On The ‘Fairness To Pet Owners Act’ And Other Prickly Access-to-Pet-Med IssuesJune 29, 2012 Ever thought you were getting the shaft when it comes to selling drugs and supplies? If so, you’re not alone. Rx flea-and-tick supplies, monthly heartworm meds, must-stock anti-inflammatories and antibiotics (among others)? If you’re like a lot of us, you’re caught between a rock and a hard place. Not only is it getting tougher to turn a profit on drugs based on the big-hit financial outlays, spooky interest rates, skyrocketing shipping charges and creeping inventory management costs, but we’re expected to stock them. If we didn’t, the grumbling would reach an uncomfortable crescendo, as happened to us recently when we temporarily decided to outsource many of our ophthalmology drugs. Moreover, most of us are in no position to dismiss a profit center, no matter how minimal the margins. This economy is taking no prisoners and few of us can afford the luxury of discarding any source of income—minuscule and headachy though it may be. Caught in the Act Enter the “Fairness to Pet Owners Act” proposed by Congress. This bill is being touted by its backers as a necessary bit of consumer protection legislation that would require us to inform our clients of …
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Drawing The Line At WorkJune 29, 2012 There’s a saying goes something like “no good deed goes unpunished.” This seems like a cruel twist of fate, doesn’t it? Yet it’s interesting to see how often this really does happen in life. For example, you step up to help at the cake walk at your child’s school, and now you’re being asked to join the PTA. Or you step in and help a volunteer organization for an event, and now they want you to become part of the leadership. Or, you go out of your way to clean up another team member’s mess at work, and it’s assumed that you “like cleaning” and are expected to do it more often. Or, you complete a project above and beyond your typical job description, so the boss comes to you for the next project. Or, you agree to come in on short notice when a colleague calls out sick, and it’s assumed you would consider it next time it comes around. In short, when we succeed or go above and beyond the typical employee, mother, or supporter of a cause, you increase others’ expectations of you. They now know that you are capable, willing, and likely available …
Are We Being Fair In What We Charge?June 26, 2012 Late one night, one of my patients weaseled out of her E-collar and licked her spay incision until it was raw but thankfully not yet dehisced. Alarmed and too far away to bring her in, the owner sent a picture of the site via text. To be safe, I suggested that she might want to see her local ER doc. She took my advice and went to the ER, whereupon, $700 later, ground zero was declared acceptably cleansed and a neat new row of staples applied. The bill included preanesthetic lab work, anesthetics, antibiotics and a surgical fee. But $700 worth of it? Now, it’s true there will always be financial tensions between after-hours facilities and referring veterinarians. I once ran an ER facility, so I should know. And while I never would have risked dissing a referring vet by racking up a big bill on one of their post-op cases, I accept that steep invoices are common in emergency medicine. But $700 for uncomplicated wound care? Business Theory In case you think me overly partisan in this case, I’ll posit that intervet politics are beside the point. As is the issue of …
Systematic Approach To Buying A Digital Radiography SystemJune 26, 2012 Purchasing a digital radiography system can be a daunting task. Considerations such as service and support, detector technology, image quality, software functionality, PACS, DICOM, backup and practice management integration are topics that must be considered at some point in the purchase. The trick is to avoid becoming overwhelmed and to approach the purchase systematically. In my pre-purchase consultation service with veterinarians, the starting point for discussion is which type of detector technology is appropriate for their practices. The two main types of detector technology are computed radiography [CR] and direct digital radiography [DR]. Step 1: Is CR appropriate for your practice? CR uses imaging plates to generate a digital image. These imaging plates are placed in a CR reader, which generates a digital image. The workflow has a similar feel to film-based systems. Despite claims to the contrary made by some DR vendors, most veterinarians choosing CR will see some degree of time savings and increased efficiency in radiology. The image quality from CR systems is equal to or superior to many DR systems. It is this author’s opinion that for pocket pets and exotics, CR systems may perform better than many DR systems. …
In-House Blood Work Pays OffJune 26, 2012 Just a few years ago, many veterinarians couldn’t imagine having in-house blood analyzers. But now, those who took the plunge can’t imagine working without them. Potential purchasers face a growing number of equipment options, service agreements and prices. Manufacturers are typically flexible with clients, allowing products to be tested in the clinic before a final decision is made. Some companies offer refurbished equipment for practices easing their way into the financial commitment of $10,000 to $30,000 worth of new machinery. “About 40 percent of veterinarians have in-house hematology, chemistry and blood gas equipment,” says Cheryl Roge, DVM, director of professional services for scil animal care co. in Gurnee, Ill. “When this equipment started picking up momentum for in-house use, vets were getting the majority of their income from other avenues and were uncertain if the equipment would prove to be profitable. But now vets are using their equipment 10 times a day or more.” Advancements in veterinary medicine allow for care that parallels human medicine and in some cases supersedes what’s available in a typical MD’s office. A Key Time-Saver Clients privy to the speed of in-house diagnostics often expect their veterinarian to offer the …
