JAVMA News

DOI:
https://doi.org/10.2460/javma.252.12.1434
Volume/Issue:
Volume 252: Issue 12
Online Publication Date:
15 Jun 2018
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Clinic devises a novel approach to employees' child care conundrum

One veterinarian gives practice-owned day care a try

By Malinda Larkin

Child care can be a headache, whether it's finding a day care that covers work hours, filling in for a co-worker who is out caring for a sick kid, or being able to afford a child care provider in the first place.

For most, these problems are simply a fact of life. Every week in the United States, nearly 11 million children younger than five are in some type of child care arrangement, with children spending, on average, 36 hours a week in child care. Although costs vary widely, depending on factors such as the child's age, the care provider's geographic location, and the type of setting (e.g., center versus home), 2014 data compiled by the not-for-profit organization Child Care Aware of America yield mean annual costs nationwide for full-time, center-based care of $9,909 for an infant and $7,943 for a 4-year-old.

One rural Texas veterinary practice owner saw child care not as a problem but as a way to increase employee performance and satisfaction.

Family first

“The culture of our practice revolves around family. We approach practice and life as one: We practice life and medicine together,” said Dr. Keelan Lewis. The 2011 Virginia-Maryland College of Veterinary Medicine graduate has owned Salt Creek Veterinary Hospital in Olney, Texas, since January 2014. The mixed animal practice—half beef cattle, the rest small animal and equine—is located about 130 miles southwest of Dallas. In 2015, she opened another practice, 40 miles west in Seymour, and in May 2017, she and her dad, Dr. Arn Anderson, bought a practice in Graham, 25 miles south of Olney.

Four veterinarians and 13 support staff rotate among the three clinics, with a fifth veterinarian starting in July. All the staff members are women and half of them have children. Initially, the demands of practice, especially the hours, conflicted with the parents' child care needs. For example, veterinarians on a farm call 40 miles away had difficulty getting to the day care facility in Olney before the required 5:30 p.m. pickup time. And in Texas, where cattle veterinarians like to work early in the morning before it gets too hot, Dr. Lewis had to have clients look for a veterinarian elsewhere if they wanted one to be on their farm before 8 a.m. because the day care providers in town didn't open until 7:30 a.m.

Dr. Lewis, who with her husband, Kyle, has two boys—Cason, 4, and Phifer, 1—thought, why couldn't she try having a practice-owned day care?

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Salt Creek Veterinary Hospital in Olney, Texas, has an open-door policy when it comes to employees' kids. Shanda Hope, the clinic-employed nanny, will bring their children from the practice's nearby day care to the veterinary hospital at the parents' request to see newborn calves or kittens, watch a surgery, or let a new mother feed her baby. (Photos courtesy of Dr. Keelan Lewis)

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

“If a mom is worried about her child who is at a facility she doesn't want them to be in, or is stressfully throwing them in there at 7:30 a.m., is she providing the best quality medicine to patients while she's worried about her kid? No, she's not,” Dr. Lewis said. “What is the value of her skills versus, say, a blood machine in the patient getting better? Her brain is more important. If she can't think through what is wrong with that animal because she is distracted, it doesn't matter how many blood machines you have. We don't second-guess buying another truck or another ultrasound or blood machine. Why is this any different?”

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Dr. Keelan Lewis (center) details her efforts to create a practice-owned day care during a panel discussion on workplace well-being at the 2018 Veterinary Wellbelng Summit, April 16–18 in Schaumburg, Illinois. (Photo by Malinda Larkinguess)

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

Dr. Lewis detailed her efforts to create a practice-owned day care during a panel discussion on workplace well-being at the 2018 Veterinary Wellbeing Summit, April 15–17 in Schaumburg, Illinois (see page 1439 for summit report). She gave a follow-up interview to JAVMA News.

Dr. Lewis says she spent a lot of time on the phone with Texas Health and Human Services, which inspects child care centers and had initially refused her proposal. The department eventually sent an inspector to see Dr. Lewis. He suggested she hire a private nanny instead of creating a certified day care center, which would have been too costly. So, Dr. Lewis, via a limited liability company, bought a two-bedroom home about 2 miles from her Olney hospital and across the street from the local elementary school. Then about a year later in 2015, the clinic hired Shanda Hope as a nanny. She rotated among the mothers' houses for the first nine months while the new home was retrofitted to be what they wanted, including having a room where rotating externs could stay overnight.

“The immediate return for us was an almost instantaneous good feeling about being at work. That trickled down to the entire staff,” Dr. Lewis said.

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Six of seven mothers who work at the clinic use the company day care. Shanda Hope, the nanny, works whenever they need her. “That allowed my group of all-female practitioners and support staff to get what they felt like they needed to be at work,” Dr. Lewis said. (Courtesy of Dr. Keelan Lewis)

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

Only employees' children can attend the day care, helping to mitigate liability concerns. Since the day care opened, Hope has cared for around six kids at a time, ages 6 weeks to 5 years. She is a salaried employee of the hospital and receives the same benefits as the rest of the staff. Hope works their hours but has weekends off, along with Thursdays, which coincides with the moms' day off. Otherwise, she is at their disposal.

“If I leave at 6 a.m., she is there at 6 a.m. At the end of the day, we try really hard to be there at 6 p.m. Sometimes, other clinicians will pick up for me or vice versa,” Dr. Lewis said. “We just finished bull testing season, so we were up early. We paid her extra for that. She is our most prized employee.”

The veterinarians have workarounds for care outside of regular hours. Each veterinarian is on call for emergencies one night a week and every fourth weekend. If one arises, the husband cares for the children. Clinic employees who clean the kennels and walk dogs are also called on to babysit if someone is in a bind. When working Saturday mornings, most of the practitioners bring their kids with them. “The clientele are accustomed to us being a family business. They're used to seeing the kids playing in back while we're examining pets,” Dr. Lewis said.

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Dr. Lewis said the clinic spends on day care costs a fraction of the amount spent on health insurance for the entire staff. The tax credits from purchasing the home (photos below) that was retrofitted as the practice's day care and the nanny's salary also help defray some of the costs. (Photos courtesy of Dr. Keelan Lewis)

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

Finally, the parents decide as a group whether a child is too sick to come to the practice-owned day care rather than have a stipulation that a child can't come if they have a temperature, a practice common among many day care centers.

“What would I have done for three days when my son had a 100-degree fever while he was teething? What would the practice have done? They would have been out a vet,” Dr. Lewis said.

Return on investment

Employees contribute a portion of their salary for the day care expenses, and the clinic pays the rest. Dr. Lewis says she is trying to decrease the percentage parents pay each year.

Though it is a cost to the practice, Dr. Lewis says she spends less money on the day care than she does on the four work trucks in a year. Plus, the hospital receives tax credits for having a company-provided day care as well as for expenses to fix and maintain the house. This year, she hopes to add a small play place outside.

“We never quantified what that day care was in return monetarily, because for us, it's a solution for a big stressor for our staff, and we're able to pay for it. Maybe we paid for that instead of another improvement for the clinic or benefit for the staff, but it's important,” Dr. Lewis said.

Otherwise, the return on investment is employee retention and productivity, she said. It's moms being excited to come to work. That's backed up by a 2014 study published in the Journal of Managerial Psychology that found employee performance was higher and absenteeism was lower among employees using on-site child care than among employees using an off-site center or those who had no children.

So the practice's employees not only gain peace of mind but also potentially save a lot of money. Rising college tuition is a well-known phenomenon. What is less well-known is how comparable college tuition is with child care costs.

According to the 2015 Economic Policy Institute paper “High quality child care is out of reach for working families,” the mean annual cost of tuition for an in-state, full-time undergraduate student in a degree-granting public institution ranges from $3,756 in Wyoming to $14,469 in New Hampshire.

“While these sums are sizable, 4-year-old care exceeds the average cost of in-state college tuition at public 4-year institutions in 24 states and the District of Columbia. Similarly, infant care costs exceed tuition in 33 states and the District of Columbia. Even when looking at out-of-state tuition at public 4-year institutions, which is significantly more expensive than in-state tuition, college costs still do not dwarf child care costs,” the report's authors state.

When Dr. Lewis presented the idea of a practice-owned day care at the Veterinary Wellbeing Summit, many attendees later asked her in amazement how she did it.

“I never understood how basic, solution-oriented problem-solving would be so novel,” Dr. Lewis said. She wonders whether the reason the idea isn't more common is that men still own most clinics and may not be as sensitive to the need as women are, given that women still generally hold the role of caretaker.

“Listen and figure out what your staff actually needs. They may not need a day care. Decide what they need to be happy and do it,” she said.

Taking responsibility for well-being in the workplace

Employee input, sense of belonging key to creating positive change

Photos and story by Malinda Larkin

The veterinary profession, which studies show has rates of burnout and suicide higher than those of the general U.S. population (see page 1442), has taken steps to address its gap in well-being in recent years but still has work to do. Jen Brandt, PhD, AVMA director of member well-being and diversity initiatives, said well-being is a holistic process, not an event.

Wellness and well-being do not mean the same thing, she said. Well-being in the workplace means personal happiness—feeling good, feeling healthy, and working safely and productively. The emphasis is on a life well-lived, looking at the whole person. Wellness is focused on physical health and illness prevention, sometimes in an effort to reduce costs.

Dr. Brandt said a culture of well-being helps attract top talent, brings out the best in employees, and increases employee retention, engagement, and satisfaction. She quoted Dr. Nick Stace, chief executive of The Prince's Trust, a U.K. organization that helps struggling young people, and former CEO of the Royal College of Veterinary Surgeons: “We believe we have a moral obligation to make the workplace great for people who spend much of their lives at work.”

Dr. Brandt gave the keynote address for the 2018 Veterinary Wellbeing Summit, April 15–17 in Schaumburg, Illinois. The AVMA teamed up with the Association of American Veterinary Medical Colleges and Zoetis to host the fifth summit focused on wellness and well-being in the veterinary profession. About 175 attended the event, including 25 veterinary mental health professionals.

