian to join our small, companion animal practice. Ideal candidate possesses excellent interpersonal skills, enjoys engaging with clients, and is committed to providing the best care possible. Candidate possesses high-quality patient care standards, strong work ethic, positive attitude and leadership qualities.

Future ownership possible to right candidate.

Practice has compassionate staff, loyal clients and has been established for over twenty-two years. We provide office well/sick visits, soft tissue surgery, radiology, in-house diagnostics, and fully-educate our clients on how quality preventive care helps pets achieve longer, healthier lives. Interested candidates should send cover letter/resume to Mountain View Pet Hospital, 739 South Logan Blvd, Hollidaysburg, PA 16648 or by email to jsmvmd@aol.com.

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.

36

VOLUME IV 2013

13_Volume_4.indd 36

CENTRAL VETERINARY Hospital is looking for a full-time day or part-time morning CVT for our new hospital in Chalfont, PA. We will be opening in February and are excited for quality additions to the team already in place. Salary commensurate with experience. Experience with exotics, advanced dentistry and impromed/infinity helpful, but not required. Send resume/CV to jrillingvmd@gmail.com.

WE CURRENTLY have an opening for a full time veterinary technician. New graduates are welcome to apply. The practice includes two busy offices, one in middlebury center and one in Mansfield. The practice is strictly small animal—primarily dog/cat.

The focus of the practice is preventive and general medicine, general and orthopedic surgery. Must be flexible willing to work evenings and weekends.

Schedule will involve hours in both offices. You may email your resume to wsahvmc@ptd.net or mail resume to Jeni Cleveland, 12043 Route 287, Middlebury center, PA 16935. No phone calls please.

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.

Competent medical and surgical skills, practices progressive high-quality medicine. 517.599.1221, rae.braudaway@gmail.com.

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.

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.

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.

SMALL ANIMAL relief veterinarian needed for our small animal practice located in beautiful South 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.

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.

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.

keystone veterinarian

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.

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.

continued on page 37 WWW.PAVMA.ORG

1/8/2014 3:35:13 PM

Classified Ads

continued from page 36 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.

light. Please call 717.692.4792 to inquire about this equipment and other possible items for sale.

Practices For Sale WELL-ESTABLISHED (50 YEARS+) small animal veterinary practice for sale in a northern suburb of Pittsburgh. The practice is situated on 7-wooded acres and includes a building with a grooming studio and 2-bedroom apartment. Owner is retiring and eager to sell. Please call Dr. Robert Hull at 412.486.3172 or email mracvetmed@yahoo.com.

SMALL ANIMAL practice for sale. Located in Luzerne County. Free-standing building included in sale. 2012 gross $406,000. Email doctort@frontier.com.

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.l

Equipment For Sale VETERINARY EQUIPMENT for sale. Equipment from a long-established Central PA veterinary hospital is for sale. Items include: Autoclave (purchased new in 2011), transport table, exam table, portable exam light, ceiling-mounted surgical

Plan to Succeed

continued from page 14

don’t take the time to build logical steps, our plans fall apart and goals are never reached. Remind yourself and your team that our goals are to be spread out over a five-year span that gets us to that defined vision of the future.

Dentistry

continued from page 29

Send dental reminders. Whenever an invoice is generated, a reminder for a follow-up oral assessment will automatically follow. Link reminders to dental group codes. Get dental reminders in my book, The Veterinary Practice Management Resource Book & CD (www.csvets.com/books.htm).

Because optimal service doesn’t just happen, plan a staff meeting to develop a strategy of how your team will deliver A+ dental services and increase client understanding and perception of value. “Don’t think ‘My clients won’t pay more,’ ” advises Dr. Eisner. “You need to show more value.”

Average dental case total

The average dental case is $427, according to AAHA Veterinary Fee Reference, 8th edition.1 This includes a preanesthetic exam, CBC with

Chronic Wasting Disease continued from page 18

• Only cervids from fully certified herds on the HCP can be moved out of or into Pennsylvania.

• Cervids from HCP herds moving to other HCP herds within Pennsylvania can only move to HCP herds of equal or higher status.

• Cervids from HMP herds are only permitted to move to other HMP herds within the state of Pennsylvania. HMP herds may receive cervids from HCP herds.

