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CV M A VO ICE

Today’s Voice, Tomorrow’s Vision

• CVMA: Your Partner for Success • Return For Care Program Goes Big! • Care Grants Help Rural and Frontier Counties

2017, ISSUE #3


CV M A VO ICE

TABLE OF CONTENTS Inside President’s Post . . . . . . . . . . . Briefings . . . . . . . . . . . . . . . . . Of Note . . . . . . . . . . . . . . . . . .

6 CVMA: Your Partner for Success

19 Care Grants Help Rural and Frontier Practices

4 5 6

CVMA: Your Partner for Success . . . . . . . . . . . . . . . . . . 6 CVMA | Education and Professional Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Have you used your Core or Premium FREE registration for CVMA BIG Ideas Forum yet? . . . . . . 8 CVMA | Advocating for the Profession . . . . . . . . . . . . 9 CVMA Veterinary Career Center Helps You Find the Right Candidates . . . . . . . . . . . . . . . . . . . . . . . 10 CVMA + Veterinary Growth Partners = Practice Success . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Return For Care Program Goes Big! . . . . . . . . . . . . . . 12 AVMA House of Delegates Summary . . . . . . . . . . . . . 15 AVMA Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Of Bison and Belonging . . . . . . . . . . . . . . . . . . . . . . . . . 17 Care Grants Help Rural and Frontier Practices . . . . . 19 Under One Roof: CSU Builds rDVM Relationships . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 Updates from the CSU College of Veterinary Medicine and Biomedical Sciences . . . . . . . . . . . . . . 22

Government Affairs . . . . . . . .  24

20 Under One Roof: CSU Builds rDVM Relationships

30 Millennials in your Veterinary Practice

CVMA Events and Deadlines October 14-15 CVMA CE Southwest Durango

October 18 PDS: What’s New in Veterinary Oncology Denver

October 19 Own the Phone: How to Lead Conversations Webinar

October 20-21 CVMA BIG Ideas Forum | Fall 2017 Beaver Creek

November 8 PDS: Common Skin and Ear Problems Denver

November 16 Best Practices for Financial Conversations Webinar

December 7 CVMA CE Equine: Sports Medicine and Rehabilitation Franktown

New Animal Incident Management Specialist at the Colorado Department of Agriculture . . . . . . 24 Rural Relief: Governor Signs Veterinary Debt Assistance Bill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25

December 21

Science Update . . . . . . . . . . .  26

CVMA CE Agricultural Animal: Bovine Greeley

Trends in Canine Liver Copper for the Last 20 Years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Hepatic Copper Concentrations and Histological Changes in the Dog . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

January 28–31

5 Phone Mistakes Receptionists Make Webinar

January 20

CVMA SkiCE Vail

In Practice . . . . . . . . . . . . . . . . 28 Growing Leaders in Your Practice . . . . . . . . . . . . . . . Millennials in your Veterinary Practice . . . . . . . . . . . . How to Encourage Considerate, Constructive Cell Phone Use in the Practice . . . . . . . . . . . . . . . . . . . Combat or Succumb to High Turnover? . . . . . . . . . . “Are You Glad You Became a Veterinarian?” . . . . . . Real Estate: The Second-highest Expense in Your Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Introducing the FRANK Communication Workshop Series at CSU . . . . . . . . . . . . . . . . . . . . . . . Pet Owner’s Perceptions and Use of Veterinary

28 30 32 33 34 36 37

Mobile Applications . . . . . . . . . . . . . . . . . . . . . . . . . 38

CVMA News . . . . . . . . . . . . . . 41 CVMA Members Approve New Board and Leadership Council Structure . . . . . . . . . . . . . . . . . . . . 41 Meet Your New CVMA Secretary/ Treasurer-elect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44 CVMA CE West Sees Success Once Again in Colorado Wine Country . . . . . . . . . . . . . . . . . . . . . . 46

Our Mission To enhance animal and human health and welfare, and advance the knowledge and wellbeing of Colorado veterinarians.


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Colorado Veterinary Medical Association 191 Yuma Street Denver, Colorado 80223 303.318.0447 or 800.228.5429 Fax 303.318.0450 info@colovma.org www.colovma.org MANAGING EDITOR Cami Cacciatore PUBLISHER Ralph Johnson The CVMA VOICE is published quarterly to members (Core and Premium members will receive a mailed print copy and Basic members will have online access only) and once a year to nonmembers free of charge.   Information and advice presented in this publication do not necessarily represent the views of CVMA.

Deadlines for Submission All articles, contributions, and display ads must be received in the CVMA office by the dates below. For more information or to obtain a rate schedule, contact the CVMA office at 303.318.0447 or info@cvma.org. Issue Issue Issue Issue

#1 — January 15 #2 — April 15 #3 — July 15 #4 — October 15

Follow CVMA on Facebook! We invite you to follow our page and share it on your practice page and website: www.facebook.com/Colorado VeterinaryMedicalAssociation/.

PAG E 4   |   CV M A VOIC E 2017 : 3

PRESIDENT’S POST Sam Romano, DVM President The Pen Colorado House Bill 17-­1282 was signed into law by Governor Hickenlooper on June 5. It created a program to assist veterinarians with education loan repayments in exchange for providing services in rural areas of the state in need of veterinary services. Witnessing the ceremony at the state capitol was an honor, and perhaps the greatest moment of my time as CVMA president. Although I attended a bill signing last year, this one was extra special. The reason why can be summed up in one word: Leadership. I’m grateful for the opportunity to share this story of the power of leadership and advocacy as witnessed from ground level. I finally got to see in action my favorite Harry S. Truman quote: “It’s amazing what you can accomplish if you do not care who gets the credit.” The journey HB17-­1282 took getting to the Governor’s desk was arduous, filled with many twists and turns. It required a large team, a partnership, to successfully guide it to completion. Here’s but a few of the many people who invested time, energy, and pure grit in this project. Dr. Mark Setter, Dean of The College of Veterinary Medicine and Biomedical Sciences at CSU, and his staff, worked tirelessly on this bill. Similar to CVMA, CSU is deeply committed to the wellbeing of students and Colorado veterinarians. They recognize the negative impact high educational debt has on the lives of veterinarians and their communities, particularly in rural Colorado. And rural Colorado is a reminder of the heart and power Dr. Lora Bledsoe (Wittenberg) displayed in the delivery of her testimony to the Colorado legislature. Dr. Bledsoe is a large animal mobile practitioner in southeastern Colorado. As a 2013 CSU graduate, Lora’s testimony emphasizing the importance of passing HB17-1282 to help keep veterinarians in rural communities was instrumental in its passage. Taking time out of her

practice to travel a long distance was no easy task. Lora did it with enthusiasm, and a spirit of servant leadership. The dedication to serving the people of Colorado exhibited by bill sponsors State Representative Dr. Joann Ginal and State Senator Jerry Sonnenberg cannot be overstated. What a shining example of political collaboration. CVMA lobbyist Leo Boyle helped orchestrate things at the state capitol as well. We’re fortunate to have Leo on our team. Of equal accomplishment is the work completed this past year by CVMA’s staff and Executive Committee. First the staff. I don’t have enough space to adequately describe everything they do to keep the lights on and members happy. But something shared by each CVMA staff member is their unwavering positivity, can-­do attitude, and willingness to help others. Whether it’s Cami’s gentle reminder to submit my column, a request to Katie for a document I’ve misplaced twice before, or asking Kristin fifteen times how to use the microphone at presentations (terrifying), I’m always met with patience, respect, and a warm smile. It’s no surprise, since this is how the entire CVMA staff treats all of our members. Management experts say this kind of organizational culture is a reflection of authentic leadership, and finding the best individuals. That’s definitely the case with the CVMA staff. It’s hard not to feel a sense of awe working with members of the CVMA executive leadership, both past and present. Dr. Pete Hellyer’s strategic work a few years ago came to fruition. CVMA’s change to a chapter structure, along with bylaw changes, electronic voting capability, and an updated governance model, were completed in 2017. Our CEO-­ designate, Diane Matt, helped drive the process to a successful completion with her focus and attention to detail. And then there’s the chiropractic bill, also part of the 2017 legislative session. The debate at the state capitol regarding this bill was contentious. And into the fray willingly stepped yet another servant President’s Post continued on page 21


CV M A VO ICE

BRIEFINGS Ralph Johnson CEO Hello, Colorado— This issue of the VOICE reaches every licensed veterinarian in Colorado. If you are already a member of CVMA, you’re accustomed to receiving the magazine and all the information and insight that it delivers to you—and this issue holds true on that promise. If you are not a member, our hope is that by perusing the articles you’ll gain a sense of CVMA’s value. Perhaps you are seeking connections with your peers as a way to sustain your passion for the profession . . . or looking for high-quality biomedical science education offerings without the hassles of traveling to farflung and expensive destinations . . . or banking on a legal and regulatory environment that protects and advances your interests . . . or seeking pathways for personal and professional development . . . and so much more. And I’m hoping you’ll do more than enjoy this magazine—that you’ll become an active participant in CVMA by enrolling as a member. Your support powers the programs that serve you and your professional community. CVMA doesn’t have commercial interests or generate profits for shareholders. Instead, CVMA is driven by its mission to invest your dues in programs and initiatives that serve you. Find your value point and decide to join, today. You’re not just helping yourself, you’re advancing your profession. PS to Hello, Colorado—I’ve always been enthusiastic about the annual opportunity for chapter visits. I mean, what’s not to like about touring this great and beautiful state in May and June, experiencing its majesty and diversity? What’s not to like about spending countless hours in conversation with the president-elect (and this year with the CEO-designate, too) sharing stories of personal journeys and discussing ideas that range from trivial to strategic? What’s not to like about breaking bread (and occasionally sipping

CVMA Board of Directors Dr. Sam Romano President

wine!) with veterinarians in every corner, crook, and valley of Colorado? What I’ve come to appreciate over time is that the chapter visits have deep significance for CVMA. They are integral to the social fabric that fosters connections amongst colleagues and nourishes the spirit of community. They provide unparalleled opportunities to catch up with one another about life, about business, and about the profession. They create a setting where small group discussion can occur, and where nuances of needs, expectations, and aspirations can be understood. And they reinforce that members, elected leaders, and staff all share the same goals for a vibrant, dynamic, relevant, and responsive CVMA. Thank you for extending your warm welcome, great ideas, and enjoyable hospitality. The Trifecta of Change—Not one of the 30+ participants in the CVMA strategy workshop held in October, 2014 placed any bets—but they certainly envisioned a run of three wins! During that workshop, the track was groomed to undertake three interrelated strategic initiatives: • First was to develop the tiered membership structure that enables members to select the bundle of programs and services that affords them the most value. Colorado veterinarians have responded to this offering most positively, with CVMA experiencing an 11% membership growth since the changes were instituted. • Second was to transition from districts to chapters in an effort to relieve district organizations of a variety of compliance responsibilities and, instead, to create a structure that unites the components into a more integrated, robust professional community. This too has met with success, and it was gratifying to hear a common theme emerge during chapter visits around ways that CVMA can support the chapters as they connect members through social, educational, and service opportunities. • Third was to refine the governance structure so that the organization is

Dr. Will French President-elect Dr. Joy Fuhrman Secretary/Treasurer Dr. Stacee Santi Secretary/Treasurer-elect Dr. Curtis Crawford Immediate Past President Dr. Melanie Marsden AVMA Delegate Dr. Rebecca Ruch-Gallie AVMA Alternate Delegate Mr. Ralph Johnson CEO* Ms. Diane Matt CEO-designate*

Chapter Representatives 1 – Dr. Kimberly Radway 2 – Dr. Wayne Jensen 3 – Dr. Hannah Klein 4 – Dr. Adam Tempel 5 – Dr. Colleen Carnes 6 – Dr. Jeff Fankhauser 7 – Dr. Debra Stirling 8 – Dr. Dale Davis 9 – Dr. Kayla Henderson 10 – Dr. Marguerite Flett 12 – Dr. Randal Hays 13 – Dr. Renee Rumrill 14 – Dr. Matt Braunschmidt 15 – Dr. Mark Ryan 16 – Dr. Mark Cowan 17 – Dr. Leon Anderson

Student Chapter Representatives Fourth year – Madeline Anna Third year – Courtney Mael Second year – Amy Zug First year – Laurel Krause * Ex-officio, non-voting

Briefings continued on page 15 CVMA VOI C E 201 7: 3  |   PAG E 5


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CVMA: Your Partner for Success

Colorado veterinarians need to advance their knowl-

Our lives as veterinarians, and our industry, are

create a sustainable and profitable practice and pro-

changing rapidly. Thanks to CVMA educational

fession.

