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AVMA funds economic study of veterinary workforce

Plan for pet and horse health research network also moves forward

By R. Scott Nolen

The AVMA Executive Board has appropriated more than half a million dollars to conduct an economic analysis of the U.S. veterinary workforce and to fund a national network supporting health and wellness studies benefiting companion animals and horses.

Board members approved the programs in accordance with the goals of the Association's strategic vision that call for strengthening the economics of the veterinary profession and advancing veterinary scientific research and discovery.

AVMA strategic funds were tapped to pay for the initiatives—up to $330,000 for the workforce study and $250,000 to implement the research program. Both proposals were part of a larger agenda considered by the Executive Board during a meeting at AVMA headquarters, April 19–21 (see stories, page 1397).

The workforce study was proposed by the AVMA Veterinary Economics Strategy Committee. The committee recommended the board allocate up to $330,000 from the AVMA National Economics Strategy Fund for the project. The study will identify, quantify, and evaluate various economic, demographic, technologic, and sociologic factors influencing the supply and demand for veterinarians and veterinary services across the nation.

The committee chose IHS Global Insight, a Washington, D.C., economics consulting firm, to conduct the study in partnership with the New York Center for Health and Workforce Studies. IHS will also create and provide the AVMA with a veterinary workforce forecasting model to estimate future supply and demand under alternative scenarios.

To assist the workforce researchers, the board formed an advisory committee comprising the AVMA economics committee, an Association of American Veterinary Medical Colleges representative, and AVMA staff.

Knowledge about the various factors driving demand for veterinarians and veterinary services is an essential component of AVMA activities ensuring the profession's economic viability, according to Dr. Link Welborn, Veterinary Economics Strategy Committee chair.

“The relative supply of veterinarians and the demand for the services of those veterinarians obviously has a significant impact on the economics of the profession,” Dr. Welborn said. “Understanding the dynamics of supply and demand for each of the major segments within the veterinary workforce is critical to understanding and potentially influencing the overall economics of those segments.”

Work on the study begins this year and is expected to be completed in 2013.

As Executive Board chair, Dr. Ted Cohn was a key figure in the AVMA's establishing a division and committee dedicated to veterinary economics, and he has been an advocate for the study. He hopes the analysis will not only yield a fuller understanding of the veterinary workforce but will also improve veterinarians' financial situation. But first, Dr. Cohn said, “We need to gain a big picture, strategic perspective before we can utilize that knowledge to formulate tools or advice to the benefit of individual members.”

Animal Health Network

The millions of dollars directed to companion animal and equine health studies in the United States each year pale in comparison with the billions spent on human and livestock health investigations. One explanation for this is the absence of a national organization whose sole purpose is supporting research for both pet and horse health.

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Dr. Ted Cohn, AVMA Executive Board chair (Photo by R. Scott Nolen)

Citation: Journal of the American Veterinary Medical Association 240, 12; 10.2460/javma.240.12.1384

The AVMA Executive Board has sought to remedy this funding imbalance since 2007, when it first approved a Council on Research plan establishing an Institute for Companion Animal and Equine Research. Since then, the board has continued supporting the concept while plans for the organization have evolved.

The latest proposal originated within an AVMA Strategic Goal Team and was brought to the Executive Board by the AVMA Office of the Executive Vice President. The recommendation was for the American Veterinary Medical Foundation to manage a national effort to raise awareness about health-related research for dogs, cats, and horses and increase investment in such studies.

The plan approved by the board allocates a total of $250,000 from the AVMA Strategic Goal Fund in 2012–2013 for the AVMF to develop, promote, and launch what is now tentatively referred to as the Animal Health Network.

“The Animal Health Network has long been a dream for the members of the (Council on Research), who have spent several years discussing and working with AVMA to address the desperate need for increasing support for research into diseases and disorders that afflict animals, particularly companion animals,” COR Chair Kent Lloyd said.

“The COR envisions AHN to begin to address this deficiency by generating financial support; coordinating like-minded groups, foundations, and other entities with the AVMF; and expanding the kinds and level of scientific investigation into enhanced diagnostics, novel therapeutics, and new preventative strategies to improve animal health,” Dr. Lloyd explained.

The idea behind the AHN is that investment in pet and equine health studies will increase if like-minded foundations work together within a single organization. Last year, several feline organizations and the AVMF came together as the Cat Health Network, a species-specific pilot component of the AHN providing $100,000 annually for feline health studies in U.S. and foreign laboratories (see JAVMA, Nov. 15, 2011, page 1281).

Although the details have yet to be worked out, the AHN might model its marketing and business strategy after the Children's Miracle Network. Donors could make contributions to a local AHN chapter or the AHN's national office, with the option that their donations go to a specific project or institute conducting studies related to companion animal or horse health.

“The AVMF has had as one of its strategic goals for most all of its 50 years the support of animal health research,” said AVMF Executive Director Michael Cathey. “We are particularly excited about the new syncing up of the AVMF and the AVMA strategic goals to both reflect the support of research and look forward to the building out of a new umbrella program to focus on the awareness of, and funding for, the health of animals.”

Federal law could affect mobile practice

Veterinarians express concern over drug access

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This photo shows a lockbox used to transport controlled substances inside a California veterinarian's truck.

Citation: Journal of the American Veterinary Medical Association 240, 12; 10.2460/javma.240.12.1384

By Greg Cima

Dr. Lisa S. Couper isn't allowed to carry some drugs she sees as essential for her mobile mixed animal practice.

She is among Northern California veterinarians with ambulatory or mobile practices who said Drug Enforcement Administration officials told them that they are violating federal law if they routinely carry controlled substances in their vehicles.

“I wasn't aware that it was against the code until now,” she said. “Now that I am, what do I do? What are the DEA's intentions?

“If they really are intent on enforcing, I'm going to have to call it quits.”

Barbara L. Carreno, a spokeswoman for the DEA, said the federal Controlled Substances Act, which Congress passed in 1970, requires that practitioners—including veterinarians, physicians, and dentists—have separate registrations for every location where they store, distribute, or dispense controlled substances. The agency has let practitioners in human and veterinary medicine register in one location and prescribe controlled substances in others, and some practitioners have been confused by that allowance.

Dr. Grant R. Miller, director of regulatory affairs for the California VMA and a veterinarian whose patients include horses, cattle, sheep, and goats, said a DEA official indicated to him that veterinarians would be allowed to bring the amount of a drug they intend to use during the day, although that allowance is not written in regulations.

“They're saying you can't take these things out in the field and use them without having some kind of preset amount that you're going to dispense,” he said.

Dr. Miller said that would, for example, allow a veterinarian carry the drugs needed for a previously scheduled appointment, such as to spay or neuter an animal. But he interprets the allowance to mean that a veterinarian would not be able to carry controlled substances for use in an emergency or a bulk amount of ketamine needed to conduct a one-day spay and neuter clinic at a rural pet store, where the numbers and sizes of animals arriving would be unknown.

On the basis of reports from California VMA members, Dr. Miller said it appeared that officials in a DEA office in Sacramento were contacting veterinarians who registered their home address as their place of business.

The VMA posted on its website a copy of a letter that states a DEA official was reviewing registrations and asking veterinarians to provide their business addresses. By early May, the VMA was receiving eight or 10 calls daily from veterinarians concerned about the issue. The number of calls dropped to a few weekly by mid-May.

Dr. Couper said her mobile practice has been registered at her home address for the past 25 years. In responding to one of the DEA inquiries, she found out that she was allowed to treat patients or dispense controlled substances there, but she was told that her mobile clinic had been transporting controlled substances illegally.

Notice issued over confusion

Back on Dec. 1, 2006, the DEA published a Federal Register notice intended to alleviate confusion over the agency's rules regarding the handling of controlled substances by practitioners, including veterinarians. In addition to stating that practitioners can store, administer, or dispense controlled substances only at registered locations, the notice states that practitioners need a separate registration for each state where they prescribe a controlled substance. The notice clarified but didn't change what was allowed under federal regulations.

“The Controlled Substances Act would have to be amended by Congress to do that because our regulations implement the law as passed by Congress, and we don't have the authority to change it,” Carreno said.

Violating the Controlled Substances Act can result in various penalties, depending on the circumstances of each violation, Carreno said. Administrative actions could include sending a letter to admonish a registrant that he or she was violating the law, initiating proceedings to withdraw DEA registration, and, if public health or safety were threatened, suspending the individual's registration, according to an August 2011 Government Accountability Office report.

Practitioners can face civil penalties such as fines for violating record-keeping requirements for controlled substances. More serious violations, such as illegal distribution, fraud, tax evasion, and money laundering, can result in criminal charges, according to the GAO report.

In a letter sent to the DEA April 30, 2012, Dr. Ron DeHaven, AVMA CEO, asked the DEA to exercise enforcement discretion when investigating ambulatory veterinary practitioners who hold valid state licenses and DEA registrations. His letter indicates many AVMA members, particularly those in rural and large animal practices, provide mobile or ambulatory services because animal owners could not easily bring their animals to a clinic or hospital. Many companion animal veterinarians also provide house call services and operate mobile clinics.

Dr. DeHaven's letter expresses support for the intent of the DEA Diversion Control Program but concern that enforcing existing regulations “will make it impossible for veterinarians to comply with the regulations while providing their patients with appropriate and complete veterinary care and fulfilling their ethical responsibilities.”

