The Wagging Tail

No question about it – these are trying financial times. Fortunately, the stature of the family pet has never been higher, and more than 80 percent of pet owners DO NOT intend to spend less on their four-legged family member in 2009. The American Pet Products Association (APPA) expects pet spending in the U.S. to increase 5 percent this year. In spite of a serious recession, that’s amazing! The APPA predicts the biggest beneficiaries of this year’s growth will be the veterinary care and pet food categories. Dogs and cats must eat, and pet owners have a propensity to bring their pets in for veterinary care.

The ever-present challenge for veterinary professionals is to demonstrate the value delivered. According to a PiperJaffray study of 248 companion animal practices, “While we were impressed with overall growth expectations, we would highlight that nearly 70 percent of the clinics we surveyed believe pet owners are deferring some treatment this year.” The BNResearch PetPoll 2008 concluded that “…with household budgets getting tighter due to the economy, clinics can expect more scrutiny and questions related to the cost of veterinary services. If pet owners do not understand the value of the services they are receiving, hospitals are at risk of facing both unsatisfied and lost clients.” Clearly, it’s never been more important to clearly explain the value you deliver.

So, how do you communicate value?

• See patients and clients on-time. Your client’s time is valuable and finite
• Articulate the comprehensive physical exam as conducted
• “Show and Tell” clients what you see, hear and feel
• Spend adequate time with clients, and probe for pet health questions
• Cliché, but true, a picture is worth a thousand words. Show Me!
• Demonstrate the cost of non-compliance:
  • Obesity likely results in osteoarthritis, shortened longevity, expensive NSAIDS and lab tests
  • Periodontal disease only worsens without veterinary intervention. The systemic risks are significant (see Dr. Glickman/Purdue CVM study of 60,000 dogs linking gum disease with heart disease)
  • Heartworm disease, as well as other diseases, is MUCH less expensive to prevent than to treat

Dogs and cats don’t know or care that the economy is weak. Their health care needs remain unchanged. As Dr. Marty Becker has said, “Your job is to be the spokesperson for the pet’s best interest.” Your oath is to protect human and animal health. Be the pet’s advocate, and everybody wins!

It all comes down to this.   The knowledge from four intense years of study, summed up in one terrifying day (seven hours to be exact) of multiple choice examination.  Ready, set, go!

I have wanted to be a veterinarian since I can remember first being asked the question, “What do you want to be when you grow up?” Twenty-something years later, here I am, six months away from graduation; a lifetime of dedication to get here, over $100,000 in debt, and there is one more hurdle to cross before I can finally call myself a doctor – the North American Veterinary Licensing Exam (NAVLE). 

This certainly isn’t the first standardized exam that has popped up during my education. College preparation included the ACT and SAT, and vet school admission involved the MCAT and GRE. I have obviously survived them all, so why does the NAVLE seem so intimidating?

For me, the NAVLE is a rite of passage. It is an assessment which marks the transition from student to professional. The usual test anxiety questions pop into my head: “What if I fail? What if I sleep though my alarm? What if I forget my 2 forms of identification?” These all feel normal.  The question that I’ve never dealt with before is: “What will passing this test indicate? Does it mean I am ready to be a doctor?”

It is this question which has inspired me the most to dedicate plenty of time for studying. I see NAVLE preparation not just as a bunch of questions which I would like to answer correctly. I see it more importantly as solidification of the knowledge that I have learned over the past few years, and an opportunity to make sense of and build on that knowledge before I step out into the field to put it to work.

The trick to NAVLE preparation is allowing adequate time for studying, setting realistic goals, and avoiding burnout. I began NAVLE preparation my first year by signing up for the free online Zuku Review question of the day. VetPrep is another internet site that provides practice questions and examination, and I purchased its 6 month preparation course at the beginning of my fourth year. From my past experiences with standardized examinations, I know that my success is not only dependant on how broad my knowledge base is, but also how comfortable I am with the testing format, time constraints, and taking educated guesses. Online practice tests found though Zuku Review, VetPrep and the NBVME site are valuable. Reviewing old class notes and reading board review books has also been helpful. Studying obviously takes time and energy, so I arranged my course schedule to allow for a free block during the month prior to the NAVLE.  

As the NAVLE approaches, I find myself comforted by advice from graduates in years past. Study hard, avoid burnout by taking frequent breaks, get plenty of rest and absolutely do not study the night before the exam. Wish me luck!

Too many cats and kittens is currently a major concern to the shelter community.  Data shows that 70,179 cats and kittens entered Colorado shelters in 2008, with 34,619 being adopted, a mere 5,175 reunited with owners and 24,619 euthanized. Only by working together can we improve these statistics.  Clearly, there is a lot to do. This blog describes some efforts to attack the problem. Your feedback is welcomed.