The summit covered a range of topics including the link between culture and well-being, the importance of boundary setting, addressing perfectionism, and the business case for well-being. Many of the sessions offered a look at real-life scenarios, such as successful initiatives for parents in various work environments (see page 1434), personal obstacles and success stories, and lessons learned. In addition to facilitating critical conversations, the summit provided practical resources and strategies to enable participants, ranging from academicians and students to practitioners, to establish a culture of well-being in their workplace and throughout the profession.

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Jen Brandt, PhD, AVMA director of member well-being and diversity initiatives, says during her keynote address that veterinary workplaces can do more to destigmatize help-seeking, to give employees a sense of belonging, and to develop communication between leadership and employees, among other things.

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

A feeling of belonging

According to a 2014 survey of over 11,600 U.S. veterinarians, only 15 percent of veterinarians with serious psychological distress somewhat agreed or strongly agreed that people are caring toward persons with mental illness.

Dr. Brandt referenced the essay “Who's really to blame for physician burnout?” by Maiysha Clairborne, MD, to explain why health care providers may feel this way. Dr. Clairborne argues that while most physicians would say the system is to blame, no one considers the possibility that the physician community as a whole has some responsibility.

Dr. Clairborne writes: “When a physician inside his or her community does not feel safe even to talk to his colleagues (not his bosses or managers), then we have to look at who we are being as individuals that someone would rather suffer in silence and continue to spiral, rather than admitting to someone that they are in trouble. Furthermore, we can look at the fact that, in many cases, we are so busy complaining about the system that we often fail to notice anything else … like a colleague who is slowly slipping away. So, while it would be a natural reaction to blame the ‘flawed medical institution’ for a physician's suicide, it would have more integrity for physicians to look at themselves every once in awhile to see where we can positively impact this issue.”

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The 2018 Veterinary Wellbeing Summit convened by the AVMA, the Association of American Veterinary Medical Colleges, and Zoetis, April 15–17 in Schaumburg, Illinois, was the fifth conference held on the topic of wellness and well-being. About 175 attended the event, including 25 social workers. The goal was to provide ideas from all parts of the profession to help others develop “a type of culture that supports everyone in their organization.” (Photos by Malinda Larkin)

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

Veterinary professionals and staff can be part of the solution by reducing stigmas around mental health and being more inclusive, Dr. Brandt said. She emphasized the importance of belonging, a concept popularized by Brene Brown, PhD, a research professor at the University of Houston Graduate College of Social Work. She has spent the past 10 years studying vulnerability, courage, authenticity, and shame.

Citing Dr. Brown's work, Dr. Brandt said that “belonging” is being accepted for who one is. “Fitting” is being accepted for being like everyone else.

“Think how exhausting it is to fit in someone else's suit, day after day. Think about the emotional toll this takes. Am I invited to the table as me, or who you think I should be?” Dr. Brandt said, noting that an inclusive workplace has people who not only work better but also are healthier.

Speak up and be heard

Creating a culture of well-being starts with defining what well-being, happiness, safety, health, and inclusion mean to workplace leaders and their team members, Dr. Brandt said. Then comes implementing a well-being program that makes sense for that workplace. This could involve staff improving their own well-being; training on communication, suicide prevention, or emotional intelligence; prioritizing inclusion by hiring people who care about it; and eliminating barriers to well-being.

Dr. Brandt encouraged leaders in the workplace to create a shared vision.

“Leaders will have greater success at creating a culture of well-being and sustained productivity by including everyone's ideas, input, (and) experiences … for how they can get on board with their own well-being, and how to support each other in creating shared objectives for well-being, according to ‘Why a Culture of Well-Being Is Critical for Performance in the Workplace’ by Wanda Krause, PhD.

“You may have an environment where people know what you don't know but are afraid to speak up, or people who aren't represented aren't there,” Dr. Brandt said.

That speaks to the importance of creating a feedback culture. Rather than conducting yearly reviews, this kind of environment requires ongoing conversations that are multidirectional.

“Employees should have a chance to give feedback as well and people (should) feel safe to do it because they know how to do it effectively,” Dr. Brandt said. “Creating permission ahead of time to inform people—this is what we can do to thrive.”

Suicide trend in the profession stretches back decades

Poisonings were more common than in the U.S. general population

By Malinda Larkin

Although the past few years have seen greater awareness of mental health issues and the incidence of suicide within the U.S. veterinary profession, evidence of the suicide mortality rate being higher among veterinarians than in the U.S. general population goes back even further.

An all-cause mortality analysis published in 1982 studied 5,016 white male veterinarians who died from 1947–77, using obituary listings published in JAVMA and state death certificates. The study showed that the proportionate mortality rate from suicide in this group was 1.7 times that of the U.S. general population.

Now come data from the Centers for Disease Control and Prevention's National Institute for Occupational Safety and Health on mortality rates from suicide among 11,620 veterinarians who died from 1979–2014. Researchers announced their findings at the 2018 Veterinary Wellbeing Summit, held April 15–17 in Schaumburg, Illinois, and sponsored by the AVMA, Association of American Veterinary Medical Colleges, and Zoetis (see page 1439). They concluded that male veterinarians were 2.1 times as likely and female veterinarians were 3.5 times as likely to die from suicide as were members of the U.S. general population, and these higher suicide mortality rates extended the entire 36-year period. The full results will be published this year or next.

“In this study, your mortality from suicide among veterinarians has been high for some time,” said Randall Nett, MD, public health service medical officer for NIOSH, who gave the presentation at the summit. “It's a complex problem, and hopefully we can work as a team to lower suicide mortality among veterinarians.”

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Randall Nett, MD, public health service medical officer for the Centers for Disease Control and Prevention's National Institute for Occupational Safety and Health, announces results of a study looking at rates of suicide among 11,620 veterinarians from 1979–2014 at the 2018 Veterinary Wellbeing Summit, held April 15–17. (Photo by Malinda Larkin)

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

Study results

This latest study by the CDC, led by Dr. Suzanne E. Tomasi, an Epidemic Intelligence Service officer at NIOSH, sought to explore the historical trends for suicide among U.S. veterinarians, particularly as the profession has shifted from majority male to female since the last analysis.

The data set for this study was created by linking data from two sources: the AVMA and the CDC. The AVMA maintains a data set of all known U.S. veterinarians who have died, through obituary information submitted to JAVMA and life insurance policies. These sources provided age, sex, race, clinical positions, and species specialization. Within the CDC is the National Center for Health Statistics, which maintains the National Death Index. The NDI provided underlying cause of death information for the deceased veterinarians.

The cause of death for 398 (3 percent) of these 11,620 veterinarians was attributed to suicide. Of the 398 who died from suicide, 326 (82 percent) of them were men and 72 (18 percent) were women. The median age was 57 years for men and 42 years for women. Seventy-five percent of those with known species specialization worked in small animal medicine.

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Source for graphs: Based on graphs from the Centers for Disease Control and Prevention

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

When comparing the methods of suicide between the general U.S. population and veterinarians, the researchers found notable differences.

Among the general population, use of firearms was the most common method. Yet in the study population, although firearms were still the most commonly used method, poisonings were higher than in the general population.

Fifty-one percent of male veterinarians who committed suicide used firearms, and 32 percent used poisoning, compared with 18 percent of female veterinarians who used firearms and 64 percent who used poisoning. “We can't really break out euthanasia drugs in poisonings, but barbiturates are a substantial part,” Dr. Nett said.

For both male and female veterinarians, those in clinical positions more often used pharmaceutical poisoning than did those in nonclinical positions.

Dr. Tomasi, in a May 2 CDC webinar, pointed to the following factors for the high suicide proportionate mortality rate among U.S. veterinarians: • Demands of practice such as long work hours and work overload.

  • • Practice management responsibilities.

  • • Client expectations and complaints.

  • • Knowledge of euthanasia procedures and training to view euthanasia as a normal and acceptable method to relieve suffering

  • • Ever-increasing educational debt-to-income ratio.

  • • Poor work-life balance

  • • Access to controlled substances such as euthanasia solution and the pharmacological training to calculate a lethal dose.

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Source for graphs: Based on a graph from the Centers for Disease Control and Prevention

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

Prevention strategies

Dr. Nett said NIOSH's hierarchy of controls—a framework used to make recommendations on methods of controlling occupational hazards to help prevent occupational illnesses and injuries—could be used in this situation to help guide suicide prevention measures. Examples of possible administrative controls could include scheduling shorter work shifts and restricting access to euthanasia solution.

Dr. Tomasi said suicide prevention needs to extend beyond the workplace. This can be done by taking the following steps:

  • • Applying evidence-based suicide prevention strategies throughout the profession.

  • • Improving U.S. veterinarians' awareness of suicide prevention resources.

  • • Collaboration among multiple stakeholders in the profession.

  • • Using data to evaluate trends and effectiveness of suicide prevention activities.

Other possible activities include studying work-related factors that led to veterinarians considering or even attempting suicide and conducting a veterinary clinic assessment on how well-being practices are being integrated into typical clinics, Dr. Nett suggested.

Current suicide rate data

Thus far, data on U.S. veterinarians' mental health and well-being have shown mixed results.

A 2014 survey by the CDC found that veterinarians were at higher risk for mental illness and suicide than the general population (J Am Vet Med Assoc 2015;247:945–955). However, a study conducted by Merck Animal Health in 2017 concluded that veterinarians as a group don't experience psychological distress at rates notably higher than the general population, although the study did find that to be the case for young veterinarians (J Am Vet Med Assoc 2018;252:1231–1238).

That said, veterinarians abroad seem to have a high prevalence of risk factors for suicide, too. Studies from the United Kingdom indicate that veterinarians have a proportionate mortality rate from suicide that is four times that of the general population and two times that of other health care providers (Vet Rec 2010;166:388-397). In Norway, male veterinarians had a suicide mortality rate that was four times that of the general population (Psychol Med 2005;35:873–880).