­programs, leadership training, and opportunities to

Advocacy. CVMA has long been the voice of the

connect with other veterinary professionals, I’ve be-

veterinary profession in Colorado when it comes to

come more self-­aware of my role as a veterinarian

advocacy and outreach, working at the state level to

in the community. Both my career and my life jour-

shape legislation and regulation that affects animal

ney have been greatly enriched by getting to know

health and welfare, as well as the practice of veteri-

so many amazing CVMA colleagues, leaders, and

nary medicine. CVMA’s efforts have helped pass—or,

friends. It’s made all the difference in improving my

when necessary, block—legislation and public policy

sense of meaning and well­being as I move through

that has far-­reaching effects and consequences on

my career. —Dr. Sam Romano, CVMA President

the animal welfare community and on how you prac-

edge and careers, to care for their patients, and to

tice. The more members we have, the stronger our The definition of partnership is “one associated

voice—and the greater impact we can have on shap-

with another especially in an action.” That sounds

ing the legislative landscape. This year alone, CVMA

simple enough, but a true partnership is anything but.

helped protect the profession by clarifying veterinary

A partner helps you solve problems, lends a hand,

pharmaceutical compounding, blocking the removal

has your back, offers guidance, understands your

of veterinary medical release requirements for animal

pain points, provides solutions, and helps you suc-

chiropractic, and moving a rural veterinary education

ceed. But why settle for just one when you can have

loan repayment forward. You can learn more about

the collective support of thousands? CVMA members

these efforts on page 9.

are 2,300 strong—a collective force with a dedicated

Education. As a CVMA member, you have access

mission to help you—and the profession—succeed.

to everything your local chapter has to offer, in addi-

Are you a long-­time member? New to practice or

tion to member access and pricing on all of CVMA’s

Colorado? Never been a part of the association? No

offerings, including the annual convention, two BIG

matter which category you fall into, we hope that

Ideas Forums, CE West, CE Southwest, the Profes-

you’ll take a moment to review what CVMA has to

sional Development Series, SkiCE, and countless

offer, not only to you, but to the profession and the

webinars created for our members on topics from

continued practice of veterinary medicine in Colo-

practice growth and performance to personal well-

rado. Your membership truly makes a difference… It

being. Learn more on page 8.

keeps the practice of veterinary medicine strong in

Support. The main purpose of any association is to

Colorado by supporting CVMA’s efforts to positively

support its members. CVMA membership includes

portray the profession and promote the importance

benefits designed to provide you the support you

of preventive pet healthcare as well as the veterinar-

need to grow and succeed, no matter where you

ian’s crucial role in public health protection. Joining

are in your career. Your exclusive benefits include

CVMA means becoming part of a strong, supportive

member-only content and resources on the new

network of colleagues and professionals, and an as-

CVMA website, including a comprehensive resource

sociation that works hard to be the partner you need

library, online communities, and directory; access

to succeed.

to and discounts on CVMA’s Career Center through

Professional Knowledge and Wellbeing. CVMA

the Veterinary Career Network (see page 10); the

provides the tools, education, and support systems

VOICE quarterly magazine; weekly eVOICE enews-

PAG E 6   |   CV M A VOICE 2017 : 3


CV M A VO ICE

letter to keep you current; a CVMA member decal;

sion updates. CVMA members also have the unique

CVMA Performance Tools, including practice ana-

opportunity to participate in the Power of Ten Lead-

lytic reports and discounts for online staff training

ership Academy, which is designed to help recent

and certification through the CVMA Certified Vet-

graduates (within the last seven years) develop

erinary Assistant program; money-­and time-­saving

foundational skills in leadership, communication,

resources through our partnership with Veterinary

and business.

Growth Partners (see page 11); access to discounted ing our new CVMA-­approved credit card processor,

Advocacy . . . Education . . . Support . . . Leadership

TMGvets—check services, medical/dental insurance

These are the four pillars CVMA was built on. As we

plans, retirement planning, and more; and a host

constantly evolve to serve our members and provide

of programs, including the economic and personal

you with the association experience you want and

wellbeing initiative, Service Awards, PetCheck, Me-

need, we invite you to customize your membership

dia Training, and Advocacy Training.

to get the most out of the services, resources, ben-

Leadership. No matter where you are in your

efits, and connectivity that belonging to CVMA and

career, CVMA offers opportunities to grow and

your local chapter has to offer.

demonstrate your leadership skills. Two annual BIG

Whether you are looking for a voice to advocate

Ideas Forums provide the chance to explore emerg-

for the veterinary profession in Colorado, world-­

ing issues or “hot topics” in veterinary medicine, or

class education to meet your CE needs, economic

better understand the evolving landscape you prac-

and personal growth and wellbeing resources, or

tice in. As a member, you will enjoy complimentary

opportunities to develop and enhance your leader-

registration(s) to BIG Ideas Forums, where you not

ship skills, CVMA is here to be your partner and to

only earn CE, but have the chance to connect with

serve your needs, at all stages of your career. Join

your colleagues and participate in a commission

or renew today at colovma.org and customize your

meeting to hear the latest association and profes-

partnership with CVMA!

financial services from trusted partners—includ-

CVMA VOI C E 201 7: 3  |   PAG E 7


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OF NOTE CVMA | Education and Professional Development In Colorado, veterinarians must complete a minimum of 32 hours of continuing education biennially to renew their licenses. Finding the time—and the dollars—to complete this can be a challenge, even if you are a life-­long learner who loves exploring new ideas, gaining new competencies, or just brushing up on daily skills. Providing top-­notch education that is both affordable and convenient is one of CVMA’s core pillars of membership. We offer you endless options for furthering your education, in a variety of ways, all right here in your own backyard, whether you live on the Front Range, the Eastern Plains, the Western Slope, or in the far corners of the state. From in-­person sessions to webinars, we’ve got you covered! CVMA’s annual convention, of course, is our cornerstone, bringing over 130 hours of education ranging from life skills to practice performance to cutting-­edge clinical and biomedical science to one convenient location over the course of four days each fall. With tracks in agricultural animal, beyond medicine, complementary medicine, equine, exotics/wildlife/zoo, and small animal, you are sure to find a session or speaker to pique your interest and give you “use it on Monday” skills and information. But CVMA has so much more to offer than our annual convention! We have webinars on practice performance and on wellbeing topics for your whole team, both live and recorded, so you can fit the education you need into your busy schedule. CVMA CE West offers 12 hours of small and large animal education to the Western Slope, providing not only a way to feed your brain, but your spirit and your palette as well in beautiful Colorado wine country! CVMA CE Southwest brings 12 hours of small animal education to Southwest Colorado so our Western Slope members can enjoy high-­quality CE in their own backyard without traveling. The CVMA Professional Development Series offers six essential topics in clinical education, featuring case-­based, interactive sessions with national experts sharing their experience and insights right here in Denver. And for the outdoor enthusiast, CVMA SkiCE offers not only 14 hours of world-­class education, but plenty of time b ­ etween sessions to hit the slopes in world-­class Colorado ski destinations. Two annual CVMA BIG Ideas Forums let you explore “hot topic” issues in veterinary medicine to shape the conversation and help CVMA navigate to solutions that benefit the profession. So what’s better than convenient CE? Affordable CE! CVMA members enjoy special pricing (and in some cases even free!) on all of our education offerings. As a Premium member, you can enjoy our highest level of savings, including free registration for both BIG Ideas Forums. Core members receive great discounts as well, and one free BIG Ideas registration annually. Basic members also enjoy special pricing on event and CE registration. PAG E 8   |   CV M A VOICE 2017: 3

From the Front Range to the Western Slope, from in-­ person meetings to work-­around-­your-­schedule webinars, CVMA has you covered! We make staying up to date on your skills and requirements convenient, affordable, and rewarding!  n

Have you used your Core or Premium FREE registration for CVMA BIG Ideas Forum yet? If you are a Premium or Core member and haven’t yet taken advantage of your free CVMA BIG Ideas Forum registration this year, we hope you’ll join us in beautiful Beaver Creek on October 21 as we explore finding your authentic, sustainable career in veterinary medicine with Dr. Kimberly Pope-Robinson. Learn more at colovma.org/big-ideas-forum/.

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CV M A VO ICE

OF NOTE CVMA | Advocating for the Profession

• Allowed practices to maintain office stock of compounded medications • Provided for limited dispensing from office stock To broaden the impact of compounding access improvements made in 2016, CVMA in the 2017 session requested a bill that eliminated the restriction to companion animals contained in the 2016 bill. As a result, Colorado veterinarians can now treat all species with compounded m ­ edications— including exotic animals, zoo animals, laboratory animals, and horses—in addition to companion animals.