The letter notes that the AVMA has been meeting with DEA officials since 2009 to address the regulations and has been told that Congress would need to amend the Controlled Substances Act to change the current regulations to address the AVMA's concerns.

Dr. M. Gatz Riddell, executive vice president of the American Association of Bovine Practitioners, noted that not all veterinarians have facilities to accept patients, and not all clients can deliver their animals to a clinic or hospital. He indicated that enforcement of the existing regulations could hinder veterinarians' abilities to anesthetize, sedate, or provide analgesia for their patients in the field.

“It would really impede a veterinarian's ability to provide for the prevention of pain and suffering of their patients in certain conditions,” he said.

Rising concern, changing practice

Dr. Thomas W. Graham of Davis, Calif., stopped carrying pentobarbital, diazepam, xylazine, and butorphanol in his vehicle after he was told this spring that the practice was illegal. He intends to comply with all directions from the DEA, and he fears penalties could result if he were to fail to follow those directions and his truck were searched during a DEA inspection or a state police traffic stop. He thinks agency officials are trying to do what is best to implement a law structured by Congress.

Dr. Graham, who is a bovine practitioner, said, however, some alternatives to controlled substances are less reliable for providing humane care.

“I have a surgery today that I'm supposed to do to remove an eye in a cow, and I guess I'll just use lidocaine,” Dr. Graham said. “And I'm not happy with it.”

Dr. Miller noted that, even if he is allowed to carry amounts of controlled substances intended for use, he often would need to see the patient to determine its weight, the amount of pain it was in, and the severity of its condition before he could know how much of any particular drug was needed. The calculated amount of a barbiturate needed for euthanasia could be insufficient if an animal were agitated, he said.

“We couldn't have an extra supply on hand in the field when we're euthanizing an animal,” he said.

Dr. Couper said she has an ethical obligation to carry proper drugs to care for her patients, but following the rules as they were explained to her would leave her unable to carry sufficient amounts of controlled substances to re-sedate an animal, if needed, or adapt in situations involving spilled drugs, missed injections, or faulty catheters.

Dr. Graham hopes congressional involvement isn't needed. For now, he uses a .22 Magnum handgun for euthanasia, and he won't carry controlled substances until he has assurances that the practice is legal.

California regulators clarifying pet dentistry restrictions

Recently defeated legislation in California would have let unsupervised nonveterinarians perform services to remove deposits from pets' teeth.

Meanwhile, officials with the California Veterinary Medical Board are working on regulatory changes that would clarify that using metal scrapers to clean a pet's teeth, or scaling, without veterinarian supervision is illegal.

Susan M. Geranen, executive officer for the board, said the California Code of Regulations has prohibited unlicensed and unsupervised pet dental scaling since May 1990. She said that while people are allowed to perform dental scaling on their own pets' teeth, the Minimum Standards of Veterinary Practice state that unsupervised nonveterinarians are only allowed to use tools such as toothbrushes, gauze, and toothpastes to clean the teeth of clients' pets. Clarifications that were proposed in fall 2011 and could be enacted as early as August 2012 would explicitly state that dental scaling is the practice of veterinary medicine, although Geranen said the existing regulations are clear.

On Feb. 24, California Assembly member Martin Garrick proposed legislation, Assembly Bill 2304, that would have allowed nonveterinarians to use nonmotorized instruments to clean teeth above the gum line for cosmetic purposes. The Assembly Committee on Business, Professions, and Consumer Protection defeated the bill April 17 with six votes against the legislation and none in favor of it.

The California VMA announced that day that its opposition to the bill had mobilized more than 7,500 people who had contacted district and capitol offices.

Dr. Richard Sullivan, a practice owner in Torrance, Calif., and a member of the AVMA State Advocacy Committee, said that, about three weeks before the bill was defeated, a client had brought in a dog that had been taken to a groomer for monthly teeth cleaning yet had an abscess so severe a tooth's roots were exposed. Other clients have brought in pets with neglected gingivitis, and colleagues have reported seeing pets with shiny teeth and infected gums. Dr. Sullivan thinks some pet owners mistakenly believe lay cosmetic teeth cleaners maintain dental hygiene.

The regulatory changes proposed in California are a product of a state consumer protection initiative started in 2009 to encourage boards that regulate professional activities to increase enforcement against unlicensed activity, Geranen said. Work by unlicensed construction contractors is a high-profile example of such activities.

The California Veterinary Medical Board can send cease-and-desist letters and fine nonveterinarians who violate the regulations, although the board typically pursues such actions only in response to consumer complaints, Geranen said. Additional proceedings require participation from prosecutors willing to pursue civil or criminal court cases.

The California VMA is currently campaigning against the illegal practice of veterinary medicine, and nearly 1,200 of 1,500 veterinarians who responded to a survey in 2010 had indicated they knew of such illegal practice in the same areas as their clinics. Anesthesia-free pet teeth cleaning was the most commonly reported.

The AVMA also is collecting reports on suspected incidents of illegal practice of veterinary medicine by nonveterinarians, and a scope-of-practice information form is available at www.avma.org/advocacy/state/issues.

Guidelines available on feline-friendly nursing care

The American Association of Feline Practitioners and International Society of Feline Medicine recently released the new Feline-Friendly Nursing Care Guidelines.

The intent of the guidelines is to provide veterinary teams with resources and recommendations to implement basic nursing care concepts with feline patients. The document defines nursing care as any interaction between a cat and veterinary team in a clinic, or between a cat and owner at home, that promotes wellness or recovery from illness or injury and addresses the patient's physical and emotional well-being.

“By looking at each section of the guidelines, a clinic can begin to understand fear and stress from the cat's perspective; make changes in protocol that will decrease stress in exam rooms, perioperative areas, and during hospitalization; avoid things that annoy cats; and counsel owners on how to behave in the exam room so as to soothe their cats rather than contribute to stress,” wrote Drs. Hazel Carney and Susan Little, co-chairs of the guidelines panel.

They continued, “These guidelines are comprehensive and may seem daunting. However, even small improvements and incremental progress in feline nursing care can pay immediate dividends and start building a culture of skilled and compassionate feline care. We firmly believe that as veterinarians understand, utilize, and adapt these techniques to their practices, they will improve the comfort and health of our cat patients.”

The guidelines appeared in the May issue of the Journal of Feline Medicine and Surgery and are available at www.catvets.com/guidelines.

Banfield report reveals increase in overweight pets, arthritis

The prevalence of overweight dogs and cats increased between 2007 and 2011, as did the prevalence of arthritic dogs and cats, according to the State of Pet Health 2012 Report that Banfield Pet Hospital released in May.

The report drew on medical data from 2 million dogs and nearly 430,000 cats that were patients at Banfield's 800 hospitals in 2011. This is the second year Banfield has issued such a report. The 2012 report focuses on chronic diseases, including obesity, arthritis, kidney disease, thyroid disease, and heart disease.

About one in five dogs and cats is overweight, the report states. The prevalence of overweight dogs increased almost 37 percent between 2007 and 2011, while the prevalence of overweight cats increased more than 90 percent. The prevalence of arthritis increased 38 percent in dogs and 67 percent in cats.

Banfield worked with Kelton Research to survey 2,000 dog and cat owners about their perceptions regarding chronic diseases and steps they can take to keep their pets healthy. Respondents selected from a list of reasons they would be likely to take their dog or cat to a veterinarian. Management of an existing condition did not rank high among the responses (see sidebar).

“At Banfield, we strongly believe in regular preventive care and early disease diagnosis. The key to successful early disease diagnosis involves a partnership between pet owners and their veterinarian to identify changes in a pet's overall health and behavior,” said Dr. Jeffrey Klausner, Banfield's senior vice president and chief medical officer.

“In partnership with pet owners, we hope to reduce the number of pets living with undiagnosed or unmanaged chronic diseases.”

The State of Pet Health 2012 Report documented an association between excess weight and other chronic conditions in dogs and cats. The report revealed that 40 percent of arthritic dogs and 37 percent of arthritic cats are overweight, 42 percent of diabetic dogs and 40 percent of diabetic cats are overweight, and 40 percent of dogs with high blood pressure and 60 percent of dogs with hypothyroidism are overweight.

The prevalence of chronic kidney disease in cats increased by 15 percent between 2007 and 2011, according to the report. In 2011, one in 12 geriatric cats had a diagnosis of kidney disease.

Dr. Ron DeHaven, AVMA chief executive officer, said the report's findings mean that veterinarians need to continually focus on regular preventive care and early disease detection.

The AVMA and Banfield are among the founders of the Partnership for Preventive Pet Healthcare. Dr. DeHaven noted the primary reason for formation of the partnership was to help veterinarians understand and communicate the importance of regular preventive care for pets.

The State of Pet Health 2012 Report is available at www.stateofpethealth.com.

Reasons for visiting a veterinarian

Responding to a survey by Banfield Pet Hospital and Kelton Research, dog and cat owners selected from a list of reasons they would be likely to take their pet to a veterinarian. Here is the ranking of the responses:

  • • Pet is injured.

  • • Routine vaccinations.

  • • Pet is sick.

  • • Routine check-up.

  • • To get spayed or neutered.

  • • Intestinal parasite testing and/or medication.

  • • Pet is acting differently than usual.

  • • Heartworm testing and/or prevention.

  • • Flea or tick medications.

  • • Management of an existing condition.

  • • Prescriptions.

  • • Dental cleaning.

