We All Have Stake In Next GenerationJanuary 31, 2012First of Two Parts Hi. My name is Patty and I’m in debt. As you may know from previous columns, I’m up to my ears in it. And that’s OK. In fact, it’s exactly as I expected it would be when I accepted an out-of-state seat in the University of Pennsylvania’s Class of 1995. At the time, students like me were riding the first wave of veterinary medicine’s new world order for graduates. The profession was just beginning to realize what being a new graduate in veterinary medicine could mean: over $100,000 in debt and a starting salary incapable of allowing graduates so besieged to meet their debt payment schedules. No whining here. Just the facts. And as you may know, it’s gotten way worse since then. That’s why understanding the extremes of debt we know new grads will encounter is crucial to the future of veterinary medicine. Mark my words: Helping new graduates deal with the financial pain they face will be fundamental to creating a healthy and sustainable profession as we move into uncharted territory on the debt front. Because it’s not just about the young ’uns. Indeed, no matter where you …
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With Thyroid Replacement, Consistency MattersJanuary 30, 2012 Everyone is aware of the economic challenges facing veterinary practices today: Visits to the veterinarian are down, and clients are getting concerned about some pet care costs. Some are even selecting alternate resources, including online pharmacies, and requesting prescriptions to have medications filled at human pharmacies at a lower cost. Practice managers or buyers might try to economize by going for the least expensive option when purchasing medications to stock for the clinic pharmacy, to help offset some of these concerns. Medically speaking, if veterinarians are dispensing human generic products in certain categories, there may not be a big difference in the actual product, but this is not the case for every prescription. Educate your staff and clients about when quality and consistency count, such as with thyroid replacement therapy. Overall, some aspects of hypothyroidism in dogs are fairly straightforward and simple. Most cases arise from irreversible acquired thyroid gland disease, due to either immune-mediated lymphoid thyroiditis (a heritable trait) or idiopathic follicular atrophy (normal thyroid tissue is replaced by connective and adipose tissue). In the immune-mediated form, there is a chronic, progressive lymphocytic destruction of the thyroid gland with a slow onset. Auto antibodies …
Welcome To Election Year Tax LimboJanuary 30, 2012 Question: Is there going to be a massive change to the tax code? Answer: Maybe yes, maybe no. Probability: A group of people will pass a group of tax-law modifications about which they know very little and these mods will change taxes. Certainty: Taxes will get more complex, as always. There are deep economic theories at play along with deep politics. There are groups with political agendas shouting that taxes are going up and if you earn more than $250,000 per year you will be hit hard. There are others pressing mightily for dramatic tax cuts in the name of economic expansion. Either could happen, but has not yet happened across the board with any certainty. It is, unfortunately, in the control of the group of people discussed above. Changes Likely in 2013 The Tax Relief, Unemployment Insurance Reauthorization and Job Creation Act of 2010 was passed in December 2010 and extended the Bush tax cuts for two more years (2011 and 2012), thereby leaving the maximum individual tax rate at 35 percent through 2012. The 15 percent capital gains tax rate stays in place for 2012. Unless Congress takes action, this …
Stop Expecting FailureJanuary 20, 2012 Recently I was in a hotel in Orlando, not really “watching” television, but it was on in the background. Along came a commercial for inventors. It was a company that you could send your invention to, and they would try launching it for you. It went on to talk about a guy who invented a drive-through “car wash” water sprinkler that allowed the child to ride under on their little tricycle or Big Wheels and subsequently get wet and have fun! Apparently this invention was then bought by Wham-O, a name we all know from the toy industry, and the inventor financially benefited from his invention. Great success story, and very motivating! Then, as the commercial is finishing up, I hear the announcer say in a low voice, “Results are not typical; most inventions do not succeed.” Seriously, that’s what he said! What a downer! I mean really, you psych up the inventor with this awesome success story, but have to qualify it with the fact that most inventions are losers! Heaven forbid that the viewer get just a little excited about the possibility of success! I just couldn’t help but burst out laughing at the irony of …
Is Early Neutering Hurting Pets?January 16, 2012Early neutering has become the norm in the U.S. Some states are asking voters to pass initiatives requiring citizens to sterilize their pets no later than puberty. Overpopulation is the driver. But what if large-scale studies found that early neutering jeopardizes the health of our pets? What if we found enough epidemiological evidence that early neutering of pet dogs may open them to orthopedic, behavioral, immunologic and oncologic issues? A veterinarian who treats canine athletes has raised questions about early neutering. In an opinion article, Christine Zink, DVM, Ph.D., Dipl. ACVP, weighs the advantages and disadvantages of early versus late neutering when considering the performance and health of canine athletes. The article, “Early Spay-Neuter Considerations for the Canine Athlete: One Veterinarian’s Opinion,” appears on Dr. Zink’s website. Click here to review the thought-provoking article and to look at the references. Zink assembled 18 references to support her article. Some show that dogs spayed or neutered early are taller than dogs spayed at an older age. Zink notes that sex hormones have a role in bone density. She concludes that the structural and physiological differences in dogs neutered early may be the reason veterinarians are seeing a …