First, let me say that it helps the Dumb Friends League (DFL) and the shelter community to have positive working relationships with Banfield, The Pet Hospital, as well as other large practices.  Locally, it helps that we have a strong partnership with the Denver Area Veterinary Medical Society.  All of us working together benefits the pets and people we serve.  Here are a few examples:  

Have you noticed the beginning of an advertising shift related to the image of the cat?  This is no accident. Two years ago, the DFL and the Hawaiian Humane Society brought together a group of about 50 stakeholders that included industry, academia, marketing, other nonprofit leaders and the veterinary community.   They came from all over the country for two days of brainstorming on how to “rebrand Felix”—in other words, to change the perceived value of the cat from negative to positive in everyone’s minds.  The intended result is that more cats will receive regular veterinary care, better quality food and be kept safely indoors—plus more will be adopted from shelters. A similar effort started about the same time in California.  Shortly thereafter, the two groups formed the national CATalyst Council.  Jane Brundt, DVM, is its chair. I am a member.  Syndicated columnist and radio host Steve Dale is a member, as are others with national clout.

Two years ago, the DFL worked with our partners in the Colorado Federation of Animal Welfare Agencies to pass legislation that requires mandatory spay/neuters at all Colorado shelters and rescues.  Because few shelters have in-house veterinary staff, most are working with local veterinarians to comply with the law, which took effect last January.

The DFL tried another legislative tactic last year—a bill that would have required urban-area cat owners to ID their cats with a tag or microchip.  The purpose was to reduce the number of unidentified cats in shelters, thus reducing costs to municipalities of maintaining, adopting or euthanizing these pets.  Some lawmakers thought it was frivolous.  The bill never made it out of committee—but we are undeterred. We plan to introduce the bill again in 2010.  

Last year, the DFL and the DAVMS spearheaded the CHIP YOUR CAT campaign. With 100,000 donated microchips from Bayer resQ and HomeAgain, we offered cat owners a year-long opportunity for free microchip implants and wellness exams at shelters and participating veterinary clinics in our six-county area.  While only about 20,000 cat owners took advantage of it, it still represents quite a number of potentially new clients for the veterinarians and thousands of cats that now have identification, making their return home a lot more likely, if they get lost.  

Together, we are making inroads.  None of us could do this alone.  This will be a long-distance marathon, not a sprint.  It will take years, but I believe we’re on the right path to addressing our cat/kitten concerns.

“There’s only so much I can do!”  How many times have you wrestled with the feeling that you didn’t accomplish enough?   At the end of the day, you think about the patients and clients you interacted with, reflecting on whether or not you did everything you could to measure-up to your standard.  Your mind then shifts to a conversation you had with a team member that morning, and you question the way you handled the exchange. 

Dealing with sick animals, bereaved clients, newly hired team members, managing the practice and trying to be the family person you want to be is a tall bill.  Being a veterinarian is rewarding and yet, absolutely taxing – physically and emotionally at times.  You love, and are devoted to, your family and your job, but the demands of both get to you, maybe more often than you’d like to admit, even to yourself.

Renee Rucinsky, DVM, DABVP, and contributing writer for dvm360.com, refers to the feeling of emotional overload in her article, Compassion Fatigue. What is compassion fatigue?  We know that compassion is about feeling for others while fatigue is related to a lack of energy. Dr. Rucinsky believes that compassion fatigue is a state of complete exhaustion that leaves a person feeling physically and mentally overwhelmed.

No doubt, we’ve all experienced extreme stress at times, but veterinarians are more likely to suffer from compassion fatigue for a number of reasons: 1) the profession inherently calls upon vets to deal with many intense emotions on a daily basis 2) vets are innately caring people which means they feel for others on a very deep level, and 3) vets tend to be perfectionists, which causes them to expect too much from themselves. 

What can you do to combat compassion fatigue? First, know the symptoms. In Dr. Rucinsky’s article, her list includes, “excessive complaining, isolation, compulsive behaviors (excessive spending, eating or other addictions), poor sleep habits, poor hygiene, apathy, difficulty concentrating, recurrent infections or chronic aches and pains.” Using a few of Dr. Rucinsky’s techniques as a guide in fighting compassion fatigue, start by saying “No” to stepping out of the exam room to answer that non-emergency client call, and reduce your stress by empowering your team to handle any issues that arise.

There are steps you can take to change things – and that might even include seeking professional help. We all know what’s good for us. Dr. Rucinsky touches upon the usual such as regular exercise (taking a brisk walk during your lunch hour), making healthy food choices (brown bagging it instead of heading for fast food), surrounding yourself with positive people (the vet tech who’s always willing to jump in and help wherever needed), for example.

If you start from within, you can consciously change your attitude – and that’s a good first step to a better outlook on life that will ultimately help you combat compassion fatigue.