  • • Dental examination.

  • • Nutritional counseling.

  • • Behavior counseling.

  • • Other.

Looking ahead

Fobian anticipates serving as 2013–2014 AVMA president

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Dr. Clark K. Fobian, District VII representative to the AVMA Executive Board, at a recent meeting (Photo by R. Scott Nolen)

Citation: Journal of the American Veterinary Medical Association 240, 12; 10.2460/javma.240.12.1384

Interview by R. Scott Nolen

Over the past six years, Dr. Clark K. Fobian has balanced the responsibilities of owning and operating a small animal practice in Sedalia, Mo., with those expected of leaders within the AVMA and American Veterinary Medical Foundation.

In the years since Dr. Fobian won the election for the District VII representative to the AVMA Executive Board, the University of Missouri-Columbia College of Veterinary Medicine alum has also been chosen to chair the AVMF board of directors. And now, with his service on both boards ending, Dr. Fobian anticipates working on behalf of his profession in a new capacity, as the 2013–2014 AVMA president.

As the sole candidate for the office of president-elect, Dr. Fobian is expected to be elected by the AVMA House of Delegates this August during its regular annual meeting in San Diego.

JAVMA News recently interviewed Dr. Fobian regarding his vision for the AVMA, the forthcoming U.S. veterinary workforce study, and the debate over the Executive Board's endorsement of controversial legislation addressing the welfare of egg-laying hens.

Why are you running for AVMA president-elect?

When I first started practice, I was elated by the profound positive impact I could have on a client's life through the medical care I provided for their animals. That sense of elation has remained with me all these years. My first time as a participant in organized veterinary medicine afforded me the same level of deep gratification, only this time I was helping tend to the professional and societal needs of veterinarians. As a result, I had a hand in enhancing their ability to care for the clients and animals in their practice. I found this chance to positively impact the delivery of veterinary medicine on so broad a scale even more fulfilling than what I experience at my own practice. Therefore, being afforded the opportunity to enhance veterinary medicine at the national level is one of the highest callings I could ever hope to participate in.

What would you want to accomplish as AVMA president?

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Dr. Clark K. Fobian

Citation: Journal of the American Veterinary Medical Association 240, 12; 10.2460/javma.240.12.1384

My goals are lofty yet simple. More than anything, I want to help current and future veterinarians have a fulfilling and rewarding career. This is not an easy feat, because the veterinary profession today is facing a number of significant workforce and societal challenges simultaneously.

Specifically, I hope to drive the AVMA toward implementing plans based on the findings of the veterinary workforce study that the Executive Board just recently approved. We have to define economic realities influencing our profession if we are to help drive its development. There is a profusion of diverse and conflicting studies, reports, and predictions concerning the supply of veterinarians versus the demand for veterinary services. We need to make sense of these perspectives and then devise an appropriate response.

I want to work with academia, government, and business to identify ways of bringing student debt in line with current veterinary earning power. As AVMA president, I would educate the public and legislators about ensuring competent medical care and accountability through licensing boards and practice acts that define the scope of veterinary practice and ultimately protect the public from deceptive, inappropriate, and unregulated veterinary activities.

I would also hope to assist animal shelters, rescue facilities, and humane societies to continue in their good work but without having a direct competitive advantage over private veterinary practices also serving the pet-owning population. And finally, I would make certain that the AVMA maintains its strong voice in the U.S. Congress with regard to regulatory activities affecting small businesses and veterinary medicine.

What do you see as the AVMA president's role?

The president's role is threefold. As a member of the Executive Board, the president should initiate and propose activities to forward the AVMA's strategic vision and agenda. The AVMA president is the spokesperson for the veterinary profession. As such, the president should reflect and communicate the current thoughts, perspectives, and activities of the AVMA to the membership and other stakeholders. The president is also a facilitator who encourages constructive relationships and networking among the many entities with which the AVMA interacts.

Many of the AVMA's agricultural allies were upset with the Executive Board's recent support for H.R. 3798, which would establish national standards for treatment of egg-laying hens. In your opinion, did the board do the right thing?

Anyone in medicine knows that the hard choices are not between good options and bad options; oftentimes, you have to choose from among a number of bad options. We are often tasked in life, medicine, and this Association to determine the least offensive of the choices we face. From my perspective, that is the case for H.R. 3798. Every board member knew the gravity and complexity of this issue. There was, in my opinion, no totally good or right answer. I do believe the Executive Board chose the right course of action, one intended to have the least negative repercussions. The Executive Board was not trying to dodge a bullet by voting to support the bill, but rather, to express support for what we, the AVMA, believe will result in optimal care for the animals at issue. Now, whether optimal care should be regulated by the federal government is a question our colleagues in production agriculture are asking us, and they have every right to do so. Some of them feel like we have hung them out to dry, but all I can say is we have not. I am most interested in seeing where this bill goes and am determined to see that this does not make us vulnerable to further inroads of federally regulated production animal care regulations.

As AVMA president, how will you assure the diverse array of veterinary stakeholders that the Association cares about their interests?

The aforementioned issues bring this question into focus. For example, has the AVMA alienated the production agriculture veterinary population—a very important sector of our diversified membership? In the heat of this legislative foray, some of these members, I am sure, feel disenfranchised. I, however, urge them to look at the totality of AVMA's initiatives and advocacy, and it is obvious that AVMA advocates for a great number of issues and is supportive of a diverse array of veterinary interests.

As for fostering a profession that reflects the diversity within society, I will certainly play a role as AVMA president in setting a positive cultural environment for both professional diversity and societal diversity. There are two reasons for increasing diversity within our profession. First, it is the right thing to do. And second, it's good for veterinarians' businesses and personal development.

Are you satisfied with the current AVMA governance structure, especially with the way the House of Delegates is being used?

Governance always has to evolve; it always has and it always will. What is at issue here are the dramatic technological advances in communication that have taken place over a historically short period of time and how these innovations are impacting our means of connecting, interacting, meeting, working, and so on. These enhancements, along with the quality-of-life expectations among new and future generations, are changing how all organizations operate, and our governance has to adapt to meet these changes as well.

However, here is the challenge: We are, by all standards, a highly successful and effectual professional organization, garnering an impressive membership rate of 83 percent of veterinarians in this county. As we implement changes, we must be careful not to throw the baby out with the bath water, as it were. In other words, let us be careful not to change those things that have made us a successful professional association.

The AVMA is involved in a lot of big-picture initiatives, but how does the Association help the individual member?

Of course, the AVMA is a national organization, so dealing on a big-picture basis is most appropriate. But the question is: How does this impact a mixed animal practitioner in little Lebanon, Kentucky, or an associate in a multidoctor practice in burgeoning Philadelphia, Pennsylvania? Every initiative needs to be addressed and entered into with the same basic questions: Is this good for animals and the people who care for them? How is this good for our dues-paying members and the veterinary profession? I believe answering the first question correctly will invariably lead to the proper perspective for addressing the second. For our profession to prosper, it always has to be a win-win-win situation: a win for the animals, a win for the animal owner, and a win for the veterinary profession.

This brings us back to the question about governance and the House of Delegates. If elected, I will be one of a minority of Association officers who never served in the HOD. In my years of service on the Executive Board, this has at times been a disadvantage. On the other hand, however, I've harbored no preconceived notions about this body and have had the advantage of an uncluttered view of the HOD's intended role and function. I say intended because the HOD at this time seems slow and cumbersome. The House serves as the voice of our membership, and I feel this is a vital role. Changes to its structure and function are needed to improve the responsiveness of this body, and I eagerly anticipate the findings of the Task Force on AVMA Governance and Member Participation.

Accreditation standards revised for clarity

Revisions to two of the 11 AVMA Council on Education Standards of Accreditation have clarified sections having to do with college research programs and with the use of outcomes assessments as part of the council's review process.

Changes to Standard 11 more clearly establish what the council requires for outcomes assessment. Previously, the standard indicated that “measures that address the college mission must be developed and implemented. Outcomes assessment results must be used to improve the college programs.”

Now the standard says that student achievement during the preclinical and clinical curriculums as well as postgraduation period must be included in the outcomes assessment. Plus, the standard dictates that veterinary colleges must provide evidence that graduating students have attained competence in patient diagnosis and welfare, surgery and medicine skills, health promotion, disease prevention/biosecurity, zoonosis, and food safety, among other things.

Essentially, the COE placed the nine clinical competencies, which have been required in the self-study document for years, directly into the standard. The council made the change for clarity, primarily on the basis of experiences during site visits, said Dr. David E. Granstrom, director of the AVMA Education and Research Division.

The other revision, to Standard 10, was a slight word change—from “shall” to “must”—in regard to colleges maintaining substantial research activities.

University of Georgia College of Veterinary Medicine Dean Sheila W. Allen—a former COE chair—was quoted in the Association of American Veterinary Medical Colleges' April newsletter saying the language was changed to reflect that integrating a high-quality research program into the veterinary curriculum is required, not desired. She added that the COE believes that veterinary students should “learn how to critically analyze and interpret research findings.”

Dr. Granstrom said, “The council is currently reviewing the North American Veterinary Medical Education Consortium report in light of the Standards of Accreditation. Several council members attended NAVMEC meetings and are aware of the findings.”