And in Australia, veterinarians had a mortality rate that was also four times that of the general population (Aust Vet J 2008;86:114–116).

AVMA president-elect candidates look to future

Angela Demaree, John Howe share their visions for AVMA

Interviews and photos by R. Scott Nolen

The agenda for the AVMA House of Delegates regular annual session in Denver this July includes electing the 2018–19 AVMA president-elect. Two veterinarians—Drs. Angela Demaree of Indianapolis and John Howe of Grand Rapids, Minnesota—are candidates for the office, hoping to be next in line for the AVMA presidency.

Dr. Demaree was a candidate for the U.S. House of Representatives for Indiana's 5th Congressional District in 2016 and is a former equine medical director for the Indiana Horse Racing Commission, for which she oversaw the equine drug testing program at the two Indiana racetracks.

Prior to joining the IHRC, Dr. Demaree was an assistant director for the AVMA Governmental Relations Division. She was also an associate in a companion animal practice and completed a surgical internship at an equine sports medicine and surgery practice.

Dr. Demaree, who was deployed in 2012 in support of Operation Enduring Freedom, received her DVM degree from Purdue University in 2002 and anticipates completing her master's of public health in biostatistics and epidemiology from the University of Southern California Keck School of Medicine this August.

Dr. Howe is in his sixth and final year as District VII member of the AVMA Board of Directors. During his term, he has chaired the AVMA State Advocacy Committee, was a member of the Board's Diversity and Inclusion subcommittee, and was the Board liaison to several AVMA councils and committees.

After receiving his DVM degree from the University of Minnesota in 1977, Dr. Howe started a solo mixed practice in North Branch, Minnesota. After selling the practice, he established an equine and large animal practice that evolved into North Country Veterinary Clinic, a five-doctor mixed practice. It became part of National Veterinary Associates in 2007, and Dr. Howe manages the practice.

Here, the candidates explain why they're ready to lead the Association.

Dr. Demaree responds:

Why are you running for AVMA president-elect?

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Dr. Angela Demaree

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

I'm running to inspire more veterinarians in the middle of their careers to participate fully in shaping the future of our profession. Through this campaign, I hope to share the value that membership in the AVMA and participation in organized veterinary medicine can provide, both personally and professionally.

I'm running to tear down barriers, real and perceived. The AVMA Bylaws allow for participation of our members with a diverse set of experiences, and it's important that our members know there is more than one path to participate in leadership positions within the AVMA.

The AVMA serves an important role as the voice of our profession, and we need to ensure we are effectively communicating with and engaging our diverse membership.

We have a profession with limitless possibilities and one of the most versatile degrees that can be obtained today. Manageable debt-to-income ratios are possible, and veterinary medicine will continue to be a sustainable career path for generations to come.

I'm running because I believe we can improve our personal health and wellness, serve our clients and our communities, and have fulfilling family lives. It's not an either-or, it's not about perfectly balancing everything; it's about living a life full of joy, meaning, and purpose.

What skills and experiences do you offer?

I have been an active AVMA member for 16 years and spent three years on the AVMA staff at the Governmental Relations Division in Washington, D.C. During my time at the GRD, I had a unique vantage point to see firsthand how the AVMA's councils, committees, House of Delegates, and Board of Directors all interacted and how our volunteer members ideas worked through the process to become policy.

I served for six years on the AVMA's State Advocacy Committee and currently serve on the American Association of Equine Practitioners' Welfare and Public Policy Advisory Council and on the Purdue University College of Veterinary Medicine's Alumni Board.

As a veterinarian, I've served our clients in companion animal and equine sports medicine practice, including a surgical internship. I've served the state of Indiana as the equine medical director for the Indiana Horse Racing Commission, ensuring the health and welfare of our equine athletes, overseeing multiyear contracts, up to 40 parttime employees, and collaborating with Purdue University on original research that we presented at the International Conference on Equine Exercise Physiology in 2014 in Chester, United Kingdom.

I continue to serve our country as a major in the U.S. Army Reserve including one deployment to the Middle East in support of Operation Enduring Freedom in 2012. During this deployment, I led a team of soldiers stationed in two countries and several remote locations. We were a diverse group of people from all around the United States; many of us had never met before our predeployment training, and yet, we came together to complete a successful mission.

These are examples of my diverse leadership experiences that I will bring to serve our profession as your 2018 president-elect of the AVMA.

Why are you the best candidate?

I have a diverse background and professional experience that I will rely on to ensure I best represent our entire profession. I will seek input from others and make strategic decisions to ensure the sustainable future of our profession. I firmly believe that the best ideas and solutions come from our volunteer members, and we should continue to engage them in meaningful ways.

I have gained a valuable perspective having served as staff at the AVMA, having a seat at the table while our volunteer leaders developed AVMA policy, and then being responsible for implementing that policy on behalf of our members at the national level to our elected and regulatory officials.

Then I took a step back and became a volunteer member serving on the State Advocacy Committee. I saw the AVMA through the eyes of our members rather than from inside the organization. These experiences have broadened my perspective and prepared me to serve as 2018 president-elect of the AVMA.

What should AVMA members know about you?

I love our profession. I feel truly blessed to share this profession with so many amazing colleagues and to have chosen to participate in a truly versatile profession with limitless and diverse opportunities for personal and professional growth.

I believe that the most important part of communication is listening. I don't have all of the answers, but I've met some of our members who have great and amazing insights during my travels around the United States. I greatly appreciate and value these conversations.

I am dedicated to lifelong learning and am completing a master's degree of public health in biostatistics and epidemiology.

My purpose in life is advocating on behalf of and serving others. I hope to have the opportunity to serve you as your 2018 president-elect of the AVMA.

In your estimation, what is the AVMA doing right?

The AVMA has many wonderful initiatives underway. Members can comment on proposed and current policy through the website, the AVMA@WorkBlog highlights achievements of member veterinarians, and our advocacy efforts in Washington, D.C., and collaboration between the state and federal levels continues to improve. The AVMA is recognizing health and wellness to be an important priority for our members, and our economic division continues to work toward ensuring our profession has a sustainable future. The AVMA provides valuable member resources such as access to a 24/7 cyberbullying hotline and online reputation and crisis management resources.

And where does AVMA need to improve?

There is always more that can be done. My number one goal is to improve the communication between the AVMA and our membership. In this day and age, we should be able to get the information to our members, where and how they want the information, when they need the information. Our website should be infinitely easier for our members to navigate. I stand by my comments from the Candidates' Introductory Breakfast: “When our members need information, no answer should be more than three clicks away. When our clients need information, no answer should be more than three clicks away. And when our new and recent graduates visit avma.org to understand the value of their membership, no answer should be more than three clicks away.”

Another issue that's been brought to my attention is related to inclusion of our diverse membership. I've been thanked for simply asking someone how to correctly pronounce their name when I was unsure; members have relayed to me that this is one sign of respect that they greatly appreciate, yet don't always experience. I've also heard how great it was that AVMA staff went above and beyond to ensure that a member's name was printed correctly on their name badge at an event. We need to continue to be mindful of small acts of kindness that ensure our members feel valued and continue to seek improved understanding of their perspectives.

If elected, what would you do to make this happen?

I will be a strong voice on the Board of Directors to encourage and ensure that improved communication is an underpinning of our strategic vision. The AVMA can do great and amazing things, but if our members don't know about it, then we aren't doing enough to serve our members or our profession.

I personally commit to leading by example and completing the online certificate program for diversity and inclusion in veterinary medicine founded by the AVMA, AAVMC, and Purdue University College of Veterinary Medicine to improve my ability to lead a truly inclusive profession. After all, this is our passion, it is our profession, and it is our AVMA.

I will continue to ensure our members' priorities and efforts of past presidents continue in the areas of leadership development, advocacy, one health, animal welfare, personal health and wellness, and the debt-to-income ratio, to name a few of the important issues facing our profession.

Is there anything else you want to share?

I'm dedicated to serving our profession and have started a podcast called “Beyond the Stethoscope” to discuss issues of importance to veterinarians and busy professionals and share ideas from experts within and outside of our profession.

I'm often asked how AVMA members can participate in this election. Your AVMA delegates will be voting at their July meeting before the start of convention. You can share your thoughts and have your voice heard by reaching out to the AVMA delegates of your state and allied organizations.

You can participate in the campaign by following us on Twitter and Facebook (@DemareeDVM). Feel free to reach out; I love to speak with our members and learn about what you'd like to see from the AVMA. You can message me on Facebook or send an email to angela@angelademaree.com.

Dr. Howe responds:

Why are you running for AVMA president-elect?

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Dr. John Howe

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

Even after many years of serving organized veterinary medicine in various ways, I have an overwhelming passion to continue to serve the profession. I have had an extremely rewarding life during my many years of veterinary practice. Veterinary medicine has provided an opportunity to meet some wonderful people—both professionals and clients. I have enjoyed the challenges associated with the advances in veterinary medicine and want to do what I can to ensure that veterinary medicine remains rewarding to all associated with this wonderful profession. A strong, responsive AVMA is one way to accomplish this objective, and I want to be a part of helping AVMA to fulfill its mission.

I view AVMA as a bridge between this great profession and each of us. We are a diverse group of veterinary professionals—that is part of what makes us able to relate to a wide range of clientele and take so many paths. We are general practitioners, specialists, owners, and associates. We work in industry, government, private practice, academia, and laboratories. We live in the city, suburbs, or rural areas. We are vegans and meat eaters, fitness advocates and couch potatoes. In my vision, AVMA must continue to be the bridge that holds us together with shared goals and objectives. This bridge must be maintained, and that is done by listening and responding to the concerns of its membership. The time I have spent with councils and committees has rounded out my understanding of the workings of the AVMA. I have met countless wonderful veterinarians from around the country, have listened to their concerns, and have come to appreciate the diversity of perspectives and ideas that make up our great profession. It is because of these experiences I can contribute to this profession by serving further in leadership.