USDA Level II Accredited Veterinarians are needed to perform a number of functions in Pennsylvania’s CWD programs. Collection of tissue WWW.PAVMA.ORG

13_Volume_4.indd 37

Would you like more guidance? You can learn more about strategic planning by emailing me at brenda@halowtassava.com or Bash Halow at bash@halowtassava.com. Start the new year off with a plan for success that your team can rally around! l Brenda Tassava and Bash Halow are veterinary practice consultants at Halow Tassava Consulting, based in New York City, Indianapolis, and Wyalusing, PA.

differential, chemistry panel with eight chemistries, dental x-rays, 30 minutes of anesthesia, IV catheter and placement, IV fluids, dental scaling and polishing, subgingival curettage, fluoride application, electronic monitoring, post-procedure pain medication, post-procedure injectable antibiotics, hospitalization, and one-week supply of antibiotics. l References: 1. AAHA Veterinary Fee Reference, 8th edition, AAHA Press 2013; p. 115.

2. Verstraete FJ, Kass PH, Terpak CH. Diagnostic value of full-mouth radiography in cats. Am J Vet Res 1998;59(6):692–5.

Wendy S. Myers owns Communication Solutions for Veterinarians and is a partner in Animal Hospital Specialty Center, a 10-doctor AAHA-accredited referral practice in Highlands Ranch, Colo. She helps teams improve compliance and client service through consulting, seminars and webinars. You can reach her at wmyers@csvets.com or www.csvets.com.

samples for CWD testing has been and will continue to be a service for which accredited veterinarians will be needed. In addition, both the annual visual inventory inspection and the triennial hands-on inventory verification must be performed by an accredited veterinarian. A guidance document will soon be coming from PDA which addresses the specifics of the veterinarian’s roles in the new program. PDA Regional Office staff is available for additional information and training.

For additional information, please visit the Pennsylvania Department of Agriculture website at www.agriculture.state.pa.us and select the CWD icon, or visit the Pennsylvania Game Commission website at www.pgc.state.pa.us. l

keystone veterinarian

VOLUME IV 2013

37

1/8/2014 3:35:13 PM

THANK

2013

The Pennsylvania Veterinary Medical Association (PVMA) and the Pennsylvania Veterinary Foundation (PVF) extend a big thank you to everyone who made a donation or volunteered their time to help us in 2013.

Pennsylvania Farm Show Dr. Dave Allgeier Johanna Appel Andrea Barr Dr. Arlene Buchholz Lisa Cassaro Paula Clifford Megen Cummings Dr. Greg Cusanno Dr. Sherrill Davison Joy Ellwanger Sarah Hall Amber Hamilton Dr. Nan Hanshaw Dr. Don Herr Dr. Denise Holliday Dr. Bryan Langlois Kelly Latchford Dr. Lisa Murphy Kacie Oberholzer Angela Poorman Dr. Lloyd Reitz Dr. Ben Rhoads Dr. Larry Samples Beth Shelby Dr. John Simms Dr. James Temple Dr. Trish Thomson Laura Turner Susan Vana Madelein Vind Dr. Mark Walter Dr. Danielle Ward Dr. Dave Wolfgang Dr. Dan Zawisza Mark Zebrowski

Pennsylvania Veterinary Foundation General Donations Dr. Donald and L. Ann Shellenberger Dr. James and Antoinette Orsini Dr. Nathan Harvey Dr. Robert W. Bishop Gene & Kayle Becker Lloyd Bitting Elaine Giorgi Dale & Judy Henne Dr. Ron & Sandra Miller Henry & Dorothy Podtod Dr. Darcie J. Stoltz Robin Bernstein, Esq. Dr. Jay Leeb Holly O'Connor Elizabeth Barrow Marilyn Tibbs Robin Bain Dr. Harvey Bendix

Native American Veterinary Services (NAVS)

Tails From the Trenches Dr. Susan Ackermann Kathryn Bach Dr. Amy Bentz Dr. Mary Bryant Dr. Sherrill Davison Dr. Christina Dougherty Dr. Hope Douglas Dr. Dan Lantz Dr. Chelsea McIntyre Kristine Stellato Dr. Darcie Stolz Nikki Wright

Bark in the Park 5k Run & 1 Mile Dog Walk Dr. Deb Landis and Dan Dr. Heather Berst and Rich Puchalski John and Joan Berst 38

VOLUME IV 2013

13_Volume_4.indd 38

Dr. Cindy Albright and Dennis Ward Dr. Bryan Langlois (aka "Chance")