COE members approved the two revisions during their spring meeting, March 4–6, at AVMA headquarters in Schaumburg, Ill. These were sent to the AVMA Executive Board to solicit its feedback during its April 19–21 meeting. The board no longer approves the COE's actions per changes in policy passed during the June 5–7, 2011, Executive Board meeting.

To view the full standards, visit www.avma.org, click on the “Accreditation” link under the “Education” heading, and then select “The accreditation process.”

AVMA PLIT celebrates 50th anniversary

Trust protects veterinarians' reputations, assets

What happens to veterinarians who are presented with a professional liability claim? Those who are insured through the AVMA PLIT–sponsored program have 50 years of experience standing behind them. This year, the AVMA PLIT celebrates five decades of sponsoring insurance solutions for veterinarians. One of the first of its kind, the PLIT was started in 1962 to serve the malpractice insurance needs of AVMA members.

The AVMA founded the Trust as a means to ensure that veterinarians would have an advocate in the management of their claims. Since the 1960s, this has been a vital component of the PLIT–sponsored program. Building on the success of the malpractice insurance program, the PLIT expanded its sponsored program offerings to include veterinary license defense, business owner policies, workers' compensation, employment practices liability, automobile insurance, and comprehensive personal insurance solutions for AVMA and Student AVMA members.

The security, stability, and strength of the PLIT-sponsored program over the past five decades explain why it is the first choice for many veterinarians and veterinary students for business, malpractice, and personal insurance solutions. Today, more than 56,000 veterinarians participate in the PLIT-sponsored program.

The PLIT's golden jubilee year began on a high note, with annual malpractice premium rates for primary and excess malpractice coverage decreasing 15 percent for classes I (equine) and II (food animal), and 5 percent for classes III (mixed animal practice) and IV (small animal). A group personal excess liability product was launched to provide another layer of liability protection in addition to homeowners and auto insurance policies.

Supporting future veterinarians

New for this year, the PLIT donated $96,000 for scholarships to assist veterinary students with their overwhelming student debt. The PLIT worked with each college scholarship committee to introduce the scholarship and asked the committees to select qualified recipients. The $96,000 has been disbursed equally to 32 veterinary schools in the U.S., Canada, and the Caribbean that the Trust representatives visit annually for their educational presentations to the students.

The PLIT also supports several student events, including the annual Student AVMA Symposium and the Opportunities in Equine Practice Seminar, as well as the Veterinary Business Management Association.

Today's veterinary education would not be complete without instruction on how to avoid allegations of malpractice. The Trust representatives visit veterinary schools every year to educate students about this. Helping further this cause are the PLIT student ambassadors, who serve as a liaison between the PLIT and their schools' student body, keeping students apprised of the PLIT's sponsored program and its services, such as student liability coverage.

Communications

Anecdotal information from the Trust suggests that most professional liability claims and state board complaints reflect some element of communication breakdown. Data from the veterinary profession in Canada also link formal complaints and malpractice cases with miscommunication. Studies in human medicine indicate that improved communication between doctors and patients is an important factor in reducing the likelihood of malpractice claims.

In an effort to improve client compliance and satisfaction, and to reduce the potential for malpractice claims, the PLIT embarked on a communication education initiative in 2007. This included having Trust representatives participate in the Bayer Animal Health Communication Project, during which they received professional training in delivering communication topics to veterinary groups. These representatives have since gone on to present these communication training modules at regional, state, and local veterinary association meetings. In addition, the PLIT has sponsored a communication expert, Dr. Kathleen Bonvicini, to present the modules at a variety of veterinary meetings.

The PLIT is a key sponsor of the annual AVMA Veterinary Leadership Experience, a multiday program with student and faculty participants from all U.S., Canadian, and Caribbean veterinary schools and colleges. The program stresses the importance of balancing medical and surgical competencies with important life skills such as communication, leadership, and relationship building. The PLIT commitment to providing communication training complements the VLE.

50th anniversary educational program

In 2011, approximately one of every 19 veterinarians reported a potential malpractice claim, which was a 12 percent decrease from 2010. The PLIT believes that one contributing factor to these positive results is the increased emphasis on communication training and risk management tools. The newest PLIT educational program will premiere Aug. 6 at the AVMA Annual Convention in San Diego: “A Privilege to Practice, Strategies for Protection.” Created to educate the entire veterinary team, this program is aimed at reducing the likelihood of a malpractice suit or veterinary board complaint. The program will share the top drivers of claims, and exposures for on-the-job injuries and practice losses—claims that can affect any veterinary team member.

Dr. Richard DeBowes will moderate the program. “When challenging events happen in the lives of veterinary health care team members, it's good to know that they have the caring support of colleagues and the exceptional protection of insurance carriers offered through the PLIT-sponsored program,” Dr. DeBowes said.

Advocates for the veterinary profession

The PLIT board of trustees consists of seven veterinarians appointed by the AVMA Executive Board and one liaison-trustee from the AVMA. The trustees oversee the PLIT to ensure that the program evolves with the changing needs of the profession. They work closely with the PLIT CEO, Dr. Rodney Johnson, along with advisers who include legal counsel and a consulting actuary.

One key to the PLIT's success is the team of in-house Trust representatives who work with Dr. Johnson to review all reported malpractice claims, speak to veterinarians regarding potential allegations of negligence, and provide guidance. The representatives—Drs. Linda Ellis, Karen Wernette, and Nina Mouledous—are veterinarians with many years of practice experience. They refer the PLIT—sponsored program's insurance company to qualified veterinary experts to assist in defense and provide veterinary insight to the insurance carrier and its attorneys.

HUB International Midwest Ltd. has been the insurance broker for the AVMA PLIT since the Trust's inception. HUB and the PLIT share a vision of being the first choice of veterinarians, offering them the best value over the long term. HUB works on behalf of veterinarians to represent their interests to top-rated insurance carriers, including Zurich American Insurance Co. (professional liability and veterinary license defense), The Hartford (business insurance), Travelers (business insurance), CNA Insurance (employment practices liability insurance), Liberty Mutual (automobile, homeowners, and renters insurance), and Chubb (personal excess liability insurance).

The next 50 years

“It is a great honor and responsibility to serve as the PLIT Trust chair during our 50th anniversary,” said Dr. R.C. Ebert II. “With more than 200 years of combined experience in our profession, the PLIT trustees are proud to support the PLIT's mission: to provide a valuable AVMA member service that protects the assets and reputations of the participants and enhances the image of the profession.

“Also, we have been very fortunate to have been associated with HUB, the same broker for the past 50 years. Your team of advocates—the PLIT trustees and Trust representatives, with the expertise of HUB—plan to enhance our services in several areas, including claim analysis and personal liability.”

When asked about the PLIT's next 50 years, Dr. Ebert responded, “Our goal remains solid—operate as veterinarians serving veterinarians, sponsoring an insurance program that offers the very best in asset and business protection.”

Javorka is new AVMA manager of recent graduate outreach

By R. Scott Nolen

Dr. Carrie Ann Javorka joined the AVMA Membership and Field Services Division this April in a new position overseeing programs and services for recent veterinary graduates.

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Dr. Carrie Ann Javorka

Citation: Journal of the American Veterinary Medical Association 240, 12; 10.2460/javma.240.12.1384

The Purdue University College of Veterinary Medicine graduate is responsible for developing and implementing initiatives promoting the benefits of AVMA membership among new veterinarians.

Dr. Javorka will also work to increase recent veterinary graduate participation on AVMA committees, councils, and task forces along with creating AVMA volunteer leadership training programs for recent graduates and emerging leaders.

Establishing a new assistant director-level position for recent graduate initiatives was a key recommendation of the Task Force on AVMA Programs for Students and Recent Graduates, which delivered its final report to the Executive Board in April 2011.

“The task force did a great job and identified a critical need for the AVMA,” said Membership and Field Services Director Kevin Dajka. “We have a segment of our membership looking to the AVMA for resources to help in their transition into the profession. While we have some resources available for our recent graduate members, quite frankly, we struggled to get the information out to them.”

“Now we have dedicated staff to focus on their needs and make sure we let them know what we have to offer,” Dr. Dajka continued. “We are very excited to have Dr. Javorka on board and look forward to her drawing from her own experience as she builds AVMA's recent graduate initiatives.”

Dr. Joseph Kinnarney, Executive Board member and task force chair, is “very excited” about Dr. Javorka's hiring. “This position is vital to the task force's plan to enhance our relationship and service to new and recent graduates. Over 40 percent of our members are recent graduates—members out of school less than 15 years—and AVMA is committed to the new initiatives recommended by the task force and approved by the Executive Board,” Dr. Kinnarney said.

After receiving her DVM degree in 2006, Dr. Javorka held associate veterinarian positions at small animal hospitals in Indiana and Illinois until her employment at the AVMA.

As a recent graduate herself, Dr. Javorka says she understands the challenges of being a new member of the veterinary workforce and community. She looks forward to supporting these veterinarians and helping them find time to participate in the AVMA, despite their hectic schedules. “We definitely need their fresh perspectives on the issues facing our profession,” Dr. Javorka said.

“I also plan to facilitate the development of educational opportunities targeted to recent graduates that are essential early in career development, such as practical veterinary medical and surgical skills, business applications, and approaches to work-life balance concerns,” she said.

Strategy and action

AVMA board actions reflect long-term goals

The Executive Board met April 19–21 to consider an agenda with recommendations on issues ranging from veterinary economics and leadership development to animal welfare and international relations.

