Buy With ConfidenceApril 9, 2010 Veterinary trade shows are like shopping malls. Making a purchase based on desire alone is easy when every gadget and high-tech device seems to shout, “Buy me!” But those in the know advise making a list and checking it twice. A lot of planning needs to go into a major purchase long before a contract is signed or a credit card is run. Big Spender Robin Downing, DVM, estimates that she has spent about $1 million on equipment since 1992, shortly after buying her Windsor, Colo., practice. Among her purchases: • Two anesthesia machines with isoflurane vaporizers • Sevoflurane vaporizers to upgrade from isoflurane • Doppler blood pressure machines • Electric, stainless steel lift table on wheels (doubles as gurney) • Medium-capacity autoclave • Three single recessed X-ray viewboxes • Double recessed X-ray viewbox • CO2 surgical laser plus evacuation vacuum • Complete in-house lab (1994) •
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Sometimes The Human-Animal Bond Transcends DeathMarch 2, 2010 Rescue, guide and other service and assistance dogs have a growing role in helping people. When these highly valued pets get sick or die, it is amazing how much their family and friends want to help. I’d like to introduce you to two special human-animal bonds that have transcended death. The participants in these bonds are as different as night and day. Former Constable James Symington was a strong young Canadian police officer with a big German shepherd search and rescue dog, Trakr. Disabled former truck driver Joe Martinez was always seen in the company his little Chihuahua-min pin mix assistance dog, Killer. Little Killer’s job was to dial 911 if Joe had trouble breathing through his tracheotomy tube or if he had another stroke or heart attack. Killer also picked up things for Joe and helped with daily routines as Joe made his way around town via the bus system and his motorized wheelchair. Everyone who saw Killer on Joe’s lap or behind his back on the wheelchair fell in love with him. Joe was happy to share his amazing service dog with friends and passers-by. Killer wore sunglasses and a little hat …
Banks Say They’re Still Lending, But ...February 7, 2010 Successful borrowing is still at the forefront of the minds of many practice owners. The banks are saying they are willing to lend, that all a practice owner needs to do is come on in and apply! But owners and vendors are complaining that getting a loan is not as easy as it used to be. An understanding of the true lending and borrowing climate is achieved only by gathering information and opinions from as many sources as possible. The major players, and the people practice owners need to listen to the most, are practice brokers, CPAs and transactional attorneys. Not everyone shares the same view, but all their opinions are important in evaluating the lending market. So, let’s see what some experts have to say. Divergent Views Ed Guiducci, a Colorado attorney with Guiducci and Guiducci, described the lending environment as “challenging.” He believes that veterinarians have had to become better managers of their practices. Trey Cutler, another Colorado attorney, feels that the lending environment has changed, “But I would not say that my clients are having significantly greater difficulty securing loans.” The results a given practice gets seem to heavily depend on …
Constructive CriticismFebruary 7, 2010 It might be hard to believe, but architects say veterinarians almost always wish they had built a bigger hospital or altered something in their well-thought-out construction plans. The top post-construction regret of veterinarians, experts say, was not hiring an experienced veterinary architect for the job. “Veterinarians who have a friend or family member in the construction business are always tempted to use those connections in order to get a perceived deal, but in the end the lack of experience can cost the owner time, money and delays in opening the new practice,” says Peter Hill, AIA, president of Hill Design Associates Architects Inc. of Dawsonville, Ga. “When it comes to safety design, just because a code isn’t currently enforced doesn’t mean the precaution shouldn’t be incorporated anyway, because it’s the right thing to do and it may eventually require changes anyway,” Hill says. “Doing things right the first time is always best.” For example, the laws governing veterinary hospital safety design are generally more lenient than those for human hospitals. Still, some municipalities have adopted parallel safety precautions for veterinarians. An architect new to veterinary practices may overlook these legal necessities and other structural and …
After Slow Start, Lending Should Pick Up In ’10January 4, 2010 Lending anxiety can take a back seat in 2010, financial advisers say, as banks are making money available for qualified veterinary applicants. However, anyone seeking 100 percent financing may have to get creative. Credit Lines to the Rescue These are trying times for clients. Beloved pets need health care, and the money has to come from somewhere. One option is a credit line for people with looming veterinary bills. These lines work similarly to credit cards in that customers need to qualify and are expected to make monthly payments. At CareCredit of Tustin, Calif., “We look at a number of different factors, including credit and payment history,” says Doug Hammond, senior vice president of sales. “Because the CareCredit card can be used in a closed network versus at the grocery store or retail chain, more people typically qualify for credit.” Because these credit lines are for a specific purpose (medical), companies typically try to work with the clients on payment options. Extended payment plans and low-interest or no-interest terms are possibilities. This is especially attractive to clients whose credit card interest rates are high. “The agreement requires the client to make …
