AVMA GHLIT medical insurance to end after 2013
Underwriter to exit insurance market as new regulations take effect
By R. Scott Nolen
AVMA Group Health & Life Insurance Trust medical coverage will end for some 17,500 Association members and thousands of their dependents at year's end.
New York Life Insurance Co. notified the GHLIT board of trustees Nov. 30, 2012, of its decision to no longer underwrite major medical coverage for professional associations after 2013 because of impending federal health care regulations.
With no other companies willing to take over for NYL, trustees had no other option than to terminate the medical insurance program, effective Dec. 31, 2013.
AVMA President Douglas G. Aspros said, “I'm concerned about how this reality is going to affect our members, many of whom have relied on AVMA GHLIT health insurance for themselves and their families for many years.
“Fortunately, we have a year to help sort this out, and I'm confident that GHLIT, who are experts in this field, will help ensure that every member finds an appropriate medical insurance home.”
The AVMA Membership and Field Services Division has received several calls and emails about the announcement but fewer than expected, according to Dr. Kevin Dajka, division director. Comments ranged from anger at the AVMA and frustration with the change to confusion and fear about finding new medical insurance, he said.
Identifying with the anxiety of policyholders jolted by this news, GHLIT and AVMA leaders—many of whom themselves carry this coverage—are focusing now on how to help affected AVMA members.
New health care law to blame
GHLIT and NYL attribute the program's demise to regulatory requirements put in place as a result of the Patient Protection and Affordable Care Act signed by President Obama in 2010. Company officials told trustees that the challenges of complying with provisions of the law that take effect in 2014 are the primary reason NYL opted to quit the association health insurance market entirely. NYL has underwritten the AVMA Trust's medical coverage for the past 20 years.
AVMA members covered by GHLIT's term life, disability income, and other nonmedical insurance policies will not be affected, as these policies will continue to be underwritten by New York Life. GHLIT CEO Libby Wallace recently told JAVMA News, “We approached a number of large and small insurance carriers about assuming this kind of business, but they all had the same reservations as New York Life.”
Later, in a presentation at the AVMA Veterinary Leadership Conference in early January, Wallace told the assembly that the health care law has fundamentally changed the way the Trust does business. “Prior to 2010, when the law was passed, the GHLIT medical insurance was a master group plan where we issued individual certificates to AVMA members for their health insurance. Beginning on January 1, 2014, we can no longer do that. They're now being treated as individual health policies,” she said.
GHLIT CEO Libby Wallace, at the AVMA Veterinary Leadership Conference in January, said provisions of the Patient Protection and Affordable Care Act make it too difficult to offer affordable medical insurance to AVMA members. (Photo by R. Scott Nolen)
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
GHLIT CEO Libby Wallace, at the AVMA Veterinary Leadership Conference in January, said provisions of the Patient Protection and Affordable Care Act make it too difficult to offer affordable medical insurance to AVMA members. (Photo by R. Scott Nolen)
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
GHLIT CEO Libby Wallace, at the AVMA Veterinary Leadership Conference in January, said provisions of the Patient Protection and Affordable Care Act make it too difficult to offer affordable medical insurance to AVMA members. (Photo by R. Scott Nolen)
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
GHLIT alerted affected AVMA members Dec. 14, 2012, that their medical insurance would end the following year. Members were assured they will be covered throughout 2013, provided they pay their premium on time. The Trust pledged to establish a program to assist members with transitioning to a new policy that meets their needs and to work to ensure there are no gaps in their coverage.
Within two weeks of the GHLIT's announcement in December, several hundred people had contacted the Trust. While a handful expressed anger at President Barack Obama for enacting the Patient Protection and Affordable Care Act, Wallace said most of them were simply afraid. “They don't know what to expect,” she said. “Anyone who has a chronic condition is worried about the cost of that new coverage.”
Approximately 35,000 people are currently covered by a GHLIT medical plan that includes such options as a preferred provider organization, health savings account, and traditional indemnity. That total includes 17,500 AVMA member veterinarians, their dependents, and 1,428 veterinary students insured by the Trust's student PPO plan.
Among the thousands losing their medical insurance are AVMA Executive Board members, trustees, and employees of the Trust, including Wallace.
As a trust “insurance designed by veterinarians, for veterinarians,” GHLIT has offered medical insurance to AVMA members at a group rate for 56 years. The 10-member board of trustees comprises nine veterinarians and one AVMA staff member who tailor the benefits package to the health needs of veterinarians, such as covering rabies prophylaxis. The board is the final level of appeals for denied claims. “Those are things that in the new world aren't going to exist,” Wallace said in an interview with JAVMA News.
Other advantages of GHLIT's medical insurance, Wallace said, are its portability and guarantee of coverage to applicants with pre-existing medical conditions.
While people are understandably worried, Dr. Aspros noted that a key fundamental of the new federal health care law is to allow people to purchase affordable health insurance, regardless of age or pre-existing medical conditions.
Events overtook lobbying, grassroots campaign
GHLIT trustees had anticipated the new health care law would usher in dramatic changes to the medical insurance market. Early in 2012, they warned AVMA leaders and members that impending regulations could require GHLIT to begin offering medical coverage outside the Association (see JAVMA, March 1, 2012, page 488).
To try to preserve its medical insurance program, the Trust hired a lobbyist to work with lawmakers and regulators to find a compromise that preserved the traditional understanding of association health plans. In addition, a grassroots campaign was initiated among AVMA members who contacted their congressional representatives to preserve the Association's program.
Trustees point to two key events in 2012 that essentially meant the end of GHLIT's medical insurance portfolio, however.
“Through most of 2011 and part of 2012, we were optimistic we'd be able to continue providing health insurance,” Dr. James Brandt, GHLIT board of trustees chairman, said. “But when the Supreme Court ruled the individual mandate was constitutional and President Obama was re-elected, we lost a lot of our enthusiasm. It seemed fairly evident at that time that New York Life would exit the association medical insurance business.”
As the underwriter for GHLIT's medical plans, New York Life currently files its plans on behalf of the Trust in Illinois, and most states recognize the terms and conditions stipulated in that filing. If NYL were to have continued underwriting the Trust's medical insurance, then starting in 2014, the new health care regulations would have compelled the company to file in every state as well as adhere to each state's medical coverage and rate requirements.
New York Life informed GHLIT that complying with all the various state mandates was too burdensome. Additionally, NYL expects the new regulations will create market conditions and a regulatory environment that would put the company at a competitive disadvantage against government-subsidized medical insurance providers.
Dr. Brandt has been a member of the GHLIT board of trustees for eight years and served the past two years as chairman. He wasn't surprised by NYL's decision to exit the association health insurance market, nor does he fault the company for doing so. “The circumstances and changes in the regulations forced what I believe was a reluctant business decision on the part of New York Life, because they really wanted to continue offering medical coverage,” Dr. Brandt said.
One benefit among many
Dr. Dajka acknowledged that when a membership benefit is lost, an organization will necessarily worry about diminishing the value of association membership. But, he noted, medical insurance was just one of many advantages of being part of the AVMA.
“You do have to worry about the impact on membership, but you have to show all the things AVMA does besides offering medical coverage,” Dr. Dajka said. “We have other insurance products, including PLIT, which isn't affected. We have over 57,000 members with that coverage, and there were no premium increases for 2013.”
All in this together
The AVMA GHLIT is in the early stages of researching whether a private medical insurance exchange is a viable option for Association members. Exchanges are like a market in bringing together insurance providers that offer a range of plans at various rates so individuals can select a plan that best meets their needs.
Throughout the year, GHLIT will update members about developments related to their AVMA medical coverage as they continue assisting them with finding a new provider.
“Members should realize we're doing everything we can to make this transition a nonevent for them,” Dr. Brandt said. “There are a lot of uncertainties about the requirements of the new law, and we're having to play it by ear, but don't panic. Stay with the AVMA.”
AVMA: COE given more time to comply with USDE standards
Accreditors receiving greater scrutiny with new regulations
By Malinda Larkin
Department of Education staff and a USDE committee have recommended continuing the AVMA Council on Education's recognition as the accreditor for U.S. veterinary schools and colleges. In addition, they gave the council one year to comply with a series of department standards.
The USDE staff recommendations were delivered Dec. 12, 2012, in Washington, D.C., during a hearing by the department's National Advisory Committee on Institutional Quality and Integrity. Dr. David E. Granstrom, director of the AVMA Education and Research Division, said the USDE advisory committee approved a motion with wording similar to that in the staff report.
The motion came at the end of the morning hearing, during which several speakers testified for and against continued COE recognition.
Critics spoke about their issues with the council, such as how members are selected and whether the council applies its standards fairly. Other concerns dealt with workforce matters and how veterinary research is conducted, which are not related to accreditation (see page 432).
In all, about 150 representatives from accrediting agencies and stakeholders attended the meeting.
Changes ahead
The COE had spent years preparing for re-recognition by the USDE. In 2010, the council examined and revised its Accreditation Policies and Procedures manual in eight areas to comply with department regulations that changed with the 2008 reauthorization of the Higher Education Act (see JAVMA, July 1, 2010, page 12).
Some of the changes were substantive—such as modifications to the appeals process—whereas others merely added clarity and consistency to policy wording.
Following that, the council underwent a yearlong evaluation by USDE staff that was required to complete the renewal process. This involved a lengthy written submission and an on-site visit to AVMA headquarters to demonstrate compliance with the recognition guidelines.
Ultimately, the staff report recommended that the COE still needs to prove that it meets certain criteria, such as being widely accepted by educators and educational institutions, providing adequate training for individuals conducting site visits, reporting progress in student achievement, accepting and considering comments on individual institutions' qualifications for accreditation, and promptly notifying the public of decisions. All told, the report suggested that the council would need to make changes in just 14 of the more than 100 areas evaluated to come into full compliance with the criteria for recognition. The report can be viewed at http://opeweb.ed.gov/aslweb/finalstaffreports.cfm.
Dr. Granstrom said one of the USDE concerns involves a recent interpretation by department staff of the regulations to suggest that allowing sitting members of an accrediting body to serve on site visit teams is a conflict of interest. COE members have participated in such site visits since its inception in 1906. To comply with this new interpretation, site team members will now be selected from a pool of trained volunteers representing the various segments of the profession, such as academia and private practice.
Dr. Granstrom said, “Without the in-depth knowledge and experience of seasoned council members on accreditation site teams, the site visit report will, of necessity, become more granular, as recommended by USDE staff,” meaning more specific evaluations of outcomes and methods.
The remainder of the deficiencies that were identified will require minor technical adjustments to existing policies and procedures, he said.
Process over product
So what exactly is the National Advisory Committee on Institutional Quality and Integrity and why is being recognized by the USDE so important? First, NACIQI is an advisory panel comprising 18 volunteer members appointed by Congress and the department.
Second, its main job is to vote to recommend to the education secretary whether the accrediting agencies it reviews, such as COE, deserve the department's stamp of approval. The Department of Education then determines whether to recognize those agencies as qualified to evaluate the education and training provided by higher education programs and to provide accreditation or pre-accreditation when appropriate.
That's important because only students at colleges or universities accredited by a USDE-recognized agency are able to receive federal financial aid (see sidebar). Recognition must be renewed every five years.
The COE is the only accrediting body for U.S. veterinary colleges and schools. Prior to the December 2012 review, the council was given five years of recognition starting in 2007. The COE also completed the Council for Higher Education Accreditation recognition renewal process in 2011 with no deficiencies noted (see JAVMA, April 1, 2012, page 785).
