OBJECTIVE To determine small animal veterinarians’ opinions and actions regarding costs of care, obstacles to client education about veterinary care costs, and effects of economic limitations on patient care and outcome and professional career satisfaction and burnout.
DESIGN Cross-sectional survey.
SAMPLE 1,122 small animal practitioners in the United States and Canada.
PROCEDURES An online survey was sent to 37,036 veterinarians. Respondents provided information regarding perceived effects of client awareness of costs and pet health insurance coverage on various aspects of practice, the influence of client economic limitations on professional satisfaction and burnout, and proposals for addressing those effects.
RESULTS The majority (620/1,088 [57%]) of respondents indicated that client economic limitations affected their ability to provide the desired care for their patients on a daily basis. Approximately half (527/1,071 [49%]) of respondents reported a moderate-to-substantial level of burnout, and many cited client economic limitations as an important contributing factor to burnout. Only 31% and 23% of respondents routinely discussed veterinary costs and pet insurance, respectively, with clients before pets became ill, and lack of time was cited as a reason for forgoing those discussions. Most respondents felt improved client awareness of veterinary costs and pet health insurance would positively affect patient care and client and veterinarian satisfaction.
CONCLUSIONS AND CLINICAL RELEVANCE Results suggested most small animal practitioners believe the veterinary profession needs to take action at educational and organizational levels to inform pet owners and educate and train veterinary students and veterinarians about the costs of veterinary care.
OBJECTIVE To assess the prevalence of medical errors (specifically, near misses [NMs] and adverse events [AEs]) and their personal and professional impact on veterinarians.
DESIGN Cross-sectional study.
SAMPLE Members of the Veterinary Information Network (n = 46,481).
PROCEDURES An electronic survey regarding veterinarians' experiences with NMs and AEs was distributed via email to an online veterinary community between September 24 and October 21, 2015. Responses were summarized and compared between genders by means of the χ2 test.
RESULTS 606 veterinarians completed the survey (1.3% response rate). Overall, 447 (73.8%) respondents reported involvement in ≥ 1 NM (n = 389 [64.2%]) or AE (179 [29.5%]). The NMs had a short-term (≤ 1 week) adverse impact on professional life for 68.0% (261/384) of respondents and longer-term negative impact for 36.4% (140/385). The impact on respondents' personal lives was similar (63.6% [245/385] and 33.5% [129/385], respectively). For AEs, these numbers were 84.1% (148/176), 56.2% (99/177), 77.8% (137/176), and 50.6% (89/175), respectively. Both NMs and AEs were more likely to negatively impact female veterinarians than male veterinarians.
CONCLUSIONS AND CLINICAL RELEVANCE These findings suggested that many veterinarians experience emotional distress after a medical error. Support should be provided to mitigate this adverse impact on the wellbeing of veterinarians and, potentially, their future patients.
Quality assurance is an implied concept inherent in every consumer's purchase of a product or service. In laboratory testing, quality assurance encompasses preanalytic (sampling, transport, and handling prior to testing), analytic (measurement), and postanalytic (reporting and interpretation) factors. Quality-assurance programs require that procedures are in place to detect errors in all 3 components and that the procedures are characterized by both documentation and correction of errors. There are regulatory bodies that provide mandatory standards for and regulation of human medical laboratories. No such regulations exist for veterinary laboratory testing. The American Society for Veterinary Clinical Pathology (ASVCP) Quality Assurance and Laboratory Standards Committee was formed in 1996 in response to concerns of ASVCP members about quality assurance and quality control in laboratories performing veterinary testing. Guidelines for veterinary laboratory testing have been developed by the ASVCP. The purpose of this report was to provide an overview of selected quality-assurance concepts and to provide recommendations for quality control for in-clinic biochemistry testing in general veterinary practice.
OBJECTIVE To develop and validate a Burden Transfer Inventory (BTI) of stressful client behaviors and to evaluate whether those behaviors are associated with client caregiver burden and contribute to veterinarian stress and burnout.
SAMPLE 1,151 small animal veterinarians and 372 dog and cat owners.