CVMA is committed to advocating effectively for the veterinary profession and animal health and welfare in Colorado. Each year brings a slew of issues and bills that CVMA must work to help pass—and in some cases defeat—to keep the profession safe and strong in Colorado. The 2017 legislative session was no different, and CVMA was agile and responsive as it monitored, supported, or opposed 18 bills. CVMA’s short list of bills covered many ­topics and promised varying degrees of potential impact to the veterinary community on animal health and welfare, public protection, the scope of veterinary practice, professional regulation, and the opioid epidemic. Through the combined efforts of CVMA’s professional lobbyist, member connections, outreach and testimony, staff engagement, and established relationships with key legislators, CVMA found great success representing the interests of the profession on behalf of its 2,300-­plus members. Once again, partnership and working together proved that CVMA members have the benefit of legislation that protects both veterinary practice and animal welfare in Colorado. Here are the successes and highlights of the 2017 legislative session. Veterinary Pharmaceutical Compounding Animal Patient (HB17-­1274) Over two legislative sessions, CVMA has invested deeply to significantly improve the landscape for veterinary compounding in Colorado. In 2016, CVMA and its sponsors successfully passed House Bill 16-­1324 that made a number of significant improvements in the compounding landscape for Colorado veterinarians, as it: • Provided access to controlled compounded medications • Provided access to resident and non-­resident compounding pharmacies

Rural Veterinary Education Loan Repayment Program (HB17-­1282) Together, CVMA and Colorado State University College of Veterinary Medicine and Biomedical Sciences took a lead role in sustaining the vitality of livestock producers and communities in rural Colorado through House Bill 17-­1282. By providing an education loan repayment incentive for veterinarians to practice in rural areas, the bill will benefit rural communities in Colorado that have underserved veterinary needs, and veterinary students who desire to practice in those communities. House Bill 17-­1282 establishes a five-­member council, on which CVMA will be represented, to administer the program, and provides funding for two veterinarians for four years each. HB17-­1282 passed on May 10 in the final hours of the session, and CVMA president Sam Romano, DVM and member Lora Bledsoe, DVM who testified in support of the bill, attended the signing ceremony with Governor Hickenlooper on June 5, as well as Dean Mark Stetter of CSU-CVMBS and Leo Boyle, CVMA lobbyist (see photo). Remove Medical Release Requirement for Animal Chiropractic (SB17-­135) In spirited testimony before the House and Senate Ag committees, CVMA countered an attempt to dismantle the unique and progressive veterinary medical clearance (VMC) requirement for the legal practice of animal chiropractic in Colorado. Animal chiropractors presented vigorous testimony from 26 witnesses on perceived restraint of trade, denial of care, and protecting the rights of animal owners. CVMA experts spoke to protecting patients, ­owners, care providers, and public health and cautioned about potentially disastrous patient safety outcomes when contraindications to chiropractic care are not identified. While the bill passed the Senate, CVMA was able to halt its progress in the House. CVMA appreciates the support of the many members who reached out to their Representatives and Senators to oppose the bill. The bill was introduced without warning, and without the opportunity for stakeholder consultation. In anticipation of continued legislative interest in this issue during the 2018 session, CVMA and the Colorado Chiropractic Association have agreed to conversations to improve mutual understanding of the VMC and to support pathways for collaborative patient care.  n CVMA VOI C E 201 7: 3  |   PAG E 9


2 017, I ssue #3

OF NOTE CVMA Veterinary Career Center Helps You Find the Right Candidates A constant challenge for hiring managers is finding good employees—regardless of the economy. Savvy employers understand that the quality of candidates is much more important than generating volumes of resumes. Cut down on your workload without sacrificing your standards by posting your position to a well-­defined, veterinary profession–­specific audience. CVMA partners with Veterinary Career Network (VCN) to expand its veterinary career opportunity listings and related services. The VCN membership consists of national and state associations, as well as veterinary schools and colleges. In addition to our regular member services, CVMA can now offer hundreds of nationwide veterinary career job listings, career development services, and more than a thousand active resumes. The nationwide resume search will give you access to over 23,000 veterinary specific resumes, attract a monthly average of 3,200 unique visitors, and you can expect to see an average of 1,200 views per job posting. And even better—with your CVMA membership, you can expect to save 10-­25% on all of your job postings. The CVMA Career Center is your best resource for finding high-­quality candidates. With a defined talent pool that focuses solely on the veterinary profession, you will only find relevant resumes, saving you time and getting your positions filled faster. There’s no better place to find qualified veterinary professionals than through the CVMA Career Center. Visit the CVMA Career Center at careers.colovma.org /employers/ to have only the most relevant candidates ­delivered to your inbox. And now . . . Connecting employers and talent in the industry just got easier! Google has officially tapped into the job search market with the launch of Google for Jobs. In a nutshell, job ­seekers that are looking for their next career opportunity can ­simply “Google it.” We are pleased to inform you that the CVMA Career Center has been fully integrated with Google’s new job search feature and the partnership in this new initiative will deliver success for CVMA members, job seekers, and employers in the veterinary industry. For Employers • Jobs posted to the CVMA Career Center are automatically searchable through Google for Jobs, creating even greater exposure. The Google for Jobs application appears before Google’s standard search results, prioritizing your positions over other employers, job boards, and staffing agencies that do not have an established partnership with Google. • Employers now have a new source of active and passive candidate traffic—a unique benefit of posting your open positions through the CVMA Career Center. • This new function alleviates the ongoing challenge of identifying the right candidates to fill open positions by PAG E 10   |   CV M A VOICE 2017: 3

increasing the reach of every job that you post with the CVMA Career Center. For Job Seekers • Streamlines the job search by displaying career opportunities from the CVMA Career Center and multiple employment sites in one convenient place. • Offers greater exposure to the outstanding career opportunities in the veterinary profession. • Increases the likelihood of finding the type of job that you are looking for and cuts down on time that is wasted ­applying to roles that aren’t a good fit. The launch of Google for Jobs will make a huge impact in the way that job seekers search for career opportunities online. The CVMA Career Center is excited to partner with Google for Jobs to help streamline the job search process and create quality connections between employers and candidates in the veterinary field. Are you looking for a position? Then visit careers .colovma.org/ to find exciting new opportunities and a wide array of resources for job seekers, including information on writing resumes and cover letters, budgeting for salary negotiations, fine-­t uning your elevator speech, job seeker etiquette, and more!  n

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OF NOTE CVMA + Veterinary Growth Partners = Practice Success As part of CVMA’s economic and personal wellbeing initiative for our members, we are proud to partner with Veterinary Growth Partners (VGP) to provide a new level of support for Colorado veterinarians to help members create healthy, thriving practices. The CVMA and VGP partnership provides you with discounts on resources like Pathway Planning, practice management tools, a buying program, educational and personal development opportunities, and so much more. CVMA Premium members receive a three-­ year complimentary membership with VGP (a $2,865 value!) and preferred pricing on pharmaceuticals, prescription diets, and more. CVMA Core members receive a one-­ year complimentary membership with VGP (a $955 value) and the preferred pricing listed above. Veterinary Growth Partners is a membership organization that helps transform practices through proven processes and new innovations. VGP will help you accelerate the vision that you have for your practice, and impact how your practice operates, serves clients, and makes business decisions. All of this results in performance improvements in virtually every aspect of your practice. VGP provides the following support for your practice: • Practice Management Tools {{Practice health assessment offers help in strategic planning, leadership, operations, financial management, client services, and marketing {{The Pathway Planner tool to help the practice store and review the missions, goals, and strategies of the practice • Marketing Tools {{Track response rates on marketing campaigns to determine where money is best well spent, converting calls and marketing to client appointments • Education & Best Practices {{Continuing education opportunities in virtual classrooms, offering convenient web-­based content in addition to live workshops, video shorts, and more • Preferred Pricing {{Save time and money by taking advantage of pre-­ negotiated agreements with top industry partners to grow your practice Pathway Planning VGP offers a proven management system for your practice. Pathway Planning is a system for diagnosing and assessing your hospital’s business health and creating a treatment plan. Most owners and administrators can easily identify

V

GP offers a proven management system for your practice.

the practice’s problems, but they can’t always create a plan to solve them. Pathway Planning is the answer. It makes your mission, vision, and values an interactive part of everyday strategy and execution. Intensive leadership training opportunities are offered through frequent free workshops, exclusively for VGP members, on practice and personal improvement skills. All workshops are three-­day interactive programs, hosted by VGP Chief Culture Officer Shawn McVey. Practices will be assigned a personalized Practice Coach to help your practice thrive. Practice Coaches are talented individuals who have spent many years in veterinary medicine as successful practice managers. They t’s like having your own help veterinary hospitals practice consultant at design the future they your fingertips! desire and achieve their goals. As part of your membership, VGP coaches help you implement best practices as outlined by Pathway Planning’s model in areas of strategic planning, operations, finance, inventory, human resources, marketing, client care, and patient care. It’s like having your own practice consultant at your fingertips!

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Ignite Workplace VGP offers Ignite Workplace exclusively for VGP member hospitals, a one-­of-­a-­k ind learning experience that is complimentary as part of your VGP membership and includes: • Access to all the practice management resources VGP has to offer in one location • Templates, forms, documents, and VGP’s recorded webinar library • Connect directly with your VGP Practice Coach for 1:1 advice and support • Access the VGP calendar of events including webinars, live workshops, and other events • Learn skills and techniques specific to your role in bite-­ sized, entertaining videos • Learn business techniques and strategies from subject matter experts • Share best practices, case studies, and solve problems with the help of your peers • Find information on the exclusive benefits and offers from VGP’s industry partners and join their individual groups on IGNITE • Eliminate redundancy and time spent reinventing the wheel CVMA’s partnership with Veterinary Growth Partners will help you save money, expand your capabilities, and help you succeed. To learn more about VGP membership and the discounted rates for CVMA members, call the VGP team at 800.577.0120 or email contact@vgpvet.com. Ready to take advantage of this CVMA member-only b ­ enefit? Sign up online at www.vgpvet.com/signup.  n CVMA VOI C E 201 7: 3  |   PAG E 1 1


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OF NOTE Return For Care: CVMA’s Cost-effective Client Acquisition Initiative is Expanding Ralph Johnson CEO, CVMA In July 2014, ten CVMA member practices in Douglas County agreed to participate in a pilot project to assess the costs and benefits of a shimmering concept called Return For Care. In a nutshell, Return For Care (RFC) creates the opportunity for a pet adopter to select a veterinarian while still at the animal shelter—a veterinarian who will provide a complimentary health exam AND who has agreed to provide complimentary treatment for any shelter-related medical issues that might emerge in the 15 days following adoption, provided the adopter brought the animal in for its initial health exam within five days following adoption. You might be asking “How could I possibly afford to take on such a commitment?” Fair question. Stay with me, because by revealing the results of the Douglas County pilot program, which collected data over a 30-month period, you will come to understand that RFC is perhaps the most costeffective mechanism for new client acquisition your practice could ever imagine. RFC Goals At the highest level, the RFC program was envisioned to enhance outcomes for animals in our communities. By connecting the adopter and veterinarian right at the point of adoption, the pet gets its start on the path to a lifetime of veterinary care. Healthy, happy pets in forever homes is the primary objective of this program. There are additional motivators too: • Deliver a cost-effective and ongoing mechanism through which veterinarians can identify new clients and create lifetime relationships, recognizing that shelters provide the largest, continuous, and most easily identifiable stream of new pets into the community—and that connecting adopters to veterinarians is a win for pets, adopters, shelters, veterinarians, and the community • Provide pet adopters the peace of mind that results from knowing post-adoption medical care for shelter-related issues will be addressed by their veterinarian • Enable shelters to repurpose scarce financial resources into areas of need such as enrichment and behavior resources to help place even more healthy, happy, adoptable pets

support of CVMA leaders and staff members (thank you Tara McChesney, Katie Koch, and Jenna Glad) who weren’t afraid to roll up sleeves and even put bandages on the inevitable bruises that result from experiments! From a project design standpoint, we also had a shelter in a discrete geographic area (so that we could define eligibility in terms of residents of Douglas County) where there was a plentiful supply of veterinarians. In short, we had all the ingredients for a successful test program. Key Findings The pilot project officially began collecting data from the participating practices on July 1, 2014 and continued with data collection through December 31, 2016. Over this period, there were 2,241 pets adopted at the Buddy Center that were eligible for the program. Here’s what we discovered: Lesson #1—High rate of enrollment, with 85% (1,899) of eligible adopters actually selecting a veterinarian at the time of adoption. Of those eligible but who opted out, the primary reason was they already had a veterinary relationship with a veterinarian who was not participating in the pilot project.

Lesson #2—High rate of adopter follow-through, with 55% (1,049) of the adopters who selected a veterinarian actually scheduling their new pet’s wellness exam.

Lesson #3—Low rate of post-adoption issues, with only 11% (201) of the participating pets needing to return for care with 15 days for the treatment of a shelter-related illness.