Four Things We Do That Make No SenseJanuary 9, 2012 Arguably, we all do strange things in daily practice. Some are acceptable, and some…not so much. Let’s go over four classic no-nos. 1. Wearing a mask that covers your mouth, but not your nose. I have seen several doctors and technicians wear a surgical mask that covers their mouths, but not their noses. The explanation is typically that they “can’t breathe” when the mask covers their noses. Since there is no reported case of someone suffocating while wearing a surgical mask in the history of modern medicine, it is imperative to understand that masks are important to protect our patients as well as ourselves. The mask decreases the risk of microbes being blown onto or into our patient. This is especially critical at a time when a strikingly high percentage of healthcare professionals have been found to harbor MRSA in their nostrils. Scott Weese, a board-certified internist-turned-infectious disease specialist at the University of Guelph’s Ontario Veterinary College (Canada), agrees: “The nasal passages harbor a wide range of bacteria, including a multitude of opportunistic pathogens. If someone is taking precautions to prevent contamination from oral bacteria, it makes no sense to neglect nasal bacteria, since the chance …
Can An HMO Help You Achieve Professional Bliss?January 6, 2012 While many veterinarians are struggling to make pet care affordable through third-party payment, compromise, pet insurance and—let’s face it—discounts, designing an in-house health maintenance organization is the natural progression of this thought process, says Louise Dunn, a practice consultant at Snowgoose Veterinary Management Consulting in Greensboro, N.C. An HMO is fair to the practice as well as the client, and it enables pets to receive the best possible preventive care year round. Some corporate practices, as well as some private clinics, have already embraced the idea. Although HMOs tend to have a bad reputation in human medicine, the concept in veterinary medicine is very different. The plan is set up and managed entirely by the clinic, not by a health insurance plan. Plan components are chosen by the clinic, not by a distant, faceless administrator. The fees are chosen by the clinic, not dictated to please shareholders. When you are ready to start the process, consider these seven steps: • Sit down with a few key team members to brainstorm about the opportunity and weigh the pros and the cons. • Design different plans, offering an increasing number of services and products as the level (and fee) …
Financing A New Building In This EconomyJanuary 5, 2012 The current economy has given rise to many questions about how a veterinarian should go about financing the construction of a new facility. The buzz in the marketplace is that construction costs are not coming down, appraisers are approaching the market conservatively and banks have tightened credit standards for real estate lending. All these statements are true. But many veterinarians just don’t have enough space to continue to grow their businesses and need new facilities. Will all this news prevent a veterinarian from securing the needed funds to build her building? It doesn’t have to. There are different financing options and one of the scenarios can work for your situation. The market has three primary products available for veterinarians looking to construct or renovate their facilities: conventional bank financing, SBA 504 loans and the SBA 7(a) loan product. The best loan type for your project depends on the appraisal, cash equity injected into the project, current business cash flow, size of the project and additional items important to each lender. As you begin your evaluation of the loan products, it is important to consider each loan type and talk to lenders involved with each product. …
Let’s Regard End Of Life As A Distinct StageJanuary 4, 2012 While I discussed end of life (EoL) care with Dr. Don DeForge on Connecticut radio, an exciting idea flashed through my mind. We were finishing a 45-minute discussion when I said, “It is time for us to declare, once and for all, that end of life is a distinctly new stage of life. Veterinarians were taught to support four main stages of life. We were not educated to focus our professional attention and develop the skills and expertise for the very important and inevitable ‘End of Life Stage.’ “We need to provide more EoL services because society’s human-animal bond demands more care in this area despite the recession and fewer office visits.” The main life stages we are educated to support are: • Puppy and kitten stage • Adult stage • Senior stage • Geriatric stage I propose a fifth life stage, the End of Life Stage. It is the only life stage that can occur during the other stages. With luck, EoL may not impose itself on the kitten and puppy stage, but sometimes it does. Let’s start thinking about EoL as an inevitable life stage that deserves more focus and expertise in management. …
Thou Shall Not Judge … Your ClientJanuary 3, 2012We’ve probably all been there, standing across an exam table from a client who doesn’t seem too enthused about sticking a pill, squirting a liquid, or cramming a capsule down the mouth of their pet. So, being good veterinary professionals, we pull out all the advice and tricks of the trade … pill pushers, pill pockets, restraint tips, confidence coaching, you name it. If we still end up with a client that “refuses” to medicate their animal, it is easy to judge them at that point as inadequate pet parents, or worse. It affects our respect for that client, and ultimately, the way we treat them in our practice. Think you can fake it, and not let your inner feelings show? Think again. In fact, let’s think of this in a whole different way. Shannon Fujimoto Nakaya, DVM, wrote a wonderful book called “Kindred Spirit, Kindred Care.” In this book, she encourages pet owners to look at their options and decisions regarding their pets in several different lights. She speaks of how to choose a veterinarian, how to assess the patient, advice on understanding the diagnosis and options, the sometimes limited financial commitments, and …
