CT or MRI? When to use each and whyMarch 15, 2019Use MRI for meningitis, encephalitis, fibrocartilaginous embolism, malignancy of liver tumors, muscle tears and strains, and cranial cruciate rupture, says Tony Pease, DVM, MS, DACVR, chief veterinary medical officer of the Western Veterinary Conference Oquendo Center in Las Vegas, Nev. For fragmented medial coronoid processes, dental disease, 3-D reconstructions, and small bone fractures, use CT, he advises. "In general, MRI can see more medically treated lesions, but CT and MRI can see lesions that are amenable with surgery," Dr. Pease says. "However, gastrointestinal lesions are questionable. The motion of the gastrointestinal tract makes large artifacts, as does metal (e.g. microchips), which is not a factor with CT as opposed to MRI." MRI is preferred whenever disease of the central nervous system is suspected, says Nathan C. Nelson DVM, MS, DACVR, clinical associate professor of radiology at the North Carolina State University College of Veterinary Medicine. "MRI has excellent ability to image soft tissue structures and is able to differentiate gray matter, white matter, nerves, and cerebrospinal fluid to a much greater extent than CT," Dr. Nelson says. "In any case, where brain disease is suspected—such as the acutely seizing dog or the dog with sudden behavior change—MRI is the …
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Seven secrets for spring cleaning your practice and your lifeMarch 14, 2019Whether out of fear of missing out (aka loss aversion), getting in trouble, or that it might be useful someday, we accumulate an extravagant amount of stuff, both physical and virtual. We've all read articles about the importance of spring cleaning and how to declutter your life. Unfortunately, most articles usually focus on physical objects, rather than the multiple facets that make up your every day. Imagine how much better you would feel knowing you are free of all types of clutter, well beyond your secret junk drawer. We are going to help you do just. All you have to do is commit the desire and the time to do it. 1) Spring cleaning in your personal life Spring is a perfect opportunity to rid your life of toxic relationships (or any relationship) that infects it with negativity and bad influence. How much better would you feel if you got rid of them? In some cases, you may not be able to cut the ties completely. So stretch them! Make the necessary changes to get away from soul-sucking individuals and get closer to positive, happy, and compassionate people. 2) Spring cleaning in your home Remember this mantra of spring …
Why your front-desk team sucksMarch 13, 2019Do you remember the first time you told a pet owner her dog was dying? You were sweating bullets, struggling to find the right words, and tried your best to be honest and compassionate. I'm going to have a similar conversation with you. Your front-desk team is in critical condition. If you don't resuscitate your employees, client relationships will die. Every client interaction begins and ends with your client-care team. From the phone call to book an exam to collecting payment at checkout, your front-office staff impacts your hospital's revenue and client relationships. Here are your team's ailments and how to cure them: 1)They don't know your standards of care. As a mystery caller, I explained I had recently moved from another state and received an email from my previous veterinarian that my dog was due for a checkup. I asked which vaccines would be needed in our new community and the cost. The employee replied, "The shots are always up to you, but we usually do leptospirosis, distemper, rabies, and bordetella." Describe core vaccines with confidence, rather than "shots are up to you." Miscommunication of basic medical information is commonplace. In another call about a 16-week-old kitten, …
How therapeutic home-delivery programs can benefit your practiceMarch 11, 2019This is an exciting, but challenging time for small-animal veterinarians, as we help clients manage their pets' health in ways that were unavailable when I started practicing more than 30 years ago. Take nutrition, for example. New therapeutic diets are enabling us to manage a much broader spectrum of disorders than ever before. But advances don't stop there. Our multiple-location dermatology practice has found success using e-commerce to deliver therapeutic diets directly to pet owners' homes. This convenient and efficient system benefits our clinic, our clients, and the patients in our care. Why sign up for a home-delivery program? While I'm not an expert regarding such programs, I will share my experience with home delivery of therapeutic pet diets in the hope other veterinarians can benefit. It's no secret online pet food sales have grown dramatically in the last few years, especially as more people use e-tailers for their shopping needs. According to a 2017 article, e-commerce accounted for more than 18 percent of dog food sales and close to 13 percent of cat food sales. Further, Amazon's pet food sales increased 34 percent in the first half of 2018 compared to the first half of 2017, and retail …
Leveraging your team to its maxMarch 4, 2019If you always do what you have always done, you always get where you have always gone. This is a slight variation of Einstein's definition of insanity. Let's explore how this unfolds within the realm of veterinary team utilization. Your veterinary team is made up of people with various passions and talents. Each team member brings great depth and breadth to the services provided to the client and patient. Clearly defining their roles, expertise, and scope of practice improves the delivery of veterinary care. You may recall the 1999 Mega Study1 commissioned by the American Veterinary Medical Association (AVMA), Association of American Veterinary Medical Colleges (AAVMC), and American Animal Hospital Association (AAHA) entitled "The Current and Future Market for Veterinarians and Veterinary Medical Services in the United States." The study defined six critical issues to be addressed for veterinary medicine to succeed moving into the next millennium: 1) Veterinarian's income 2) Economic impact of large numbers of women in the profession 3) Global demand for all categories of veterinary services 4) Inefficiency of the delivery system 5) Supply of veterinarians 6) Skills, knowledge, aptitude, and attitude of veterinarians and veterinary students Let's briefly address the other categories before delving …
Professionalism on social mediaFebruary 22, 2019Whether you actively use social media to market your skills or casually (as the majority of us do), every time you post on a site, you are leaving a lifelong impression. As such, what is your online outreach saying about you and your career?