Among the more notable board actions was the commissioning of an economic analysis of the U.S. veterinary workforce and the providing of $250,000 for the American Veterinary Medical Foundation to establish a national program supporting companion animal and equine health studies (see page 1385).

“This is certainly new territory for AVMA,” Executive Board Chair Ted Cohn said about the research initiative. “This is us stepping up and showing we're serious about the recent goal we added to the Association's strategic objectives.”

Dr. Cohn was referring to the most recent AVMA Strategic Plan that now includes the promotion of veterinary scientific research and discovery as an Association goal.

The Executive Board approved a $31.5 million budget for 2013 that projects income will exceed expenses by just over $828,000 during the AVMA fiscal year (calendar year). “This is a lean, strategically prepared budget,” commented AVMA Treasurer Barbara Schmidt.

Additionally, the board adopted a policy providing guidance on veterinary internship and residency quality, added the concept of inclusion to the AVMA policy on diversity, and authorized a plan for the Association to host representatives of the Chinese VMA later this year.

Board members voted to postpone the AVMA Animal Welfare Symposium to 2013 and change the meeting topic to current and future approaches to animal euthanasia, depopulation, and humane slaughter.

They also renewed funding support for an AVMA awards program with the National FFA Organization and a leadership development opportunity for members of the AVMA House of Delegates.

“This is a program that has a lot of traction, and it's been very beneficial to the House,” said Dr. George Bishop, California's alternate delegate to the HOD, who participates in Executive Board meetings as chair of the House Advisory Committee.

Several strategy sessions were held during the board meeting. Topics included findings from the latest AVMA member needs assessment survey, relationships between AVMA and stakeholder organizations, and the public image of veterinarians.

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Dr. Joseph Kinnarney (right), District III representative

Citation: Journal of the American Veterinary Medical Association 240, 12; 10.2460/javma.240.12.1384

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AVMA President Réne Carlson (Executive Board photos by R. Scott Nolen)

Citation: Journal of the American Veterinary Medical Association 240, 12; 10.2460/javma.240.12.1384

HOD leadership program approved for 2013

The Executive Board has approved funding for a leadership development program for AVMA House of Delegates members in 2013.

The House Advisory Committee recommendation requested $13,725 for up to 15 HOD members to spend two days at AVMA headquarters next year, meeting with staff and learning about Association operations and the policy-making process.

The AVMA has been hosting these in-depth orientations for delegates annually since 2010. The HAC recommendation noted that the events are well-received and are consistent with the AVMA's strategic goal of leadership development by allowing emerging leaders to become better-acquainted with AVMA activities while preparing them for leadership positions within the organization.

Ad hoc antimicrobial committee extended to 2013

Set to expire this year, the AVMA Steering Committee for FDA Policy on Veterinary Oversight of Antimicrobials has been extended through 2013.

The committee was formed in 2010 by the AVMA House of Delegates to work with the Food and Drug Administration as the agency sought to clarify veterinarians' role in overseeing the use of antimicrobials in animals.

After two productive meetings with FDA officials in 2011 and 2012 in Washington, D.C., the committee was set to sunset in 2012, unless the AVMA Executive Board saw a need for its continuation.

In its recommendation to the board, the committee wrote: “While progress has been made, the FDA has yet to take definitive action on the role of the veterinarian and veterinary oversight in antimicrobial use. The AVMA would be best served by having the VOSC remain in place and available for consultation as final regulatory documents are released and discussions with FDA continue.”

The board voted in favor of the committee's request, which allocated $17,280 for two 2-day meetings in Washington.

Meeting of AVMA voting members Aug. 3

The annual meeting of AVMA voting members will occur the evening of Aug. 3 in San Diego.

The 90-minute meeting starts at 6 p.m. at the San Diego Convention Center, 111 W. Harbor Drive, as part of the AVMA Annual Convention. In April, the AVMA Executive Board approved scheduling the meeting in conjunction with the convention's opening session, which will include a presentation by wildlife conservation and preservation advocate Joan Embery.

Snapshots

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Dr. M. Gatz Riddell (standing), executive vice president of the American Association of Bovine Practitioners, and Dr. Tom Burkgren (left), executive director of the American Association of Swine Veterinarians, told the AVMA Executive Board that their organizations disagreed with the AVMA's support for legislation that would create federal hen-housing requirements. Dr. Riddell indicated that decisions on some animal care and husbandry practices, such as hen housing and cattle tail docking, will be decided on the basis of public perception, but he thinks such standards shouldn't be set in federal law. Dr. Burkgren indicated the legislation, if passed, would set a precedent for federal standards on animal housing, and he expects some advocacy groups will next target sow gestation housing.

Citation: Journal of the American Veterinary Medical Association 240, 12; 10.2460/javma.240.12.1384

Changes for Animal Welfare Symposium

The timing and topic of the AVMA Animal Welfare Symposium initially planned for 2012 have changed.

The AVMA Executive Board approved a recommendation from the Panel on Euthanasia to postpone the symposium to 2013 and dedicate the meeting to a discussion on current and future approaches to animal euthanasia, depopulation, and humane slaughter.

The planned topic of the AVMA Animal Welfare Symposium had been the international harmonization of euthanasia approaches. But since the board approved the plan for the symposium in 2011, the Panel on Euthanasia has completed the latest version of the AVMA Guidelines on Euthanasia and has started developing separate guidance documents on depopulation and humane slaughter.

In its recommendation to the board, the panel explained how, during the development of the three documents, “it has become abundantly clear how much more information is available than a decade ago, but also that there are significant knowledge and performance gaps.”

The panel saw an opportunity to re-focus the event so that it would encompass the euthanasia guidelines as well as the depopulation and humane slaughter documents. With this new focus, the symposium would fulfill the needs of multiple audiences for in-depth information and still provide an opportunity to address the need for international harmonization of approved euthanasia practices.

AVMA board members approved the panel's plan for the Association's three-day symposium, which may be held in September 2013 in Chicago.

AVMA to strengthen ties with Chinese VMA

The Executive Board has approved a staff exchange between the AVMA and Chinese VMA to foster a closer relationship between the two veterinary organizations.

The plan recommended by the AVMA Committee on International Veterinary Affairs calls for hosting two ChVMA staff members or officers at Association headquarters for two weeks in late 2012. During that period, the Chinese delegation would meet with AVMA personnel to learn about Association operations and governance and possibly attend an Executive Board meeting.

Should the exchange prove fruitful, the committee may propose that two AVMA staff members or officers visit the ChVMA headquarters in 2013.

The CIVA stated in its recommendation that China is important to the world economy, and the committee believes a strong relationship with the ChVMA will assist the AVMA in advancing the quality of animal care throughout Asia and internationally.

At the ChVMA's invitation, AVMA CEO Ron DeHaven was a guest speaker and provided a plenary welcome at its inaugural meeting in 2009. Since then, the relationship between the AVMA and ChVMA has strengthened. In 2010, then AVMA President Larry M. Kornegay participated in the second ChVMA meeting. The following year, a ChVMA delegation visited AVMA headquarters to discuss association management practices and potential areas for collaboration between the two organizations.

During this meeting, a proposal was broached to conduct staff or officer exchanges between the two organizations so each could gain a better understanding of potential opportunities and challenges. Representatives from the ChVMA were particularly interested in learning more about AVMA operations, in part, to develop ideas on growing their fledgling professional organization.

The CIVA proposal approved by the Executive Board sets aside $5,000 to cover the Chinese delegation's lodging and food expenses.

Veterinary outreach to Future Farmers renewed

The AVMA has renewed its outreach program with the National FFA Organization, or Future Farmers of America, that encourages students from rural communities to consider careers in veterinary medicine.

Since 2008, the AVMA has supported the National FFA through annually sponsoring the Veterinary Medicine Proficiency Award, exhibiting at the association's national convention, and educating students and teachers about career opportunities in veterinary medicine.

Funding for the AVMA's outreach to the National FFA was set to expire in 2012. And, given that the program has introduced thousands of FFA members to veterinary medicine, the AVMA Executive Board approved a recommendation from the Office of the Executive Vice President to allocate $55,000 in 2013 and again in 2014 to maintain the program.

AVMA provides guides on internship, residency quality

By Greg Cima

The AVMA is providing a pair of guides intended to assist with development of veterinary internship programs and ensure that interns and their supervisors know what to expect.

The AVMA Executive Board approved in April policies on internships and internship disclosure. The board also approved edits to the AVMA policy “Internships and Residency Programs,” which now indicates that internships should provide mentorship, direct supervision, and didactic experiences, including rounds, seminars, and formal presentations. The latter policy also was edited to more strongly state that internships are primarily educational programs for interns rather than service benefits for hospitals.

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Dr. Larry M. Kornegay, AVMA immediate past president

Citation: Journal of the American Veterinary Medical Association 240, 12; 10.2460/javma.240.12.1384

The AVMA policy “Veterinary Internships Guidelines” states that internships should help veterinarians prepare for practice or specialty training. The document is intended to establish reasonable expectations for internship providers and participants. It lists employment information that should be provided to interns and the types of orientation information, employment goals, teaching rounds, care responsibilities, emergency scheduling duties, technician and specialist support, faculty access, facilities, equipment, and outcomes that should be connected with an internship.

The policy “Veterinary Internships Disclosure Outline” lists the practice information that potential interns should receive. Such information should describe aspects of the position such as the levels of training and certifications among veterinarians and nonveterinarians on staff, the staffing and caseload for intensive care and hospital areas, the numbers of interns who started and completed the same program, responsibilities of interns, and support available for interns.