The Douglas County Pilot Douglas County was selected for the pilot project for several reasons. We had CVMA members who were attracted to the goals and willing to invest time and effort into testing the concepts. We had a willing partner in the Dumb Friends League, and especially at the League’s Buddy Center in Castle Rock (thank you Matt Levien!). We had Continued on next page PAG E 12   |   CV M A VOICE 2017 : 3


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OF NOTE Continued from previous page

Additional Findings • Of the 201 pets that presented a shelter-related illness following adoption, the most common reasons were upper respiratory infections, kennel cough, and skin/ear infections. • The participating clinics reported an aggregate amount of $13,533 that was invested in treating the 201 cases of shelter-related illness, creating an average investment of $84 per pet treated or $12.90 average investment per pet of those scheduled for a post-adoption examination (1,049). The program is structured so that the adopter or the shelter will assume responsibility of treatment costs that exceed $500 per patient, but this outer limit was never reached in any of the 201 cases in the pilot project. • Of the 1,049 pets seen by veterinarians during the pilot project, 420 pets visited the veterinarian after the 15-day period covered in the program; appointments were scheduled most frequently for wellness care, sick care, and dentistry. CVMA obtained data for 393 of these appointments, for which the veterinary clinics reported revenue of $84,059, an average of $213.89 revenue per pet that visited (393) or an average of $80.13 per pet that received a post-adoption veterinary examination (1,049). CVMA believes these are conservative data, since only one subsequent visit per pet was recorded in the database and since pets enrolled later in the pilot project had not yet scheduled a subsequent visit. • Manual processes (at the shelter, at the veterinary clinic, and at the CVMA office) were utilized in the pilot project; these processes are labor intensive to a degree that the program cannot be sustained without an automated solution. See below for discussion of the technology platform developed by the CATalyst Council. How RFC Benefits Your Practice Let’s recap what we learned from the pilot project: • High participation rate – 85% of eligible adopters chose to participate in the program. Engaging the adopter to select a veterinarian at the adoption center is effective. • Excellent relationship activation – 55% of those adopters scheduled the complimentary wellness visit to occur within five days post adoption. This follow-through rate is the highest of any programs operating in the US for which the CATalyst Council is tracking data. • Low incidence of shelter-related illness – Only 11% of the participating pets returned for care within 15 days for the treatment of a shelter-related illness. Not surprisingly, the most common reasons for care were upper respiratory infections, kennel cough, and skin/ear infections; the total cost of care for those visits was $13,533 (an average of $84 per pet). • RFC creates opportunities for lifetime care – After the 15-day Return For Care timeframe was complete, 420 pets came in for additional care; financial data on 393 of those visits show clients spent over $84,000.

• Low client acquisition cost – These data demonstrate that the average cost of acquiring a new client through the Return For Care program is $12.90 per pet – and this investment is more than offset by the $80.13 in revenue, on average, that was generated by each pet that received the complimentary wellness exam. Overall, Return For Care created $67.23 average net revenue for EVERY pet that received a complimentary wellness exam! Scaling Up Return For Care Given the strength of the business model demonstrated in the Douglas County pilot project, the CVMA Board of Directors has approved scaling up the program. The first effort will be in the Denver area to leverage the long-standing free exam program that has been in place for many years. Veterinary clinics that wish to participate in the Return For Care Program Healthy New Pet Guide can do so at the same rates as previous editions of the publication. Participating veterinarians agree to provide a complimentary exam within five days of adoption, and complimentary healthcare for shelterrelated illnesses in the 15 days following adoption. Because there is a long and fruitful relationship between the veterinary community and the Metro Denver Animal Welfare Alliance (MDAWA)—to whose members the nearly 40,000 copies of the Return For Care Program Healthy New Pet Guide are distributed—the Return For Care program is being offered to all PACFA-licensed shelters and rescues that are members of MDAWA. It is anticipated that nearly every eligible shelter and rescue in metro Denver will be participating, and CVMA anticipates that veterinary participation in the program will grow because of the demonstrated business benefits and because the shelters and rescues will be actively connecting adopters EXCLUSIVELY to the veterinary clinics that participate in the Return For Care program. It’s a win for the animals, the adopters, the shelter partners, and the veterinary clinics! Veterinarians in the Denver and Boulder metro areas will be receiving a printed packet describing the program, presenting questions and answers about its operation, and providing the enrollment form for inclusion in the Return For Care Program Healthy New Pet Guide. Additionally, it will include an invitation to an in-person meeting the evening of October 17 where veterinarians will enjoy food and refreshments provided by CVMA, a presentation on the program, and an opportunity to get questions answered. The Denver area program will go “live” in January when the new edition of the Return For Care Program Healthy New Pet Guide is distributed. Ultimately, CVMA desires to implement the Return For Care program in additional communities in Colorado. Conversations have already begun in Colorado Springs and Fort Collins. Technology Solutions CVMA has been working with the CATalyst Council, which has committed the resources necessary to develop a Return For Care continued on page 14 CVMA VOI C E 2017: 3  |   PAGE 1 3


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OF NOTE Return For Care continued from page 13

technology platform that can automate the processes involved in Return For Care. Think of Catalyst Connection as the hub of a wheel, with spokes that connect to shelter information systems (SIMS) and practice information management systems (PIMS). By connecting the SIMS and PIMS to Catalyst Connection, this portal can now automatically accomplish these processes: • The newly adopted pet’s health record goes from shelter to clinic • Clinic receives notification of new client selection and is encouraged to call for appointment scheduling • Adopter receives email encouraging them to schedule the health exam • Adopter and clinic receive reminders if scheduling isn’t activated • Shelter has access to shelter metrics screen • Clinic has access to clinic metrics screen • CATalyst and CVMA have access to community metrics data Veterinary clinics that participate in the Return For Care program will receive a complimentary version of Sikka Software’s Practice Optimizer, which can be installed in less than 15 minutes. Practice Optimizer then facilitates

the transfer of permitted information with the Catalyst Connection portal so that clinics can forget about manual processes to support Return For Care – and instead focus on what the clinic does best, which is providing exceptional healthcare to a sustained stream of new clients who have adopted a new pet and decided to become connected with a veterinarian. Launching in January 2018 While the concept for Return For Care is straightforward, the processes underlying the technology platform have required extensive development and testing prior to launch – but we are now ready to go! Denver area veterinarians will receive an informational packet by mail, including an invitation to the October 17 “dinner and details” gathering at the CVMA office. The Denver area’s free exam program will officially transition to the Return For Care program in January 2018, followed by expansion of the program into additional communities. Thanks to your efforts and those of our partners at the Dumb Friends League and CATalyst Council, CVMA and Colorado are leading the way so that pets, shelters, clinics and communities can enjoy the benefits of Return For Care. I hope to welcome you aboard!  n

Award Winning Veterinary Architecture

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www.animalarts.com PAG E 14   |   CV M A VOICE 2017: 3


CV M A VO ICE

OF NOTE AVMA House of Delegates Summary Melanie Marsden, DVM, AVMA Delegate Rebecca Ruch-­Gallie, DVM, MS AVMA Alternate Delegate The AVMA House of Delegates (HOD) met in Indianapolis for the annual meeting just prior to the start of the July convention. It was a busy session with two bylaws amendments, eight resolutions, and four veterinary information forum (VIF) topics to discuss. After conversations with the Allied Caucus, Reference Committees, Districts, and within the House, the following recommendations and results were agreed upon. Amendment 2 made changes to the Student American Veterinary Medical Association (SAVMA) organization by moving Student Chapters of the American Veterinary Medical Association (SCAVMA) directly under the SAVMA, which has a seat on the HOD. This amendment aligns the missions of both organizations and alleviates confusion around the acronyms. This resolution was supported by SAVMA and passed. Amendment 3 altered the membership requirements for allied organizations to have a seat in the HOD. The amendment passed with the addition of a start date for the amendment to take effect. Resolution 4 adopted the policy on stem cell therapeutic use. The resolution passed with recommendations to COBTA to change language from validated to evidence based and to further define stem cell therapy. Resolution 5 language around veterinary involvement in service dog selection and training was amended to help and have a role. After much discussion, recommendations were made to ask the Steering Committee on Human Animal Interactions to include a human mental health professional to provide additional infographics on the differences between service, assistance and emotional support animals and to be involved with improving definition clarity between government agencies. Additionally, there was discussion concerning the role of veterinarians in helping develop public health guidelines for all assistance animals. The resolution passed and recommendations made to the Board of Directors. Resolutions 6 and 7 were passed with minor amendments to acronym removal. These resolutions encourage placement of veterinarians within appropriate organizations of the federal government, particularly in food safety, infectious disease control, and disaster assistance. Resolution 8 concerned respectful handling of cremains. The resolution passed with minor amendment. Resolution 9 provides a policy for hospice care. There were several amendments to this, including a change from ‘hospice’ to ‘end-­of-­life’ care. This better aligns with the AAHA published guidelines. There were additional minor wordsmithing edits and the amendment passed. Resolution 10 supports the AVMA policy on telemedicine. After an amendment to not allow direct owner contact with specialist and other minor changes, the resolution

passed. The policy leaves changes open based in changing technologies. Resolution 11 updated the model practice act based on current technologies and passed. Two of the four VIF topics were related to resolutions (VCPR and service animals) and the summaries are included above (resolutions 11 and 5). Marijuana use in animals was discussed and recommendations to the Board included changing classification from schedule 1 to schedule 2. This may assist in needed research to provide evidence of effectiveness, or lack thereof, in various disease processes. A recommendation was made that the Board also ask appropriate councils to provide infographics targeting both veterinarians and clients with current legal status, what we currently know, toxicity signs, and what diagnosis and treatment are recommended. The final VIF topic involved opioid usage and the Prescription Drug Monitoring Program (PDMP). Veterinary requirements vary across states. Within states that have high reporting requirements, software programs do not integrate with reporting systems. The impact of veterinary use of opioids in society is unknown. After deliberation, the HOD recommendations to the board were: (1) develop model language for veterinary involvement to be used at state level to include reporting, differences in human and veterinary opioid prescribing and use and continuing education requirements (CE); (2) create model waivers; (3) provide guidance in working with state pharmacy boards; (4) explore options for software integration development and permanent identification of veterinary patients that can be included in PDMP; and (5) develop CE. Just a reminder that the full policies and statements are available on the AVMA website. If you have any questions or concerns, please contact us either by email or phone. It is our honor to serve you at the state and national level.  n Briefings continued from page 5

deeply informed yet agile in decision making, and where chapter leaders are afforded professional development opportunities that enrich them and deepen their effectiveness in serving as strategists and ambassadors for the organization. A full report can be found on page 43, but in short it was highly significant that 94% of voting members supported this evolution of governance. From an association management perspective, accomplishing any one of these changes could be considered significant—so to fulfill all three objectives envisioned in the strategic framework should be celebrated as phenomenal on the part of CVMA! It has been personally fulfilling to work with your elected and volunteer leaders in effecting these changes, which position CVMA to be effective, efficient, and impactful as a 21st century organization. Implementing this trifecta of change will allow CVMA to collect “winnings” not just today, but well into the future.  n CVMA VOI C E 2017: 3  |   PAG E 1 5