Veterinarians wanted: Half-dead or aliveFebruary 22, 2019Today, as a profession and as people who share our homes with pets for comfort or therapy, our ranches with horses for work or pleasure, or depend on animals for our livelihood or research, we face a looming crisis. Simply put, the glass isn’t half full or empty when it comes to veterinarians—it’s running dry.
What veterinarians can learn from the Sears bankruptcyFebruary 20, 2019Sears, one of America's longest standing household names, recently raised the white flag and filed for bankruptcy. Started by Robert Sears in 1886, the company bearing his name clearly struggled in the past few years. The reasons are important and somewhat universal lessons to be applied. So how can veterinarians avoid mistakes that brought a 133-year-old iconic business to its knees? Adapt or die Sears was a pioneer in catalog sales, but slow to change with the times. More recently, it struggled to compete with Walmart and other big box stores. Similarly, veterinary practices face competition from multiple "players," including low-cost vaccine businesses (e.g. farm stores, feed stores, human pharmacies, pet stores), spay and neuter clinics, and even local family practices. This has profoundly affected the profitability of practices that relied heavily on "yearly shots," instead of focusing on the importance of (bi)yearly physical exams. Sadly, this philosophy made vaccines look like commodities, which means clients are likely to gravitate to the cheaper provider. Another factor that has historically affected revenue is the development of three-year vaccines. Again, those of us who didn't stress the value and importance of a (bi)annual exam are now facing clients who feel they …
Veterinary gender wage disparities—Why planet Venus pays less (and what to do about it)February 8, 2019Last July, the principal flutist at the Boston Symphony Orchestra filed a lawsuit alleging it had discriminated against her "by paying her an amount less than other comparable males." Though she records and performs more solos than the principal oboist (a comparable position in any symphony orchestra), she's paid 75 percent of what he makes. When I heard about this lawsuit, my brain veered directly toward veterinary medicine. Of course there's a wage gap, but surely there's more to it than that. As the French say, men and women are equal… yet different. No one can deny the biological, the cerebral, and the societal differences separating us. Our bodies differ, our brains vary, and our culture therefore perceives us in very disparate ways. This, it's clear, forms the basis for fundamental unfairness when it comes to compensation. Yet, there's more to it than that. This is what we'll have to grapple with if we're going to change things. And change them we must for our profession's sake. Mind the veterinary wage gap There's no arguing the fact of the gap. The 2013 American Veterinary Medical Association (AVMA) Report on Veterinary Compensation shows us that in 2011, female veterinarians in …
If I knew then what I know nowFebruary 8, 2019If you had the chance, what would you tell your younger self? For that matter, what would you tell an aspiring veterinarian or recent graduate? I asked several colleagues from a variety of backgrounds and niches one simple question: What do you wish you knew when you were younger? There were three categories of answers: personal advice, business advice, and medical advice. Here's what our panelists had to say. (See the box at the bottom right for who they are.) Personal advice Rebecca Tudor recommends finding people to whom you can delegate tasks. "You can't do it all, so find people who can help you run errands, shop, and do anything you need to get off your to-do list." Of course, you don't have to be a millionaire to do that. You can get just about anything delivered to your doorstep these days, from a book of stamps to prepared meals for a week. Peter Pelissier encourages you to "be willing, at the end of every day, to walk away and leave all the anxiety and frustration at the practice. Spend quality time with your family and friends, and be emotionally present. All the pressure will be waiting for you …