Bridget Heilsberg, Student AVMA president, said SAVMA encourages the AVMA and the Association of American Veterinary Medical Colleges to work together to establish quality control and protection measures for graduates who participate in internships and residencies. Fourth-year students have expressed concern over the lack of consistency among such programs, mostly among internships. Students often have trouble distinguishing whether they will receive structured learning and mentorship or will be used as “cheap labor.”

“SAVMA really encourages and stands behind the AVMA taking a stance and making sure that internships are structured to the benefit of the individual, not the benefit of the hospital,” she said.

Dr. Larry M. Kornegay, AVMA immediate past president, said he also had concerns about inconsistent quality among internship programs and rapid increases in the numbers of students who were participating in such programs. He thinks the guidelines proposed by the AVMA Council on Education and approved by the board “will go a long way toward defining and clarifying what internships and residencies are and will assist not only the candidates who are pursuing these programs, but it will also help the program administrators in providing more consistent and useful internships and residencies.”

Dr. Kornegay noted that surveys of graduating students from U.S. veterinary colleges have shown that increasing percentages of those students are participating in internships. The AVMA's 2011 survey found that, of about 1,540 graduates who had accepted employment offers, 700 had accepted internships, according to JAVMA. The 2009 survey indicated that, of 1,525 graduates who had accepted a position, 600 had accepted internships.

AVMA expands diversity policy

The AVMA Executive Board has expanded the policy describing the Association's commitment to diversity.

The board adopted the first AVMA policy on diversity in November 2004. The Member Services Committee recommended revising the original diversity policy to add the concept of inclusion, to acknowledge that veterinarians live and work within communities that are constantly changing, and to recognize and embrace the value of the many aspects of diversity.

The board approved the revisions, and the new policy reads as follows.

AVMA POLICY

Diversity

The AVMA is committed to diversity and inclusion in all aspects of the profession of veterinary medicine so that we can best serve the animals, the public and our members. Our goal is to mirror the growing diversity of the communities we serve and to promote an understanding of their varied needs. To this end, we are committed to actively promoting and maintaining diversity in our membership and organization, and educating our members regarding the value of diversity. This commitment embraces the value of the many areas of the veterinary medical profession, and the value of our members' varied cultural backgrounds, ethnicities, genders, sexual orientations, ages, religions, physical and mental abilities, and racial representations.

Military experience invaluable to SAVMA president

By Malinda Larkin

The way Bridget Heilsberg tells it, she did not choose the position of Student AVMA president, it chose her.

Heilsberg, pictured here with Dr. Jan K. Strother, AVMA vice president, at the April AVMA Executive Board meeting, felt compelled to join the ranks of the SAVMA House of Delegates after a presentation by her college's delegates during orientation week. The third-year veterinary student at Colorado State University later ran for the position and won. She eventually became the Association of American Veterinary Medical Colleges' liaison with SAVMA. Heilsberg also chaired the SAVMA subcommittee that created guidelines for duty hours during clinical rotations for fourth-year students. Both positions meant a lot of time in front of the microphone, which translated into suggestions from peers that she run for president and, later, a victory.

Heilsberg credits her service as a patrol leader in the United States Navy Reserve with honing her leadership skills. She deployed for two tours to Kuwait and Iraq from November 2006 to July 2007 in support of operations Enduring Freedom and Iraqi Freedom. The 31-year-old was medically discharged from the service in 2009. A horse she had been training flipped over and landed on her knee, breaking it in three places. Heilsberg describes the recovery process as long and slow, but she hasn't ruled out re-entering the military. Currently, she is focusing her energy on college and representing SAVMA.

SAVMA recently has concentrated its efforts on the economic situation of veterinary students, and she looks for the association to continue to deal with this issue at its next meeting during the AVMA Annual Convention in early August in San Diego. Heilsberg also anticipates SAVMA working more closely with the AAVMC in helping implement objectives from the North American Veterinary Medical Education Consortium.

Once she finishes her term and veterinary college, Heilsberg hopes to eventually work at an equine referral hospital with a focus on sports medicine.

Board makes appointments

The AVMA Executive Board recently named the following individuals to the entities indicated, representing the designated areas. The duration of each term varies.

Animal Welfare Committee

Humane or animal welfare organization—Dr. Barry Kellogg, North Port, Fla.; American Association of Bovine Practitioners—Dr. Johann Coetzee, Cambridge, Iowa; state veterinary medical associations—Dr. Lori Teller, Houston; state veterinary medical associations, alternate—Deborah Johnson, Waterville, Ohio; aquatic animal medicine—Dr. Stephen Smith, Blacksburg, Va.; American Animal Hospital Association—Dr. Rodney Jouppi, Lively, Ontario; American Society for Veterinary Medical Association Executives—Jack Advent, Columbus, Ohio; American Association of Equine Practitioners—Dr. Harry Werner, North Granby, Conn.; Association of Shelter Veterinarians—Dr. Martha Smith-Blackmore, East Weymouth, Mass.

Aquatic Veterinary Medicine Committee

Corporate or laboratory aquatic veterinary medicine—Dr. James Brackett, Qualicum Beach, British Columbia; aquatic invertebrate health—Dr. Roxanna Smolowitz, East Falmouth, Mass.

AVMA Group Health and Life Insurance Trust

At large—Dr. Robert Hatch, Litchfield Park, Ariz.

AVMA Political Action Committee Policy Board

Area 1, Eastern states—Dr. Gary Bullard, Austell, Ga.

AVMA PLIT

At large—Drs. Jim Benefield, Montgomery, Ala., and John Ehrhardt, McNabb, Ill.

Clinical Practitioners Advisory Committee

American Association of Avian Pathologists—Dr. Danny Magee, Brandon, Miss.; American Association of Avian Pathologists, alternate—Dr. Hector Cervantes, Watkinsville, Ga.; American Association of Swine Veterinarians, alternate—Dr. James Kober, Holland, Mich.

Committee on Disaster and Emergency Issues

State veterinarian—Dr. Linda Hickam, Thompson, Mo.

Council on Education Candidate Qualification Review Committee

Council on Education—Dr. John Scamahorn, Greencastle, Ind.

Committee on Environmental Issues

Small animal medicine—Dr. Charlotte Edinboro, San Carlos, Calif.; zoo and wildlife medicine—Dr. James Sikarskie, East Lansing, Mich.; government service—Dr. Katie Portacci, Fort Collins, Colo.; swine practice—Dr. Peggy Anne Hawkins, Northfield, Minn.; small ruminant practice—Dr. Grant Seaman, Canisteo, N.Y.

Committee on International Veterinary Affairs

Council on Education—Dr. John Pascoe, Winters, Calif.; AVMA liaison to Pan-American Association of Veterinary Sciences Directive Council—Dr. Theresa Bernardo, East Lansing, Mich.; AVMA liaison to the World Small Animal Veterinary Association—Dr. Laurel Kaddatz, Pound Ridge, N.Y.

Committee on Veterinary Technician Education and Activities

At large—Dr. Kimberly Kratt, Onalaska, Wis.; veterinary technicians—Deborah Gadomski, Bailey, Colo.; laboratory animal medicine—Dr. Margaret Piel, Chicago

Food Safety Advisory Committee

Aquatic food animal medicine veterinarian—Dr. Hugh Mitchell, Kirkland, Wash.; American Association of Small Ruminant Practitioners—Dr. Joan Bowen, Wellington, Colo.; American Association of Bovine Practitioners—Dr. Jared Taylor, Morrison, Okla.; American Association of Swine Veterinarians—Dr. Jennifer Koeman, Des Moines, Iowa; American Association of Avian Pathologists—Dr. Suzanne Young Dougherty, Madison, Ala.

Governance Performance Review Committee

AVMA councils—Dr. Paul Cook, Atwater, Calif.

Legislative Advisory Committee

American Association of Avian Pathologists—Dr. Gregg Cutler, Moorpark, Calif.; American Association of Equine Practitioners—Dr. Miles Hildebrand, St. Clair, Mich.; American Association of Equine Practitioners, alternate—Dr. James Zeliff, Export, Pa.; American Society of Laboratory Animal Practitioners—Dr. Rowland Kinkler, East Lyme, Conn.; American Society of Laboratory Animal Practitioners, alternate—Dr. Elizabeth Nunamaker, Chicago; American Association of Swine Veterinarians—Dr. Max Rodibaugh, Frankfort, Ind.; American Association of Swine Veterinarians, alternate—Dr. Jason Kelly, Algona, Iowa

Member Services Committee

Honor roll members—Dr. Lawrence Borst, Indianapolis; private clinical practice, practice owner—Dr. Earl Strimple, Blue Ridge Summit, Pa.

Liaison representatives

American Fisheries Society Fish Health Section—Dr. Myron Kebus, Madison, Wis.; American Feed Industry Association Feed Regulatory Committee—Dr. John Waddell, Sutton, Neb.; Codex Alimentarius Commission Ad Hoc Intergovernmental Task Force on Animal Feeding—Dr. Christine Navarre, Baton Rouge, La.; National Foundation for Infectious Diseases Annual Conference on Vaccine Research—Dr. Mark Wood, Bogart, Ga.; National Conference on Interstate Milk Shipments—Dr. Patrick Gorden, Ames, Iowa; National Coalition for Food and Agriculture Research—Dr. G. David McCarroll, Goldsby, Okla.; Association of Laboratory Animal Science—Dr. Kevin Lewis, Deerfield, Ill.; Pan-American Association of Veterinary Sciences Directive Council—Dr. Theresa Bernardo, East Lansing, Mich.; World Small Animal Veterinary Association—Dr. Laurel Kaddatz, Pound Ridge, N.Y.