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OF NOTE AVMA Highlights Michael Whitehair, DVM AVMA District IX Representative Chairman, AVMA Board of Directors Hi, I’m Mike Whitehair, your District IX representative on the Board of Directors of the AVMA. I’m pleased to report that the profession as a whole continues to remain relevant to the public and the animals under our care. It’s an exciting time to be involved in veterinary medicine. AVMA continues to do outreach to our members to hear your voices and direct formation of policies that are reflective of member needs, especially in advocacy, education, economics, and protecting the value of your professional degree. We’ve selected a few of the current topics under consideration for this report. We welcome your thoughts on the ways for continuous improvement of the AVMA. Mobile JAVMA • The AVMA recently launched an app for tablets and mobile devices that gives subscribers to JAVMA access to the full journals at their convenience. Designed with AVMA members in mind, the app optimizes the journal for reading on Apple and Android tablets and smartphones. • The JAVMA app allows members to access journal content on demand wherever they are. They can also download issues for offline reading at any time. Features of the app include: {{Pinch-­to-­zoom functionality to view text and images in greater detail {{Full text search and archival search {{Note taking and bookmarking pages {{Article sharing via/to email or social media {{Navigation by table of contents and page carousel {{Browsing of bookmarked pages and page history via carousel • The app also allows readers to take notes and make freehand annotations on journal pages. Bookmarks and notes are associated with the user’s account. Eventually, the journal, which celebrated its 100th anniversary last year, hopes to add multimedia to the app such as video, audio, animations and slideshows. • The app does not replace the print version of the publication. Subscribers will continue to receive the print edition as well as online access to the journal. • Issues prior to 2017 will not be available through the JAVMA app. To access issues published prior to 2017, ­subscribers can visit the JAVMA archives at avmajournals .avma.org. • JAVMA subscribers can download the app from the Google Play Store (Android) and the App Store (Apple). Once downloaded, subscribers can log into the app with the same user ID and password used to access the AVMA website. Users must be an individual subscriber to JAVMA to log in and view issues. PAG E 16   |   CV M A VOICE 2017: 3

Diversity and Inclusion Policy • The AVMA Board approved a revised AVMA Policy on Diversity and Inclusion. This new version of the policy is now consistent with our Principles of Veterinary Medical Ethics and reinforces the importance of diversity and inclusion in ensuring access to veterinary care for all segments of the U.S. population. • The policy reads: “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 and inclusion in our membership, leadership, and organization, and educating our members regarding the value of diversity and inclusion. This commitment embraces the value of the many areas of the veterinary profession, and the value of our members’ and their clients’ varied backgrounds, including but not limited to race; ethnicity; physical and mental abilities, gender, sexual orientation; gender identity or expression; parental, marital, or pregnancy status; religious or political beliefs; military or veteran status; and geographic, socioeconomic, and educational backgrounds.” Proposed Veterinary Botanical Medicine Specialty • The American Board of Veterinary Specialties (ABVS) is soliciting public comments on a petition that seeks to have the American College of Veterinary Botanical Medicine recognized by the AVMA as a veterinary specialty organization. • The petition cites several factors as evidence that a specialty in veterinary botanical medicine would serve a public need. Among these, the petition says: {{Herbal therapy is one of the most common topics offered in complementary and alternative veterinary medicine courses in veterinary schools. {{The number of faculty members with training in botanical medicine at veterinary colleges is increasing. {{Externship sites for 18 veterinary schools include sites that use botanical medicine. {{CE programs are available for veterinarians through four sites (Chi Institute, Veterinary Information Network, International Veterinary Acupuncture Society, College of Integrative Veterinary Training) and are included at most national veterinary conferences, including those of ABVS-­recognized specialty organizations. • There currently are 22 specialty organizations recognized by the AVMA. • The ABVS is accepting comments on the proposed new specialty from both the veterinary profession and the public. Comments must be submitted in writing—either via email (to DBanasiak@avma.org) or U.S. mail (to AVMA headquarters)—no later than August 31. Commenters should refer to the guidelines in the ABVS Policies and Procedures manual when developing their comments.  n


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OF NOTE Of Bison and Belonging Curtis Crawford, DVM CVMA Immediate-­Past President One of the most feared alarms in any clinic is “Escapee!” I’ve lost count of the number of cats that have escaped from owner’s arms when they attempted to bring their “mellow” pet in without a carrier. Numerous bleeding arms and chests have been treated in our bathroom because “Fluffy Marshmallow” magically transformed in to “Saber-­Toothed Tiger with Velociraptor Talons” when she suddenly realized that this wasn’t the parking lot to the previously promised “Fresh Milk and Mouse Feline Bistro.” Cattle aren’t all that thrilled to come to a veterinary hospital either—it ranks barely above a meat processing plant to them. When your clinic is just outside the city limits and close to a major highway, the sphincter pucker factor increases exponentially when a bull finds a poorly latched gate and makes a break for downtown. Our receptionist knows to start the phone call tree whenever she sees an unescorted bovine, ovine, or caprine bolt down the road towards the bright lights of Monte Vista. The Sheriff and several local team ropers are on speed dial, then she starts cancelling our appointments so “all hands on deck” can run down the errant patient and try to keep it off the highway. John is one of our favorite clients and runs bison on the opposite side of town. One day we received an emergency call from him after one of his best bulls was driven off by three maturing young juvenile delinquent bulls. “Buffalo Bill” didn’t feel the need to stay with the herd and had gone on a walkabout through several neighborhoods in town. Animal control and the police had driven the lonely beast out of town and he was now heading to Mexico. Bison do not herd well as a group and a lone individual is particularly difficult and dangerous. Cowboys on horses are just targets and a rope is just something to climb as they run down the horse. Fences are mere suggestions to such a marauding lone wolf. The overwhelming consensus, then, was to tranquilize Buffalo Bill and try to load him in a trailer to get him back home before anyone got hurt. Now, tranquilizing an 1,800 pound semi-­wild beast is not as easy as it looks on nature documentaries. They only show you the successful attempts. I’m sure there’s a lot of footage that gets left back in the sands of the Serengeti. So I was pretty skeptical about this one as I took the message. This wasn’t my first tranq-­a-­bison rodeo—I had attempted to dart one of John’s sick bisons a few years back with antibiotic in pasture using a dart rifle. He hadn’t been able to coax the patient into his working corrals but had lured the herd into a corner of the pasture by feeding a large round bale of hay. Then my assistant Mike had crawled up into the bucket of John’s frontend loader and John drove Mike into the milling melee with the bucket lifted 10 feet off the ground. I watched from the safety of the pickup feeling like Marlin Perkins from the old Mutual of Omaha’s Wild Kingdom TV

show (way before most of your all’s time, came on Sunday nights just before The Wonderful World of Disney). Marlin was always saying things like “We’ll watch here from the safety of the boat (or truck, tree stand, etc.) while my assistant, Jim, jumps into the swamp (or bush, cave, etc.) to wrestle the alligator (or shark, bear, etc.).” Marlin Perkins was the original Steve Irwin; I’m guessing that Steve couldn’t afford a good assistant like Jim. But I had Mike and a legitimate excuse—I’m afraid of heights. And one time my brother dumped me out of the front bucket of a moving backhoe and dang near became the only child he always wanted to be. And I had just got a new pair of bifocals so my aim wasn’t so hot. You pick the excuse that works for you; they all worked for me that day, so off Mike went with this antique dart rifle that didn’t pack much ‘umph.’ My grandmother could throw mixing spoons at me faster than that dart traveled. Mike did a great job holding onto the swaying bucket, getting a good shot, and popping him in the rump, but the dart just glanced off the tough hide. We tried twice more before the patient decided not to let that tractor within 50 yards of him, well outside the range of the rifle. I reminded John about our previous attempts with that old rifle, but he assured me he had access to a new one that could get the job done. Before leaving the office, I stopped to look up a tranquilizer dose for bison. Nothin’ in my books. I gave CSU a call. An extremely helpful receptionist at the food animal desk put me in touch with a young clinician who probably wishes she’d never answered that page. “Well. . . . I don’t have a bison dose either,” she drawled as she looked through her formulary, “But, I have a dose for a large cow. And I have a dose for a mad cow. So maybe if we add them together, you can slow down a big, pissed-­off bison.” Cattle are unpredictable when it comes to sedation and when the adrenaline is high, they can be like a 350-­pound dude on PCP. Standard sedatives available for regular veterinary use may work, but often they’re about as effective as spitting in the cow’s ear until you get to near-­lethal dosages. When I finally found John’s bison, he had amassed quite an entourage: John with his gooseneck trailer, the hired hand with an old Jeep Grand Cherokee, two sheriff’s pickups, and two Department of Parks and Wildlife trucks with three game wardens. Apparently ol’ Buffalo Bill had changed his mind about going to Mexico and was headed back towards town. I asked John about the dart gun and he pointed at the game wardens. They pulled out an air rifle. I laughed. My cousin used to plink me in the butt with an air rifle when we were kids. How was that going to launch a dart with enough force to penetrate buffalo hide? They assured me that air rifles were much stronger than they used to be, so I mixed up the tranquilizer cocktail, loaded a dart, and handed it to one of the wardens. It was his turn to laugh. They were authorized to allow use of the dart rifle as a favor to the Sheriff, but they were not going to be involved in the administration of this drug. In other words, their hands were going to be clean if the bison got injured Of Bison and Belonging continued on page 18 CVMA VOI C E 201 7: 3  |   PAGE 1 7


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OF NOTE Of Bison and Belonging continued from page 17

or died or some other of a thousand other things went wrong. I looked at the sheriff. He laughed too. He was only there to block traffic if that bison got back on the highway. I handed the pickup keys to one of the game wardens and I climbed into the passenger side of my truck and hoped that my PLIT insurance was up to date. We crept up to the edge of the field about 50 yards from where Buffalo Bill was going to exit near a large irrigation canal so we could come in behind him and keep him from turning back into the field. The game warden came up on Bill’s flank as I leaned out the window and rested the barrel of the gun on the side mirror. A perfect shot availed itself and I pulled the trigger. Nothing happened. I had forgotten to release the safety. Bill was a bit nervous now and kicked it into a higher gear. We regrouped and made the same approach but at a significantly faster speed. The mirror wasn’t such a great gun rest anymore as we bounced over the rough terrain. I pulled off my first shot. Hitting high on his rump, the dart immediately bounced off. We backed off and retrieved the dart. The medication had been dispensed but we couldn’t tell if it was in the bull or on the bull. All we could do was wait and watch. In the meantime, Bill climbs up on to the bank of the canal. “Oh, that sucks” said the game warden. I cursed under my breath. All we needed now was for that bison to pass out in the irrigation canal. Try explaining that one to a county commissioner. “Please God, no!” I muttered, making some promise that I won’t admit to you in exchange for some divine intervention to keep that bison from drowning as Bill slipped down into the canal and started across. It must have worked, because ten seconds later he clambered out and headed across the prairie. We found a place to cross the canal and Buffalo Bill’s private parade followed him on county roads staying a quarter of a mile back to keep him as quiet as possible. At least he wasn’t heading directly for town now. But after several minutes, it was pretty evident that he wasn’t slowing down either. We mixed up another cocktail and made another shot. This time the dart stuck. By now Bill was closing in on the local drive-­in theater and was on some property that the Sheriff was a bit hesitant about trespassing onto. On the other side of the property was a major state highway. He sent a deputy ahead to be prepared to block traffic and tried reaching the property owner. I figured if the owner wanted to keep people off of his property, there would have been a fence; so when Bill started staggering and finally went down, we decided it was “easier to beg forgiveness than to ask permission,” and we all sped across the property line. We pulled up within several yards of Bill as he lay flat and lightly snoring that pig grunt that bison make. We grabbed some heavy panels out of John’s trailer and stealthily crept up on Bill to fence him in. Now these weren’t regular cattle panels. These puppies were made of pipe, stood over six feet tall, and weighed over 100 pounds each. Heavy and awkward, it took two PAG E 18   |   CV M A VOICE 2017 : 3

