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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To characterize and compare fourth-year students of US veterinary schools graduating with and without related educational debt (ie, DVM debt) from 2001 through 2020.

SAMPLE

45,756 fourth-year veterinary students who participated in the annual AVMA Senior Survey from 2001 through 2020.

PROCEDURES

Survey data were summarized for variables hypothesized to be associated with DVM debt. Multivariable modeling was used to investigate associations between these variables and the likelihood of graduating with DVM debt.

RESULTS

Mean DVM debt increased fairly steadily from $56,824 in 2001 (n = 1,587) to $157,146 in 2020 (2,859). Of 45,756 students, 6,129 (13.4%) had no DVM debt. Attending Tuskegee University and having children (both men and women) were associated with an increased likelihood of DVM debt. Attending certain other veterinary schools and more recent survey year were associated with a decreased likelihood. For 2020, the likelihood of DVM debt decreased with increasing percentage of tuition paid by family and increased with increasing percentage of tuition paid by educational loans, being a woman with children, and increasing total cost of attendance. No association was found with state cost of living index or per capita income.

CLINICAL RELEVANCE

Results suggested a growing rift between US veterinary students who cannot afford tuition and fees without accumulating financially concerning levels of debt and those who have the financial ability or family situation to fully fund veterinary school. Efforts should be undertaken to recruit across socioeconomic statuses and provide meaningful scholarships to students with greatest financial needs to support diversity, equity, and inclusion in veterinary medicine.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To determine the contributions of veterinarians and support staff to revenue and veterinarian productivity (ie, number of patients seen/full-time–equivalent veterinarian/wk) in private mixed and companion animal practices in the US and identify staff-to-veterinarian labor ratios (SVLRs) that maximized these 2 practice outputs.

SAMPLE

409 owners of mixed and companion animal practices who participated in the 2020 AVMA Practice Owner Survey.

PROCEDURES

Data regarding owner demographics, practice characteristics, labor (defined as mean total hours worked/wk), and gross revenue in 2019 were obtained from participating practices. Multivariable ordinary least-squares regression was used to identify factors associated with revenue and productivity as well as the SVLRs at which revenue and productivity were maximized.

RESULTS

For each 10% increase in total veterinarian hours worked per week, revenue increased by a mean of approximately 9%. A 1-unit increase in total number of technician hours used to support 1 hour of veterinarian work was associated with a 20.5% increase in revenue but with no change in productivity. The same increase in total number of nonmedical staff hours was associated with a 17.0% increase in revenue and 14.4% increase in productivity. In terms of revenue, the optimal SVLRs for veterinary technicians and nonmedical staff were 9:1 and 8:1, respectively. In terms of productivity, the optimal SVLR for nonmedical staff was 10:1.

CLINICAL RELEVANCE

Findings confirmed the important role of nonveterinarian staff in revenue and veterinarian productivity in mixed animal and companion animal practices and may be useful for making evidence-based staffing decisions.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To determine whether career choice and starting salary of new DVM graduates in the US were associated with their educational debt accrued during veterinary school.

SAMPLE

Up to 48,527 fourth-year students at US veterinary schools who responded to the AVMA Senior Survey in 2001 through 2021 and accepted a full-time position or advanced education opportunity.

PROCEDURES

To determine whether career choice was associated with educational debt, multiple linear regression was performed, controlling for graduation year, gender, age, marital status, having children, tuition level, and school location. The correlation between educational debt and starting salary was also determined.

RESULTS

On average, mean educational debt increased by $6,110 each successive year. A mean of 60.5% of respondents accepted positions in private practice (public practice, 3.3%; advanced education, 36.2%). Respondents choosing public practice had a mean of $24,913 less debt than those choosing advanced education, controlling for other factors. Respondents choosing public practice also had less debt than those choosing private practice, but debt did not differ significantly between private practice and advanced education. The correlation between educational debt and starting salary was significant but low (r = 0.177).

CLINICAL RELEVANCE

Findings suggested that the amount of debt incurred during veterinary school was associated with new veterinarians’ career paths. Notably, graduates with higher debt levels appeared to seek higher paying jobs or clinical training that might lead to higher paying jobs, leaving public practice—a field in which critical needs have been identified—underrepresented despite the availability of loan forgiveness programs and other incentives.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To determine prevalences of low compassion satisfaction (CS), high burnout (BO), and high secondary traumatic stress (STS) scores among full-time US veterinarians and estimate effects of selected demographic, employment-related, and education-related factors on those scores.

SAMPLE

5,020 full-time veterinarians who participated in the 2016, 2017, and 2018 AVMA Census of Veterinarians surveys.

PROCEDURES

Data were obtained from census surveys regarding demographic, employment-related, and education-related factors, and scores assigned to items from a professional quality-of-life instrument designed to measure CS and compassion fatigue (ie, BO and STS) were compared between and among various demographic and employment groups.

RESULTS

Overall, 35.5% of veterinarians were classified as having low CS scores, 50.2% as having high BO scores, and 58.9% as having high STS scores. Controlling for other variables, high educational debt was associated with low CS, high BO, and high STS scores. Veterinarians who spent ≥ 75% of their time working with dogs or cats had higher BO and STS scores than did those who spent < 25% of their time. Veterinarians with more experience and higher annual incomes had higher CS scores and lower BO and STS scores. Women had higher BO and STS scores than did men, but no gender differences were observed in CS scores.

CONCLUSIONS AND CLINICAL RELEVANCE

Several variables were identified that may put veterinarians at higher risk than others for compassion fatigue and low CS. These findings may be useful in the development of resources and targeted initiatives to support and defend veterinarian well-being.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine whether dogs that visited human health-care facilities were at greater risk of acquiring certain health-care–associated pathogens, compared with dogs performing animal-assisted interventions in other settings, and to identify specific behaviors of dogs associated with an increased risk of acquiring these pathogens.