Neither USDE nor CHEA recognition is required for an accrediting agency. The AVMA voluntarily sought recognition when the process was first initiated by the USDE and CHEA in 1952 and 1949, respectively.
CHEA represents 3,000 colleges and universities and recognizes 60 accrediting organizations. Many of the accreditors who go before NACIQI are also recognized by CHEA.
CHEA President Judith Eaton said she has noticed in the most recent rounds of NACIQI reviews of accrediting agencies that the staff reports have contained a number of citations requiring the accreditor to do more work to achieve federal recognition—same as what the COE encountered. Typically, these accreditors receive recognition when they return after a year spent making whatever changes were necessary, as opposed to receiving it after just one trip before the NACIQI.
What's at stake
Once again, the AVMA Council on Education was recognized by the Department of Education as the accreditor for U.S. veterinary schools and colleges, despite a handful of detractors arguing for the USDE to revoke this designation. Had the COE lost this designation, however, the following would have occurred:
• Veterinary students would have lost access to loans and scholarships from the Department of Health and Human Services' Health Resources and Services Administration Bureau of Health Professions. The loss of these programs, which include health professions loans and scholarships for disadvantaged students, would have disproportionately impacted veterinary students with the greatest financial need. For the 2012–2013 academic year, 11.6 percent of U.S. veterinary students were awarded funds from these programs to help pay tuition and living expenses, for a total of more than $5.9 million in assistance.
• The lifetime total amount in federal student loans that veterinary students would be allowed to acquire, currently $224,000, would have been decreased. The aggregate loan limit for students outside the health professions is currently $138,500, and currently enrolled veterinary students would presumably have been held to this lower figure. This is important because in 2012, 1,153, or 43 percent, of students graduated with debt greater than $140,000. The lowered federal debt ceiling would mean students would have to supplement with private financing, which is typically not as competitively priced as federal student loans.
• Veterinary students would no longer be able to participate in the Veterinary Medicine Loan Repayment Program or the National Institutes of Health Loan Repayment program, because graduation from an accredited veterinary institution is required.
• Veterinary schools and colleges would no longer be eligible for the Health Careers Opportunity Program grants, which support programs such as Michigan State University's Vetward Bound program, or for the Higher Education Multicultural Scholars Program.
Source: Association of American Veterinary Medical Colleges
In fact, all but two of the past approximately 40 accrediting agencies evaluated for renewal by USDE staff have experienced similar scrutiny with the same result—a one-year extension to come into full compliance.
Rules and regulations
Eaton said this “two-step” process has been happening for the past few years; the difference is the frequency with which this is happening.
This greater scrutiny of accreditors stems from recent changes, additional federal regulations, and a greater emphasis by the USDE accreditors on having to fully meet all the federal recognition standards, she said.
“In general, folks are finding that the process that's currently carried out is very, very demanding and very, very detailed, and they are concerned about that,” Eaton said. She gave an example of one accreditor having to turn in 300 documents for the agency's recognition petition; 400 were required of another.
“The amount of time and effort this is taking is greater and greater. It takes time away from other activities in which accreditors need to engage, like more directly focusing on academic quality and serving students,” Eaton said.
“The level of detail is causing some frustration as well. In other words, we seem to be moving into a period where the process of recognition by the federal government is less about holding accreditors accountable and more about telling them how to be accountable and monitoring it.”
Eaton expects even more regulation for accreditors in the near future, both tied to the next reauthorization of the Higher Education Act, which is anticipated to happen this year, and in general.
‘Philosophical differences of opinion’
Plenty of issues brought up at USDE meeting; few answers
By Malinda Larkin
Conflicting views within the veterinary profession related to workforce issues and student education have taken center stage recently.
The AVMA Council on Education, in pursuit of recognition by the Department of Education, appeared before a USDE advisory panel, the National Advisory Committee on Institutional Quality and Integrity, Dec. 12, 2012, in Washington, D.C. (see page 430).
Critics of the council saw this as an opportunity to voice their opinions in a public forum.
NACIQI, which makes recommendations to the USDE on whether to recognize accreditors, received 13 letters recommending against the council's continued recognition, and a few of the authors made remarks at the meeting.
Though the meeting did not settle any disputes, it did spur action for potential changes to the COE. It also provided a clearer picture on the role of accreditation and what it is—and is not—responsible for.
Up to standards
Drs. Paul D. Pion, president of the Veterinary Information Network, and Robert R. Marshak, dean emeritus of the University of Pennsylvania School of Veterinary Medicine, were among those who sent letters to the DOE and spoke against the council at the meeting. Both are longtime, vocal critics of the COE, particularly after its accreditation of the veterinary schools at the Western University of Health Sciences, Pomona, Calif., and the National Autonomous University of Mexico, Mexico City, in 2010, as well as those at Ross University, Basseterre, St. Kitts, and St. George's University, True Blue, Grenada, in 2011.
Also making comments critical of the COE were Dr. William J. Kay, a former COE member; his wife, Dr. Nancy Brown; Dr. James F. Wilson, co-founder of VetPartners, a veterinary management consulting firm; and Dr. Frank Walker, a former COE member.
Representing the council were its chair, Dr. Sheila W. Allen, dean of the University of Georgia College of Veterinary Medicine, and Dr. David E. Granstrom, director of the AVMA Education and Research Division. Those who spoke in favor of the council were Dr. Deborah Kochevar, former COE chair and dean of the Tufts University Cummings School of Veterinary Medicine; Dr. Andrew Maccabe, executive director of the Association of American Veterinary Medical Colleges; Dr. John Pascoe, executive associate dean at the University of California-Davis and a COE member; and Mark Cushing, a lawyer and veterinary education consultant. Dr. Kochevar also read a statement at the meeting, signed by 50 individuals who said they believe the COE offers a “proven process for educational evaluation.” (The signatories were current administrators representing programs at 22 of the 28 U.S. veterinary colleges, among them: two provosts, 18 current deans, three emeritus deans, 16 associate deans, one emeritus associate dean, and 10 department chairs or hospital/diagnostic laboratory directors.)
St. George's University School of Veterinary Medicine received AVMA Council on Education accreditation in fall 2011. Subsequently, the veterinary school saw the number of applications nearly double from its fall 2011 semester (281) to its fall 2013 semester (587). St. George's starts two new classes each year, in the fall and spring. Its total enrollment as of mid-January was 509 students. (Photo by Malinda Larkin)
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
St. George's University School of Veterinary Medicine received AVMA Council on Education accreditation in fall 2011. Subsequently, the veterinary school saw the number of applications nearly double from its fall 2011 semester (281) to its fall 2013 semester (587). St. George's starts two new classes each year, in the fall and spring. Its total enrollment as of mid-January was 509 students. (Photo by Malinda Larkin)
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
St. George's University School of Veterinary Medicine received AVMA Council on Education accreditation in fall 2011. Subsequently, the veterinary school saw the number of applications nearly double from its fall 2011 semester (281) to its fall 2013 semester (587). St. George's starts two new classes each year, in the fall and spring. Its total enrollment as of mid-January was 509 students. (Photo by Malinda Larkin)
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Generally, it is uncommon for accreditors going before the federal panel to have third-party commenters, said Judith Eaton, president of the Council for Higher Education Accreditation, who has watched the recognition process for many years.
“Oftentimes, when it does happen, it's tied to philosophical differences of opinion in a professional field,” she said.
In the COE's case, this was no exception.
Dr. Marshak, in his comments before NACIQI and in published editorials, criticized the way the COE has applied its standards. In one commentary, he wrote: “I believe that the COE's recent interpretation of the standards has been excessively lenient and that such a permissive trend, if continued, threatens the future quality of veterinary education.” (See JAVMA, Nov. 1, 2011, page 1183.)
At the meeting, he singled out Western as an example of an institution where he doubts students are getting the training worthy of an accredited veterinary program. Among his concerns is the fact that student receive their clinical exposure at a large number of off-site facilities that can be very different from one another. He contends that, given that Western contracts with more than 700 private practices, it's impossible for academicians to monitor what students are learning, if anything.
Dr. Maccabe, in an interview with JAVMA, said while that may seem like a large number, there are, in fact, a much smaller number of core clinical sites—slightly more than 50—that constitute the veterinary college's distributive teaching hospital.
The COE, which had a site visit at the campus late this past year, visited each of those sites for evaluation, Dr. Granstrom told JAVMA.
Western faculty also visit each core clinical site during every two- or four-week rotation for the third- and fourth-year students.
Students are taught and evaluated by both Western faculty and preceptors. Plus, they all rotate through the on-campus small animal clinical facility during their first two years. They may also select on-campus elective rotations during their last two years.
“The other thing about distributive models is nearly all veterinary colleges use some form of the distributed or off-campus clinical instruction model and have for many years, in the form of externships. It's nothing new, just that Western has taken it to another level,” Dr. Maccabe said. He added that many medical schools have fully distributive models and have had them for a long time.
Dr. Granstrom said Dr. Marshak's concerns about the relaxing of standards are unwarranted. Importantly, accredited colleges are not required to use identical methods to meet the standards, and the standards are designed to have enough flexibility to allow innovation and creativity, he said.
USDE staff seemed to agree, saying in their report: “In the absence of supporting information, department staff could not make an assessment of the agency's alleged misapplication of standards in the case of the for-profit schools in question.” (Western and St. George's are actually private, nonprofit institutions; only Ross is for-profit.)
Money woes
Three of the four veterinary schools accredited by the COE in the past three years are located in the Caribbean or Mexico. This has stirred its own debate among veterinarians on whether the COE should continue to recognize non-U.S. schools and how their graduates affect the U.S. workforce.
Dr. Wilson said by accrediting these schools, the COE has created adverse effects on the profession because of the higher-than-average debt the graduates from the Caribbean incur. Through his experience teaching at one or both schools over the past decade, he estimates that most of the students attending Ross and St. George's now graduate with $250,000 to $320,000 of federally funded educational debt, compared with the mean educational debt of $151,672 incurred by U.S. students graduating with debt in 2012.
(According to St. George's figures, the average loan debt for its students during the 2011–2012 year was $151,928.)
Dr. Wilson, who teaches veterinary students at most U.S. and Caribbean veterinary schools about personal finance, also predicts that continuing to expand the number of U.S. graduates of accredited foreign programs will feed an already oversupplied market of small animal veterinarians in the United States.
According to Dr. Wilson's prepared remarks, “What has been most disconcerting is that until recently neither the AVMA, the COE, nor the AAVMC have sought to determine an accurate head count of the number of students in veterinary school outside of the U.S.A. nor have they studied the impact this rapidly growing number will have on the fiscal health of the nation's privately owned veterinary practices.”
The AVMA did create the Task Force on Foreign Veterinary School Accreditation in August 2011 to evaluate, among other things, the impact of foreign veterinary school accreditation on the U.S. veterinary profession, and the quality of standards for the U.S. veterinary profession, and the impact of not requiring graduates of accredited foreign schools to be certified by the AVMA Educational Commission for Foreign Veterinary Graduates or by the American Association of Veterinary State Boards' Program for the Assessment of Veterinary Education Equivalence. The task force report should be ready for review at the April AVMA Executive Board meeting.
In addition, the AVMA has funded a comprehensive workforce study to determine whether an oversupply actually exists, and, if so, which sectors of the profession are affected and to what extent. The results of that study should be available this spring.
The AVMA doesn't plan to include St. George's and Ross in its Annual Senior Survey. Allison J. Shepherd, AVMA senior research projects manager, said the problem is that doing so causes issues with trended data, and the institutions can't be reported individually.