Practice Owners Still Cautious About Incurring More DebtDecember 30, 2009 Editor’s note: Dr. Mark Crootof recently finished an 18-city lecture tour sponsored by Abaxis Inc. of Union City, Calif., on recession-proofing the practice. This article is based on his talks to hundreds of hospital owners and associates about the state of their businesses. Are lenders lending? Do veterinarians want loans? What has changed? These are some of the questions I am asked every day as a veterinary practice consultant. Seeking input from a variety of people in the banking industry is the best way to get a good perspective. So, I took this question to some lenders and from their responses, I’ve concluded that the money is there and they’re willing to lend it. Take a look at what they said. Are Lenders Lending? Brian Faulk of Live Oak Bank, Wilmington, Del.: “We continue to be aggressive, lending to all subsegments of the [veterinary] industry … with the exception of startup leasehold facilities and boarding facilities. Our loan funding on a month-to-month basis has remained relatively constant from year to year.” Melissa Edwards of Bank of America Practice Solutions: “Veterinarian lending continues to deliver solid growth …
Getting A Boost From SupplementsDecember 30, 2009 When the sign is a general absence of vitality, Ava Frick, DVM, recommends supplements she trusts. For the patient, yes, but also for the practice. “There are times in a veterinarian’s career when you’re just going along and you start asking yourself, ‘Am I having as much fun?’ and ‘What is my purpose?’ ” says Dr. Frick, who owns and operates the Animal Fitness Center in Union, Mo. “This is an opportunity to see that turn around.” Veterinarians who research the effects of supplements and make them available to clients say the benefits go beyond aiding patients. Supplements can help improve the financial health of practices and sometimes even the outlook of practitioners. “If you like nutrition and you’re interested in how the body works from a nutritional perspective, integrating supplements into your practice can be very rewarding,” says Frick, who has three decades of experience in veterinary practice and who recommends and promotes Standard Process supplements. “For me, seeing the results is both enjoyable and rejuvenating.” Interest in supplements appears to be at an all-time high these days. Many clients use them to safeguard their own health and are eager to …
Anti-Pain Options AboundSeptember 1, 2009 Relying on an animal’s physical cues to determine its level of pain and educating clients to detect the pain can be a challenge. Experts say the best route to achieving pain control in the non-verbal patient is a thorough and accurate diagnosis coupled with veterinary and client education. Keeping an open mind on all avenues of pain relief is essential. While one patient may have an unfavorable response to a drug or therapy, the same option could alleviate discomfort in another patient. Experts say so many pain control options are available that close to 100 percent of patients can be helped through a multimodal approach. “Pain control has been available in the industry for quite some time, but veterinarians and owners sometimes miss out on opportunities,” says Robert Stein, DVM, CVA, CCRT, Dipl. AAPM. “Quite a few clients don’t let you go all the way with pain control, which is why veterinarians must be educating clients on ways to determine pain in the canine and feline patient and be open-minded in offering a variety of pain control options.” Difficulty in assessing the degree of pain has long been a problem. Clients often don’t …
Predictive Value Of Glucose MonitoringAugust 31, 2009 Over the past decade, as studies shed new light on blood glucose testing in human and veterinary medicine, veterinarians have responded with varying degrees of enthusiasm and caution. Greet Van den Berghe, M.D., Ph.D., and her team at the Catholic University of Leuven in Belgium, have been studying the topic for the better part of 10 years. Dr. Van den Berghe’s original study, published in the New England Journal of Medicine in 2001, showed that intensive insulin therapy to maintain blood glucose at or below 110 milligrams per deciliter reduced morbidity and mortality among critically ill patients in the surgical intensive care unit. This therapy was compared to the previously standard therapy, which involved responding only when insulin levels exceeded 215 milligrams per decileter and a maintenance of glucose levels between 180 and 200. This new therapy was called intensive insulin therapy. Reid Nakamura, DVM, Dipl. ACVECC, of Red Bank Veterinary Hospital in Red Bank, N.J., says further veterinary research increased the excitement among veterinarians when it showed that patients with higher blood sugar levels had worse outcomes and longer hospitalizations. “In 2008, though, the same Belgian group basically ran the study again on a …