What skills and experiences do you offer?

I have over 30 years of experience in organized veterinary medicine serving in various capacities at the state, regional, and national level. I came up “through the ranks.” I have served as an officer of my regional association, as president of my state association, and served on several committees for my state association. I was selected as Minnesota's Veterinarian of the Year in 2011 and additionally was honored to receive Minnesota's Distinguished Service Award in 2015.

Nationally, I have served on numerous councils and committees for AVMA as either a member or a board liaison, including for such groups as the American Association of Equine Practitioners and American Association of Swine Veterinarians. I served as vice chair of the AVMA Council on Veterinary Service, vice chair of the Governance Performance Review Committee, and on the State Advocacy Committee and the Budget, Finance, and Review Committee, among others. I am now finishing my sixth year on the Board of Directors representing District VII. These activities have given me a broad knowledge base, and I feel I have been able to effectively represent my district and constituents.

Beyond the organized medicine aspect of my experiences, I have 41 years of mixed animal practice experience working with small animals, swine, and equine, bovine, aquatic, and exotic animals. I have had the opportunity to experience multiple forms of practice life. I began as a solo mixed animal practitioner, grew my practice into a five-doctor practice, and have managed a practice for a corporate entity. Starting, growing, and selling two mixed animal practices gave me a strong business sense and helped me to see the struggles that many practitioners face in their day-to-day lives. I worked in a sale barn one day a week in my first practice. I served on the State Board of Animal Health as a governor-appointed member for two terms (two years as president) overseeing the activities of the state veterinarian. This gave me great insight into regulatory veterinary medicine. I have worked in aquaculture involving the Minnesota (Department of Natural Resources) and private practice. These experiences allow me to see veterinary medicine from many angles and to better serve the AVMA membership.

Why are you the best candidate?

I believe my experiences as outlined above uniquely qualify me to see many sides of this umbrella organization. As I mentioned earlier, I have served on many different councils, committees, and BOD subcommittees. I believe I understand the workings of the AVMA. I have seen the great strides AVMA has made in the last six years and especially the last three years. I know where we have come from, and I know where we are heading. I want to continue this effort to help keep us heading in the right direction.

I can personally relate to many of your concerns and challenges because I have experienced them. I am an advocate for unity in our profession as we cross our bridge and confront our challenges together. Team efforts are needed, and leadership means bringing out the best in everyone on the team. I have worked with interns, students, new graduates, and old graduates. AVMA must remain focused on items which unite us, must secure the confidence of our members, and must be well-maintained. I want to ensure that there are enough lanes running across our bridge to accommodate all of us.

While I am a volunteer leader with great experience, I never forget that I am also a member and, as such, membership value is a high priority for me. I have been a voice for our membership. I have a unified vision of one AVMA: member, leader, and staff working toward common goals.

What should AVMA members know about you?

I am very passionate about veterinary medicine. I love mentoring students and early-career veterinarians. I have never been afraid to try new things, and I always strive for the best. I am a listener.

In your estimation, what is the AVMA doing right?

As a member of the Board of Directors, I have been able to see firsthand the benefits of recent actions. We have greatly strengthened the tie between the House of Delegates and the Board of Directors by including House members on Board subcommittees. This has been very effective and has brought us together. Involving the House of Delegates in many of our workings and decisions has helped to lessen the us-versus-them syndrome. The Veterinary Economics Division has been greatly expanded. This has given us valuable data to see where we've been, where we are going, and what changes may need to take place. The changes in the Marketing Division will enable AVMA to better communicate to our members the things this Association can (do) and is doing for them. We have strengthened the Governmental Relations Division and the State Advocacy Committee. This is critical to keep our members informed so they can respond to good and bad legislation. We are much more diverse than we were six years ago. We have just decided as a Board to finally upgrade our website, which will be much appreciated. There are so many things AVMA is doing right at this time. I'm excited to talk to members when I travel and have the opportunity to answer their questions.

And where does AVMA need to improve?

Even though we are doing a lot of things right, the general membership doesn't always get the message. Our communication has improved, but the average member doesn't always take the time to read through the Journal. We still need to be that inspiring voice sometimes on a one-to-one basis. People don't care how much you know until they know how much you care. When people see that we care as a profession about all aspects of veterinary medicine, they tend to listen more.

I also think we need a stronger public presence. People don't understand all that AVMA does and is capable of doing. We need to continue the push for one-health issues and strengthen our ties to the entire medical profession, especially regarding antibiotic-resistance issues.

If elected, what would you do to make this happen?

Member polls show that member satisfaction has increased, and I want to continue doing what we need to do to increase that further. We need to continue the strategy of measuring everything AVMA does to see if it is improving member value. We need to continue to look at things strategically to see if they are appropriate and if we have the time and resources to do them. I would continue the push to make sure we can be represented positively nationally on radio and/or television when possible. I think there are a few more areas we can improve on, but we will need a team effort.

Is there anything else you want to share?

One last issue that I have not mentioned and that is extremely important to me is scope-of-practice issues. Many states battle the same issues. It is critical that veterinarians get involved and stay abreast of what is going on in their state. Knowing your local representative is very important. If your state (veterinary association) has a political action committee, please donate to it. Also donate to the AVMA PAC. We need to open many doors to have a positive influence. If elected, I will do my best to continue to serve this profession to the best of my ability.

AVMA welfare director joins OIE panel on slaughter, depopulation

By Greg Cima

An AVMA staff member is representing North America on a panel that is drafting revisions to international standards on slaughter and emergency killing of animals.

Dr. Cia Johnson, director of the AVMA Animal Welfare Division, is among seven panelists that first met this April in Paris on a project to update some World Organisation for Animal Health (OIE) standards. The OIE World Assembly of Delegates from member countries would vote on whether to update the terrestrial code.

The updates would modify existing OIE guidance on humane slaughter and killing to control disease as well as expand the disease control guidance to include depopulation in response to other types of emergencies, such as natural disasters. The panelists will address welfare measurements, animal husbandry, worker training, stunning, and species-specific techniques.

Dr. Johnson expects the revisions will include a shift away from technical details—such as units of measurement, animal handling methods, and acceptable stocking densities—and toward outcomes and performance-based standards. That would shift attention toward how animals respond, using those observations to guide animal welfare decisions.

Dr. Johnson worked with AVMA staff and expert volunteers on the Association's euthanasia, slaughter, and depopulation guidelines. The euthanasia guidelines were revised in 2013, and they are scheduled for updates this year. The slaughter guidelines were published in 2016, and the depopulation guidelines are in editing, with plans for publication late this year.

Dr. Johnson said the OIE panel is expected to be a three-year commitment. She is the only representative from North America, and she said her inclusion shows the AVMA's importance in developing standards for humane endings to animal lives.

AVMA and industry-developed guidance are more likely to be used within the U.S. than are the OIE standards, Dr. Johnson said. But the OIE standards have implications for trade and global animal industries.

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Dr. Cia Johnson

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

She expects harmony between the revised OIE standards and the AVMA guidance.

Dr. Johnson said she was surprised and honored to be selected by the OIE to participate in the panel, and she feels great responsibility for such an important task. She also is happy to help the AVMA be at the forefront of issues regarding humane killing of animals and to give veterinarians helpful resources, she said.

ASPCA poison control takes 3 millionth case

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Rosita is shown during treatment for carprofen ingestion at a veterinary hospital (Courtesy of Amanda Fernandez)

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

An animal poison control service has taken calls from 3 million clients in the past 40 years.

The American Society for the Prevention of Cruelty to Animals' Animal Poison Control Center reached 3 million cases in late April, when the service advised the owner of a cat that had eaten a flavored NSAID, carprofen, pill intended for a dog. The cat recovered after treatment.

Amanda Fernandez, a veterinary technician, called when her 10-month-old Sphynx cat, Rosita, ate about three-quarters of a 100-mg chewable carprofen pill, according to an APCC announcement. The drug is administered to dogs for arthritis and other joint diseases.

Rosita found the drug after Fernandez had placed it on a counter while preparing her pets' meals, the announcement states. She and her boyfriend saw Rosita was eating something and were able to take away part of the pill.

Rosita had no clinical signs of illness, but she received treatment to prevent ulcers and renal damage and spent a weekend at a veterinary hospital, according to the announcement and Dr. Tina Wismer, the center's medical director.

Dr. Wismer said the poison control center had eight veterinarians and seven support staff members when she started working there about 20 years ago. It now has 22 veterinarians and 50 support staff members, who are registered veterinary technicians and veterinary assistants.

The University of Illinois started the service that would become the APCC in 1978 as an inperson consulting service for large animal clinics near the central Illinois campus. In 2017, the service received about 250,000 calls on 200,000 cases, about 90 percent of those cases involving dogs.

Dr. Wismer said the 3 million-case total shows that an unfortunate number of animals have been in danger. But the calls also have given the center data that can be used to assess the risks of various poison exposures and help determine whether a particular animal needs emergency medical care.

Veterinary products were the fourth most common source of pet toxins connected with calls to the control center in 2017, accounting for 9 percent of cases, according to an ASPCA announcement from March. The top three poisoning sources were prescriptions for human medicine, over-the-counter medications, and foods other than chocolate, which was the fifth most common.

Prion disease found in camels

Dromedary camels in northern Africa have a neurodegenerative prion disease that may have originated decades ago.

“Although it has not been possible to date back the first cases of illness, information gathered from breeders and slaughterhouse personnel suggests the illness has been present since the 1980s,” according to an article in Emerging Infectious Diseases. The article, published online in April (https://jav.ma/PrionsCamels) ahead of print in June (Emerg Infect Dis 2018;24:1029–1036), indicates researchers found the prion disease among dromedaries brought to one of Algeria's largest abattoirs, by volume, for cattle, camels, and small ruminants.

The report authors examined the brains of three camels with neurologic signs and a fourth without. They found spongiform changes and degeneration in brains of the three animals with clinical signs.