As for the AAVMC, Dr. Maccabe said the association is just beginning to collect data on UNAM, Ross, and St. George's, now that they are full AAVMC members. Recent AAVMC data show that, among all accredited overseas veterinary colleges, the Class of 2012 numbered 419 U.S. citizens. For the Class of 2015, that figure was 554. Comparatively, the total number of fourth-year graduates from U.S. colleges went from 2,201 in 2006 to 2,725 in 2012. The national Class of 2015 at U.S. colleges is right at 2,938.
Regardless, the main impact accreditation of these programs has had, Dr. Granstrom said, is that “it does provide oversight and ensures continuous improvement for two schools (Ross and St. George's) that have been educating American citizens for years, thus boosting the quality of veterinary medicine in the U.S., not diminishing it, as some have stated.”
Notably with UNAM, only two graduates have taken the North American Veterinary Licensing Examination since the veterinary school was accredited.
Making sure standards are met
Despite the impassioned testimony of those who warned that COE actions fuel a looming veterinary surplus, back-breaking student indebtedness, and unchecked tuition hikes, NACIQI members told critics at the meeting that it's not within the agency's purview to consider market demands or an accreditation body's endeavors in foreign countries. Moreover, it is not the COE's responsibility to act as a workforce gatekeeper, according to the advisory panel.
Increased enrollment can compromise compliance with several standards. This is the only reason the COE requires veterinary colleges to report enrollment annually. If they intend to increase enrollment by 10 percent or more, they must notify the COE immediately.
“Along with that, they are required to provide documentation they have changed resources accordingly. So as long as the institution can document the increase in enrollment has been accommodated for with resources applied, it's not up to the COE to say if it can increase or decrease. Our responsibility is to make sure the quality of the educational experience is not diminished,” Dr. Allen said.
Accreditation, after all, is about setting standards, collecting data, and determining whether an institution meets standards, Dr. Kochevar said.
Criticism is healthy, Dr. Kochevar noted, and the COE may have areas to improve on, but the approach taken by critics at the meeting was not constructive.
“I think the council does an excellent job, and I think the key to getting (to an even better place) is to work collaboratively rather than taking the approach for the (USDE) not to credential the COE. That's a destructive approach,” she said. “I wish those with relevant issues would come forward and talk about it in a data-driven, rational way.”
Two are better than one?
Concerns about the accreditation process were also brought up at the meeting, and as a result, changes may be on the way.
According to the DOE staff report: “The comments express concern regarding the agency's independence from the association and thereby its ability to reach impartial accrediting decisions. The comments also allege that the agency represents a commercial bias that favors corporate veterinary practice. Commenters assert that such a focus has compromised the rigor of veterinary education and has deteriorated the quality of the veterinary profession's research and scientific contributions.”
Dr. Allen responded at the meeting that, having been on the COE for six years, she can say with conviction that the AVMA having influence over the COE is not true.
And as for a commercial bias, “There are practitioners on the council, and I think that is appropriate, since private practitioners make up the vast majority of our profession. I think they should have a voice in how veterinary education is moving. I don't think they should be the majority, and they aren't. It's a pretty good balance, in my opinion, but I don't think there's commercial influence or bias at all. Clearly, we need to do something to dispel that perception, and that's something we're trying to work on during the coming year,” she told JAVMA.
Those plans may involve something mentioned in a letter sent to the USDE by Dr. Michael I. Kotlikoff, dean of the Cornell University College of Veterinary Medicine. He supports the creation of a joint accrediting body similar to the Liaison Committee on Medical Education, the accrediting body for medical schools.
The Association of American Medical Colleges and American Medical Association each appoints six professional members and one student member. The LCME itself appoints two public members, and a member is appointed to represent the Committee on Accreditation of Canadian Medical Schools.
“Such a separately incorporated body responsible for veterinary accreditation, constituted equally by the AVMA and the AAVMC, would better insulate decisions about academic standards and accreditation from political and legal considerations of the AVMA,” Dr. Kotlikoff wrote. He said it would also provide an opportunity to craft a more balanced and appropriate mechanism for membership selection than currently exists for the COE.
Currently, the AVMA House of Delegates elects 15 of the council's 20 members. The AAVMC and Canadian VMA appoint one member each, and the COE elects three public members.
Dr. Kochevar, who is also AAVMC president, said her association agrees that the way members are appointed should be re-evaluated, although she expressed no concerns about the selection process.
“The current process is inherently with the HOD. The political process is not always driven by ‘Let's elect the most qualified person.’ It's driven by politics,” she said. “The goal is to assemble a group of people who are only there to assure quality education; they aren't there for other reasons.”
At the annual deans' conference in January in Naples, Fla., the veterinary college deans discussed various models of accreditation. On hand were representatives from the LCME to answer questions about the advantages and disadvantages of their accreditation model. Further discussion is expected at the AAVMC annual meeting in March in Alexandria, Va.
“The current system has served the profession well,” Dr. Kochevar said. “Where we are now, we're asking questions about more major changes that would make the system better.”
AAEP COVERAGE
Practice: AAEP convention covers lots of ground
From proper communication to muscle diseases
Photos courtesy of AAEP
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Photos courtesy of AAEP
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Photos courtesy of AAEP
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
By Malinda Larkin
Equine veterinarians have plenty to chew on these days.
The American Association of Equine Practitioners' 58th Annual Convention, Dec. 1–5, 2012, in Anaheim, Calif., provided a forum for discussions on a number of pressing issues. Welfare concerns such as medication in horse racing (see page 440) and soring of Walking Horses (page 438) were the focus of a few sessions, as were scope-of-practice matters (page 440) and the declining number of horse owners (page 442).
Other continuing education sessions covered topics including joint therapies, developments in medicine, the anatomy of the equine foot, field emergencies, techniques for ultrasound, caring for orphan foals, and reproductive challenges.
The Kester News Hour once again relayed important medical news with a review of studies published in the past year. Dr. Patrick M. McCue handled reproduction, Dr. Lisa A. Fortie covered surgery, and Dr. Stephen M. Reed discussed medicine.
In all, the five-day meeting attracted 5,730 veterinary professionals, students, guests, and exhibitors.
Hearing what others have to say
Incoming AAEP President Ann E. Dwyer (page 440) addressed attendees at the opening session on how the AAEP hopes to help improve equine practices.
She said while the association can't change the economics of the industry, its members can develop stronger relations with their clients so that economic shifts are easier to weather.
The first step in strengthening that relationship is to figure out what one values in the other, she said. The AAEP conducted a survey in September 2012 with horse owners and trainers; 6,100 people responded.
Most clients—85 percent—said they were satisfied or very satisfied with their current veterinarian, and 87 percent would recommend their veterinarian to others.
Notably, though, when asked whether they've ever switched veterinarians, more than half had fired their veterinarians or chosen another. The primary reasons—listed in descending order of importance—were poor communication, lack of availability, misdiagnosis, and cost.
Racehorse owners, specifically, put more value on their practitioner's knowledge of breed and industry. Sport horse owners valued advanced diagnostics and imaging. All owners and trainers expect veterinarians to be able to travel to the horse and provide emergency services.
The survey showed opportunities for improvement in the areas of communication, knowledge of developments in equine medicine, and lameness skills, Dr. Dwyer said.
An area of concern for the AAEP emerged from the survey question posed to owners and clients about services they receive from someone other than their primary veterinarian.
“Twenty-five percent said they have used another provider for dental care, most often a layperson. A few did take their horse to a veterinarian who truly was a specialist, but most, when asked, had a perception that lay providers were specialists,” Dr. Dwyer said.
“This shows the perception of being an expert is out there, even if the individual in question doesn't hold a veterinary degree.”
Full results from the survey will be shared later this year at www.aaep.org.
Dr. Stephanie J. Valberg, this year's Frank J. Milne State-of-the-Art Lecturer, mapped the diagnosis and management of exertional muscle disorders.
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Stephanie J. Valberg, this year's Frank J. Milne State-of-the-Art Lecturer, mapped the diagnosis and management of exertional muscle disorders.
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Stephanie J. Valberg, this year's Frank J. Milne State-of-the-Art Lecturer, mapped the diagnosis and management of exertional muscle disorders.
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Connect, convey, convince
In her convention keynote address, “Talk Less, Say More,” journalist Connie Dieken challenged audience members to take a new look at how to use influence as a means to become the communicator clients want them to be, as outlined in the client survey.
“I see a huge difference between your intent and your impact; you intend to get as many animals (as possible) in a day, but your impact could obliterate this,” she said. “Have you turned a client off when you didn't intend to? You're busy being efficient, getting everything done, but maybe a client was turned off.”
Dieken identified three habits of the most successful influencers: the abilities to connect, convey, and convince.
Connecting means capturing people's attention. This can be done by reading the client as well as the animal, understanding resistance and knowledge gaps of the client, being candid, and listening.
To successfully convey information, Dieken suggested using “portion control.”
“Some of us have the fire hydrant habit of inundating clients with information so they know how much we know. That's not helpful, because a confused brain doesn't remember anything,” she said.
Giving clients visuals such as radiographs or showing them conditions on the animal's body, as well as telling stories, can help convey information, too.
Finally, to convince others, Dieken encouraged practitioners to be cognizant of their body language and energy and to use short sentences.
Incorporating these traits will boost the influence factor with clients, she said. The return on influence, according to Dieken, is clients for life, payments from absent owners, and respect for boundaries from others.
Untying causes of tying up
Another featured speaker at the meeting was equine muscle diseases expert Dr. Stephanie J. Valberg. She laid out for equine practitioners tactics to diagnose and manage exertional muscle disorders during her Dec. 3 Frank J. Milne State-of-the-Art Lecture, “ Muscling in on the Cause of Tying Up.”
Following a review of historical research into exertional rhabdomyolysis, Dr. Valberg discussed her ongoing research into the disease, which she said could be managed by improving the horse's energy supply through a combination of diet and regular exercise. Specifically, Dr. Valberg recommended moderating dietary starch to lower the horse's insulin concentration. She encouraged attendees to emphasize to owners of ER-affected horses that a dietary change alone is ineffective without daily exercise. Even minimal exercise of 10 to 20 minutes per day with turnout has a beneficial effect.
Dr. Valberg is the first female practitioner selected to deliver the lecture. She also was a student of Dr. Milne's in 1982 at the University of Guelph Ontario Veterinary College. Dr. Valberg received her DVM degree in 1983 and her doctorate from Swedish University of Agricultural Sciences, Uppsala. She is director of the University of Minnesota Leatherdale Equine Center. She is also a diplomate of the American College of Veterinary Internal Medicine and certified in veterinary sports medicine and rehabilitation.
Through her clinical research, Dr. Valberg has identified new equine muscle disorders, including polysaccharide storage myopathy, recurrent exertional rhabdomyolysis, glycogen branching enzyme deficiency, and immune-mediated myopathies. Her current research focuses on identifying the heritable basis for neuromuscular disorders and developing genetic tests.
Practice: Change hard to come by
USDA looking at new ways to detect soring
The Walking Horse industry averages about 600 horse shows per year; Department of Agriculture veterinary medical officers attend approximately 80 of those.
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
The Walking Horse industry averages about 600 horse shows per year; Department of Agriculture veterinary medical officers attend approximately 80 of those.
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
The Walking Horse industry averages about 600 horse shows per year; Department of Agriculture veterinary medical officers attend approximately 80 of those.