men to carry each one. As we started to join them together, the guy on the other end of my panel let go to place a connecting pin and the panel fell onto my head, then slammed onto Bill. We all froze. The safety of the trucks now seemed miles away and we had no idea what kind of a drunk Buffalo Bill was as he rolled up on his chest and shook that massive head. As we all stood there thinking we might have to change our shorts, he stood up and staggered away. We waited for Bill to lie back down but after another five minutes he was still up, swaying in the gentle breeze. So how much more tranquilizer do you give? Another half dose seemed to be about right, so I loaded up another dart, crept up to the front of the pickup closest to Bill, popped up over hood, and fired another dart into his thigh. You know, those game wardens weren’t kidding when they said there had been some big improvements in air rifles since my childhood. At 10 feet, that dart went straight and true . . . to the bone. Buried that sucker so just the plume stuck out. Bent the drug chamber, too. Pretty sure that Bill got the full dose this time, we waited until he lay back down. Then we backed up the trailer and chained the panels to it so he had no choice but to get in when he woke up. I carefully extracted the dart and gave a whopping dose of antibiotics before quickly exiting the scene while Buffalo Bill slept the sleep of drunken stupor. There’s a motto at our clinic: If the patient is still breathing when you leave the premises, the call is counted as a success. I chalked that one up in the win column as I reached for the ibuprophen on the dash and rubbed the rapidly growing knot under my cap. Sometimes we’ve all felt a little like Buffalo Bill, like we really don’t belong somewhere and we’re just wandering aimlessly by ourselves through life’s prairies. It’s a lonely place to be. I firmly believe that we are meant to be part of a group. Humankind does not abandon its young at birth, but raises them in a family. We learn to unselfishly give and thankfully receive from one another as we grow and mature. One of the blessings of working in a multi-­person clinic is sharing our practice experiences together. Different perspectives and different approaches to cases and clients produce solutions that were obscure to a single mind. Pushing and challenging each other broadens our professional perceptions and forces us beyond mediocrity or the status quo. The security of knowing someone has your back offers the confidence to move forward towards excellence. The support of colleagues that understand the joys and frustrations of veterinary medicine keeps me going. CVMA works to build those relationships and meet those needs for all veterinarians. We strongly focus on supplying you with the tools to help you be successful professionally, financially, and even emotionally. We seek to help develop a spirit of cooperation and mutual respect for one another. Whether through advocacy in the public and legislative arenas, cutting-­edge educational opportunities, support programs for the challenges of professional and personal life, or leadership development for the profession, the

Of Bison and Belonging continued on page 19


CV M A VO ICE

OF NOTE Care Grants Help Rural and Frontier Practices with Charitable Care Jenna Glad, Administrative Support Specialist CVMA and PetAid Colorado It happens every day . . . When a pet suffers an extreme injury or a life-­threatening health issue accompanied by a large medical bill, not all clients are fortunate enough to have the money to pay for a necessary surgery or treatment. This is especially true in rural and frontier areas of Colorado where poverty levels are high, per capita income is low, and people often struggle to pay essential bills and make ends meet. If you practice in one of these areas, what do you do when one of your clients just can’t afford the unexpected expense to help their pet? PetAid Care Grants can help. The PetAid Care Grant program serves veterinary practices and clients in 47 rural and frontier counties throughout the state. Veterinary practices in these areas can apply for a grant to supplement their own charitable giving. Care Grants support a one-­ time surgical or medical intervention for a pet with a high chance of recovery. Upon approval of a Care Grant, a veterinary clinic will receive financial assistance up to $500 per case for the animal’s medical care. For Care Grant clients, this is often their last chance to safeguard a pet’s wellbeing or even save its life. This was the case for Bandit, a ten-­year old terrier mix. His owner, Raelene, was in the Emergency Room battling a sickness of her own when Bandit was hit by a car and found in critical condition by a neighbor. He was rushed to the hospital and needed surgery to save his life. Raelene is on a fixed income, and she scraped together as much money as she could. In the end, however, it was not enough to cover the full cost of the surgery. She didn’t know where to turn. The clinic had already donated hundreds of dollars’ worth of care but additional help was needed. The clinic staff that took in Bandit knew about the PetAid Care Grant program and applied for assistance. With the help of both the clinic’s discounted care and the Care Grant, Bandit received a life-­saving surgery. He was able to recover and return home to his owner a few days after the accident.

Bandit and Raelene

Raelene is forever grateful to the PetAid Care Grant program for stepping in and helping to save Bandit’s life. As the charitable partner of CVMA, PetAid Colorado aims to provide care and services to strengthen and keep the human-­animal bond intact. Care Grants provide assistance in a time of need, when few or no other options exist. When a client cannot afford surgery or treatment for their animal, Care Grants work in partnership with the clinic to help cover the costs of these procedures. In 2016, practices donated over $7,000 worth of care in these cases, which was met by over $17,000 in PetAid Care Grants. Clients must also make a financial contribution to the overall care, and in these instances, they are usually happy and eager to pitch in for their animals’ wellbeing. PetAid makes the process to apply for a Care Grant simple and straightforward. A veterinary hospital may contact Katie Koch at katiekoch@petaidcolorado.org or at 303.539.7273, or visit www.petaidcolorado.org/care-­grants for the application form. There is a checklist of paperwork that must be included in the application. Once the application and the amount of aid are reviewed and approved, PetAid will directly pay the hospital for the treatment. When a pet is injured or experiencing a life-­threatening ailment, owners will do all that they can to help them. Unfortunately, it is not always within their financial means to do so. PetAid Care Grants are used to support these owners that cannot afford the treatment needed to help their pets. From emergency amputations to the treatment of serious medical crises, Care Grants can assist the pet owner and the hospital to help an animal in need. If you know of an owner that is struggling to pay for a one-­time medical intervention for a serious condition, or you would simply like more information on the Care Grant program and process, please contact Katie Koch or visit the website address listed above. PetAid is proud to be the charitable partner of CVMA and to work with rural and frontier veterinary clinics to help keep pets and owners together.  n Of Bison and Belonging continued from page 18

veterinary team, or in the community, you can count on CVMA to be there for you. We foster the herd, not just the family or team. But just as in family or team, every member has a responsibility to contribute to the whole for the betterment of the profession. Every individual on a winning Super Bowl team puts in something to make the franchise a winner. We are inviting you to come on board with your talents and a little bit of time and investment to continue making CVMA one of the best state associations in the country. We aren’t going to run you down and shoot you in the rump with a tranquilizer dart, but we think if you contemplate our offerings and goals, you will find some real value for you and an opportunity to give back to your chosen profession. Give us a chance—we would love to run with you. CVMA. Welcome to the herd.  n CVMA VOI C E 2017: 3  |   PAG E 1 9


2 017, I ssue #3

OF NOTE Under One Roof: CSU Builds rDVM Relationships Timothy B. Hackett, DVM, MS, DACVECC Director, James L. Voss Veterinary Teaching Hospital The James L. Voss Veterinary Teaching Hospital at Colorado State University is committed to building relationships with referring veterinarians. In response to a survey we conducted last year, your thoughtful comments and feedback have become strategic goals for our hospital. In order to enhance our communication with ­referring veterinarians, we developed the rDVM Newsletter, a quarterly hospital email with personnel updates, service profiles, new clinical trials, upcoming events, and continuing education opportunities. If you would like to subscribe, please call the director’s office, 970.297.1269, or send an email to csu-­vth@colostate.edu. We would love to hear from you! Here are some highlights from the first two issues: Under One Roof You might have seen our new advertising campaign, “Under One Roof,” designed to share our multiple areas of expertise with the veterinary profession and the broader community. As the tertiary referral center for the

Boone was referred to CSU after being hit by a truck. He was treated by at least eight services in the hospital, and is now active, pain-­free, and starring in our “Under One Roof” campaign. (William A. Cotton/CSU Photography) PAG E 20   |   CV M A VOICE 2017: 3

Intermountain West, we house 79 veterinarians on clinics, representing 28 boarded specialties. Each issue spotlights the capabilities of a different service: Our Diagnostic Imaging service has a 1.5 Tesla superconducting magnet that recently underwent a software and hardware upgrade and is of comparable quality to human hospitals. The radiologic technologists who obtain these images are trained in human hospitals and work here for the love of animals and the challenge of veterinary medicine. We have a full complement of board-­certified radiologists who interpret all of our MRI images. With the high quality of our MRI equipment, skill of our technologists, and knowledge of our team of veterinary specialists, your patients receive a unique level of care at CSU. We are able to provide advanced imaging 365 days a year, for routine service Monday-­Friday or on an emergency basis after hours and on weekends and holidays. In Small Animal Orthopaedics, our mission is to enhance the quality of life of pets and their owners through effective treatment of musculoskeletal injury and disease. We combine our “high-­touch” vow to treat our patients just as we treat our own pets with our state-­of-­the-­art orthopaedic techniques and technology. Some of our most common procedures include treatment of cranial cruciate ligament tear, patellar luxation, bone fractures, elbow and hip dysplasia, and osteoarthritis. New Faces Dr. Miranda Sadar joined Dr. Matt Johnston in Avian, Exotic, and Zoological Medicine in July. Dr. Sadar comes from Saskatoon, Saskatchewan, Canada, where she was assistant professor of zoological, exotics, and wildlife medicine and surgery service at the Western College of Veterinary Medicine. Sadar is originally from Colorado and received her DVM from CSU in 2009. She moved to Canada after graduation to complete a one-­year zoological, exotics, and wildlife medicine and surgery internship at the Western College of Veterinary Medicine. Upon completion of her internship, Sadar moved to Waynesboro, Virginia, for a two-­year fellowship in wildlife medicine and surgery at the Wildlife Center of Virginia. She completed a zoological medicine residency with a focus on zoological companion animals at the University of California, Davis. Dr. Sadar is a diplomate of the American College of Zoological Medicine, and is one of the first 10 people in the world with the new subspecialty certification in zoological companion animal medicine.

Continued on next page


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OF NOTE Continued from previous page

Dr. Michala de Linde Henriksen joined our Ophthalmology section in the summer of 2017. She received her DVM from the Royal Veterinary and Agricultural University in Denmark; her PhD from the University of Copenhagen, Faculty of Health and Medical Sciences; and her residency training in ophthalmology at the University of Florida, where she developed a special interest in equine ophthalmology. She is a diplomate of the American College of Veterinary Ophthalmologists. Most recently, she was assistant professor in comparative ophthalmology at the University of Minnesota College of Veterinary Medicine. To ensure that you are familiar with our faculty and house officers for each service, we update our directory annually with new faculty, residents, and interns. See it online at csuvth.colostate.edu under “For Veterinarians,” or give us a call, 970.297.1269, to request a hard copy. Construction Update: Hybrid OR This summer, the hospital broke ground on a new 1,400-­square-­foot, state-­of-­the-­art operating room, the Pocket Foundation Hybrid Cardiac Interventional Suite.