They also collected the lymph nodes from one of those with clinical signs and found disease-causing prion proteins in that tissue, the article states. Spread of prions through the lymph nodes, as with scrapie and chronic wasting disease, is associated with prion shedding.

Retrospective analysis showed about 70 dromedaries brought to the slaughter facility during 2015 and 2016—3 percent of the total—had neurologic signs consistent with the disease. The disease has been observed only in animals more than 8 years old, whereas camels tend to be slaughtered at younger than 5 years.

“In the past 5 years, neurologic symptoms have been observed more often in adult dromedaries at antemortem examination,” the article states.

Clinical signs of the disease included weight loss, behavior abnormalities, and neurologic signs such as tremors, aggression, hyper-reactivity, gait changes, ataxia of hind limbs, falls, and difficulty rising. The disease kills dromedaries three to eight months after clinical signs begin.

The authors wrote that the prion disease may have originated in another species, but it has a biochemical signature distinct from those of bovine spongiform encephalopathy and scrapie, and neither disease has been found in Algeria. Further study of the disease's geographic distribution will help.

“Our identification of this prion disease in a geographically widespread livestock species requires urgent enforcement of surveillance and assessment of the potential risks to human and animal health,” the article states.

Heartworm, Lyme diseases threaten pets in 2018

Heartworm disease and Lyme disease are expected to be increased threats this year.

The Companion Animal Parasite Council, in an announcement published April 18, predicted higher than usual heartworm transmission rates throughout the U.S. in 2018. Hot, wet weather in 2016 and 2017 was ideal for breeding mosquitoes.

CAPC officials also wrote that heartworm-positive dogs relocated throughout the U.S. following 2017 storms likely will contribute to heartworm transmission.

The organization predicts transmission will be especially high in the lower Mississippi River region, where heartworm disease is “hyper-endemic.”

The council also predicts spread of Lyme disease into nonendemic areas, including North Dakota, South Dakota, Iowa, Missouri, southern Illinois, Ohio, Kentucky, Tennessee, and North Carolina. Migratory birds and a growing white-tailed deer population are carrying the ticks that transmit the bacteria that cause Lyme disease into new areas, CAPC information states.

Western Pennsylvania, eastern Ohio, West Virginia, and the Appalachian region of Virginia need to prepare for increased prevalence of Lyme disease, the announcement states. The District of Columbia, Philadelphia, and Boston areas are expected to have lower Lyme disease prevalence.

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Heartworm prevalence forecast, 2018 (Courtesy of CAPC)

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

Anaplasmosis prevalence is expected to be typical in most of the U.S., with exceptions for higher than usual prevalence in northwestern Minnesota and lower prevalence along the Wisconsin-Minnesota border and in the Boston-Cape Cod region. Ehrlichiosis is expected to have high prevalence in southern Virginia and North Carolina and typical prevalence in the rest of the U.S.

Study reveals genetic diseases of mixed-breed, purebred dogs

A study has identified genetic diseases that mixed-breed dogs are likely to develop, also finding that fewer mixed-breed dogs than purebred dogs are affected by the disease-causing mutations tested.

Wisdom Health and Genoscoper Laboratories, which offer genetic tests for dogs and cats, published “Frequency and distribution of 152 genetic disease variants in over 100,000 mixed breed and purebred dogs” on April 30 in PLOS Genetics, an online journal of the Public Library of Science.

The study examined the DNA of 83,000 mixed-breed dogs and of 18,000 purebred dogs representing 330 breeds, types, and varieties. Disease mutations tested included those for progressive retinal atrophy, hyperuricosuria, Collie eye anomaly, multidrug sensitivity, and von Willebrand's disease.

“There has been a long-standing perception that mixed breed dogs are less disease-prone than purebred dogs,” said Dr. Cindy Cole, general manager at Wisdom Health, in an announcement about the study. “This DNA-testing-based evidence shows that while mixed breed dogs are in fact less likely than purebreds to develop the recessive disorders evaluated in the study, they may still be carriers.”

On the basis of 152 diseases tested, approximately two out of 100 mixed-breed dogs were at risk of becoming affected, and 40 out of 100 were carriers for at least one of the diseases. Approximately five out of 100 purebred dogs were at risk of becoming affected, and 28 out of 100 were carriers for at least one of the diseases.

The research also indicated that through healthy breeding practices, which often include genetic testing, some diseases appear to have been eradicated from breed pools. For example, X-linked severe combined immunodeficiency, a mutation originally found in Basset Hounds, appears to have been eradicated.

The ocular, nervous, and circulatory systems were the most commonly affected across both the purebred and mixed-breed dog populations in the study.

The study is available at https://jav.ma/dogDNA.

Henry Schein animal health business merging with Vets First Choice

Henry Schein Inc. and Vets First Choice announced plans April 23 for Henry Schein to spin off its animal health business and merge it with Vets First Choice to create Vets First Corp.

Vets First Choice, founded in 2010, has approximately 750 team members in the United States and manages prescriptions for more than 5,100 companion animal and equine practices. The company is based in Portland, Maine, where the combined company will be headquartered.

Henry Schein Animal Health distributes animal health products and provides related services. HSAH has approximately 4,300 team members, and active customers include about 75 percent of U.S. veterinarians and 70 percent of veterinarians in Europe, Australia, and New Zealand. More than half of U.S. practices use Henry Schein's software platform for practice management.

HSAH will combine with Vets First Choice to form a new publicly traded company. The company would have had combined 2017 sales of about $3.6 billion.

Parent company Henry Schein Inc. will focus on providing products and services for human medical and dental practices. Henry Schein's total 2017 revenue for the remaining businesses would have been about $9 billion.

Wild Animal Health Fund awards 13 grants for zoo animal, wildlife research

The Wild Animal Health Fund has awarded 13 grants for research on zoo animals and wildlife for 2018 totaling $105,407. The fund, in its seventh year, is a program of the American Association of Zoo Veterinarians.

Much advancement has taken place in veterinary medicine for domestic animals over the past century, according to the AAZV. Sources for research funding have included governments, the food animal and fiber industries, veterinary schools and other animal-related institutions, pharmaceutical companies, and, to a lesser extent, the public. But research funding for zoo animals and wildlife has not been abundant. Until the AAZV founded the Wild Animal Health Fund, only one other major funder supported research for these animals.

“The Wild Animal Health Fund is building a donor base of concerned citizens who are passionate about zoo animals and wildlife and understand the threats of mass extinction we are facing,” according to the AAZV. “The Wild Animal Health Fund is growing in an effort to advance veterinary medicine for zoo animals and wildlife.” The new studies are in these areas:

  • • Diagnostic tools for African tree pangolins.

  • • Respiratory diseases in Bornean orangutans.

  • • Cardiac disease in marine mammals.

  • • Anthrax vaccine for use in wildlife.

  • • Disease risk assessment of pink pigeons.

  • • Lethal pathogens carried by invasive cane toads.

  • • Antimicrobial-resistance genes in wild seabirds.

  • • Lactate measurements in Quaker parrots.

  • • Health status of translocated Bolivian river dolphins.

  • • West Nile virus seroconversion in loggerhead shrikes.

  • • Relationship among microbiomes, pathogens, and host condition in African buffalo.

  • • Novel tuberculosis assay for African elephants.

  • • Nannizziopsis guarroi in companion lizards.

Morris Animal Foundation awards $750,000 for studies on horses, alpacas

Morris Animal Foundation announced April 25 that it has awarded grants totaling nearly $750,000 to seven studies on the health of horses and one study on the health of alpacas.

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Morris Animal Foundation

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

The studies are as follows:

  • • “Efficacy of maternal immunization against PNAG to protect newborn foals against Rhodococcus equi pneumonia,” Dr. Noah D. Cohen, Texas A&M University, $219,897.

  • • “Determining the role of diet in insulin dysregulation in horses and ponies: a metabolomic and microbiomic analysis,” Dr. Molly E. McCue, University of Minnesota, $55,308.

  • • “Cell-mediated immunogenicity and MHC expression regulation of TGF-beta2-treated mesenchymal stem cells for improved clinical use in the horse,” Dr. Lauren V. Schnabel, North Carolina State University, $131,479.

  • • “Effect of concurrent intravenous and intra-articular amikacin administration on plasma and synovial fluid amikacin concentrations in healthy neonatal foals,” Dr. Mike J. Schoonover, Oklahoma State University, $52,436.

  • • “Deciphering the molecular mechanisms and transmission of macrolide resistance in Rhodococcus equi,” Sonsiray Alvarez Narvaez, PhD, University of Georgia, $100,000.

  • • “Exploring the antimicrobial, immunomodulatory, and chondroprotective properties of platelet-rich plasma lysate to combat infectious arthritis in vitro,” Dr. Jessica Gilbertie, North Carolina State University, $100,000.

  • • “Molecular phenotyping of airway mast cell proteases in healthy versus asthmatic horses,” Dr. Jane S. Woodrow, University of Tennessee, $10,800.

  • • “Shades of alpaca grey: genetic tools to prevent health problems in grey alpacas,” Kylie A. Munyard, PhD, Curtin University, $79,000.

CDC honors two public health veterinarians

Two public health veterinarians were honored in April for work to prevent disease and support the veterinary profession.

Lt. Laura Adams and Lt. Col. Thomas Doker received the 2018 James H. Steele Veterinary Public Health Award from the Centers for Disease Control and Prevention. The awards were given during the annual Epidemic Intelligence Service Conference April 16–19.

Dr. Steele was the first chief of the CDC Veterinary Public Health Division. The award in his name honors current or recent EIS officers for contributions to veterinary public health and one health.

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Lt. Laura Adams

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

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Lt. Col. Thomas Doker

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

Dr. Adams was honored for domestic and international contributions toward preventing and controlling zoonotic and vector-borne diseases. She is in the U.S. Public Health Service and is the activity lead for the Data Analyses and Data Management group in the Dengue Branch of the CDC Division of Vector-borne Diseases. Dr. Doker was honored for domestic and international contributions toward prevention and control of high-consequence zoonotic diseases and support of organized veterinary medicine. He is in the U.S. Air Force and is chief of the Infectious Disease and Countermeasures Division in the National Center for Medical Intelligence.