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
By Malinda Larkin
As the AVMA, American Association of Equine Practitioners, federal government, and others put pressure on the Walking Horse industry to eradicate the practice of soring, pushback on reform remains.
On Nov. 20, 2012, the AVMA and AAEP released a statement indicating their support for amendments to the Horse Protection Act. As written, the amendments (H.R. 6388) would have strengthened penalties for violations of the act and improved Department of Agriculture enforcement (see JAVMA, Nov. 1, 2012, page 1133).
Five months earlier, the associations had jointly called for a ban on the use of action devices and performance packages on Tennessee Walking Horses. These are commonly used to accentuate the breed's distinctive gait but can also be used to facilitate soring, i.e., deliberately inflicting pain to exaggerate the gait of horses to gain an unfair advantage in the show ring.
The Tennessee Walking Horse Breeders' and Exhibitors' Association and the Tennessee Walking Show Horse Organization issued letters Nov. 21 and Nov. 28, respectively, to the AVMA and AAEP. Both indicated opposition to the associations' efforts and the amendments to the HPA.
The TWHBEA wrote that, while it is committed to ending soring: “The Association is aware of no scientific evidence supporting the idea that pads and action devices, when used properly, harm horses. In reality, it is the actions of unscrupulous individuals that harm horses.”
The TWSHO letter followed in the same vein. The group also took issue with the proposed amendment to the HPA that would eliminate the role of horse industry organizations such as the TWHBEA and TWSHO in horse show inspections.
Currently, horse show managers can voluntarily hire USDA-trained lay inspectors, known as designated qualified persons, chosen by certain horse industry organizations. The USDA also has its own veterinary medical officers who perform inspections at some venues.
Under the new provision, the USDA would be responsible for choosing inspectors for horse shows, auctions, and other Horse Protection Act–regulated venues; however, the decision to hire a designated qualified person would still be up to the horse show, sale, or auction organizers.
“Without HIOs there are no assurances of consistent inspections, tracking of individuals that have been previously ticketed, and thus no effective enforcement of the HPA,” TWSHO's letter stated.
Currently there are 12 horse industry organizations; only six are active. Three are undergoing decertification. That's because in 2012, the USDA changed regulations to create a more consistent penalty structure for the industry (see JAVMA, Aug. 1, 2012, page 296). It requires designated qualified persons who inspect horses to assess minimum penalties for soring. These three organizations didn't follow the mandate, claiming the regulations were unconstitutional.
Facts and figures
Dr. Gail C. Golab, director of the AVMA Animal Welfare Division, responded to the two organizations' letters in a Dec. 3 post on the AVMA@Work blog, explaining the AVMA's and AAEP's position as well as the proposed amendments.
The science that is available says that raising the heels (placing a horse on pads and wedges) 8 degrees can cause the horse to stumble and tire easily, Dr. Golab wrote. Additionally, horses placed on pads and wedges had inflammation in the flexor tendon area of the pastern.
“Chains that weigh 6 ounces will start to cause hair loss without the use of chemical irritants. Chains heavier than 6 ounces used on horses that have been previously sored will cause open lesions within two weeks,” Dr. Golab added.
Regardless, she said, the horse industry organizations were missing the point of the AVMA's and AAEP's decision.
“The AVMA's and AAEP's primary concern is that chains and pads are used to exacerbate and/or hide soring. And they can do so irrespective of their size and/or weight,” Dr. Golab wrote. “To remove opportunity and incentive to sore, and to facilitate the inspection process under the HPA, the AVMA and AAEP agree with the authors of H.R. 6388 that self-policing, and chains and pads, have to go.”
Recent statistics bear out Dr. Golab's claim on self-policing.
As of Nov. 17, 2012, designated qualified persons had completed 62,835 inspections for the year and found 641 violations (1.02 percent). By comparison, 9,685 inspections were completed when USDA veterinary medical officers were present. During those inspections, 572 violations were found (5.91 percent).
During the 2012 Tennessee Walking Horse National Celebration, the biggest show for this community, 1,849 entries were inspected with USDA veterinary medical officers present, and 166 violations were found (8.98 percent). The preceding year, there was a 9.5 percent violation rate, with 2,143 horses inspected and 203 violations found.
Plus, from 2005–2008, the USDA was present at only 6 percent of all Walking Horse shows, yet designated qualified persons found 39 percent of all their violations at these horse shows.
Divisions remain
Further discord in the Walking Horse industry was made evident when the TWHBEA voted in late 2012 to reject a proposal submitted by the TWSHO to unify the industry under one voice.
The proposal was a draft plan developed from meetings with various independent equine experts, including multiple nationally renowned veterinarians. The mission of the organization was to have a “one-voice” horse industry organization for performance horses.
“Goals include the implementation of one set of HIO protocols, procedures and penalties to ensure consistent, fair and complete inspections throughout the industry. The group's primary goal would be to eliminate soring through an aggressive reform agenda. Additionally, the group intends to coordinate all industry communications regarding the show horse in matters relating to the HPA, regulatory, and political issues. The proposal intends to create one rule-book, penalty structure, and judging program,” according to an email sent by the TWHBEA.
The proposed 12-member board of directors would have consisted of two members from five current organizations—the TWSHO, TWHBEA, Walking Horse Owners Association, Tennessee Walking Horse National Celebration, and Walking Horse Trainers' Association—along with two “independent, non-industry” veterinarians.
The TWHBEA cited concerns over the lack of financial details and the representational structure of the board for not joining. The WHOA held a similar vote and rejected the plan but voted to keep lines of communication open with the TWSHO.
Keeping an eye on things
Going forward, while H.R. 6388 is expected to be reintroduced in the 113th Congress, the USDA continues to test new methods to detect soring and keep horses that have been sored from being entered in horse shows.
The USDA Horse Protection Program has begun a pilot project on drug testing. Veterinary medical officers obtain blood to look for agents that could be linked to soring.
“Just as numbing and masking agents are found from the foreign substance testing, we are concerned that these types of agents may be injected in the horses as well to cause soring or mask soring during inspections,” said Dr. Rachel Cezar, Horse Protection Program coordinator with the Animal Care program of the USDA Animal and Plant Health Inspection Service.
So far, 50 samples have been collected at three horse shows, and more sampling is planned in 2013.
In addition, the USDA Horse Protection Program will be working with the equine identification system EyeD to establish a program for identifying horses in violation of the Horse Protection Act via a scan of their irises. The USDA will begin using it this year.
“We hope that introducing this technology to the industry will influence (horse owners) to start utilizing it as well for equine identification,” Dr. Cezar said.
Practice: Dynamic personality ready to lead AAEP
Dwyer started at racetrack, now a practice owner
Dr. Ann E. Dwyer (Photos courtesy of AAEP)
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Ann E. Dwyer (Photos courtesy of AAEP)
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Ann E. Dwyer (Photos courtesy of AAEP)
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
By Malinda Larkin
Dr. Ann E. Dwyer recalls the culture of equine practice 30 years ago as truly being 24/7 with lots of time on call.
“The last thing you wanted anyone to do was to accuse you of being soft or not being able to cut it, so you just did it,” she said.
But when she took over in 1995 as director and principal owner of the Genesee Valley Equine Clinic in Scottsville, N.Y., Dr. Dwyer resolved to make some changes. She figured if she could grow the practice to support multiple practitioners, a more civil schedule was possible for everyone, which it has been.
“Out of adversity is born innovation, I guess,” she told JAVMA News during the American Association of Equine Practitioners Annual Convention Dec. 1–5, 2012, in Anaheim, Calif.
That attitude will likely serve Dr. Dwyer well in the AAEP presidency this year as the organization continues to grapple with how to handle issues that threaten equine practice.
State of affairs
For one thing, nonveterinary health care providers continue to perform services that compete with veterinarians. The main areas where this occurs are equine dentistry, reproductive services, and complementary and alternative veterinary medicine.
Dr. Stephen S. Galloway said during a presentation in Anaheim on scope of practice that laypeople who perform equine dentistry claim more than a dozen different titles.
“It's a confusing thing for the horse owner to decide and determine what their level of training is,” Dr. Galloway said.
According to an AAEP survey of members, 62 percent of respondents said they were concerned about nonveterinary health care providers; only 12 percent said they were satisfied with what the AAEP is doing about it.
Dr. Dwyer said state VMAs, not the AAEP, should be responsible for lobbying on these matters. Instead, the AAEP can be a resource to help members educate legislators when state practice acts are opened for changes.
She has personally been involved with legislative efforts in New York involving equine dentistry.
“AAEP helped me from an education standpoint, and just to be able to say what's happening in other states. I was a couple of phone calls away from that information. It would have been harder if I had to do the research on my own,” she said.
Dr. Dwyer and the AAEP have also been keeping a close eye on the greater scrutiny of horse racing. The New York Times ran a series of articles last year chronicling an “industry still mired in a culture of drugs and lax regulation and a fatal breakdown rate that remains far worse than in most of the world,” according to a March 24, 2012, story.
An analysis by the newspaper of data from more than 150,000 races showed that from 2009–2011, trainers at U.S. tracks were caught illegally drugging horses 3,800 times. In the same period, 6,600 horses broke down or were injured. A state-by-state survey by the Times showed that about 3,600 horses had died racing or training at state-regulated tracks during that time.
Dr. Dwyer said the Times articles have helped galvanize the blueprint for racing changes that the AAEP has been calling for all along.
“If you read the 50 years of history of the AAEP, it has been a constant evolution of trying to put a stake in the ground and saying this is how racing should operate. It's very difficult to do that, but we keep getting closer and closer, I think,” she said.
Dr. Dwyer and the AAEP continue to refer to the Racing Committee's “Clinical Guidelines for Veterinarians Practicing in a Pari-Mutuel Environment,” which came out in October 2010. Among other things, the document called for the following: no medication, with the exception of furosemide, to be given to a horse on race day; integrative therapies to be based on valid medical diagnoses; all procedures performed to be documented in a medical record; and all communication with owners and trainers to be transparent.
On the last point, Dr. Dwyer said the AAEP is working to provide tools that would facilitate better communication among trainers, owners, and veterinarians. The association also has stated support for the concept of a national, uniform medication policy.
Dr. Dwyer notes that issues of medication are not unique to racing but cover every aspect of the performance horse world.
“It's a fine tightrope to walk, because there is definitely medication that is therapeutic. That's why we went to veterinary school—to learn what tools we have available to help horses,” Dr. Dwyer said.
“However, there are times where there is too much medication, in my opinion. And I think we need to raise member and public awareness of this and help our members with guidelines, and we have. And we may need to emphasize them more.”
Bare essentials
The AAEP is not only dealing with external issues but also with changes internally. Much of Dr. Dwyer's time as president will be spent implementing governance changes and continuing to advance the association's strategic plan.
On Dec. 4, 2012, members voted to pare down the 20-member AAEP board of directors to 12. Future board members will now be elected to at-large positions rather than as geographic representatives. Plus, the association is reducing the number of standing committees.
“Three key advisory councils will provide continuous oversight for philanthropy, issues relating to leadership succession, and equine welfare and public policy. Action items formerly assigned to committees will become completed by targeted groups of members working as task forces. Important issues will always be tackled, but now by groups of members with specific expertise, a defined goal, and a finite timeline,” Dr. Dwyer said.
