How To Maximize A Clinic’s Cash FlowNovember 29, 2011 The current economy has affected veterinary practices in many ways. Practice owners can use a multitude of tools to manage through these challenging economic times. Practices have experienced record drops in revenue, a decrease in the number of patient visits per year, lower average transaction cost, greater marketing expense and an overall greater demand on time to just maintain the same level of revenue as two years ago. This has forced many practice owners and managers to find ways to improve cash flow to cover the practice’s expenses. Several steps can help to alleviate the cash flow crunch. The supplies and drug inventory should be closely inspected and analyzed to get cost of sales in line with industry standards. Aggressive marketing campaigns can generate new business and retain current customers. When these basics don’t pan out, an owner might consider reducing staff hours to ensure that the lay staff salaries are appropriate for the amount of revenue being generated. The next step might include reducing associate DVM hours and having the owner cover additional hours. The true challenge as a manager or owner comes when these methods still do not provide the cash …
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Banking Stem Cells A New Option For AnimalsNovember 29, 2011 Cryobanking allows pet owners to put something away for a rainy day—their pets’ stem cells—in case the animal suffers arthritis or degenerative disease later in life. “Banking stem cells is like having an extra insurance policy for your pet,” explained Jeremy Delk, CEO of MediVet America of Nicholasville, Ky. MediVet sells in-clinic equipment and the adipose stem cell procedure kit, as well as provides banking services for harvested cells. After a regenerative medicine procedure, the veterinarian can send any leftover cells to MediVet’s laboratory in Nicholasville, where they will be banked for future use. This is a good move, Delk said, because stem cells do not cure the degenerative diseases for which they are indicated. Instead, stem cell therapy reduces the inflammation and pain associated with osteoarthritis and degenerative joint diseases, and it provides healing to the joint, but that joint might need a future treatment, or a different joint might need treatment. Banking extra cells allows a second procedure to be done without having to harvest new tissue from the pet—a cost savings to both the veterinarian and the pet owner. Cryobanking is the long-term preservation of the fraction of hemopoetic stem cells that …
Baby On BoardNovember 28, 2011 Most of us have heard that there are more female students in veterinary school than male students. This preponderance of estrogen will likely have various effects on the profession, and many of them will reflect the reality that often it is the female who bears the brunt of starting a family. The female of a couple is often responsible for a lot of the parenting. That’s not to say there aren’t “househusbands,” and this may be one trend we see climb in the veterinary profession. But out of necessity or pure desire, Mom will need to make time for her family and begin the challenging task of balancing work and home. Creating a Plan As an employee, the female veterinarian who intends to have children must have a frank discussion with her employer as to what they each expect and will tolerate. This requires the veterinarian to determine what those expectations look like on her end, to see if an agreement is possible. How much time off do you expect to need, depending on the ages and number of children in the household? What shifts can you work, and what times are reasonable for …
Putting A New Nutritional Tool To WorkNovember 7, 2011 The word is out: Nutrition is a new option for managing cats with hyperthyroidism. Limiting dietary iodine induces euthyroidism in cats that have naturally occurring hyperthyroidism, according to studies by Hill’s Pet Nutrition Inc. of Topeka, Kan. Hill’s determined that if the iodine content can be kept below 0.32 ppm, hyperthyroidism in cats can be controlled through nutritional therapy alone. Hill’s released its Prescription Diet y/d Feline Thyroid Health in dry and wet formulations in October. Hill’s describes the food as a daily, low-iodine nutrition solution designed to manage hyperthyroidism in cats, and says it is clinically proven to improve thyroid health in three weeks. The next step is incorporating this new option into the veterinary practice. First Things First: Diagnosis “Fortunately, diagnosing [feline] hyperthyroidism is pretty easy,” said David Bruyette, DVM, Dipl. ACVIM, medical director at VCA West Los Angeles Animal Hospital. Hill’s invited Dr. Bruyette to use the pet food with some of his patients before the new product’s launch. “Most veterinarians now are screening older cats by measuring T4, the major thyroid hormone,” he said. “The vast majority of cats—about 93+ percent—that are hyperthyroid will have a high total …
What’s Beyond For Baby Boomers And The HAB?November 3, 2011 As a baby boomer, I officially enter my senior years when I turn 65 on Nov. 5. My husband, Ira Lifland, who is two months younger than I, follows in January. We are glad to be eligible for Medicare and thankful to be able to save a lot of money on our health insurance premiums, which were more than $30,000 last year. Even though we are healthy, our premiums have been upped annually, paralleling the profits of our carrier. Going on Medicare will be a raise for us. Our strategy is to forgo Social Security payments until we turn 70 so we receive more in the long run if we survive past 80. Ira always envied me for loving what I do. This profession is wonderful, and I enjoy working our concierge referral practices. Animal Oncology Consultation Service and Pawspice is one. Carreen Lynch, RVT, is my Pawspice partner. Pawspice offers palliative care and gentler standard care for cancer patients. It transitions into hospice as the patient’s quality of life declines or if death is expected soon. Carreen has worked with me for most of the past 25 or so years. She has read my …