Florida VMA

Event: Annual meeting, April 5–8, Tampa

Awards: President's Award: Dr. Larry G. Dee, Fort Lauderdale. Dr. Dee (Auburn '69) co-owns Hollywood Animal Hospital in Hollywood, Florida. From 2008–14, he represented District IV on the AVMA Board of Directors. Dr. Dee is a past president of the FVMA, American Animal Hospital Association, and American Board of Veterinary Practitioners. He is treasurer of the American Veterinary Medical Foundation. Distinguished Service Award: Dr. Jack L. Blackwood, DeFuniak Springs. Dr. Blackwood (Auburn '82) owns Walton County Animal Clinic in DeFuniak Springs. He co-founded the Okaloosa-Walton Veterinary Emergency Clinic, serving as president of its board of directors for several years, and launched the Animal Sterilization Assistance Program of Walton County. Dr. Blackwood is a past member of the FVMA Financial Committee. Veterinarian of the Year: Dr. Mitsie Vargas, Winter Haven. Dr. Vargas (Tuskegee '94) practices at Orchid Springs Animal Hospital in Winter Haven. A past president of the Ridge Veterinary Medical Society, she has served on the FVMA's Awards and Veterinary Assistant/Technician Certification committees. Dr. Vargas is a certified veterinary journalist. Gold Star Award: Drs. Jenifer A. Chatfield, Dade City; Donald S. Howell, Largo; Tracey Ladue, Orange Park; Jennifer Locke, Jacksonville; Harvey Partridge, St. Petersburg; Thomas M. Potter, Tallahassee; Lauren Prather, Winter Garden; Ruth-Anne Richter, Brandon; Claudia Valderrama, Hallandale; and John S. Woodby, Miami

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Dr. Larry G. Dee

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

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Dr. Jack L. Blackwood

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

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Dr. Mitsie Vargas

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

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Dr. Marc A. Presnell

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

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Dr. Michael Epperson

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

Officials: Drs. Marc A. Presnell, Lakeland, president; Michael Epperson, Fort Walton Beach, president-elect; Donald H. Morgan, Largo, treasurer; Alex “Steve” Steverson, Tallahassee, immediate past president; and AVMA delegate and alternate delegate—Drs. Ernest C. Godfrey, Pinellas Park, and Richard B. Williams, Jacksonville

John Melcher, first veterinarian elected to Senate, dies at 93

Montana Democrat known for his devotion to agriculture and veterinary medicine

By R. Scott Nolen

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Montana Sen. John Melcher accepting the 2003 AVMA Meritorious Service Award in Denver.

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

Dr. John Melcher, a Montana Democrat and the first veterinarian elected to the Senate who advocated for agriculture and veterinary interests and the preservation of federal lands, died April 12 at his home in Missoula, Montana. He was 93.

On April 19, the Senate passed a resolution honoring their colleague's humility and integrity, devotion to his family and home state, and years of public service. Members of the veterinary community also celebrated Dr. Melcher's life. “Senator Melcher was devoted to the AVMA, the profession, agriculture, and Montana,” said Dr. Mark Lutschaunig, director of the AVMA Governmental Relations Division.

“Everyone on Capitol Hill knew Senator Melcher, and he remembered everyone's name,” he said. “I remember one time we were in the Capitol, and he saw one of the Capitol Police officers—knew his name, asked about his family, including his daughter, who was interested in veterinary medicine.”

Dr. Bernadette Dunham worked at the AVMA GRD and with the senator during the mid-'90s before leading the Food and Drug Administration's Center for Veterinary Medicine. “Dr. Melcher never hesitated to speak his mind, and he tenaciously fought for what he believed in, be it an environmental issue or an animal welfare issue,” said Dr. Dunham, now a lecturer at the George Washington University Milken Institute School of Public Health.

“I learned so much from Dr. Melcher during my eight years at the AVMA GRD, and I continue to pass it forward, as he did so generously,” she added.

John David Melcher was born Sept. 6, 1924, in Sioux City, Iowa. He attended the University of Minnesota but left after only a year to join the Army in 1943. He served with the 76th Infantry Division in Europe and was part of the Normandy invasion. In 1945, Dr. Melcher was wounded in Germany and awarded the Purple Heart, the Combat Infantryman's Badge, and the Bronze Star.

He was discharged from the Army in 1945 and married a former high school classmate, Ruth Klein. They had six children and remained together until Ruth's death in 2015.

Dr. Melcher earned a DVM degree from Iowa State University in 1950. He and his family moved to Forsyth, Montana, where he opened Yellowstone Veterinary Clinic, a mixed practice that he ran until his election to Congress in 1969.

His political career began in 1953 as an alderman in Forsyth, a small city in eastern Montana. Two years later, Dr. Melcher was elected mayor and was twice reelected. Next, he won a seat in the state House of Representatives in 1960, then a seat in the state Senate in 1962. Dr. Melcher's first run at national office in 1966 was unsuccessful. Three years later, however, he was elected one of Montana's two U.S. representatives after he won a special election to replace a retiring congressman.

Dr. Melcher was reelected to the House of Representatives three more times. During those eight years, he took a leading role in animal welfare legislation, such as introducing a bill that would appropriate $10 million for animal research. The funding appeared to be a shoo-in after passing the House and Senate. Then President Gerald Ford called.

“We knew each other well from time in the House together,” Dr. Melcher told JAVMA News in a 2005 interview. “He called me to say, ‘John, I'm sorry. I know you've worked to get that bill passed. You actually got it out of the House twice, but I called just to tell you it's going to be my first veto.’

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Senator Melcher with Dr. John de Jong, current AVMA president-elect, and former Colorado Sen. Wayne Allard, a veterinarian, at the 2007 AVMA Political Action Committee luncheon in Washington, D.C.

Citation: Journal of the American Veterinary Medical Association 252, 12; 10.2460/javma.252.12.1434

“I was shocked. ‘Why is that, Mr. President?’ He said, ‘It's a new program, and we're having no new programs.’ ‘But research in animal health is not new, Mr. President,’ I replied. ‘Yes, but (the bill) is a new slant. I'm very sorry, John, I hate to tell you this, but I have to do it.’ So I thanked him for calling me; it was very nice of him,” Dr. Melcher said. The congressman introduced the bill again, this time during the Carter administration, and it was signed into law.

In 1976, Dr, Melcher was elected to the U.S. Senate—the first veterinarian to become a senator—and he was reelected twice. He sponsored an amendment to the Animal Welfare Act in 1984 that required the psychological well-being of nonhuman primates to be considered in research. Jane Goodall, the famed primatologist, praised the amendment and gave him a copy of her book “The Chimpanzees of Gombe” in which she wrote the following inscription: “When this bill is well and truly implemented, the difference in the lives of hundreds of animals will truly be great.”

Following Dr. Melcher's narrow reelection defeat in 1988, a columnist with The Washington Post described his Senate career as one having helped “farmers, miners, the elderly, the hungry and a constituency of the world's poor. If all those who had been helped by him—from Washington's homeless women to the Bangladesh starving—could have voted in Montana, (Dr. Melcher) would always have run unopposed.”

Dr. Melcher remained in Washington, D.C., opening a consulting and lobbying firm that included such clients as the AVMA and the Association of American Veterinary Medical Colleges. He was unapologetic about his work, saying in the 2005 JAVMA News interview that lobbying is essential to the political process: “What I do is lobby. I'm not one of those who thinks lobbying is shameful. Lobbying is one way that the public can let Congress and the Executive Branch know what is important and how bills ought to be shaped.

“That's what I do for the AVMA, and I'm very proud of it.”

The late senator was known for his contributions to passage of the “AVMA legislative initiative”—the Animal Medicinal Drug Use Clarification Act of 1994—by the 103rd Congress, entrusting veterinarians with discretionary extra-label drug use. A sample of the other veterinary-related legislation he lobbied for includes the National Senior Citizen Pet Ownership Protection Act; the National Veterinary Medical Services Act, which became the Veterinary Medicine Loan Repayment Program; and the Veterinary Public Health Workforce and Education Act.

Dr. Melcher received numerous accolades from the veterinary profession, including the AVMA President's Award and AVMA Meritorious Service Award, and the University of Pennsylvania School of Veterinary Medicine's Centennial Medal. Since 2007, the AAVMC has been giving out the AAVMC Senator John Melcher, DVM Leadership in Public Policy Award.

He is survived by five children; a brother, half sister, and half brother; 10 grandchildren; and five great-grandchildren. Another child of Dr. Melcher's died at age 6.

Obituaries: AVMA member: AVMA honor roll member: Nonmember

Norman F. Baker

Dr. Baker (California-Davis '52), 91, Dixon, California, died Feb. 16, 2018. He was a professor of parasitology at the University of California-Davis School of Veterinary Medicine prior to retirement in 1988. During his tenure at UC-Davis, Dr. Baker served as an assistant veterinarian in the Agricultural Experiment Station, earned his doctorate in comparative pathology, and developed the parasitology diagnostic service at the Veterinary Medical Teaching Hospital.

He was a charter member of the American Association of Veterinary Parasitologists, co-founder of the Northern California Parasitologists, and a member of the World Association for the Advancement of Veterinary Parasitology. In 1987, Dr. Baker received the AAVP Distinguished Service Award.

His two daughters survive him.

Jay A. Benton

Dr. Benton (Texas A&M '84), 62, Silsbee, Texas, died April 18, 2018. A mixed animal veterinarian, he owned Silsbee Animal Clinic. Dr. Benton was a member of the Texas VMA and was active with the National FFA Organization. His mother, brother, and two sisters survive him.

Memorials may be made to the Texas A&M Foundation, 401 George Bush Drive, College Station, TX 77840.

