HEARD IN AN AUSTRALIAN VETERINARY SURGERY: Hey Doc, I’ve got a problem with my moggy. I’ve been taking her to a different vet for yonks but I don’t think he’s much chop. He’s always been in real good nick but now he’s bloody crook. I think he’s cactus . . . TRANSLATION: Please Doctor, I have a problem with my domestic shorthair cat. I have been taking her to a different vet for quite some time, however, I am starting to have doubts as to his abilities. The cat has always been in good body condition, but is now extremely unwell. I am concerned she may not be able to be saved. The above comments are not unusual. Australians use slang like we Americans use acronyms. Last year, with Seminars at Sea, we spent two weeks going from Sydney to Auckland, including 12 exotic ports of call in Australia and New Zealand, with participants from three OZ (Australian) practices, two Kiwi (New Zealand) practices and about a dozen American practices. Sharing medical and surgical paradigms was an amazing experience, and having Dennis T. “Tim” Crowe Jr., DVM, Dipl. ACVS, ACVECC, as part of our faculty really caused exciting acute-care exchanges to occur. Dr. Karen L. Koks, BVSc (hons) shared the wellness programs, ala www.npwm.com, that she had adopted and implemented over the past three years in her small Brisbane companion-animal practice. The discussions were meaningful to all. The practice of companion-animal healthcare delivery is not that much different between countries, but the paradigms and demographics do vary. Petrol (we call it gas) – one level in OZ usually – 134.9 cents a liter, no octane rating. Gas in Australia is propane, like used in the barbie! In 2004, when the AVMA and Fort Dodge Animal Health launched the “Twice a Year for Life” initiative directly to clients, U.S. practices were already at 1.9 visits per year. By 2007, we moved to 3.3 visits per year, and only about half the companion-animal practices in the U.S. have subscribed for free AVMA/FDAH in-clinic training kits distributed each year. In Oz, the president of the Australian Veterinary Assn. in 2004 stated, “We only need one visit a year, more than that is overservicing!” The 28 practices we have been consulting with during the past three years have embraced the “Twice a Year for Life” programs, and about 80 percent of clients, even in the most depressed economic communities, have responded. When asked in a 2007 survey about using extended duration of immunity vaccines, the majority of Oz practitioners stated they should stay with the annual vaccines. Yet Intervet in Australia has a puppy vaccine approved for extended DOI starting at 10 weeks of age. To draw a stronger comparison, while 89 percent of U.S. clients consider their pets family members, 85 percent of Australian clients consider their pets family members or “best mates,” and in both countries, a third of the clients give their pets child status. (A New Zealand survey shows only 75 percent of the clients consider their pets family members, with a third of those giving the pet child status.) The population of Oz is one-tenth that of the U.S., and the number of companion-animal practices is about one tenth that of the U.S.; the population of New Zealand is one-tenth that of Oz, and the number of companion-animal practices is about one-tenth that of Oz. The U.S. propofol induction is put to shame with Alfaxan (Jurox). It’s rapidly metabolized with no tissue residual, just like propofol, with longer shelf life and minimal blood-pressure effects. The Australian practices are using ProHeart 12 extended release for heartworm control with outstanding efficacy and virtually no adverse effects, but then patient advocacy is “suss” (suspect in Oz slang). They have traditionally done only strategic deworming (e.g., quarterly Drontanal Plus), without any fecal flotation screening. The Veterinary School in Western Australia has published a 15 percent parasite infection rate found in pets on regular deworming, and that has been replicated in the practices which we have mentored into doing routine fecal examination, but we still cannot sway the masses. The Gold Class movie theaters run the best movies, have plush recliners, serve wine and food during the movie (at whatever times you dictate upon entry) and allow no one under 18 to enter. When I made my recent speaking tour of capital cities, the actual population centers of each state, they commented that they thought my “accent was cute.” There are very few chain restaurants, virtually no breakfast restaurants and most all grocery stores are inside shopping malls. Veterinary nurses (not technicians) have pay scales (awards) established by the state, and have annual pay raises directed by the state. The starting salary in Queensland for a veterinary nurse--school trained or just off the street--is about $17.50 per hour, with four weeks paid vacation (salary plus 15 percent pay) and a 9 percent superannuation fund investment requirement by the employer. Maternity leave is mandated at six to 12 months, depending on the state, and can be shared with the husband. The starting salary (level 1) award for new veterinary graduates is only $36,500, so it is cheaper to hire new graduates than it is veterinary nurses. Maybe that is why about 50 percent of all veterinary graduates are out of the profession within the first 10 years after graduation. Brothels are not only legal in all Oz states, they also have a government-directed compensation award system for the ladies. Students have to choose veterinary medicine after their second year of high school (some are called “colleges,” and the term “college” is never applied to education institutions past the high school level), and take university prep classes for their last two years. Students must place in the top ranking in a 25 sliding-scale scoring system when graduating from high school to qualify for veterinary medicine enrollment, since they enter the veterinary curriculum direct from high school. In five years they become a graduate veterinarian. The veterinary school first-year class in Melbourne was 100 percent female in 2007. CareCredit and pet health insurance is available and practices learning using them effectively have been as slow as in the U.S. Some Oz and U.S. practices perform 10 to 20 additional inpatient procedures a month just because of CareCredit or pet insurance, yet since it is new, practices have been slow to adopt third-party payments. The term “veterinary surgery” is what Australians call the average companion-animal clinic; and there are now private specialty clinics emerging, with the one in Brisbane opening its linear accelerator for cancer therapy. The annual Australian Veterinary Assn. meeting has space for only 96 exhibitors at $2,800 Australian for a booth (that is 50 percent more than WVC, a 2,000-vet meeting). The AVA meeting is the largest meeting with about 1,000 vets, students and allied personnel combined. Therefore they have about one-fifth the tracks of WVC or NAVC, but they use more international speakers and charge about double the registration fee. At Christmas, it was 29 degrees in Brisbane, and 29 degrees in Denver, except Brisbane was Centigrade and Denver was Fahrenheit. One day it was minus 18 in Gunnison, Colo., and there are no thermometers in Oz that go to 30 degrees below zero Centigrade. Most everyone carries a UBD in their car--what they call a street directory--since intra-city expressways are rare and traveling by surface streets is an adventure. There are speed cameras everywhere and you get your speeding ticket in the mail. Voting is mandatory, with a fine (sent in the mail) if you do not vote. National and state boards do not exist, and in fact, most new graduates like to go overseas for their first year or two of practice. “Overseas” is usually the United Kingdom, but does include South Africa and Europe, which have no foreign graduate screening or special licensure for Australia or New Zealand veterinary graduates. Yep, sure is interesting dividing my consulting time between two hemispheres! <Back to TOC> ------------------------------------------ Dr. Catanzaro is a full-time practice consultant, boarded in healthcare administration, and a respected speaker and author. He is chief executive officer of Veterinary Consulting International and may be contacted at DrTomCat@aol.com. He will return to the Land Down Under in November for a capital cities speaking tour, presenting “Program-based budgeting with staff-driven income centers.”