The 2013 AAEP officers: Drs. James P. Morehead, treasurer; Ann E. Dwyer, president; Jeff Blea, president-elect; G. Kent Carter, vice president; and John S. Mitchell, immediate past president
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
The 2013 AAEP officers: Drs. James P. Morehead, treasurer; Ann E. Dwyer, president; Jeff Blea, president-elect; G. Kent Carter, vice president; and John S. Mitchell, immediate past president
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
The 2013 AAEP officers: Drs. James P. Morehead, treasurer; Ann E. Dwyer, president; Jeff Blea, president-elect; G. Kent Carter, vice president; and John S. Mitchell, immediate past president
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
The biggest challenge, she says, will be communicating to members and volunteers the value of the structural changes and the point that none of these changes was made to fix a broken system. Instead, they were made proactively to address a changing culture, demographics, and technology.
“I want to help our profession be sustained for a long time. Since we have challenges coming from every direction, I have to work hard in whatever areas I can influence to make sure that the greater world knows how relevant we are and how much we can do to benefit the welfare of the horse,” Dr. Dwyer said.
New officers, board members
The 2013 AAEP officers and new members of the board of directors took office Dec. 5, 2012. New members of the board are Drs. Monty McInturff, Thompson's Station, Tenn., District IV; Wendy Vaala, Alma, Wis., District V; and Kenton Morgan, Pleasant Hill, Mo., District VI.
See accompanying photo of the officers.
The Ann E. Dwyer file
• Worked as a groom and exercise rider for trainers at racetracks in New York and Florida.
• During veterinary school, worked as a veterinary assistant at Belmont Park, Gulfstream Park, and Finger Lakes Racetrack.
• Received her DVM degree from Cornell University in 1983.
• Hired after graduation as an associate at Genesee Valley Equine Clinic (Scottsville, N.Y.), which serves the area's pleasure and performance horses.
• Purchased the practice from AAEP past president Dr. Bob Pearson in 1995.
• Published four book chapters on equine eye disease.
• Serves as a reviewer for Equine Veterinary Ophthalmology and Equine Veterinary Journal.
• Named an honorary diplomate of the American College of Veterinary Ophthalmologists in 2011.
• Enjoys kayaking and playing the cello.
Practice: What lies ahead
Nonveterinary health care providers continue to perform services that compete with veterinarians'. The main areas where this occurs are equine dentistry, reproduction services, and complementary and alternative veterinary medicine.
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Nonveterinary health care providers continue to perform services that compete with veterinarians'. The main areas where this occurs are equine dentistry, reproduction services, and complementary and alternative veterinary medicine.
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Nonveterinary health care providers continue to perform services that compete with veterinarians'. The main areas where this occurs are equine dentistry, reproduction services, and complementary and alternative veterinary medicine.
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
By Malinda Larkin
Looking at the state of the horse industry is sometimes enough to leave equine veterinarians reaching for their own ulcer medication.
A big area of concern is the declining number of horses and horse owners.
In 2005, a study commissioned by the American Horse Council showed there were 9.2 million horses in the U.S. and 4.6 million horse owners. The size of the industry shrank 4.4 percent from 2005–2010, and today, it continues on that path.
“Horse owners in all segments are aging. Plus, it costs a lot to own a horse,” especially for those participating in competitions, said Dr. Eleanor Green, dean of the Texas A&M University College of Veterinary Medicine & Biomedical Sciences, during a presentation at the American Association of Equine Practitioners Annual Convention about the future of equine practice.
“Further add to that, equine events aren't drawing as many spectators as they had in the past, there are fewer practicing equine veterinarians—who are deterred by economic pressures, and then there are alternative channels for products for clients from retailers. It's not a pretty picture.”
But there are areas for improvement, she pointed out, and equine veterinarians can flourish by openly facing circumstances that affect the horse industry and equine veterinary medicine, deriving data-driven responses, and being open to new ideas.
First, Dr. Green said they need to remember that the public influences them, whether it's through horse ownership or attendance at spectator events. This means veterinarians need to come together and proactively address welfare issues. Changing societal views of animals and urbanization have led to greater scrutiny of established and developing practices, she said.
Second, Dr. Green emphasized that equine veterinarians need to be innovative in their business models and find ways to attract young practitioners. She cited AVMA estimates that 122 new equine graduates are needed annually to maintain that segment of the veterinary workforce. In reality, only 37 or so are graduating annually.
Further, as of March 2011, AAEP membership consisted of 7,766 veterinarians and 1,697 veterinary students. Membership increases by 700 to 800 a year, Dr. Green said, but there is a comparable loss, primarily among recent graduates. Most often, they cite lack of job satisfaction as the reason for leaving equine practice. In fact, half of equine practitioners leave the field within the first five to 10 years, she said.
Likewise, half of all equine practices report difficulty retaining employees, according to an AAEP survey. It also found that 64 percent of respondents older than 60 were very satisfied with their work while only 29 percent under the age of 30 were very satisfied.
“There is a strong correlation to income levels, but other factors come into play as well,” Dr. Green said. Small animal medicine, by comparison, generally has higher starting salaries, less stress, less risk of injury, less emergency work, better working hours, and shorter, flexible schedules—all of which appeal to the younger generations.
“Younger equine practitioners are not lazy; they simply want balance in their lives, and being told they need to act more like older practitioners simply won't cut it,” she said. Instead, Dr. Green suggested retraining clients to expect 24-hour quality care from any member of a team of qualified veterinarians.
Third, veterinarians may need to find new ways to deliver equine veterinary services, such as through remote medicine, telemedicine, or concierge medicine, in which the client pays an annual fee or retainer in exchange for enhanced care.
Chris Ragland, of Axxiom LLC, who also spoke during the forum, said consumer behavior has evolved to a point where consumers are better informed because they have easier access to information.
“There is a burden that exists for you to figure out what does that mean to your business model. How are you going to interact with clients who are very different today than they were in previous generations? … There's lots of pressure coming into your practice that will change how dispensing behaviors will be conducted over the next several years,” Ragland said, in reference to the Fairness to Pet Owners Act (H.R. 1406). The legislation would require veterinarians to provide clients with written prescriptions for all prescription drugs for pets, even if the client then asks the veterinarian to dispense the drugs, and to provide them with written notification of the option to fill prescriptions elsewhere.
Ragland said the legislation is symptomatic of how consumer demands are changing.
Outside pressures may force equine veterinarians to change drug dispensing behaviors in coming years, according to Chris Ragland of Axxiom LLC.
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Outside pressures may force equine veterinarians to change drug dispensing behaviors in coming years, according to Chris Ragland of Axxiom LLC.
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Outside pressures may force equine veterinarians to change drug dispensing behaviors in coming years, according to Chris Ragland of Axxiom LLC.
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
He said big-box stores want mostly drugs that people buy and use routinely, such as omeprazole, to become over-the-counter, but not vaccines, anesthetics, or anti-inflammatories.
“I think it (equine practice) will change the same way it did 15 or 20 years ago when the equine veterinarian dewormed a horse, and now we don't. There'll be things you don't do anymore after things migrate over (to OTC),” Ragland said.
In wrapping up the discussion, Dr. Green said this is about perspective.
She reminded audience members of the prediction when the automobile was invented that the veterinary industry would cease to exist.
“It didn't. It's flourished; it's just been different,” she said. “The world is changing around us, and we can flourish, but we need to change to do that and change our thinking, which needs to be data-driven, but interpreted correctly.”
She also cautioned against making sweeping conclusions and predictions in the face of the greatest recession since the Great Depression.
Dr. Green added that a big opportunity for growth in the equine industry is to create new possibilities for horse involvement without ownership. Other opportunities are to re-engage previous horse owners, help current horse owners increase their involvement, and embrace new horse owners.
American Kennel Club funding research on bloat
The American Kennel Club Canine Health Foundation has launched a research initiative with the aim of better defining and ultimately eradicating bloat in dogs.
“Bloat is of foremost concern to the AKC Canine Health Foundation and its donors, and as such will require a major research effort to identify the underlying mechanisms of this disease,” according to the request for proposals.
The foundation anticipates providing two to three grants of $250,000 each for studies on bloat. March 18 is the deadline for letters of intent.
“The exact cause of bloat is not understood, and to date only risk factors have been identified,” according to the request for proposals. “It is clear that large-breed and/or deep-chested dogs are at higher risk, and it is consensus opinion that these anatomical features may predispose certain breeds to disease. Beyond anatomical features, genetics, feeding practices, exercise, gut motility, and stress have been proposed to be associated with development of bloat, but definitive studies are lacking. In order to move beyond these anecdotal and associative relationships, we must better define the pathophysiology of disease.”
The foundation strongly advises grant applicants to collaborate with breed clubs to identify study participants and samples.
The request for proposals is available at www.akcchf.org/research by clicking on “Application Process” and then on “Bloat Initiative.”
Practice: Travel rules added for farm animals
Rules apply to most livestock, horses starting March 11
It is the cattle industry that will be most affected by regulations that, starting in March, will require identification for most livestock that cross state, tribal, or international borders.
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
It is the cattle industry that will be most affected by regulations that, starting in March, will require identification for most livestock that cross state, tribal, or international borders.
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
It is the cattle industry that will be most affected by regulations that, starting in March, will require identification for most livestock that cross state, tribal, or international borders.
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
By Greg Cima
Livestock owners soon will need to provide identification and travel documents for most farm animals sent across state borders.
With some exceptions, animals raised for food and fiber as well as horses and other equids will need approved types of individual or group identification for such travel starting March 11, the Department of Agriculture's Animal and Plant Health Inspection Service announced in a Jan. 9 Federal Register notice. The animals also will need interstate certificates of veterinary inspection or, when shipping and receiving states agree, alternate movement documents.
The identification needed varies by species. Livestock owners can, for example, use ear tags to identify large and small ruminants, group identification documents for pigs, group identification or leg bands for poultry, descriptions and images of horses, and—if shipping and receiving states agree—hot-iron brands on cattle. The USDA also is giving animal health officials and cattle owners two years to use up current stocks of ear tags that do not have the official ear tag shield.
The regulations will not affect some animals, such as livestock shipped for custom slaughter, chicks moved from a hatchery, and beef cattle that are younger than 18 months old and not traveling for events such as exhibitions or rodeos. State governments will need to know which grazing livestock herds routinely cross state lines, but those herds do not need health certificates or movement documents for daily travel.
The farm animal rules are intended to help APHIS react more quickly to disease emergencies and at reduced cost. They are the final version of an August 2011 proposal in which APHIS officials indicated they wanted to create minimum identification and documentation requirements for moving livestock.
“Traceability does not prevent disease, but knowing where diseased and at-risk animals are, where they have been, and when, is indispensable in emergency response and in ongoing disease control and eradication programs,” the agency said in the Federal Register notice.
In a press statement, Dr. Ron DeHaven, AVMA CEO and a former APHIS administrator, praised APHIS' work to establish identification and documentation requirements for animals moving interstate. He hopes the program becomes the foundation for an even more comprehensive, mandatory, and uniform system that would be consistent across states.
Veterinarians' records affected
Veterinarians and others who issue or receive certificates of veterinary inspection for animals crossing state borders will need to keep copies of the certificates or related records for two years when those certificates are used for poultry or swine, and five years when they involve cattle, bison, equids, cervids, sheep, or goats. Anyone who distributes official identification devices, such as ear tags, will need to maintain records related to those devices for five years. Livestock facilities must keep records of movements of poultry and swine for at least two years and others for five years.
The different times for record keeping are connected with the shorter lives of most pigs and poultry.
The USDA accepted comments through Jan. 30, 2013, on the document “Data Standards for Interstate Certificates of Veterinary Inspection.” APHIS will publish a final version of the document on its website at www.aphis.usda.gov.