Alan F. Berger

Dr. Berger (Michigan State '59), 84, Ray Township, Michigan, died April 7, 2018. A small animal veterinarian, he was the founder of Macomb Veterinary Associates in Utica, Michigan, where he practiced for 40 years. Dr. Berger helped establish the Humane Society of Southeast Michigan and served in a leadership role with the Macomb Oakland Management Seminars Group. A member of the Michigan VMA, he was a past member of its Information Technology Committee.

In 1983, the MVMA honored Dr. Berger with its Merit Award, and, in 2013, he received the association's W. Kenneth McKersie Service Award. His wife, Cherie; two daughters; two grandchildren; and a brother survive him.

Ryan B. Brown

Dr. Brown (Colorado State '99), 46, Spokane, Washington, died April 9, 2018. Following graduation, he moved to Spokane and began his career in small animal medicine at North Division Veterinary Hospital. In the late 2000s, Dr. Brown bought what is now known as Indian Trail Animal Hospital in Spokane, where he worked until his death. He is survived by his wife, Colette; two sons; his mother; and a brother.

Memorials may be made to Basset Rescue, P.O. Box 13665, Spokane Valley, WA 99212, or Angel Compassion Fund, c/o Indian Trail Animal Hospital, 5150 W. Barnes Road, Spokane, WA 99208.

Beryl W. Cline

Dr. Cline (Texas A&M '56), 86, Alvin, Texas, died Feb. 22, 2018. A mixed animal veterinarian, he co-owned Alvin Animal Clinic from 1956–2005. Active in his community, Dr. Cline was a member of the Alvin Independent School District board of trustees for several years, served in leadership roles with the Alvin Chamber of Commerce, and was a 50-year member of the Alvin Rotary Club. His wife, Margaret; three daughters and a son; 11 grandchildren; and three great-grandchildren survive him.

Memorials may be made to Friendswood Friends Church, 502 S. Friendswood Drive, Friendswood, TX 77546.

David A. Hildreth

Dr. Hildreth (Missouri '70), 72, Coupeville, Washington, died Dec. 20, 2017. He owned Hildreth's House Calls for Animals, based in Coupeville. Earlier in his career, Dr. Hildreth practiced mixed animal medicine at Lake Sammamish Veterinary Hospital in Issaquah, Washington. He was a past president of the Seattle-King County VMA. Dr. Hildreth's wife, Jacqueline; two daughters and a son; seven grandchildren; and a brother survive him. Memorials may be made to Oak Harbor Church of the Nazarene, 1100 W. Whidbey Ave., Oak Harbor, WA 98277.

Clinton J. Hof Jr.

Dr. Hof (Minnesota '57), 84, De Smet, South Dakota, died Oct. 27, 2017. He owned Hof Veterinary Clinic in De Smet for 54 years prior to retirement. Dr. Hof is survived by his wife, Janet; three sons; and two grandchildren.

Frank E. Hoopes

Dr. Hoopes (Colorado State '65), 90, Afton, Wyoming, died Dec. 9, 2017. He worked as a federal veterinarian in Buffalo, Wyoming, prior to retirement. Early in his career, Dr. Hoopes served as a professor of veterinary medicine at Kabul University in Afghanistan for five years, as part of a joint program between the University of Wyoming and the United States Agency for International Development. He was a veteran of the Navy.

Dr. Hoopes' wife, Madalyn; three sons and a daughter; 18 grandchildren; 29 great-grandchildren; and a sister survive him.

Kathryn M. Krista

Dr. Krista (Kansas State '03), 41, Bluemont, Virginia, died Jan. 5, 2018.

An equine veterinarian, she practiced at Piedmont Equine Practice in The Plains, Virginia, where she focused on emergency care, gastroenterology, and geriatric horses. Earlier, Dr. Krista worked in Kentucky and Florida. She is survived by her husband, Ben; her parents; and a brother.

Memorials, honoring Dr. Katy Morton Krista, may be made to KSU Foundation, 1800 Kimball Ave., Suite 200, Manhattan, KS 66502, www.ksufoundation.org/give.

Amanda Lumsden

Dr. Lumsden (North Carolina State '08), 46, Santa Barbara, California, died Feb. 9, 2018. She owned Cat Calls Mobile Veterinary Service, incorporating alternative medicine into her work. Dr. Lumsden began her veterinary career in Arlington, Texas. She subsequently moved to California and worked for Animal Shelter Assistance Program in Santa Barbara and Mercy Crusade Spay and Neuter Clinic in Oxnard. Dr. Lumsden is survived by her parents and a brother.

Memorials may be made to Mercy Crusade Spay and Neuter Clinic, 2252 Craig Drive, Oxnard, CA 93036, www.dogcatfix.com, or Animal Shelter Assistance Program, The Lester Fund, 5473 Overpass Road, Santa Barbara, CA 93111, www.asapcats.org.

Tiffany Margolin

Dr. Margolin (California-Davis '91), 52, Summerland, California, died Nov. 26, 2017. A small animal veterinarian, she owned a mobile practice in southern California, incorporating alternative and holistic medicine into her work. Dr. Margolin was a diplomate of the American Board of Veterinary Practitioners (avian medicine), a past president of the Santa Barbara Ventura VMA, and a member of the International Veterinary Acupuncture Society, American Academy of Veterinary Acupuncture, American Association of Avian Veterinarians, and California VMA.

She authored the book “Relationship Reset: Get Her To Love You As Much As Your Dog Does.” Dr. Margolin is survived by her family.

Joe K. Neff

Dr. Neff (Texas A&M '63), 84, Big Spring, Texas, died Jan. 15, 2018. Following graduation, he worked at Highland Animal Clinic in Big Spring for a year. Dr. Neff then began his career in large animal medicine, serving ranches all over West Texas, the Texas Panhandle, and eastern New Mexico. For many years, he also provided his services to cattle auction barns in Texas' Howard and Midland counties. Dr. Neff raised commercial cattle and fine-wool sheep on his ranches in Howard County and Texas' Glasscock County.

He is survived by his wife, Sue; a son; seven grandchildren; and a brother. Dr. Neff's son, Dr. Bryan G. Neff (Texas A&M '89), is an equine veterinarian in Bandera, Texas.

Carleton W. Potter

Dr. Potter (Cornell '40), 99, Ithaca, New York, died March 16, 2018. From 1943–2008, he owned a practice in Homer, New York, practicing primarily large animal medicine until the 1980s, focusing later on small animals. Dr. Potter also coordinated the annual Cortland County rabies clinic during that time. Earlier, he worked in Claremont, New Hampshire, and Lawrence, Massachusetts. Dr. Potter was a member of the New York State VMS and Central New York VMA.

Active in his community, he represented the township of Homer on the Cortland County Legislature, was a past president of the Cortland Kiwanis Club, and served on the Homer School Board. Dr. Potter was a member of the Boy Scouts of America, Homer Fire Department, Masonic Lodge, and Homer Elks.

His wife, Esther; three sons and three daughters; 10 grandchildren; and eight great-grandchildren survive him. Dr. Potter's late father, Dr. Wilburn Potter (Cornell '18), was a veterinarian in upstate New York. His granddaughter, Dr. Megan Potter (Purdue '07), is a veterinarian in Abilene, Kansas.

Memorials may be made to the Homer Phillips Free Library, 37 South Main St., Homer, NY 13077, www.phillipsfreelibrary.org, or Homer Congregational Church Endowment Fund, 28 S. Main St., Homer, NY 13077, www.homercc.com.

R. Tracy Rhodes

Dr. Rhodes (Colorado State '60), 82, Buffalo, Wyoming, died April 5, 2018. A former member of the AVMA Board of Directors and several of its committees, he began his career in a predominantly feedlot practice in Mitchell, Nebraska. From 1964–90, Dr. Rhodes owned a mixed animal practice in Buffalo, where he focused on bovine medicine. In 1990, Dr. Rhodes was named Wyoming Veterinarian of the Year. He later did relief work and ranched. Dr. Rhodes was a past president of the Wyoming VMA and Wyoming Board of Veterinary Medicine.

He began his service at the national level when he became Wyoming's alternate delegate to the AVMA House of Delegates from 1982–85, and delegate from 1986–90. From 1987–99, Dr. Rhodes was a trustee of the AVMA Group Health & Life Insurance Trust, serving as chair from 1992–94. In 2000, he was elected to a six-year term on the AVMA Board of Directors, representing District IX. Dr. Rhodes was a director of the American Veterinary Medical Foundation from 2003–12, serving as chair from 2005–08, and represented the Foundation on the AVMA Committee on Disaster and Emergency Issues from 2006–11. He was a member of the AVMA Member Services Committee from 2006–12, also serving on the former AVMA Long-Range Planning Committee and the former AVMA Task Force on the Housing of Pregnant Sows.

Dr. Rhodes was active with the Johnson County Cattlemen's Association and Wyoming Stock Growers. He served three terms as Johnson County commissioner; was a past president of the Wyoming County Commissioner's Association, Buffalo Chamber of Commerce, and Buffalo Jaycees; and was a member of the Masonic Lodge.

He is survived by his wife, Phyllis; a son; and three grandchildren.

William E. Ripple

Dr. Ripple (Colorado State '44), 96, Dodge City, Kansas, died Nov. 27, 2017. Following graduation, he served in the Army during World War II. In 1946, Dr. Ripple co-established Drs. Ripple and Liebl, a mixed animal practice in Dodge City. He was a life member of the Kansas VMA.

Dr. Ripple is survived by two sons, two daughters, 10 grandchildren, and five great-grandchildren. One son, Dr. David Ripple (Kansas State '72), is a retired mixed animal veterinarian in Dodge City.

Memorials, toward the Dr. William E. Ripple Scholarship in Veterinary Medicine or First Presbyterian Church in Dodge City, may be made c/o Swaim Funeral Home, 1901 6th Ave., Dodge City, KS 67801.