Christy Grossman Dr. Arthur & Sharon Wirtz Isaac Lyons Susan & Frederick Deremer Stacey Rister Lorraine Victoria Jennifer Locke Dr. HMS Smith P. A. Laurie & William Hance Tara Tilton Sheryl & Reginald Basile Nina Thompson Lisa Plasters & Mario Gaffi Dawn & Matthew Weate Donna & Robert Lizanich Lisa Sterling Paul & Whitney Maffia Nancy & Christopher Bourke Stephen & Kathleen OConnor Danielle & Steven Beyers Matgaret Lefkin Ross & Suzanne Gardinor Dennis & Susan Bartels Elizabeth Gilbert

keystone veterinarian

The Last Chance Fund (TLC) Farrell Veterinary Associates, Inc. Holly Pike Animal Hospital Willow Mill Veterinary Hospital S.M. Gofhus Tom & Teresa Kline Dr. Larry & Barbara Gerson Dr. Dave Dorn Penny Foster Charles McGarry David Buffington Theodore Martin Sherry Houseal David Bartoli Dr. Leslie Elliot Constance Hoon

Memorial Gift Program

Mrs. Mary Jane Umble (in memory of Dr. Calvin Umble) Mrs. Judy Herman (in memory of Dr. Max Herman) Dr. William Hope (in memory of Carol Hope) Dr. William Rogatz Mrs Jane Rozmiarek (in member of Dr. Harry Rozmiarek) Mrs. Joy Hoffman (in memory of Dr. William Hoffman) Mrs Jean Franko (in memory of Dr. George Franko) Mrs Chata Carr (in memory of Dr. William Carr) Peter & Patricia Bobrowski (in memory of dog, Eddi) Frank Cambria (in memory of dog, Crash) Carmine & Joel Franco (in memory of dog, Mugsy) Gloria & Peter Uhdiat (in memory of dog, Reggie) Daniel & Darby Wiekrykas (in memory of dog, Sydney) Mrs. Matthew Murphy (in memory of Dr. Matthew Murphy) Mrs Nancy Reeser (in memory of Dr. Donald Reeser)

PVF Scholarship Fund Dr. Dave Medic

PVPAC Fund

Dr. Ron and Linda Kraft Dr. R.A. Dubensky Dr. Kenton Rexford l

WWW.PAVMA.ORG

1/8/2014 3:35:13 PM

what’s happening

Events & Education 2014 is a license renewal year—let PVMA help you get the credits you need with top notch education offerings!

february 2014

February 8, 2014 10th Annual Winter Conference ACE Conference Center, Lafayette Hill, Pennsylvania 9 HOURS OF CONTINUING EDUCATION WILL BE OFFERED Featured Tracks: • Companion Animal Surgery—Howard Seim, III, DVM, DACVS • Companion Animal Pain Management—Ann Weil, DVM, DACVA • Equine (including ultrasound wet lab) • Practice Management • Student and Recent Graduate Track • Veterinary Technology 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.

april 2014

April 25, 2014

Animal Crimes Awareness Seminar at Penn State: Responding to Animal Cruelty in Veterinary Practice Bryce Jordan Center, University Park, PA CONTINUING EDUCATION WILL BE OFFERED TO VETERINARIANS AND VETERINARY TECHNICIANS If a suspected case of animal cruelty presented to your practice today are you prepared to respond appropriately? Penn State University will be hosting an educational meeting for veterinarians and veterinary technicians that will focus entirely on recognizing and responding to animal

From Where I Sit

continued from page 11

practices and on them as employers and individuals. We also were able to align ourselves with one of the top wholesalers in the country, AMWINs. This relationship allows us to open doors to our members on products and resources related to personal lines homeowners, auto, and renters insurance, long-term care insurance, voluntary products, and much more. If you need help with any insurance needs or questions, please feel free to email us at info@pvmaassure.com.

Our Road to Relevance

As part of governing PVMA over the last several years, our leadership has taken on the labor of love of reading and embracing the Race for Relevance and Road to Relevance by association gurus, Harris Coerver and Mary Byers. Why? Because they understand the need for PVMA to evolve with its changing membership to remain relevant and to develop our areas of strengths by leaving some unneeded projects and initiatives behind to make way for more resources to be dedicated to these strengths. The Executive Committee and I began work on

WWW.PAVMA.ORG

13_Volume_4.indd 39

crimes in veterinary practice. Speakers will include Colleen Shelly, Animal Crimes Institute; Elizabeth Anderson, Pennsylvania SPCA; Dr. Elizabeth Santini, Pennsylvania Dept of Agriculture; Dr. Jason Brooks, Penn State University; and Trooper David McGarvey, PA State Police. The meeting will be held on Friday, April 25, 2014, from 8:00am–5:00pm in Room B of the Bryce Jordan Center on the Penn State Campus in University Park, PA. Register by March 21 to get a reduced registration fee. For more information, visit http://adl.psu.edu. To register contact Rynne Crissinger at the Animal Diagnostic Laboratory, 814.863.0837 or rmo110@psu.edu.