Dr. Larry Dee, District IV representative

Board gives guides on workplace, competition, courts

Policy changes enacted in April provide new or adjusted advice from the AVMA on work environments, competition, court-ordered compensation, and consent forms.

The Executive Board revised the policy “Harassment and Discrimination-Free Veterinary Workplace” to provide guidance, rather than an updated model policy, on what employers should include in their workplace policies. Information provided with the Council on Veterinary Service's recommendation to make the change indicates the updates are intended to help practices develop policies appropriate for their businesses and compliant with local laws.

The new policy “Delivery of Veterinary Services by Not for Profit/Tax-Exempt Organizations” expresses support for organizations that help indigent and underserved populations receive animal care. It also states that such organizations should comply with regulations on fee-for-service veterinary care and state laws on missions, funding, ownership, licensure, and quality. When applicable, eligibility for such services should be determined through means testing, the policy states.

The policy supersedes two previous policies, “Competition from Tax-Exempt Organizations” and “Unfair Competition by Nonprofit Organizations.” The first of those indicated the AVMA supported efforts to prevent tax-exempt humane organizations and tax-supported governmental animal control agencies from infringing on veterinarians in private practice, and the latter policy supported legislation and regulations that would prohibit unfair competition from nonprofits.

Dr. Carlos E. Bonnot, chair of the Council on Veterinary Service, which recommended the change, said the new policy is intended to show that the AVMA wants to ensure animals receive care and considers the needs of veterinarians who work in private practice and with shelters and animal welfare groups.

He said that, while the AVMA understands some veterinarians are concerned about competition from tax-exempt organizations, the council members were concerned that a more strongly worded policy would give the appearance the Association was trying to stifle trade or wasn't most concerned about animal welfare.

Information given to the board with the council's recommendation states that a charitable organization can avoid taxation on income from activities connected with its tax-exempt purpose. Some organizations can receive tax-exempt status for prevention of cruelty to animals, for example, partly to give veterinary care to owners unable to afford fees from private practices.

The policy “Compensatory Value for Animals” became the policy “Recovery of Monetary Damages in Litigation Involving Animals.” It now states that courts should consider an animal's economic utility and notes that economic damages beyond those needed to compensate for economic loss could reduce the availability of affordable veterinary care. It also was edited to recognize that punitive damages can be awarded when appropriate, in accordance with state laws.

The AVMA policy “Owner Consent in Veterinary Medicine” also was edited to state that practices may need procedure-specific consent forms.

Appointments, from 1402

Association Feed Regulatory Committee—Dr. John Waddell, Sutton, Neb.; Codex Alimentarius Commission Ad Hoc Intergovernmental Task Force on Animal Feeding—Dr. Christine Navarre, Baton Rouge, La.; National Foundation for Infectious Diseases Annual Conference on Vaccine Research—Dr. Mark Wood, Bogart, Ga.; National Conference on Interstate Milk Shipments—Dr. Patrick Gorden, Ames, Iowa; National Coalition for Food and Agriculture Research—Dr. G. David McCarroll, Goldsby, Okla.; Association of Laboratory Animal Science—Dr. Kevin Lewis, Deerfield, Ill.; Pan-American Association of Veterinary Sciences Directive Council—Dr. Theresa Bernardo, East Lansing, Mich.; World Small Animal Veterinary Association—Dr. Laurel Kaddatz, Pound Ridge, N.Y.

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Dr. Larry Dee, District IV representative

Citation: Journal of the American Veterinary Medical Association 240, 12; 10.2460/javma.240.12.1384

Salmonella contamination in dog food linked to outbreak in humans

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Cases of human infection with the outbreak strain as of May 2 (Source: Centers for Disease Control and Prevention)

Citation: Journal of the American Veterinary Medical Association 240, 12; 10.2460/javma.240.12.1384

Governmental officials have linked an outbreak of Salmonella Infantis infection in humans with dry dog food from a Diamond Pet Foods manufacturing facility in South Carolina.

The Centers for Disease Control and Prevention, Food and Drug Administration, and state officials are investigating the ongoing outbreak. As of early May, the investigation had identified 14 people in nine states infected with the outbreak strain. Among nine individuals for whom information was available, five had been hospitalized but none had died.

On April 2, Michigan officials detected Salmonella organisms in Diamond Naturals Lamb Meal & Rice Formula dry dog food during retail surveillance. Public health investigators matched the Salmonella strain from the dog food with the outbreak strain.

In interviews, seven of 10 infected individuals reported contact with a dog in the week before becoming ill. Five recalled a type of dog food with which they had contact, and four identified Diamond dry dog food that may have been manufactured at a single facility in South Carolina.

As part of the investigation, Ohio officials tested Diamond dog food. They isolated the outbreak strain from an opened bag of Diamond Chicken Soup for the Pet Lover's Soul Adult Light Formula dry dog food from the home of an infected individual and from an unopened bag of the product from a retailer.

A sample of Diamond Puppy Formula dry dog food collected by the FDA during an inspection at the South Carolina manufacturing facility also yielded Salmonella Infantis.

Diamond has issued recalls of certain dry pet food that it manufactured at the South Carolina manufacturing facility, including the three aforementioned products. Other pet food companies also have recalled certain products manufactured by Diamond at the facility.

Details about recent recalls of pet food and other animal feed are available at www.fda.gov/Safety/Recalls by clicking on the “Animal Health” tab.

What keeps you up at night?

The Veterinary Hospital Managers Association recently conducted a survey about what keeps veterinary professionals awake at night.

The VHMA administered the survey to 1,190 attendees at the recent North American Veterinary Conference, Ontario Veterinary Medical Association Conference, and Western Veterinary Conference. Respondents identified their position by job title and selected, from a list of 22, the three issues that are the most perplexing or stressful or that interfere with their ability to perform their jobs.

Among practice owners, 47 percent selected profit margin as one of their top three concerns. Practice owners' other top concerns included cash flow, for 28 percent, and client retention, for 27 percent.

Thirty percent of associate veterinarians identified client retention as a top concern. Other concerns were staff relations, 27 percent; staff training, 24 percent; and wages and benefits, 20 percent.

Practice and office managers identified their top concerns as staff training, 42 percent; profit margin, 24 percent; cash flow, 13 percent; and staff relations, 12 percent. Hospital administrators selected staff relations, 36 percent; profit margin, 24 percent; and staff training, 15 percent.

“When we introduced the survey, the association's goal was to provide a good base line analysis of where the profession currently is and what changes are needed,” said Christine Q. Shupe, VHMA executive director. “The results indicate that for any practice to function effectively, the needs and issues of a diverse group of stakeholders—those holding various positions within the practice—must be addressed.”

Feline health research grants awarded

The Winn Feline Foundation in late March announced grants totaling $174,018 had been awarded to 10 feline health studies.

Forty-four proposals were submitted by researchers seeking funding in the 2012 review cycle. To date, Winn's cumulative total in feline health research funding exceeds $4 million.

One project received a grant through the Ricky Fund Project to study the efficacy of a mixed endothelin A-endothelin B receptor antagonist in cats with arterial thromboembolism. Another study was awarded a grant through the Bria Fund Project to research anti-immune evasive therapy in the treatment of feline infectious peritonitis.

Two breed-specific studies are being funded in the current 2012 cycle. The first project intends to map the hypertrophic cardiomyopathy gene in the Sphynx cat, while the other study is a molecular characterization of progressive retinal atrophy in Bengal cats.

Other projects the Winn Foundation awarded funding to include studies relating to feline tumors, wool sucking behavior in Siamese and Birman cats, chronic kidney disease, and decontamination of household textiles exposed to Microsporum canis spores.

Dr. Vicki Thayer, Winn president, said, “The Foundation looks forward to seeing the results of these projects and to sharing them with the veterinary community as well as with cat owners and pedigreed cat breeders.”

A listing of the projects available for sponsorship appears at the end of the descriptions. Donations can be made online at www.winnfelinehealth.org.

American Association of Zoo Veterinarians

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Dr. Kirk Suedmeyer

Citation: Journal of the American Veterinary Medical Association 240, 12; 10.2460/javma.240.12.1384

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Dr. Paul Calle

Citation: Journal of the American Veterinary Medical Association 240, 12; 10.2460/javma.240.12.1384

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Dr. Elliott Jacobson

Citation: Journal of the American Veterinary Medical Association 240, 12; 10.2460/javma.240.12.1384

Event: Annual conference, Oct. 24–28, 2011, Kansas City, Mo.

Program: The conference drew 405 attendees representing 22 countries.