Disease-specific livestock identification requirements already have helped the USDA trace animals' movements, the Federal Register notice states. For example, APHIS officials during 2010 identified the origins of 96 percent of scrapie-positive sheep, “typically in a matter of minutes,” because 92 percent of cull breeding sheep have official identification at slaughter through the National Scrapie Eradication Program.
“Other diseases, particularly contagious ones, require that we trace to more than the birth premises,” the notice states.
The new rules could help the USDA control domestic diseases such as bovine tuberculosis and new or foreign animal diseases such as foot-and-mouth disease. Shortcomings in animal traceability have hurt efforts to eradicate tuberculosis in the U.S., a goal since 1917, the notice states.
NAIS legacy
The state-based animal identification and tracking system is a replacement for the National Animal Identification System, a voluntary federal system APHIS began implementing nearly a decade ago. After receiving mostly critical comments in a 15-city “listening tour” about the NAIS, the agency announced in February 2010 that it planned to abandon the system.
“USDA spent more than $120 million, but only 36 percent of producers participated,” an APHIS fact sheet stated. “It is no secret that there are concerns about and opposition to NAIS.”
Instead, APHIS would make state and tribal governments track interstate livestock travel. The USDA announced that it planned to let local governments lead and administer a new animal disease traceability program, and the USDA would provide support and cooperation to help them meet standards.
Bovine industries most affected
USDA officials said in 2011 that the livestock identification regulations were most needed for the cattle industry, and the 2012 notice states that the new rules will have the most impact on owners of cattle and bison. Industry's total additional identification and documentation costs associated with implementing the regulations for all U.S. cattle are estimated to be between $11 million and $34 million.
The American Association of Bovine Practitioners generally supports implementing individual identification for animals, which provides a safety net for the national cattle industry, said Dr. M. Gatz Riddell, AABP executive vice president.
“In the event of a foreign animal disease, failure to have good animal identification will become immediately problematic,” Dr. Riddell said.
Dr. Riddell cited foot-and-mouth disease as an example of a disease that could cause devastation in the absence of an animal identification system.
APHIS officials noted that the U.S. exported about $2.8 billion worth of beef and $132 million worth of live cattle during 2010, and the total value of U.S. cattle and calf production during 2009 was $32 billion.
“If there were an animal disease outbreak in the United States that affected our domestic and international beef markets, preservation of only a very small proportion of these markets would justify estimated private sector costs attributable to the animal disease traceability program,” the notice states.
The regulations will have little effect on the swine industry and veterinarians who work in that industry, said Dr. Tom Burkgren, executive director of the American Association of Swine Veterinarians. Existing identification and tracking systems, which had been required for the federal pseudorabies eradication program, meet the new regulations, he said.
Future regulations could require that state and tribal governments meet performance standards for tracking interstate livestock movements. APHIS also is giving states and tribes information systems connected with the tracking requirements. Local governments will cover costs of locally developed systems, but federal money can be used for administration of local traceability activities.
Additional information on the new regulations is available on the APHIS website.
Practice: Exhibitors need to give USDA more travel details
Animal exhibitors licensed and registered with the Department of Agriculture need to give federal authorities itineraries for their animals at least 48 hours before travel.
The USDA Animal and Plant Health Inspection Service announced in December 2012 that the agency was amending its Animal Welfare Act regulations to require more information on travel starting Jan. 30, a Dec. 31 Federal Register notice states. The regulations are intended to help APHIS Animal Care inspectors enforce the Animal Welfare Act by ensuring animals are given adequate handling, housing, treatment, and transportation when taken away from their home sites at least overnight. The regulations are expected to affect about 425 exhibitors.
“The rule is expected to eliminate costs APHIS incurs in attempting to inspect animals that are not at locations where APHIS expected them to be, and to reduce some costs associated with responding to inquiries and complaints about traveling exhibitors alleged to have violated Animal Welfare Act regulations and standards,” the notice states. “Money saved on these activities can be put toward inspections and other activities that will benefit animal welfare.”
Since 1997, an APHIS policy has required animal travel itineraries from frequently traveling exhibitors. Those who occasionally traveled with animals needed to provide itineraries if their animals would be away from home more than four consecutive days or when APHIS requested itineraries for shorter trips.
The itineraries now required for animal exhibitors need to include where animals will be housed, exhibited, and stopped for layovers.
Asked whether the regulations also were intended to help the department find animals exposed to disease, Dave Sacks, a USDA spokesman, said the increased ability to identify possible disease exposure during an outbreak is a benefit but not a reason for implementing the rule.
Practice: Researchers, dealers, exhibitors need disaster plans
Animal dealers, researchers, exhibitors, and others licensed and registered under the Animal Welfare Act will need to have plans to protect their animals during disasters.
Authorities in the Department of Agriculture want to make sure such animal holders know what they will do during emergencies. The written emergency plans need to be in place by July 29, and all employees of the registered facilities need to be trained in the specifics of the plans by Sept. 27.
The USDA Animal and Plant Health Inspection Service said in a December 2012 announcement that many registered facilities have had inadequate contingency plans, as shown during the 2005 hurricane season, when Hurricane Katrina hit New Orleans.
A Dec. 31 Federal Register notice states that each contingency plan will need to identify likely emergencies ranging from electrical outages to natural disasters; describe tasks to be performed during emergencies, such as evacuating animals and providing backup sources of food, water, shelter, and veterinary care; identify who is responsible for the tasks; and describe what materials, resources, and training are needed for response and recovery.
APHIS officials will not make affected animal owners submit their plans because processing, reviewing, and storing plans for more than 10,000 license and registration holders would require “enormous” resources, according to the Federal Register notice. Instead, the agency wants facilities, dealers, exhibitors, handlers, and carriers to review their own contingency plans at least once annually and document the reviews.
APHIS inspectors must be able to examine the contingency plans, annual review documentation, and training records.
Issues: Recalls of pet food rise on the radar
By Katie Burns
Recalls of pet food are not increasing, but awareness of them might be. The primary cause of these recalls is Salmonella contamination, which could pose more of a threat to human health than to animal health.
The number of U.S. firms that recall pet food is fairly constant from year to year, said Dan McChesney, PhD, director of the Office of Surveillance and Compliance at the Food and Drug Administration Center for Veterinary Medicine. During the 2011 federal fiscal year (beginning Oct. 1, 2010), 26 firms recalled 131 pet food products. In fiscal 2012, 24 firms recalled 67 pet food products.
Dr. McChesney believes public awareness and press coverage of pet food recalls have increased recently. In 2010, the FDA introduced the Safety Reporting Portal to allow online reporting of safety problems with pet food, among other products.
“Pet food in general is a very safe product and occasionally, like any other food, becomes contaminated with Salmonella,” Dr. McChesney said.
Salmonella contamination of pet food is decreasing but remains the primary cause of recalls, he said. The FDA found the bacteria in 12.4 percent of 153 samples between 2002 and 2006 and in 6.1 percent of 719 samples between 2007 and 2009. Other major causes of pet food recalls are aflatoxin contamination and nutrient imbalances.
Dr. McChesney said Salmonella contamination of pet food rarely results in animal illness but can lead to human illness. Pet foods prone to Salmonella contamination include pig ears, jerky treats, and raw meat diets. Dry pet food can also provide a growth medium for the bacteria.
Dr. Kate KuKanich, assistant professor of small animal internal medicine at Kansas State University, wrote a 2011 overview on Salmonella in pet food (J Am Vet Med Assoc 2011;238:1430–1434). In a recent interview, she said pet food contamination is very rare in the United States.
“We're doing a really good job of looking for it. We have better testing mechanisms in place now for it,” Dr. KuKanich said. “We're doing an excellent job about educating the public, and our dog food companies and cat food companies are very good at implementing recalls when they're needed.”
Salmonella contamination of dry dog and cat food has resulted in some outbreaks of human illness, but animal illness has been unconfirmed in these outbreaks, Dr. KuKanich noted. When she has seen pets with salmonellosis, the cases usually involved a homemade raw meat diet instead of a commercial pet food.
As of press time, the FDA was finishing draft regulations to implement provisions of the Food Safety Modernization Act of 2011 that will require manufacturers of pet food and other animal feed to increase preventive controls for safety hazards.
Duane Ekedahl, president of the Pet Food Institute, which represents pet food manufacturers, said manufacturers have come together particularly in the past two years to share practices to improve product safety—partly in anticipation of the new regulations.
“We all share the value of doing everything we can to ensure absolutely safe product,” Ekedahl said. “We believe that the safety record of pet food is excellent, and it is a safe product. We will follow strong safety practices and utilize continuous improvement to make the safest products possible.”
He said pet food manufacturers are making a major effort to prevent and detect Salmonella and other contaminants in pet food at every phase of the manufacturing process.
While recalls of pet food do get a lot of attention, Ekedahl said, the American Customer Satisfaction Index indicates that consumers remain more satisfied with the pet food industry than with many other industries.
Resources
Information about recalls of pet food and other animal feed is available from the AVMA at www.avma.org/News/Issues/recalls-alerts and from the Food and Drug Administration at www.fda.gov/AnimalVeterinary/SafetyHealth/RecallsWithdrawals.
The Centers for Disease Control and Prevention provides tips on safe handling of pet food to prevent salmonellosis at www.cdc.gov/Features/SalmonellaDryPetFood.
Veterinarians and others may report safety problems with pet food via the Safety Reporting Portal at www.safetyreporting.hhs.gov. The FDA recommends also reporting problems to the product's manufacturer or distributor.
Issues: Antifreeze manufacturers agree to bittering agent addition
This past December, the Consumer Specialty Products Association and Humane Society Legislative Fund announced antifreeze and engine coolant manufacturers had voluntarily agreed to add a bitter flavoring agent to their products sold nationwide.
Antifreeze and engine coolant are made with ethylene glycol, a highly toxic compound with a sweet taste that appeals to animals and children. The Humane Society Legislative Fund, an advocacy organization working to pass animal protection laws, estimates at least 10,000 animals are poisoned as a result of ingesting these products each year.
Seventeen states currently require adding a bittering agent to ethylene glycol, usually denatonium benzoate. Multiple attempts at making it a federal requirement have been unsuccessful, however.
HSLF Executive Director Sara Amundson hailed the agreement, announced Dec. 12, 2012. “After years of battling over legislation addressing this important issue, the manufacturers of antifreeze and engine coolant have been working with animal advocates to pass state laws with mutually agreed-on language,” Amundson said.
“Today, all major marketers are placing the bitterant in antifreeze in all 50 states,” said Phil Klein, executive vice president of legislative and public affairs for the Consumer Specialty Products Association. The trade organization represents the household and industrial products industry.
The AVMA supported federal legislation mandating the addition of a bittering agent. Additionally, the Association has a policy that encourages using clear warning labels emphasizing the potential danger of ethylene glycol and efforts to make the compound less palatable to animals.
Issues: Agency says GE salmon unlikely to harm US environment
A Massachusetts-based company's salmon, genetically engineered to grow more quickly than wild salmon, are unlikely to escape and damage environments in the U.S., federal officials said in two reports provided in December 2012.
The documents published by the Food and Drug Administration indicate the agency did not consider how the salmon could affect the environment in Canada, where AquaBounty Technologies would produce its salmon eggs, or Panama, where the salmon would be grown to market size, other than as needed to identify any potential effects on U.S. environments. The assessment does note that the salmon, known as AquAdvantage salmon, would be effectively sterile and grown in land-based, freshwater culture facilities, not in the ocean net pens or cages used to farm other fish.