may 2014

May 28-29, 2014 15th Annual Spring Clinic Penn Stater Conference Center Hotel, State College, Pennsylvania 12 HOURS OF CONTINUING EDUCATION WILL BE OFFERED Full details and online registration will be available in 2014 at www.pavma.org.

august 2014

August 14-17, 2014 8th Keystone Veterinary Conference Hershey Lodge, Hershey, Pennsylvania 30 HOURS OF CONTINUING EDUCATION WILL BE OFFERED Full details and online registration will be available in 2014 at www.pavma.org.

november 2014 November 1-2, 2014 7th 3 Rivers Veterinary Symposium Sheraton Station Square, Pittsburgh, Pennsylvania 12 HOURS OF CONTINUING EDUCATION WILL BE OFFERED Full details and online registration will be available in 2014 at www.pavma.org. l

identifying our strengths this November and the management team and I are now working on ways to cut out some of the things which pull resources away from those strengths. 2014 will be a big year for us as we make some tough cuts and streamline how we manage the association for the betterment of our members. I encourage you to share your thoughts with me on what you think our strengths are.

This is just a small sample of the many ways we have been hard at work on your behalf. In 2014, we will continue our efforts on behalf of Pennsylvania’s veterinary team and are excited to continue many of the initiatives that got their start this year. Stay tuned for more information! If you have any questions or have any feedback on what we can do for you as a member, feel free to email me at cwandzilak@pavma.org or call 1.888.550.7862.

Best wishes for happy and prosperous 2014! We look forward to serving you as a member in the coming year. l

keystone veterinarian

VOLUME IV 2013

39

1/8/2014 3:35:13 PM

the grand finale

Laughter Is the Best Medicine Dogs Mobilize Against Terrorist Threat Courtesy of Dean Scott, FunnyVet.com

T

he terrorists known as squirrels have a new enemy to deal with.

"We're done with the ineffectual barking and just chasing them back over the fence-line," Tank, a black Lab and leader of a new outfit known as Squirrel Team 6 explained. "We're going to make a statement."

Tank has had enough of waiting for his people to deal with the situation. "These guys. They ain't scared of us. They just keep on comin' into our yards, onto our sovereign property, chattering their stupid little squirrel talk. They've got some people fooled." He adopts a high falsetto, "Oh, look! Aren't they just the cutest things! No, Tank, no! Don't chase them!" They're vermin!"

Tank has assembled a crack team of canines to implement a plan to get rid of this enemy for good.

Former military working dogs King, Big Harold, and Mr. Nickles have worked together before. "Yeah, we can't, ya know, talk 'bout our missions, ya know," King explained succinctly.

Another member, a mixed-breed named Wolf, comes from a dubious background. Tank tells us, "He's been in and out of pounds. Some people say he's unstable, but as long as you don't look him in the eye

too long, he's good.

He's a remarkable tactician."

The last member of the group, a Dachshund named Ray, is also the youngest, relatively green in comparison to the veterans around him. "They've got me because of my eyesight and speed. I, mean, come on, look at these guys—bad hips, chipped teeth, a little cataracts. They need me!" He then proceeded to pass around a picture of his latest girlfriend who he declares is "the One".

Bringing their meeting to order, Squirrel Team 6 recited their code: "To kill, you must know your enemy. And in this case, my enemy is a varmint. And a varmint will never quit—ever. They're like the VietCong—Varmint Cong. So you have to fall back on superior firepower and superior intelligence."

While we can't print details due to Neighborhood Security, we can tell our readers that they can feel safer knowing this team is on our side.

Tank gave us some last reassuring words, "We will not rest. We will not tire. We will hunt these terrorist squirrels down until they … Ball!" l

Our Feline Friends in Their Finest Courtesy of Funny Cat Site

final words of wisdom "A bad attitude is like a flat tire, you can’t get very far until you change it."

40

VOLUME IV 2013

13_Volume_4.indd 40

keystone veterinarian

—Author unknown

WWW.PAVMA.ORG

1/8/2014 3:35:14 PM

13_Vol_4_cover.indd 3

1/8/2014 11:27:50 AM

PVMA 8574 Paxton Street Hummelstown, PA 17036

13_Vol_4_cover.indd 4

PRSRT STANDARD US POSTAGE PAID HARRISBURG, PA PERMIT NO. 533

1/8/2014 11:27:51 AM