Awards: Emil P. Dolensek Award: Dr. Elliott Jacobson, Gainesville, Fla., for exceptional contributions to the conservation, care, and understanding of zoo and free-ranging wildlife. A 1975 graduate of the University of Missouri-Columbia College of Veterinary Medicine, Dr. Jacobson started his career as an assistant professor at the University of Maryland Department of Veterinary Science and served as Maryland's state wildlife veterinarian. He joined the University of Florida College of Veterinary Medicine as an assistant professor in 1979 and became a professor in 1990. He earned certification from the American College of Zoological Medicine in 1985. AAZV/Morris Animal Foundation Postgraduate Student Manuscript Competition: First place—Dr. Olivia Petritz, University of California-Davis, for “Effects of deslorelin acetate on egg production and plasma sex hormones in Japanese quail (Cotrnix coturnix japonica)”; and second place—Dr. Christoph Mans, University of Wisconsin-Madison, for “Efficacy of intrathecal lidocaine, bupivicaine, and morphine for spinal anesthesia and analgesia in red-eared slider turtles (Trachemys scripta elegans).” AAZV/Wildlife Pharmaceuticals Inc. Undergraduate Student Manuscript Competition: First place—Dr. Claire Simeone, Virginia-Maryland Regional College of Veterinary Medicine, for “Visceral gout and death of a California condor (Gymnogyps californianus) under dual chelation treatment for lead toxicity”; and second place—Dr. Jennifer Gilbert, Tufts University, for “Significant morbidity and mortality findings in gibbons (Hylobates and Nomascus spp) housed at the Smithsonian National Zoological Park.” Safe Capture International Inc. Poster Competition: First place—Dr. Carolyn Cray, for “Application of acute phase protein assays in wildlife medicine”; and second place—Dr. Meredith Clancy, for “Hydrocoelom and lymphedema in dendrobatid frogs at the National Aquarium, Baltimore.”

Business: The AAZV established the Zoological Medicine and Wildlife Health Research Grant to provide grants of $5,000 to $10,000 to zoological medicine professionals to improve the care and conservation of captive and free-ranging wildlife. The association has begun offering a limited membership, with access to online resources, to veterinarians from developing nations for nominal annual dues of $15.

Officials: Drs. Kirk Suedmeyer, Kansas City, Mo., president; Paul Calle, New York City, president-elect; Doug Armstrong, Omaha, Neb., vice president; Meg Sutherland-Smith, San Diego, secretary; Chris Hanley, Toledo, Ohio, treasurer; Kay Backues, Tulsa, Okla., immediate past president; and Robert Hilsenroth, Yulee, Fla., executive director

Community: Obituaries AVMA member AVMA honor roll member Nonmember

George H. Atkins

Dr. Atkins (ISU ′66), 69, Springfield, Ill., died Jan. 20, 2012. A small animal veterinarian, he practiced at Animal Medical Clinic in Springfield for almost 30 years. Dr. Atkins also helped establish the Animal Emergency Clinic in Springfield. He was a life member of the Illinois State VMA. Dr. Atkins' wife, Muriel; two sons; and two daughters survive him. Memorials may be made to American Cancer Society, 675 E. Linton, Springfield, IL 62702; or American Heart Association, 3816 Paysphere Circle, Chicago, IL 60674.

William D. Bush

Dr. Bush (AUB ′54), 81, Albany, Ga., died April 3, 2012. He owned Bush Animal Clinic, located first in Blakely, Ga., and later in Albany, for 46 years. Dr. Bush was initially a mixed animal veterinarian, focusing on small animals for the last 19 years of practice. He was a past president of the Georgia Board of Veterinary Medicine and University of Georgia Veterinary Advisory Board, and a member of the Georgia VMA. In 2003, Dr. Bush was named GVMA Veterinarian of the Year. His wife, Linda; two sons; and a daughter survive him. Memorials may be made to The Anchorage (a nonprofit organization dedicated to the rehabilitation of men with substance abuse issues), 162 Hampton Lane, Leesburg, GA 31763; or The Albany Humane Society, P.O. Box 3151, Albany, GA 31706.

Joseph R. De Leo

Dr. De Leo (COR ′69), 68, Cranbury, N.J., died March 13, 2012. He practiced equine medicine in New Jersey, including the Meadowlands Racetrack. Dr. De Leo is survived by his wife, Christine; two sons; and a daughter. Memorials may be made to the Standardbred Retirement Foundation, 108 F Old York Road, Hamilton, NJ 08620; or American Cancer Society, P.O. Box 22718, Oklahoma City, OK 73123.

Andrew M. Draper

Dr. Draper (COR ′38), 99, Ocala, Fla., died March 2, 2012. Prior to retirement in 1972, he practiced small animal medicine in Fairfield, Conn. Dr. Draper was known for his expertise in veterinary dermatology. He is survived by two daughters; a stepson; and a stepdaughter. Memorials may be made to Hospice of Marion County, P.O. Box 4860, Ocala, FL 34478.

Newton P. Eunice

Dr. Eunice (GA ′80), 63, Pelham, Ga., died April 13, 2012. A small animal practitioner, he owned Mitchell County Animal Clinic in Camilla, Ga. Dr. Eunice was a member of the Pelham Rotary Club and a veteran of the Air Force. His wife, Margaret, and a son survive him. Memorials may be made to Hand Memorial United Methodist Church, P.O. Box 424, Pelham, GA 31779.

Robert C. Graham

Dr. Graham (IL ′57), 79, Arthur, Ill., died March 21, 2012. He owned a practice in Arthur for 51 years prior to retirement in 2008, beginning with mixed animal medicine and then focusing on small animal medicine in later years. Dr. Graham's father, Dr. Thomas L. Graham, and his brother, Dr. Thomas L. Graham Jr., were also veterinarians. He was a member of the Illinois State VMA and a 20-year member of the Moultrie Douglas Fair Board. Dr. Graham was also a past president of the Arthur Business Club. He is survived by his wife, Verneal; a son; and two daughters. Memorials may be made to Arthur United Methodist Church, 128 E. Illinois St., Arthur, IL 61911.

James L. Hourrigan

Dr. Hourrigan (KSU ′40), 94, Vienna, Va., died March 27, 2012. He worked for the Department of Agriculture for 39 years, stationed in Mexico; Texas; Washington, D.C.; and Maryland. During that time, Dr. Hourrigan developed and executed programs for the control and eradication of infectious livestock diseases, managed operations to eradicate foot-and-mouth disease in cattle, and conducted feasibility studies. He also conducted research on the causes and eradication of scrapie and bovine spongiform encephalopathy. Dr. Hourrigan was an Army Veterinary Corps veteran of World War II. After the war, he served in the Reserve, retiring as a colonel in 1973. Dr. Hourrigan is survived by two stepdaughters.

Robert H. McLain

Dr. McLain (ISU ′64), 76, Richmond, Ill., died April 8, 2012. A small animal veterinarian, he owned a practice in Addison, Ill., for 41 years. Earlier in his career, Dr. McLain worked at Berwyn Animal Hospital in Berwyn, Ill. He was a member of the Illinois State and Chicago VMAs. Dr. McLain's wife, Linnea, and two daughters survive him. Memorials may be made to Leader Dogs for the Blind, 1039 S. Rochester Road, Rochester Hills, MI 48307; or American Heart Association, 3816 Paysphere Circle, Chicago, IL 60674.

Fayne H. Oberst

Dr. Oberst (KSU ′43), 92, Barefoot Bay, Fla., died April 5, 2012. A member of the organizing committee, charter diplomate, and second president of the American College of Theriogenologists, he was professor emeritus at the Oklahoma State University College of Veterinary Medicine since 1984. Following graduation, Dr. Oberst practiced briefly in Grinnell, Iowa. He then joined the Kansas State University College of Veterinary Medicine, where he eventually became a professor in the Department of Surgery and Medicine.

From 1962–1964, Dr. Oberst was director of development for Vet-A-Mix Inc. in Shenandoah, Iowa. He next served as director of veterinary medicine extension and was professor of medicine and surgery at the University of Missouri-Columbia, until being appointed director of veterinary clinics and professor and head of the Department of Large Animal Medicine and Surgery at Michigan State University in 1965. From 1974–1984, Dr. Oberst was a professor and head of the Department of Medicine and Surgery in the veterinary college and director of the Boren Veterinary Teaching Hospital at Oklahoma State University.

He was a past president of the American Association of Veterinary Clinicians and Kansas VMA, and he served on the AVMA Council on Veterinary Service from 1965–1975, chairing the council from 1970. Dr. Oberst also served on an AVMA Executive Board advisory committee on animal technicians and was a member of the American Association of Bovine Practitioners and Michigan VMA. He received several honors, including the Pfizer-Norden Distinguished Teacher Award in 1968, the Michigan VMA Service Award in 1974, the Oklahoma State University Clinician of the Year Award in 1988, and the KSU-CVM Distinguished Alumnus Award in 1998.

Dr. Oberst is survived by a daughter and two sons. One son, Dr. Richard D. Oberst (OKL ′83), is a professor of diagnostic medicine and director of the Molecular Diagnostic Lab in the Kansas State Veterinary Diagnostic Laboratory.

Hallsey R. Palmer

Dr. Palmer (COR ′43), 90, New Hartford, N.Y., died March 2, 2012. He practiced in the Canton area of Pennsylvania from 1947–1983. During that time, he co-founded Troy Veterinary Clinic in Troy, Pa. Dr. Palmer was a member of the Pennsylvania VMA and Northern Tier VMA. He served as a captain in the Army during World War II and was a member of the American Legion. Dr. Palmer's two daughters and a son survive him. Memorials may be made to the Presbyterian Home of Central New York, Stars of the Night Sky Program, 4290 Middle Settlement Road, New Hartford, NY 13413.

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