The agency is accepting comments on the documents through Feb. 25. The two documents include a draft environmental assessment and a preliminary “Finding of No Significant Impact.”
AquaBounty claims that its triploid female Atlantic salmon grow to market size in half the time of conventional Atlantic salmon. The company uses an rDNA construct that contains gene-coding sequences from ocean pout and Chinook salmon.
The FDA is evaluating the rDNA construct as a new animal drug because of its effects on the fish, and the environmental assessment is part of that evaluation.
The FDA noted in its draft environmental assessment that, if the agency denied AquaBounty's drug application, the company could still produce and sell the salmon outside the U.S., making the effects on the U.S. environment “highly uncertain.”
“Because production of AquAdvantage Salmon would be possible at any number of locations worldwide, under different containment conditions, and potentially within areas where native Atlantic salmon are present, there are too many variables and unknowns to perform a comprehensive assessment and make any predictions with respect to potential environmental impacts on the United States,” the assessment states.
The documents and instructions on providing comments are available under docket number FDA-2011-N-0899 at www.regulations.gov.
Community: Accolades
American College of Veterinary Surgeons
Although Hurricane Sandy forced the American College of Veterinary Surgeons to cancel its 2012 annual symposium, which was scheduled for Nov. 3–5 in National Harbor, Md., the ACVS announced the recipients of three prestigious awards and its new officials. The college also welcomed 103 new diplomates in 2012 (see JAVMA, Jan. 15, 2013, page 148).
Dr. Stephen J. Withrow (MIN ′72) of Colorado State University was the recipient of the ACVS Founders' Award for Career Achievement, which recognizes the service of ACVS diplomates who have distinguished themselves through important contributions to the development of surgical techniques and methodology and through dissemination of knowledge to colleagues, residents, and students. According to the ACVS, Dr. Withrow is one of the most renowned veterinary surgical oncologists in the world. His commitment to the ACVS and the training of young surgeons is evidenced by the clinical surgical oncology programs and procedures he has developed and the oncology research he has fostered.
The ACVS Merit Award was presented to Dr. Thomas M. Turner (AUB ′72) of Willowbrook, Ill. This award is given to an individual outside the ACVS whose career has been dominated by major and ongoing contributions to the art and science of veterinary surgery. For nearly 40 years, Dr. Turner has contributed to innovative techniques in veterinary and human orthopedics. He made major contributions to the development of total hip replacement in dogs and humans, and to a canine total knee replacement implant used in studies that helped guide the development of total knee replacement implants used in humans.
Dr. Stephen J. Withrow
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Stephen J. Withrow
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Stephen J. Withrow
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Thomas W. Turner
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Thomas W. Turner
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Thomas W. Turner
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. H. Phil Hobson
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. H. Phil Hobson
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. H. Phil Hobson
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Cheryl S. Hedlund
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Cheryl S. Hedlund
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Cheryl S. Hedlund
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Earl M. Gaughan
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Earl M. Gaughan
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Earl M. Gaughan
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Rolf M. Embertson
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Rolf M. Embertson
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Rolf M. Embertson
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. H. Phil Hobson (IL ′56) of College Station, Texas, was the recipient of the ACVS Foundation Legends Award. This award recognizes ACVS diplomates who have developed a valuable surgical or diagnostic procedure that has become the treatment or test of choice for a given condition. Dr. Hobson developed procedures for the use of external ring prostheses for tracheal collapse, creation of a permanent tracheostomy, and treatment of pectus excavatum, and for other reconstructive techniques for congenital abnormalities.
The new ACVS officials are as follows: ACVS—Drs. Cheryl S. Hedlund, Ames, Iowa, president; Earl M. Gaughan, Blacksburg, Va., chair of the Board of Regents; Rolf M. Embertson, Lexington, Ky, president-elect; and C. Collins “Andy” Anderson III, San Antonio, treasurer; ACVS Foundation—Drs. Mark D. Markel, Madison, Wis., chair; and trustees—Drs. Matthew D. Barnhart, Worthington, Ohio; Sara A. Colopy, Madison, Wis.; William R. Daly, Friendswood, Texas; Erick L. Egger, Steamboat Springs, Colo.; Michelle L. Haven, Hampton, N.J.; Elizabeth Laws Kilgallon, Bedford Hills, N.Y.; William A. Lindsay, Arnaudville, La.; and Janet Kovak McClaran, New York City.
American Association of Equine Practitioners
The American Association of Equine Practitioners honored the 2012 recipients of several awards Dec. 4, 2012, at its 58th Annual Convention in Anaheim, Calif.
Dr. Nat T. Messer (COL ′71) was honored with the Distinguished Life Member Award. A professor of equine medicine and surgery at the University of Missouri-Columbia College of Veterinary Medicine, Dr. Messer was elected to the AAEP's board of directors in 1996 and has served as a member of the association's Equine Welfare, Abstract Review, Biologic and Therapeutic Agents, Nominating, and Research committees.
Dr. Messer has also represented the AAEP as a member of the AVMA Animal Welfare Committee, the Unwanted Horse Coalition, and the American Horse Council. He is a life member of the American Quarter Horse Association and has served on the AQHA Equine Research Committee. Dr. Messer is a member of the American Board of Veterinary Practitioners, certified in equine practice.
Dr. Jay Merriam (KSU ′69), a practitioner with the Massachusetts Equine Clinic, was given the President's Award. He is a founding member of Project Samana, a group of veterinarians who have visited the Dominican Republic twice a year for the past 20 years. He wanted to expand the outreach effort by visiting other countries and started a movement to inform veterinarians about the plight of the world's working equids, most of which work under terrible conditions but are vital to families' survival in these countries.
Dr. Merriam coined the term “equitarian” for his cause, built grass-roots support for the effort, and then brought the equitarian idea to the AAEP, which in 2010 formed the Equitarian Task Force to improve the health and welfare of working equids worldwide through promotion of education, direct aid, and organizational leadership and collaboration.
The Distinguished Service Award was given to Dr. Midge Leitch (UP ′73). Recently retired from the University of Pennsylvania's New Bolton Center, Dr. Leitch has facilitated forums, led task forces, presented at educational meetings, and guided the governing entities of the association since joining the AAEP in 1973. She was a member of the AAEP board of directors from 2003–2006, served as chair of the Equine Welfare Committee from 2008–2010, and represented the AAEP as an alternate delegate to the AVMA Animal Welfare Committee and as a member of a previous AVMA Panel on Euthanasia. She is a diplomate of the American College of Veterinary Surgeons.
Dr. Jill Johnson (MIN ′72), of Baton Rouge, La., was awarded the Distinguished Educator Award. Before retiring in 2011, she trained students at the Louisiana State University School of Veterinary Medicine for 34 years. Dr. Johnson continues to pursue research projects on blood typing/immunogenetics, GPS technology for racehorses, and hospital-acquired Salmonella infections in horses.
The Christian Veterinary Mission was chosen to receive the Lavin Cup—the AAEP Equine Welfare Award.
Established as a nonprofit organization in 1976, the CVM was founded on the principle of changing communities in the Third World by providing veterinary care for livestock and other animals. The CVM operates long-term mission sites in 12 countries throughout Africa, Asia, and Latin America. Members of the CVM have propelled the AAEP's Equitarian Initiative, first presented at the 2009 AAEP Annual Convention, and provided guidance for equitarian projects.
Dr. Nat T. Messer
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Nat T. Messer
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Nat T. Messer
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Jay Merriam
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Jay Merriam
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Jay Merriam
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Jill Johnson
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Jill Johnson
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Jill Johnson
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Tom Juergens (for Christian Veterinary Mission)
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Tom Juergens (for Christian Veterinary Mission)
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Tom Juergens (for Christian Veterinary Mission)
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Two equine researchers were recognized as the 2012 Equus Foundation Research Fellows. Texas A&M University Master of Science candidate Dr. Michelle C. Coleman (GA ′07) and University of Kentucky Gluck Equine Research Center doctoral candidate Dr. Allen E. Page (CAL ′08) each received a $5,000 fellowship to support their endeavors in equine research.
Dr. Coleman is the study coordinator for the AAEP Foundation's Case-Control Study of Pasture- and Endocrinopathy-Associated Laminitis in horses, currently under way at Texas A&M University. Dr. Page is investigating why only a small proportion of Lawsonia intracellularis–exposed weanlings develop clinical signs of equine proliferative enteropathy, while most fail to show any ill effects of exposure.
University of Minnesota doctoral candidate Dr. Nichol Schultz (PUR ′03) is the 2012 AAEP Foundation Past Presidents' Research Fellow. A $5,000 grant is awarded each year to a doctoral or residency student who has made substantial progress in the field of equine health care research. Dr. Schultz's thesis project is focused on the epidemiology and genetic basis of equine metabolic syndrome.
American Association of Zoo Veterinarians
Event: Annual conference, Oct. 20–26, 2012, Oakland, Calif.
Program: The conference drew 468 attendees representing 30 countries.
Awards: Duane Ullrey Award: Dr. Michael M. Garner, Monroe, Wash., for exceptional achievements in the science of wild animal health and for support of the AAZV. A 1987 graduate of the Washington State University College of Veterinary Medicine and a diplomate of the American College of Veterinary Pathologists, Dr. Garner owns Northwest ZooPath, a consulting service that specializes in the pathology of non-domestic species. He also serves as an adjunct associate professor of pathology at the WSU CVM's Department of Microbiology and Pathology. AAZV/Morris Animal Foundation Postgraduate Student Manuscript Competition: First place—Dr. Kate Freeman (NCU ′08), for “Does orally administered doxycycline achieve adequate concentration in the plasma and tears of elephant seals (Mirounga angustirostris)?”; and second place—Dr. Krista Keller (ROS ′10), for “Development of a cutaneous wound healing model for evaluation of platelet-derived growth factor (Regranex®) in the bearded dragon (Pogona vitticeps)”; AAZV/Wildlife Pharmaceuticals Inc. Undergraduate Student Manuscript Competition: First place—Greg Bishop (CAL ′13), for “Successful management of recurrent eosinophilic granuloma with steroids and antihistamines in a black rhinoceros (Diceros bicornis)”; and second place—Dr. Alexander Alvarez (FL ′12), for “Development of a quantitative PCR for rapid and sensitive detection of an intranuclear coccidian parasite of tortoises (tinc) and identification of tinc in the critically endangered Arakan forest turtle (Heosemys depressa)”; Safe Capture International Inc. Poster Competition: First place—Grayson Doss (LSU ′13), for “Evaluation of metomidate hydrochloride as an anesthetic in amphibians”; and second place—Gabby Drake, North of England Zoological Society, United Kingdom, for “Management of an outbreak of cowpox in a group of captive cheetahs (Acinonyx jubatus soemmeringii) (224).” Lifetime membership was awarded to Dr. Duanne Ullrey, East Lansing, Mich., for outstanding contributions to the AAZV. Winners of the International Scholarship Program were Monica Bando, Animals Asia Foundation, China; Omar Gonzales Viera, Sao Paulo University, Peru; Rupak Khadka, Tacugama Chimpanzee Sanctuary, Sierra Leone; Gianmarco Paolo Rojas Moreno, Parque Zoologico Huachipa, Peru; and Kinani Sangwa Jean Felix, Mountain Gorilla Veterinary Project, Rwanda.