Design—Prospective cohort and nested case-control studies.

Animals—96 dogs that visited human health-care facilities and 98 dogs involved in other animal-assisted interventions.

Procedures—Fecal samples and nasal swab specimens were collected from dogs at the time of recruitment and every 2 months for 1 year and were tested for methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile, and other selected bacteria. Information was also obtained on facilities visited during animal-assisted interventions, dog diet, dog illnesses, and antimicrobial use within the home. At the end of the study, dog handlers were asked about the behavior of their dogs during visits to health-care facilities.

Results—Rates of acquisition of MRSA and C difficile were 4.7 and 2.4 times as high, respectively, among dogs that visited human health-care facilities, compared with rates among dogs involved in other animal-assisted interventions. Among dogs that visited human health-care facilities, those that licked patients or accepted treats during visits were more likely to be positive for MRSA and C difficile than were dogs that did not lick patients or accept treats.

Conclusions and Clinical Relevance—Results suggested that dogs that visited human health-care facilities were at risk of acquiring MRSA and C difficile, particularly when they licked patients or accepted treats during visits.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To examine potential associations between periodontal disease (PD) and the risk of development of chronic azotemic kidney disease (CKD) among cats and determine whether the risk of CKD increases with severity of PD.

DESIGN Retrospective cohort study.

ANIMALS 169, 242 cats.

PROCEDURES Cats were evaluated ≥ 3 times at any of 829 hospitals from January 1, 2002, through June 30, 2013. Cats with an initial diagnosis of PD of any stage (n = 56,414) were frequency matched with cats that had no history or evidence of PD (112,828) by age and year of study entry. Data on signalment, PD, and other conditions potentially related to CKD were extracted from electronic medical records. Cox proportional hazards modeling was used to estimate the association of PD with CKD after controlling for covariates.

RESULTS PD was associated with increased risk of CKD; risk was highest for cats with stage 3 or 4 PD. Risk of CKD increased with age. Purebred cats had greater risk of CKD than mixed-breed cats. General anesthesia within the year before study exit and diagnosis of cystitis at any point prior to study exit (including prior to study entry) were each associated with increased CKD risk. Diagnosis of diabetes mellitus or hepatic lipidosis at any point prior to study exit was associated with decreased CKD risk.

CONCLUSIONS AND CLINICAL RELEVANCE The findings supported the benefit of maintaining good oral health and can be useful to veterinarians for educating owners on the importance of preventing PD in cats.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To identify risk factors associated with diagnosis of chronic kidney disease (CKD) in cats.

Design—Retrospective case-control study.

Animals—1,230 cats with a clinical diagnosis of CKD, serum creatinine concentration > 1.6 mg/dL, and urine specific gravity < 1.035 and 1,230 age-matched control cats.

Procedures—Data on putative risk factors for CKD were extracted for multivariate logistic regression analysis from the medical records of cats brought to 755 primary care veterinary hospitals. For a subset of cats evaluated 6 to 12 months prior to the date of CKD diagnosis or control group inclusion, the percentage change in body weight between those dates as well as clinical signs at the earlier date were analyzed for associations with CKD development.

Results—Risk factors for CKD in cats included thin body condition, prior periodontal disease or cystitis, anesthesia or documented dehydration in the preceding year, being a neutered male (vs spayed female), and living anywhere in the United States other than the northeast. The probability of CKD decreased with increasing body weight in nondehydrated cats, domestic shorthair breed, and prior diagnosis of diabetes mellitus and increased when vomiting, polyuria or polydipsia, appetite or energy loss, or halitosis was present at the time of diagnosis or control group inclusion but not when those signs were reported 6 to 12 months earlier. Median weight loss during the preceding 6 to 12 months was 10.8% and 2.1% in cats with and without CKD, respectively.

Conclusions and Clinical Relevance—The probability of CKD diagnosis in cats was influenced by several variables; recent weight loss, particularly in combination with the other factors, warrants assessment of cats for CKD.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To identify factors associated with development of struvite urolithiasis in dogs evaluated at general care veterinary hospitals in the United States.

Design—Retrospective case-control study.

Animals—508 dogs with a first-time diagnosis of struvite urolithiasis and 7,135 control dogs.

Procedures—Electronic medical records of all dogs evaluated at 787 general care veterinary hospitals in the United States between October 2007 and December 2010 were reviewed to identify dogs that developed struvite urolithiasis and 2 groups of control dogs with no history of urolithiasis. Information extracted included diet, age, sex, neuter status, breed size category, hospital location, and date of diagnosis. Urinalysis results, urolith composition, and other disease conditions were recorded if applicable. Potential risk factors were assessed with univariable and multivariable regression analysis.

Results—Toy- or small-sized breeds had significantly greater odds of struvite urolithiasis, compared with medium- or large-sized breeds. Neutering significantly increased the odds of this outcome in females only; sexually intact females were more likely to develop struvite urolithiasis than were sexually intact males, but only up to 5 years of age. Urinary factors significantly associated with the outcome were basic (vs acidic) pH, presence of RBCs or WBCs, protein concentration > 30 mg/dL, and ketone concentration ≥ 5 mg/dL.

Conclusions and Clinical Relevance—Evaluation of demographic characteristics and urinalysis results may be useful in the early identification of struvite urolithiasis in dogs. Periodic urinalysis in dogs is recommended because of the potential health impact of a late diagnosis of urolithiasis.

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in Journal of the American Veterinary Medical Association