Larry Nemetz, DVM, has turned his dream clinic into reality after about 20 years in practice. Today he sees only birds, after working in general practice and later with exotics and birds. He opened The BIRD Clinic in 1987, at first keeping night and weekend office hours there and working at other clinics during the day to stay afloat financially while he built his avian practice. Over the years, Dr. Nemetz made note of the things he didn’t like about office layouts and work flow. He spent five years planning and designing his new practice, inspired by the explosion of medical technology and wanting to turn those tools to the betterment of his patients. His 2,100-square-foot clinic in Orange, Calif., represents an investment of nearly $2.4 million, counting the land, the building and the practice but counting no equipment except his digital radiography system. It opened in 2007. Nemetz’s surgical suite alone houses $250,000 worth of equipment, including videorecording setups, endoscopy and electrosurgery units – “In birds, no one uses scalpels anymore.” Still, a simple household appliance is one of his most important tools. “The Dust Buster is the key to all avian practices. I thought it was a natural,” he explains in his signature rapid-fire delivery, the classic fast talker showing off the appliance. Birds, after all, are messy. “But I have talked to people who never heard of a Dust Buster.” Click images to enlarge Dr. Nemetz with a patient The BIRD Clinic’s treatment room includes a wet table, center, and a food prep area, left. The surgical suite is through the doorway at right. The clinic's surgical suite. Dr. Nemetz welcomes a client in the clinic’s lobby. Custom-made Nemetz Avian Bandage Scissors. His voice registers his disbelief. Each exam room at The BIRD Clinic is equipped with a Dust Buster, computers with flat screens and wireless keyboards—“Birds like to chew on cables,” notes Nemetz, 49. He often treats birds in the exam rooms instead of taking them to the back, a gesture his clients appreciate. “Clients like to watch, so when I can I’ll do things without taking the bird to the back. That’s how you teach. Your best assets are your clients; if you educate them, it helps you. They’re with their birds all day long and see things you never will.” The clinic is built around the needs of birds. “Some people put birds on heating pads to keep warm,” Nemetz says. “In surgery, I heat up the whole room to 78 degrees. Friends always wonder why my birds live. Hypothermia is the No. 1 cause of death in birds. When you open their bodies, they cool.” Nemetz is the son of a dentist and the nephew of a plastic surgeon. He attends veterinary and human dental trade shows, and when he finds a snazzy new state-of-the-art device in the human world, it gives him ideas. “I’m always looking at how I can adapt technology from the human world into my practice,” says the native Californian, who has attended dental conferences annually since 1989. “For most intents and purposes, 80 percent of what we need has already been discovered. Why reinvent the world?” Nemetz works closely with his various equipment suppliers, and if he can’t find what he needs, he’s not afraid to ask for it. Much of his equipment has been tweaked to his needs, sometimes even built to his specifications. Take, for example, the Nemetz Avian Bandage Scissors from Sontec Instruments Inc. of Centennial, Colo. They are sharp and serrated, with a small but thick tip that doesn’t twist so Nemetz can cut off casts without breaking the tool. They started out as a not-quite-right tool that Nemetz asked the supplier to change. Sontec obliged. “I’ve always been interested in making things better when it comes to performing my job, and I have been talking to manufacturers for years about the needs of an avian veterinarian,” he says. “As expected, they were not too interested [in my needs] at first. But over a few years I have gotten some of them to warm up to my ideas and take a chance. Luckily, many that have helped me have found a new revenue stream that they did not realize was a possibility before meeting me. “This is a win-win situation, and I believe it is why I have a good rapport with many companies today.” Efficiency is among Nemetz’s guiding principles. “I’d been in practice long enough that I knew the common flaws, and I tried to correct everything I didn’t like. In my previous clinic,” he says by way of example, “it was 18 feet from the incubator to the scale.” In this clinic, a scale sits on a counter opposite the incubators. “Now it’s just a question of moving a bird two or three feet back and forth instead of 36 feet both ways. It saves a lot of time.” Other features of the clinic include an oxygen generator so he doesn’t have to worry about running out; a pharmacy; an intercom system; video surveillance both in the clinic and outside; and a computer server room. “Trying to get all the computers talking sometimes is a challenge,” Nemetz says. “The last thing I thought about [in planning] was, ‘What happens if the server goes down?’ If it goes down, the whole clinic goes down. Now, with battery backups, the system will run for three hours. “If the rolling blackouts come, they won’t faze me.” Nemetz moves purposefully around the clinic, exuding passion and energy. “The main motivation for me is the quest to answer the unknown, to solve the challenge, ‘It cannot be done,’ ” he explains. “To me, normal anatomy and physiology are the core tools all doctors use in practice to figure out how something could go wrong. Once it goes wrong, then the game is to use our knowledge to return the animal back to a normal homeostatic condition. “This challenge to succeed and allow life to continue with no pain is what drives me and gives me the greatest satisfaction. I never was very good with failure, but I understand at the same time not all conditions are reversible. “Over the last 22 years I have seen true miracles and have performed many procedures others said could not be accomplished. These successes and the progression in avian medicine only make me more excited for the many years ahead. “The added bonus to all this is seeing the glow in my clients’ eyes after I succeed when others told them there was no hope for their beloved pet bird.” <HOME> Marilyn Iturri is editor of Veterinary Practice News magazine and VeterinaryPracticeNews.com.