Dr. Michael M. Garner
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Dr. Michael M. Garner
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Dr. Michael M. Garner
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Dr. Paul Calle
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Dr. Paul Calle
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Dr. Paul Calle
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Dr. Doug Armstrong
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Dr. Doug Armstrong
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Dr. Doug Armstrong
Citation: Journal of the American Veterinary Medical Association 242, 4; 10.2460/javma.242.4.426
Business: The AAZV's Developing Nation Limited Member program is in its second year with 115 participants, compared with 26 at the same time last year. DNLM members cannot vote or hold office but receive all other member benefits and access to the online journal, electronic mailing list, and the members-only area of the website. In addition, the European Association of Zoo and Wildlife Veterinarians gives DNLM members access to the members-only area of its website. The DNLM program builds in-country capacity worldwide, as the AAZV recognizes that most of the endangered species on the planet inhabit developing nations.
Officials: Drs. Paul Calle, New York, president; Doug Armstrong, Omaha, Neb., president-elect; Meg Sutherland-Smith, San Diego, vice president; Kelly Helmick, Seattle, secretary; Chris Hanley, Toledo, Ohio, treasurer; Kirk Suedmeyer, Kansas City, Mo., immediate past president; and Robert Hilsenroth, Yulee, Fla., executive director
Korean Veterinary Society of America
Event: 40th anniversary meeting, Dec. 1–2, 2012, Anaheim, Calif.
Awards: Drs. Moonso Kim, Boston; Haksuk Hong, Tampa, Fla.; and Young Kim, Canoga Park, Calif., were honored for their dedicated contributions to society members and to the expansion of the society.
Business: The society has established an annual veterinary scholarship at the Western University of Health Sciences in Pomona, Calif., and has invited veterinary students from Korea to spend time in clinical practice at member hospitals and other advanced clinical facilities during their summer vacations. The KVSA was established 40 years ago in Philadelphia by 10 Korean academicians and practitioners to assist veterinary professionals coming to the United States in pursuing their professional careers. It has grown to be a 400-member organization with mostly practitioners and industry workers as well as academicians. The society has three major chapters on the East Coast and West Coast and in Canada. Some members are part of Christian missions to Mongolia, Guatemala, and other parts of the world. The society also assists veterinarians from other cultures in establishing their professional careers in the United States and provides academic assistance to Korean veterinary schools that are interested in applying for AVMA accreditation.
Officials: Drs. Youngjun Choi, Glendale, Calif., president; Yousik Bang, Long Beach, Calif., vice president/president-elect; Lyon Lee, Pomona, Calif., secretary general; Henry K. Yoo, Santa Monica, Calif., immediate past president; and Jinyoung Choi, Lomita, Calif., chief editor
Obituaries: AVMA member AVMA honor roll member Nonmember
Ramsay S. Buchanan
Dr. Buchanan (UP ′54), 86, Coatesville, Pa., died Nov. 20, 2012. A small animal practitioner, he was a partner at King of Prussia Veterinary Hospital in King of Prussia, Pa., from 1961 until retirement in 1988. Earlier in his career, Dr. Buchanan worked for Merck Sharp & Dohme, serving on the team that worked with monkeys for polio vaccine research. An Army veteran of World War II, he later served in the Army Veterinary Corps Reserve. He was a member of the Pennsylvania VMA and a past president of the Suburban VMA.
Dr. Buchanan worked with hounds, serving as an honorary whipper-in and field master for hound exercising for several years. He was a member of the Pickering Hunt Board and a past president of the Buck and Doe Trust Board.
He served eight years in the 1970s as a supervisor in Schuylkill Township, working on land preservation and municipal zoning. Dr. Buchanan is survived by his wife, Susie, and a son. His daughter-in-law, Dr. Cynthia M. Buchanan (UP ′96), is a mixed animal veterinarian in Coatesville. Memorials may be made to the Cheshire Hunt Conservancy Land Preservation Fund, P.O. Box 528, Unionville, PA 19375.
James E. Calender
Dr. Calender (MSU ′57), 79, Lakeland, Fla., died Dec. 19, 2012. Prior to retirement in 1980, he practiced small animal medicine at Pennfield Animal Hospital, a practice he established in Battle Creek, Mich., in the early 1960s. Early in his career, he practiced mixed animal medicine in Bellevue, Mich. In retirement, Dr. Calender served as a relief veterinarian. He was a member of the Michigan VMA. His wife, Carolyn; a daughter; and two sons survive him.
Robert S. Dedrick
Dr. Dedrick (COR ′65), 72, Nashua, N.H., died Oct. 7, 2012. A small animal practitioner, he owned East Side Veterinary Clinic in Meriden, Conn., from 1972–2004. Earlier in his career, Dr. Dedrick served as a captain in the Army Veterinary Corps. He volunteered with the New Hampshire Audubon Society. Dr. Dedrick's wife, Kay Lynn, and three daughters survive him. Memorials may be made to Home Health and Hospice Care, 7 Executive Park Drive, Merrimack, NH 03054; or Massabesic Audubon Center, New Hampshire Audubon Society, 28 Audubon Way, Auburn, NH 03032.
Will A. Hadden
Dr. Hadden (TEX ′75), 61, Tyler, Texas, died Oct. 31, 2012. He practiced mixed animal medicine in Tyler for 32 years. During that time, he established Gresham Veterinary Hospital and the Equine Medical Center Laboratory. Dr. Hadden was also an attending veterinarian at the University of Texas Health Science Center for the past 15 years. Early in his career, he served in the Army as post veterinarian at Fort Ord in Monterey, Calif. Dr. Hadden attained the rank of captain.
He was a past president of the East Texas VMA and a past director of the Texas VMA and Tyler Animal Emergency Clinic. Dr. Hadden also co-authored and edited the Horseman's Veterinary Encyclopedia. He is survived by his wife, Joy, and three daughters. Memorials may be made to All In Project, Grace Community Church, 3215 Old Jacksonville Highway, Tyler, TX 75701.
Larry L. Larrow
Dr. Larrow (COR ′56), 81, St. Albans, Vt., died Dec. 2, 2012. A small animal practitioner, he owned Champlain Veterinary Clinic in St. Albans for 38 years. Dr. Larrow was a past mayor of St. Albans and served on the board of directors of the Franklin County Home Health Agency. He was also active with Meals on Wheels and Habitat for Humanity. Dr. Larrow's wife, Margaret, and five children survive him. Memorials in his name may be made to the Green Mountain Habitat for Humanity, Franklin/Grand Isle Chapter, P.O. Box 1375, St. Albans, VT 05478; or Shriners Hospital, c/o Mount Sinai Shriners, P.O. Box 742, Montpelier, VT 05601.
Hiram N. Lasher
Dr. Lasher (COR ′42), 92, Millsboro, Del., died Oct. 7, 2012. He founded, and, until recently, served as president of Lasher Consulting Inc., providing technical advice and support to vaccine producers in the United States and abroad since 1982. Earlier in his career, Dr. Lasher owned two poultry vaccine manufacturing companies in Millsboro. Known for his expertise in avian vaccine development, he was instrumental in developing a program to eradicate pullorum and conducted research that led to the development of numerous, innovative vaccines.
Dr. Lasher was an honorary diplomate of the American College of Poultry Veterinarians and a member of the American Association of Avian Pathologists, New York Academy of Sciences, and Poultry Science Association. In 1994, he received the AAAP's C.A. Bottorff Award, and, in 2004, was inducted into the American Poultry Historical Society Hall of Fame.
Active in civic life, Dr. Lasher was a founding board member of the Delaware Technical Community College and served 12 years on the Delaware State Board of Education. He was active with the Boy Scouts of America and received the Silver Beaver Award for his service. Dr. Lasher is survived by his wife, Bertha; three sons; and three daughters. Memorials may be made to the B.V. Rao Poultry Scholarship Fund, Office of Gifts Processing, University of Delaware, 83 E. Main St., Newark, DE 19716.
Angus MacDonald
Dr. MacDonald (TEX ′68), 80, Flower Mound, Texas, died Oct. 10, 2012. A small animal veterinarian, he owned a practice in Dallas, also operating a house call practice. Dr. MacDonald served as a captain in the Army. His wife, Winnie, and four children survive him. Memorials may be made to Animal Trustees of Austin, 5129 Cameron Road, Austin, TX 78723.
Lester M. Schwab
Dr. Schwab (OSU ′63), 84, Alamo, Calif., died June 16, 2012. A small animal practitioner, he founded Valley Veterinary Hospital in Walnut Creek, Calif., and an outpatient clinic in Danville, Calif. His wife, Olivette; two daughters; and a son survive him.
Andrew N. Vedros
Dr. Vedros (KSU ′50), 87, Overland Park, Kan., died June 27, 2012. He practiced small animal medicine in Kansas' Johnson County prior to retirement in the late 1980s. Dr. Vedros was an Army Air Force veteran of World War II. He is survived by three daughters. Memorials may be made to St. Dionysios Greek Orthodox Church, 8100 W. 95th St., Overland Park, KS 66212.
William C. Wagner
Dr. Wagner (COR ′56), 80, Reston, Va., died Dec. 10, 2012. He was dean of the St. Matthew's University School of Veterinary Medicine on Grand Cayman prior to retirement in 2011.
Following graduation, Dr. Wagner worked in a general practice in Interlaken, N.Y. He then served as a research associate in veterinary pathology and earned his doctorate in physiology from Cornell University. In 1968, Dr. Wagner joined the faculty of the Veterinary Medical Research Institute at Iowa State University as an assistant professor, becoming a professor in 1976. The following year, he moved to the University of Illinois at Urbana-Champaign to head the Department of Veterinary Biosciences and, in 1990, was named associate dean of research and graduate studies. During that time, Dr. Wagner also served as a program manager for competitive grants in animal reproduction at the U.S. Department of Agriculture's Cooperative State Research, Education, and Extension Service, and was a member of the Study Section on Fetal Development at the National Institutes of Health.
From 1990–1993, he was involved in the development of the competitive grants program in animal health at the USDA CSREES. In 1993, Dr. Wagner left the university to head the CSREES' section on animal systems and serve as national program leader for veterinary microbiology and pathology in plant and animal systems. He continued in these positions until 2002 when he began serving as a visiting professor at The Ohio State University. There, he worked on strategic planning and research funding and the development of the National Animal Health Laboratory Network.
In 2007, Dr. Wagner became dean of the St. Matthews veterinary school.
He was a charter diplomate and a past president of the American College of Theriogenologists and represented the college on what is now the American Board of Veterinary Specialties from 1971–1979. Dr. Wagner served on the AVMA Council on Education from 1987–1993, chairing it in 1991. He was also a past chair of the Scientific Advisory Board of the Morris Animal Foundation and a past president of the Conference of Research Workers in Animal Diseases, International Congress on Animal Reproduction, and the national society of Phi Zeta. Dr. Wagner was a charter member of the Society for the Study of Reproduction and a member of the Society for the Study of Fertility, American Society of Animal Science, American Physiological Society, and American Association of Veterinary Laboratory Diagnosticians.
He received several honors, including the David Bartlett Award from the American College of Theriogenologists in 1995 and induction as a Distinguished Practitioner Member into the National Academies of Practice in Veterinary Medicine in 1996. In 1999, Dr. Wagner received the William P. Switzer Award from Iowa State University and, in 2012, the annual meeting of the CRWAD was dedicated to him.
He is survived by his wife, Victoria; a son; three daughters; and a stepson. Memorials may be made to Christ the King Lutheran Church, 10550 Georgetown Pike, Great Falls, VA 22066.
Kenneth L. White
Dr. White (CAL ′70), 69, Reno, Nev., died July 17, 2012.