This operating room includes advanced image-­guidance (X-­ray, ultrasound, endoscopy) for both surgical and catheter-­based therapies. A ceiling-­mounted fluoroscopy system allows fluoroscopy and angiography to be performed in a sterile operating environment, while incorporating the newest technologies available in human health care—live integration of 3-­D echocardiography, rotational angiography, and intraoperative CT scanning. Images are displayed on five large high-­definition monitors. A control room with a large viewing window facilitates student observation and houses advanced image-­analysis systems to both plan and review clinical cases. Every case can be recorded in detail with several high-­definition cameras mounted around the suite, and live cases can be streamed anywhere in the world in real time, allowing teaching and demonstration of the newest and most advanced image-­guided procedures. The Hybrid Cardiac Interventional Suite provides clinical capabilities that currently do not exist in veterinary medicine and are available at only a handful of human medical centers, providing the most advanced care possible to our animal patients. Referral Process We are working to make our referral process easier for our colleagues. Just call us at 970.297.5000 and our team will gladly help with the referral process. Or, you may make a referral online under “For Veterinarians” at csuvth.colostate.edu.  n

President’s Post continued from page 4

leader, our incoming president, Dr. Will French. As an equine practitioner, and certified veterinary acupuncturist and chiropractor, Will’s testimony was vital and invaluable. Under the best circumstances, testifying is intimidating. This one was particularly difficult. The professionalism and grace under pressure exhibited by Dr. French, along with testimony from Drs. Kevin Haussler and Keith Roehr, was nothing short of amazing. So what does this have to do with the title of this post, “The Pen?” After the signing of a bill the governor distributes pens used in the ceremony to the attendees. Usually it’s two or three. Three pens were distributed after the HB17-1282 signing. Representative Ginal gave hers to Dr. Bledsoe, Dr. Stetter received one on behalf of CSU, and I received the final pen on behalf of CVMA. This was no cheap ballpoint pen—its gold surface is etched with the governor’s name. It felt particularly heavy as I tucked it into my suit pocket for safe keeping. I didn’t think much of it as it sat on my desk at home for a few weeks waiting to be dropped off at the CVMA office. But over time, something began to bother me about its presence. And then I figured out what it was about that pen that felt so powerful.

This pen reminded me of a conversation I had following a CVMA chapter visit last year as president-­elect. A recently graduated veterinarian and her husband shared they were soon leaving their rural community. Both had grown up in the area prior to marrying and “loved it dearly” (her words). Moving out of the community meant their parents would not know their future grandchildren. Older relatives, with time short, would miss seeing them daily. Their community would miss her expertise as a veterinarian, including the local physician. She began to get tears in her eyes. Her student debt was driving them to seek higher incomes elsewhere, probably in the city. They didn’t want to go. They would be breaking the generational chain that had existed in their community for decades. I can still see them holding hands at the end of the table. I had no response. But now, the future looks brighter. Funding is available to assist veterinarians and the communities of rural Colorado. It wasn’t just Governor Hickenlooper’s hand on that pen that day in June. It was the hands of many leaders, all moving in unison, striving to make a difference in the lives of others. I’m grateful for the experience. It’s something I’ll never forget.  n CVMA Voice 2017: 3  |   PAGE 2 1


2 017, I ssue #3

OF NOTE Updates from the CSU College of Veterinary Medicine and Biomedical Sciences Melinda Frye, DVM, MS, PhD, DACVIM Associate Dean for Veterinary Academic and Student Affairs, CSU College of Veterinary Medicine and Biomedical Sciences DVM Demographic Snapshot Comparative national data from 2014–16 have been encouraging. While student debt continues to be an issue, our graduates indicate a very high appreciation for the financial literacy support we provide in our program. Some highlights from the past three years: • CSU graduate compensation is slightly higher than the national average. • Average student debt is slightly lower than the national average. • Our students going into private practice each receive about two offers, consistent with the national average. • About 40 percent of our students go on to advanced educational opportunities (internships, residencies, other degrees). Of those, 75 percent are in companion animal, 23 percent in equine and 2 percent in mixed or “other.” • Over 70 percent of our graduates stay in the West after graduation and of those, the largest percentage stay in Colorado, at 24 percent. • The CSU class of 2016 had a 98-percent NAVLE pass rate, compared to national average of 95 percent.

Navajo Nation Partnership For the second year, CSU veterinary students travelled to Kayenta, Arizona, in June to participate in a camp at the Monument Valley High School AgriScience Center. We are fortunate to have been invited to partner with the center with the goal of improving student education, as well as exposure to college and professional opportunities in the sciences. Every year, teacher and program founder Clyde McBride conducts this veterinary camp for high school students PAG E 22   |   CV M A VOICE 2017: 3

in the area to teach them about basic medical care, husbandry, the role of veterinarians, and much more. CSU students conducted demonstrations on ultrasonographic pregnancy detection in cattle, hoof trimming, bandaging, fecal flotations for parasites, and other procedures. The trips have proven to be an impactful opportunity for our students in learning about life on the reservation, working with local veterinarians and staff, reinforcing knowledge gained in high school courses, and creating enthusiasm surrounding college and careers in science. Veterinary Summer Scholars

The 2017 CSU Veterinary Summer Scholars. (CSU photo) This summer, 30 veterinary students worked in labs across all four college departments (Microbiology, Immunology and Pathology, Environmental and Radiological Health Sciences, Biomedical Sciences, and Clinical Sciences) to conduct summer research. Additionally, three CSU students traveled outside of CSU to the University of Alaska, Fairbanks (UAF). Summer fellowships are funded by eight different sources, including federal, private, and industry partners. The primary goal of the Summer Scholars program is to assist in the development of knowledge and skills of professional veterinary students in comparative and veterinary medicinerelated research problems. This program provides mentorship and infrastructure for veterinary students to attain specific technical and conceptual skills to perform hypothesis-based research as part of faculty supervised projects. From Fairbanks to Fort Collins The start of the fall 2017 semester marks a milestone for 10 CSU DVM students from the University of Alaska Fairbanks (UAF) as they move from Fairbanks to Fort Collins for their third year of veterinary school. As part of the 2+2 program, 10 students each year complete the first two years of the veterinary program at UAF. Student learning objectives are aligned so that course content is consistent across programs. Students then move to Fort Collins to join their colleagues in completing years three and four at the CSU James L. Voss Veterinary Teaching Hospital. Program highlights include: Continued on next page


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OF NOTE Continued from previous page

UAF Clement: Third-year (class of 2019) student Christopher Clement examines a reindeer at the Large Animal Research Station, during the Foundations course at the University of Alaska Fairbanks Department of Veterinary Medicine. (UAF photo)

• Engaging in hands-on experiences and exploring research questions relevant to unique species and ecosystems (i.e. musk ox, sled dogs, caribou, bison, and reindeer) • Studying sports medicine, nutrition and animal husbandry in the context of Alaska’s sled-dog population • Learning about public health and rural medicine • Learning about unique food security issues in rural Alaska

UAF class: The joint UAF/CSU class of 2019, front row left to right: Megan Kelley, Jessica Ladd, Victoria Hammer and Jean Acuna. Back row: Josh Link, Liz Millman, Jed Harding, Chelsea Huffman, Joelene Kronz and Christopher Clement. (UAF photo) The UAF/CSU Collaborative Program was established between the two land-grant universities to give students in Alaska access to a top-ranked veterinary education partially in their home state, wh​ere veterinarians are in high demand. The partnership also allows Fort Collins-based veterinary students externship opportunities to learn about veterinary and public health issues unique to Alaska.  n

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CVMA VOI C E 201 7: 3  |   PAGE 2 3


2 017, I ssue #3

GOVERNMENT AFFAIRS New Animal Incident Management Specialist at the Colorado Department of Agriculture Maggie Baldwin, DVM Colorado Department of Agriculture Animal Incident Management Specialist The Colorado Department of Agriculture, Animal Health Division is responsible for animal health and disease control activities in Colorado and is the lead agency in any livestock health-­related emergency occurring in Colorado. The division works in close cooperation with the livestock industry and veterinary medical organizations, as well as other state and federal agencies, to protect the health, welfare, and marketability of Colorado livestock. As part of the Department’s mission, one of the vital components of the Animal Health Division is to prepare for, control, and mitigate livestock disease incidents and outbreaks. The Animal Incident Management Specialist helps to fulfill this critical component for the division by: • Overseeing the data management for reportable animal disease incidents in Colorado, such as Rabies, Tuberculosis, and Trichomoniasis. • Working with local and state emergency management, federal agencies, and the livestock industry to prepare for and coordinate response efforts for livestock emergencies in Colorado. Before starting with the Colorado Department of Agriculture, I worked for the USDA for several years, most recently as a Veterinary Medical Officer during the 2014-­2015 Highly Pathogenic Avian Influenza outbreak. An animal disease outbreak really shows the strength that communities and response agencies have when they work together to control the disease and recover afterwards. I am looking forward to working with the veterinary community, livestock industries, and response agencies in Colorado as the new Animal Incident Management Specialist at the CDA. The CDA has recently updated all of the livestock emergency disease response plans and created two new continuity of business plans specific to the state: Colorado Secure Egg Supply Plan and Colorado Secure Milk Supply Plan. These plans are critical to provide guidance to the egg and dairy industries in Colorado on how they can prepare for a disease outbreak and if an outbreak occurs, how they can continue to move product from uninfected farms in a control area. We are in the process of planning two new Secure Milk Supply workshops for milk haulers and processors which will take place in the fall and winter. If you would like to view any of these updated or new plans, please visit: https://www.colorado.gov/pacific /aganimals/emergency-­preparedness-­and-­response. The CDA also manages the Colorado Rapid Response for Ag & Livestock (CORRAL), which is a program to train a ready reserve of livestock emergency responders for an PAG E 24   |   CV M A VOICE 2017: 3

effective and efficient response. The CORRAL consists mostly of veterinarians, but also includes veterinary technicians, CSU Extension agents, livestock specialists and producers. If you are interested in being a member of our CORRAL, please contact me directly at: Maggie Baldwin, DVM Colorado Department of Agriculture Animal Incident Management Specialist 303.869.9132 or maggie.baldwin@state.co.us  n