PROCEDURES During stage 1, a pool of 34 items representing stressful client behaviors was created through open-ended surveys of practicing veterinarians and 3 phases of pilot testing. During stage 2, 1,151 veterinarians recruited through the Veterinary Information Network completed a survey including those behavior items and validated measures of stress and burnout. Completed surveys were randomly assigned to either a measure development or validation database for factor and item analyses. Data were then combined to determine whether the BTI was correlated with measures of stress and burnout. During stage 3, owners of dogs and cats with a serious illness completed an online survey to assess how frequently they engaged in each BTI item as well as a validated measure of caregiver burden.
RESULTS For dog and cat owners, there was a significant positive correlation between caregiver burden and the frequency that those owners reported engaging in BTI items. The frequency that veterinarians reported encountering BTI items was positively correlated with measures of stress and burnout, which suggested burden transfer from owners to veterinarians. The extent to which veterinarians reported being bothered by BTI items was a more robust predictor of stress and burnout than the frequency with which those items occurred.
CONCLUSIONS AND CLINICAL RELEVANCE Results indicated the BTI can be used to understand how client behaviors associated with caregiver burden affect veterinarian stress and burnout. The BTI may be useful to identify specific stressors affecting individual veterinarians and how they react to those stressors.
OBJECTIVE To survey practicing veterinarians regarding their perceptions of and experiences with cases of suspected or confirmed animal abuse and related state laws.
DESIGN Cross-sectional study.
POPULATION Members of the Veterinary Information Network (VIN; n = 34,144) who were in veterinary practice at the time of the survey.
PROCEDURES A survey was designed and distributed online to all VIN members from January 26 to February 28, 2015. Responses were compiled, and binary logistic regression analysis was performed to identify factors that influenced decisions or perceptions regarding animal abuse encounters and related legislation.
RESULTS 1,209 completed surveys were received (3.5% response rate); 1,155 (95.5%) surveys were submitted by currently practicing veterinarians. One thousand five (87.0%) practicing veterinarians reported having encountered at least 1 case of animal abuse while in practice; 561 (55.8%) of these veterinarians indicated that they had reported at least 1 case. The most common reasons selected for reporting abuse were to protect the animal, ethical beliefs, and to protect other animals in the household. The most common reasons selected for not reporting the abuse were uncertainty that the animal had been abused, belief that client education would be better, and belief that the injury or illness was accidental versus intentional. Most respondents were unaware of the current status of laws in their state regarding animal abuse reporting.
CONCLUSIONS AND CLINICAL RELEVANCE Results suggested a need for state and national veterinary and humane-law enforcement organizations to increase communication and education efforts on recognition and reporting by veterinarians of animal abuse and the related laws.
OBJECTIVE To determine attitudes of small animal practitioners toward veterinary clinical trials and variables influencing their likelihood of participating in such trials.
DESIGN Cross-sectional survey.
SAMPLE Small animal practitioners with membership in 1 of 2 online veterinary communities (n = 163 and 652).
PROCEDURES An online survey was developed for each of 2 veterinary communities, and invitations to participate were sent via email. Each survey included questions designed to collect information on the respondents’ willingness to enroll their patients in clinical trials and to recommend participation to clients for their pets.
RESULTS More than 80% of respondents to each survey indicated that they spend no time in clinical research. A high proportion of respondents were likely or extremely likely to recommend clinical trial participation to clients for their pets when those trials involved treatments licensed in other countries, novel treatments, respected investigators, or sponsoring by academic institutions, among other reasons. Reasons for not recommending participation included distance, time restrictions, and lack of awareness of ongoing clinical trials; 28% of respondents indicated that they did not usually learn about such clinical trials. Most respondents (79% to 92%) rated their recommendation of a trial as important to their client's willingness to participate.
CONCLUSIONS AND CLINICAL RELEVANCE Participation in veterinary clinical trials by small animal practitioners and their clients and patients appeared low. Efforts should be increased to raise practitioner awareness of clinical trials for which patients might qualify. Specific elements of trial design were identified that could be modified to increase participation.