Competing With Online PharmaciesJune 26, 2012 Online pet pharmacies continue to grow into increasingly formidable competitors in the veterinary supplies market. But consultants say veterinarians shouldn’t conclude that the death of all in-clinic sales is inevitable. Jennifer Inbody, CVPM, PHR, of Lead Dog Consultants in Punta Gorda, Fla., notes that many veterinarians and practice managers are concerned about competition from online pet pharmacies, as many practices are seeing a decrease in revenues from pharmaceuticals. Online Resources Several companies offer Web-based services to help veterinarians compete with online pet pharmacies. Often, they appear as part of a veterinarian’s clinic website. Here are options that clinics may want to investigate. AAHA MarketLink 888-722-2242 www.aahamarketlink.com CapsuleNet 973-328-4644 www.capsulenet.com MWI Veterinary Supply Pharmacy Solutions 800-824-3703 www.mwivet.com VetCentric 866-838-2368. www.vetcentric.com/ Veterinary Internet Pharmacies 631-757-2844 www.vetinternetpharmacies.com VetSource 877-738-8883 www.vetsource.com Vetstreet 888-799-8387 www.vetstreet.com “I have even heard several veterinarians argue …
The Facts About Non-Communicable Diseases And One HealthJune 25, 2012 Posted: June 25, 2012, 7:00 p.m. EDT The human-animal bond connects veterinarians to millions of families, communities and organizations worldwide. Each of us can play a more active role in the One Health movement. The One Health movement calls for greater cooperation and integration of human health, animal health and ecosystem health sciences. It fosters collaboration at the local, national and global levels to achieve optimal health for people, domestic and free-living animals, plants and the environment. If or when properly implemented, it will help protect and save untold millions of lives in present and future generations. You can help promote the One Health concept from your exam room, home or community. If you know the common factors that cause disease in people, companion animals, livestock and free-living animals, you can inform your clients, communities and organizations. Infectious Disease At least 60 to 75 percent of human infectious disease agents and emerging human pathogens can be acquired from other animal species. The list includes SARS, mad cow disease, Nipha virus, West Nile virus, avian influenza, Lyme disease and Bartonella (cat scratch disease), which was recently found to be associated with rheumatoid arthritis. The U.N. …
Radiation Protection ConniptionJune 18, 2012 Dr. McCoy doesn’t mince words. Here is an email he sent to his entire staff about radiation protection: It has been brought to my attention that many of you are not wearing lead gloves while taking radiographs. Furthermore, fingers have been spotted within the primary beam on some exposures. THIS IS NOT ACCEPTABLE!!!! For your safety, you must: 1. ALWAYS wear lead-lined gloves and apron and thyroid shield. 2. NEVER allow a body part to enter the primary beam, even gloved. Should I discover that anyone has broken these rules, they will receive one warning. A second violation will result in IMMEDIATE TERMINATION. Yes, it's that dangerous, and that important. Wow, that is one strong message! And after a quick investigation, it turns out that several practices I perform surgery at would actually write an employee up for not wearing adequate protection. Others are, shall we say, more … casual (which sadly is a ginormous euphemism). Radius fracture in a …
Ultrasound Remains A Sound InvestmentJune 15, 2012The way Danny W. Dutton, DVM, sees it, “If precision is the placement of several darts on a dart board, and accuracy is the placement of those darts in the bull’s-eye, ultrasound is the nexus of accuracy and precision in diagnosis and treatment for a large number of equine veterinary problems.” Dr. Dutton, chief of staff for Frontera Division – Equine Sports Medicine & Surgery in Sunland Park, N.M., says ultrasound has allowed him to detect arthritis and osteochondromas missed on radiographs. He’s also able to follow up with increasing precision the recovery of horses from a variety of musculoskeletal injuries. “With improved detail and technique, we are now putting our finger right on the problem instead of addressing a ‘general area,’ ” Dutton says. “Having the ability to look under the skin greatly enhances success, perception of ability and accuracy of prognosis.” Carol Gillis, DVM, of Vacaville, Calif., says she was one of the first equine practitioner to use musculoskeletal ultrasound. Before 1984, Dr. Gillis says, ultrasound was used only in reproductive modalities. Today, practitioners use CT and MRI scans, but she still likes to use ultrasound for lame horses. “Ultrasound can evaluate damage from inflammation and swelling as …
Surprise! The OSHA Inspector Is Here!June 13, 2012 If the Occupational Health and Safety Adminstration made a surprise inspection of veterinary clinics, most would fail to be in compliance, says Chery F. Kendrick, DVM, of Kendrick Technical Services in Knoxville, Tenn. One common violation she sees as a provider of OSHA-compliance services for veterinarians is lack of or insufficient labeling of secondary containers—those used to hold chemicals in other than their original containers. These can include spray bottles of disinfectant and cold sterile soak for instruments. Another sticking point: If inspectors find that even one employee doesn’t know how to access the clinic’s Material Safety Data Sheets, it is a violation. The fine for potentially harming the health of your employees is $7,000 per incident. “If you have 25 unlabeled containers, that’s 25 times $7,000, or $175,000,” Dr. Kendrick says. “Even if you appeal and get your fines reduced by 95 percent, $8,750 is still a significant amount of money.” Inspectors may use formulas of comparative risk-taking and take into account the number of employees and the number of days they were at risk by using the unlabeled containers. OSHA’s stringent documentation requires practice-specific safety manuals and training records, as …