What To Say Back When Money TalksNovember 2, 2011It is a scene that’s all too familiar. We know what needs to be done for a pet’s health, but the client cannot afford the care. They come to us for help, but we are stopped short by the tough choices they have regarding how much they can afford. Some people go much further than we’d imagine, even spending kids’ college funds and mortgaging the house to save their pets from extreme illness or injury. But we’ve also seen people who think the veterinary profession should provide care even when they can’t pay for it. When we have to explain that the pet owner is responsible for funding the pet’s treatment, they often question our emotional attachment to animals in general, or accuse us of letting a pet die. This is when veterinary medicine is the toughest, when we are made to feel responsible for their inability to pay. What do we do when faced with this situation? Which of several options we use will depend on the situation and the client’s frame of mind. The Humorous Approach Sometimes, particularly with clients who comment on the price but don’t seem to be disappointed or angered by the total, it can …
Are our patients being sold out by Big Pharma?November 2, 2011Only a fraction of the drugs we veterinary professionals use on our patients are actually approved for use in veterinary settings.
Technology Brings Stem-Cell Therapy In-HouseNovember 2, 2011 Stem-cell therapy for the treatment of joint diseases in animals, particularly dogs, cats and horses, has been available in the U.S. for a number of years. Today, second-generation technology is enabling more veterinarians to take advantage of this modality by making the investment less expensive and improving the process and delivery. Proponents say stem cells harvested from adipose tissue accelerate the healing of muscles and joints in adult animals suffering from osteoarthritis, hip dysplasia, ligament and cartilage injuries and other degenerative joint diseases. Researchers have found that “activating” stem cells before returning them to the animal’s body enhances the healing of these musculoskeletal problems. “This technology can be adapted for any animal, be it a dog, horse, cat or an exotic,” said Mike Hutchinson, DVM, owner of Animal General of Cranberry, near Pittsburgh. “We take that individual’s fat, process it and activate the stem cells. Then, we put them back into the same animal. We are using the animal’s own repair system, the adult stem cells.” Because it is an autologous procedure, he said, it is safe and effective. MediVet America of Nicholasville, Ky., is the company that sells the in-clinic equipment, adipose stem …
The $10,000 DogNovember 1, 2011 When Christine Gowen took her 7-year-old Labrador retriever, Shelby, to the veterinarian for a cough in January 2010, she could not have been less prepared for the eventual outcome. After an initial diagnosis of kennel cough, a few days on medication and several follow-up calls to the veterinary hospital, alarm bells started going off all the way around. Gowen, an employee of Veterinary Pet Insurance Co. (VPI) in Brea, Calif., has seen many examples of veterinary medical issues that were more serious than they originally appeared, so she and her family were concerned. The veterinarian took some radiographs, and the journey to the $10,000 medical bill began. Shelby presented with no history of trauma or cardiac/respiratory disease, had not been to the dog park, boarding kennel or groomer recently, and appeared to have a normal appetite and energy level. Her owner indicated that she was breathing oddly, taking deep, slow breaths, and was coughing occasionally. The exam was relatively unremarkable, although her respiratory rate and heart rate were elevated at 28 and 90, respectively. Diagnosis Shelby was re-presented on emergency a week later. She was in obvious respiratory distress, was tachypneic and had decreased …
Lavage Or Drug—What’s The Right Treatment?November 1, 2011 When a horse or companion animal becomes sick or lame, the owner turns to his trusted veterinarian for a diagnosis and the best proven treatment to make his animal better. However, what is prescribed might not always be the best option, as when a lavage solution is injected systemically. So do you treat with an FDA-approved drug, a generic drug, a medical device or a compounded product? In considering this question, Jeffrey Berk, VMD, a veterinarian at Equine Medical Associates in Lexington, Ky., says two things need to be considered very carefully. “You need to consider the safety of the patient and the liability or legal issues regarding the use of those products,” says Dr. Berk, a member of the Executive Committee of the American Association of Equine Practitioners. FDA-Approved Products “It’s important for veterinarians to understand that they are not guaranteed the same level of quality, i.e. potency and purity, that you would be with an FDA-approved product,” Berk says. “And if there is a therapeutic failure, the veterinarian has more legal exposure when treating with medical devices or compounds than when he treats with FDA-approved products.” Some experts estimate it takes …