Richard E. Shirbroun

Dr. Shirbroun (Iowa State '52), 88, Winterset, Iowa, died March 4, 2018. Following graduation and after serving in the Air Force, he established a mixed animal practice in Coon Rapids, Iowa, where he worked until 2001, focusing on food animal medicine. Dr. Shirbroun then moved to Illinois as Trust veterinarian for the AVMA Professional Liability Insurance Trust, having served as an AVMA PLIT trustee from 1984–2000. He retired to Winterset in 2008.

Dr. Shirbroun was a past director of the American Association of Bovine Practitioners, a past president of the Iowa VMA, and a member of the Society for Theriogenology. In 1986, he received the IVMA President's Award, and, in 1987, the AABP Excellence in Preventive Medicine Award for beef practice. In 1988, Dr. Shirbroun was honored with the Stange Award by the Iowa State University College of Veterinary Medicine.

He is survived by his wife, Wava; four sons; two daughters; 13 grandchildren; and eight great-grandchildren. Dr. Shirbroun's son, Dr. Randy Shirbroun (Iowa State '79), is a veterinarian in Worthington, Minnesota, and his grandson, Dr. David Shirbroun (Iowa State '08), works in Spencer, Iowa.

Samuel C. Spangler

Dr. Spangler (Texas A&M '72), 77, Austin, Texas, died Dec. 28, 2017. He practiced small animal medicine in Austin for 45 years. Dr. Spangler's son, two daughters, and five grandchildren survive him. Memorials may be made to the Austin Humane Society, 124 W. Anderson Lane, Austin, TX 78752.

Harley H. Sutton Sr.

Dr. Sutton (Michigan State '49), 94, Jamestown, Tennessee, died Nov. 22, 2017. In 1970, he founded Central Kentucky Veterinary Center in Georgetown, Kentucky, retiring in the mid-1990s. In 1971, Dr. Sutton was named Kentucky Veterinarian of the Year. Earlier in his career, he worked in Lexington, Kentucky, and served as a partner in a Georgetown veterinary practice. He served in the Army during World War II.

Dr. Sutton was a past president of the Kentucky VMA, served on the Kentucky Board of Veterinary Examiners, and was a member of the American Association of Equine Practitioners, Kentucky Thoroughbred Association, and Thoroughbred Club of America.

Dr. Sutton is survived by two sons, two daughters, 11 grandchildren, and 23 great-grandchildren. Dr. Sutton's sons, Drs. George F. Sutton (Cornell '76) and Harley H. Sutton Jr. (Auburn '80), are veterinarians in Georgetown and Jamestown, respectively. Memorials may be made to Central Kentucky Riding for Hope, 4185 Walt Robertson Road, Lexington, KY 40511.

James P. Watson

Dr. Watson (Cornell '45), 99, Union Dale, Pennsylvania, died March 25, 2018. Following graduation, he established a mixed animal practice in Lakewood, Pennsylvania, retiring in 1987. In 2008, Dr. Watson authored the book “A Country Veterinarian Reminisces.” Active in his community, he served as deputy coroner in Pennsylvania's Wayne County, was a member of the local school board, and volunteered with Meals on Wheels.

Dr. Watson was a veteran of the Army and a member of the American Legion. His three sons, a daughter, 10 grandchildren, 13 great-grandchildren, and a great-great-grandchild survive him. Memorials may be made to American Legion Post 209, 412 Como Road, Lake Como, PA 18437, or Northern Wayne Community Library, 11 Library Road, Lakewood, PA 18439.

Cover Journal of the American Veterinary Medical Association
Journal of the American Veterinary Medical Association
ISSN:
0003-1488
Publication Date:
15 Jun 2018
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    Salt Creek Veterinary Hospital in Olney, Texas, has an open-door policy when it comes to employees' kids. Shanda Hope, the clinic-employed nanny, will bring their children from the practice's nearby day care to the veterinary hospital at the parents' request to see newborn calves or kittens, watch a surgery, or let a new mother feed her baby. (Photos courtesy of Dr. Keelan Lewis)

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    Dr. Keelan Lewis (center) details her efforts to create a practice-owned day care during a panel discussion on workplace well-being at the 2018 Veterinary Wellbelng Summit, April 16–18 in Schaumburg, Illinois. (Photo by Malinda Larkinguess)

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    Six of seven mothers who work at the clinic use the company day care. Shanda Hope, the nanny, works whenever they need her. “That allowed my group of all-female practitioners and support staff to get what they felt like they needed to be at work,” Dr. Lewis said. (Courtesy of Dr. Keelan Lewis)

  • View in gallery

    Dr. Lewis said the clinic spends on day care costs a fraction of the amount spent on health insurance for the entire staff. The tax credits from purchasing the home (photos below) that was retrofitted as the practice's day care and the nanny's salary also help defray some of the costs. (Photos courtesy of Dr. Keelan Lewis)

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    Jen Brandt, PhD, AVMA director of member well-being and diversity initiatives, says during her keynote address that veterinary workplaces can do more to destigmatize help-seeking, to give employees a sense of belonging, and to develop communication between leadership and employees, among other things.

  • View in gallery

    The 2018 Veterinary Wellbeing Summit convened by the AVMA, the Association of American Veterinary Medical Colleges, and Zoetis, April 15–17 in Schaumburg, Illinois, was the fifth conference held on the topic of wellness and well-being. About 175 attended the event, including 25 social workers. The goal was to provide ideas from all parts of the profession to help others develop “a type of culture that supports everyone in their organization.” (Photos by Malinda Larkin)

  • View in gallery

    Randall Nett, MD, public health service medical officer for the Centers for Disease Control and Prevention's National Institute for Occupational Safety and Health, announces results of a study looking at rates of suicide among 11,620 veterinarians from 1979–2014 at the 2018 Veterinary Wellbeing Summit, held April 15–17. (Photo by Malinda Larkin)

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    Source for graphs: Based on graphs from the Centers for Disease Control and Prevention

  • View in gallery

    Source for graphs: Based on a graph from the Centers for Disease Control and Prevention

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    Dr. Angela Demaree

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    Dr. John Howe

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    Dr. Cia Johnson

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    Rosita is shown during treatment for carprofen ingestion at a veterinary hospital (Courtesy of Amanda Fernandez)

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    Heartworm prevalence forecast, 2018 (Courtesy of CAPC)

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    Morris Animal Foundation

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    Lt. Laura Adams

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    Lt. Col. Thomas Doker

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    Dr. Larry G. Dee

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    Dr. Jack L. Blackwood

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    Dr. Mitsie Vargas

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    Dr. Marc A. Presnell

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    Dr. Michael Epperson

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    Montana Sen. John Melcher accepting the 2003 AVMA Meritorious Service Award in Denver.

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    Senator Melcher with Dr. John de Jong, current AVMA president-elect, and former Colorado Sen. Wayne Allard, a veterinarian, at the 2007 AVMA Political Action Committee luncheon in Washington, D.C.

Salt Creek Veterinary Hospital in Olney, Texas, has an open-door policy when it comes to employees' kids. Shanda Hope, the clinic-employed nanny, will bring their children from the practice's nearby day care to the veterinary hospital at the parents' request to see newborn calves or kittens, watch a surgery, or let a new mother feed her baby. (Photos courtesy of Dr. Keelan Lewis)

Dr. Keelan Lewis (center) details her efforts to create a practice-owned day care during a panel discussion on workplace well-being at the 2018 Veterinary Wellbelng Summit, April 16–18 in Schaumburg, Illinois. (Photo by Malinda Larkinguess)

Six of seven mothers who work at the clinic use the company day care. Shanda Hope, the nanny, works whenever they need her. “That allowed my group of all-female practitioners and support staff to get what they felt like they needed to be at work,” Dr. Lewis said. (Courtesy of Dr. Keelan Lewis)

Dr. Lewis said the clinic spends on day care costs a fraction of the amount spent on health insurance for the entire staff. The tax credits from purchasing the home (photos below) that was retrofitted as the practice's day care and the nanny's salary also help defray some of the costs. (Photos courtesy of Dr. Keelan Lewis)

Jen Brandt, PhD, AVMA director of member well-being and diversity initiatives, says during her keynote address that veterinary workplaces can do more to destigmatize help-seeking, to give employees a sense of belonging, and to develop communication between leadership and employees, among other things.

The 2018 Veterinary Wellbeing Summit convened by the AVMA, the Association of American Veterinary Medical Colleges, and Zoetis, April 15–17 in Schaumburg, Illinois, was the fifth conference held on the topic of wellness and well-being. About 175 attended the event, including 25 social workers. The goal was to provide ideas from all parts of the profession to help others develop “a type of culture that supports everyone in their organization.” (Photos by Malinda Larkin)

Randall Nett, MD, public health service medical officer for the Centers for Disease Control and Prevention's National Institute for Occupational Safety and Health, announces results of a study looking at rates of suicide among 11,620 veterinarians from 1979–2014 at the 2018 Veterinary Wellbeing Summit, held April 15–17. (Photo by Malinda Larkin)

Source for graphs: Based on graphs from the Centers for Disease Control and Prevention

Source for graphs: Based on a graph from the Centers for Disease Control and Prevention

Dr. Angela Demaree

Dr. John Howe

Dr. Cia Johnson

Rosita is shown during treatment for carprofen ingestion at a veterinary hospital (Courtesy of Amanda Fernandez)

Heartworm prevalence forecast, 2018 (Courtesy of CAPC)

Morris Animal Foundation

Lt. Laura Adams

Lt. Col. Thomas Doker

Dr. Larry G. Dee

Dr. Jack L. Blackwood

Dr. Mitsie Vargas

Dr. Marc A. Presnell

Dr. Michael Epperson

Montana Sen. John Melcher accepting the 2003 AVMA Meritorious Service Award in Denver.

Senator Melcher with Dr. John de Jong, current AVMA president-elect, and former Colorado Sen. Wayne Allard, a veterinarian, at the 2007 AVMA Political Action Committee luncheon in Washington, D.C.

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