CV M A VO ICE

GOVERNMENT AFFAIRS Rural Relief: Governor Signs Veterinary Debt Assistance Bill Kristen Browning-­Blas, Assistant Director of Communications CUS College of Veterinary Medicine and Biomedical Sciences Signed into law by Gov. John Hickenlooper on June 5, 2017, the Veterinary Education Loan Repayment Program paves the way for veterinarians to work in rural communities where large and small animals, and their owners, need professional services. Like most accomplishments in rural Colorado, the passage of the bill was the result of hard work by a group of people who care deeply about agriculture. Thanks to the bipartisan support from Rep. Joann Ginal and Sen. Jerry Sonnenberg, and input from the state Department of Agriculture, the Colorado Cattlemen’s Association, and the Colorado Veterinary Medical Association, Dr. Mark Stetter and leaders from the College of Veterinary Medicine and Biomedical Sciences successfully steered the bill to the governor’s desk. “Dr. Mark Stetter, Dr. Ashley Stokes, and their team have a global, holistic vision of the state that really inspired people to work together,” said Dr. Sam Romano, president of the CVMA and a 1983 alumnus of the CSU veterinary program. “The CSU folks do such a wonderful job putting their effort where their mouth is, helping people and animals.” With more than 34,000 farms on nearly 32 million acres, Colorado agriculture consistently ranks as one of the state’s top three leading industries, providing more than 173,000 jobs, contributing more than $40 billion to the state’s economy annually, and feeding the world with nearly $2 billion in exported products, according to the Colorado Department of Agriculture. But there is an acute shortage of large-­animal veterinarians in Colorado’s rural communities. “Hopefully, this loan repayment program will provide additional opportunities for students to ease the burden of debt and move forward with assisting our agricultural producers with their veterinary needs,” said state Commissioner of Agriculture Don Brown, a third-­generation farmer in Yuma. Like their human medicine counterparts, veterinarians are trusted professionals who help tie a community together by caring for animals, supporting their owners, and protecting the food supply. “Veterinarians work very closely with physicians, the communities rely on them. This bill helps maintain the fabric in rural Colorado and keeps it from fraying even more,” said Romano. “Cattle production and agribusiness is important to this state. The meat and the milk don’t just show up in King Soopers by accident.” Speaking from experience running his family farm in Sterling, Sonnenberg has seen the need for veterinary care up close. “Rural Colorado and agriculture are highly dependent on veterinarians,” he said. “It takes a special person to

practice in rural areas and many choose another option because of the financial obligations after college. I am anxious to see how many students this will entice to practice in rural communities.” Once the governor appoints a council to review applications, veterinary medicine graduates from 2017 forward can apply for up to $70,000 in student loan debt relief. Here’s how it works: • They must have graduated from an accredited doctor of veterinary medicine school • Currently live in Colorado or, at some point, have lived in Colorado for at least three years • Agree to practice veterinary medicine for up to four years in a rural area of the state that is experiencing a shortage of veterinarians that the council designates for participation in the program “One of the things I learned through this process is that the debt young veterinarians come out with is almost $150,000, and what keeps them from working in rural areas is the need to pay off that debt,” said Ginal, who earned her PhD in reproductive endocrinology from CSU. “There are a lot of farmers and ranchers out there who need veterinarians, and this is an incentive for those who want to practice in rural areas of Colorado. I really am proud that we passed this bill.”  n

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CVMA VOI C E 201 7 : 3  |   PAGE 2 5


2 017, I ssue #3

SCIENCE UPDATE Trends in Canine Liver Copper for the Last 20 Years

Does this really represent an increase in liver copper in recent years?

Dwayne Hamar, PhD, CSU VDL, Chemistry and Toxicology Section Head Kevin Daniels, CSU VDL, Laboratory Technician A. Russel Moore, DVM, MS, CSU Microbiology, Immunology and Pathology Assistant Professor

Diagnostic and Treatment Implications Although the percent of samples with high and toxic levels of copper analyzed for 2016 increased vs. 2006, the data are probably somewhat skewed in regard to the canine population. The samples analyzed do not represent the population of normal canines; the tested animals were suspected of having sufficient clinical signs and liver dysfunction to warrant biopsy, histology and copper quantitation. The table below gives the number of samples, average and range of some selected breeds that have been reported as having high liver copper. For 1995–1996, five of the nine Bedlington Terriers were in the toxic range, while three were in the high range. Also note that in 2006 and 2016, a low number of Bedlington Terriers were analyzed. This decrease reflects the breeders’ attempts to remove from the gene pool those that carry the defective gene. One Bedlington Terrier in the 1995–1996 group had a liver copper of 23,400 ppm dry weight. We have had some liver samples from non-­Bedlington Terriers since that have been higher. The breed designation is what the client recorded on the accession form.

In the early 1980s, CSU Veterinary Diagnostic Laboratory started determining copper on dog liver biopsies. A method for determining copper on small samples had been developed as part of a research project to determine copper storage in bovine liver biopsies. Initially, the analysis in the dog was a response by the laboratory to a request from a clinician at the veterinary teaching hospital to help evaluate liver disease in Bedlington Terriers. Thus, most of those first samples were from Bedlington Terriers. We performed the analysis on a dry-­weight basis and received samples as fresh or frozen, in formalin and paraffin blocks. After discussions with clinicians and reviewing the literature, it was determined to classify liver copper values in the following manner: • Deficient < 119 ppm dry weight • Normal 120 to 400 ppm dry weight • High 401 to 1,499 ppm dry weight • Toxic > 1,500 ppm dry weight. Some researchers have suggested the “normal” amount of copper in the liver is dependant on the breed. Based on histologic and clinical data, toxic effects have been seen in some cases when the hepatic copper content is lower than 1,500 ppm dry-­weight Trends Over the Decades Some people have thought the amount of copper in canine liver has increased in recent years. Thus, we decided to do a retrospective evaluation of the data stored in the diagnostic laboratory data system. The oldest data in the database are part of fiscal year 1995 and all of 1996; thus, we combined them as the oldest data we had available. We then evaluated the data for fiscal year 2006 and the last fiscal year, 2016. The bar chart on page 5 gives the percent in the various groups as defined above for the three different time periods. The time period for the fiscal years ends June 30 and represents the previous 12 months. The 1995–1996 category represents half of fiscal 1995—the only months for which data were available—and all of fiscal 1996. Numbers above the bar are the number of samples analyzed in each group. The numbers analyzed and percent indicating increased liver copper include: Total Analyzed 1995-­1996

Percent either high or toxic

91

57%

2006

638

43%

2016

2,116

58%

PAG E 26   |   CV M A VOICE 2017: 3

Average and range of liver copper (ppm dry weight) for select breeds 1995–1996 n

Average (Range)

2006 n 3

2016

Average (Range) 268 (124-­436)

n 3

Average (Range)

Bedlington terrier

9

6,890 (179-­23,400)

511 (347-­658)

Dalmatian

1

84

10

1,820 (196-­6,010)

22

3,900 (194-­ 16,500)

Doberman Pinscher

15

912 (216-­2,430)

50

766 (142-­3,330)

71

1380 (71-­5,430)

Retrievers*

8

971 (309-­2,210)

76

785 (77-­2,550)

426

West ­Highland White ­Terrier

7

1,879 (250-­5,870)

35

982 (128-­3,070)

49

972 (52-­8,000) 1,430 (184-­ 5,490)

*Retrievers are combination of Retriever, Labrador Retrievers, and Golden Retrievers

When assessing liver dysfunction, it is important to perform a histologic evaluation with copper stain as well as the copper quantitation. Histologic evaluation can provide information on the pattern of copper deposition and the amount of inflammation and architectural changes present in the liver. This information can be helpful in determining the cause of increased hepatic copper and in formulating an approach to treatment.  n Continued on next page


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Hepatic Copper Concentrations and Histological Changes in the Dog Dan Moezzi, CSU CVMBS student; Barbara Powers, DVM, PhD, DACVP, CSU VDL Director; and David Twedt, DVM, DACVIM, CSU Professor Clinical Sciences Abnormal hepatocyte copper concentrations are associated with oxidative stress resulting in cell death and subsequent necroinflammatory hepatic changes. The accumulation of hepatic Cu with inflammatory liver changes in the dog has been linked to certain breeds, due to suspected excessive dietary copper intake and the result of cholestatic disorders. We hypothesized that Cu concentrations would be higher in dogs having necroinflammatory liver biopsies compared to those with non-­inflammatory hepatopathies or other changes that did not fulfill the criteria of inflammatory or non-­inflammatory. A second aim was to determine if the level of hepatic Cu concentrations are related to the extent of necroinflammatory changes. We examined the CSU VDL records of 675 samples obtained in 2014 having both liver histopathology and hepatic Cu quantitation. Normal hepatic Cu concentrations are reported to range from 200 to 400 µg/g dry weight. Inflammatory groups were characterized by being lymphoplasmocytic or suppurative and grouped as being mild, moderate or severe. Non-­inflammatory samples were characterized by hepatocellular cell swelling, hyperplasia, or lipidosis. A third “other changes” group was characterized either as nonspecific reactive hepatopathies, fibrosis or hepatic neoplasia. The mean hepatic Cu concentrations (in parts per million) were higher in the inflammatory groups; mild (553), moderate (1013) and severe (1143) compared to the non-­inflammatory (353) and other group (471). These preliminary findings suggest the highest hepatic copper concentrations are associated with inflammatory liver disease and the severity of inflammatory changes tends to increase with hepatic Cu concentrations.

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IN PRACTICE Growing Leaders in Your Practice: What Is a Leader? Wendy Hauser, DVM Peak Veterinary Consulting Who are the leaders in your practice? While facilitating a leadership workshop, I asked “Who are the leaders in your practice?” This question stimulated some robust discussion. While some groups discussed the positions on their organizational leadership chart, one thoughtful response was “Everyone is a leader in my practice.” I asked this practice manager to describe to the group what leadership looked like in her hospital. She explained that every employee was invested in the success of the practice. Rather than defined leaders, the management team in the hospital believed every team member was a stakeholder and had an equal voice in the crafting of policies and procedures. She went on to explain that there was a culture of trust within the practice that encouraged constructive conflict. Because every individual participated, the discussions incorporated many different perspectives, allowing for better decisions to be made. This attitude helped to drive a culture of accountability. These factors helped to shape a healthy and happy work environment with low employee turnover, less burnout, better teamwork, and high workplace satisfaction. So how did the management team in this hospital create the environment described above? Qualities of a leader The qualities of effective leaders have been described in many ways. Simply defined, a leader is “a person who motivates a group of people toward achieving a common goal.”1 I believe that this definition is incomplete and that effective leadership requires agility. We live in a rapidly evolving world, with an uncertain and complex business climate. Our workforces are shaped by the events occurring in the world as our employees reached maturity. As such, we have a very diverse generational workforce with differing ideas about what effective leadership is. Today’s successful leaders possess the following six characteristics. 1. Emotional Intelligence Identified in 1995 by Daniel Goleman, this term was applied to business in 1998, when studies indicated highly developed emotional intelligence was more than twice as important than IQ or experience in predicting success in truly effective leaders.2,3 Emotional Intelligence, or EQ, is defined as the “ability to identify and manage your own emotions and the emotions of others.”4 According to Goleman’s research,5 Emotional Intelligence is comprised of five separate skill sets. The first three represent self-­management skills: self-­awareness, self-­regulation, and motivation. The final two are relationship management skills: empathy and social skills. While there is a genetic PAG E 28   |   CV M A VOICE 2017: 3

as well as a nurture component to Emotional Intelligence, it is widely recognized that EQ increases with maturity. Furthermore, Emotional Intelligence can be learned. It requires that individuals break old habits and form new ones, focusing on the five EQ skills. 2. Vulnerability In the not-­so-­recent past, leaders shied away from showing any sign of weakness. Admitting to being vulnerable would have been a career-­limiting action. While often viewed as synonymous with weakness, vulnerability is a paradox in that it takes great courage to allow oneself to be vulnerable. Brené Brown, a social scientist who has performed extensive research on Wholehearted Living and Vulnerability, defines vulnerability as “uncertainty, risk, and emotional exposure.”6 She states that “vulnerability is the catalyst for courage, compassion, and connection.” Great leaders understand that when they allow themselves to be vulnerable, they invite others to be vulnerable as well. These actions require humility, transparency, and trust; they serve as the basis of relational interactions and as an inspiration for loyalty. 3. Communication Effective leaders are great communicators. They have learned the value in listening with the intent to understand what the speaker is trying to convey. They ask curious questions that “promote discovery and insight.”7 Leaders who build organizations like the one described in the opening paragraph understand the value of encouraging a culture of feedback between team members. They don’t avoid critical conversations, understanding that unresolved crucial conversations become conflicts. They have learned the value of understanding others’ perspectives. Successful leaders utilize good communication tools such as open-­ended questions, reflective listening, and allowing others to complete their thoughts without interrupting. They understand that 93% of communication is non-­verbal; they seek to understand the non-­verbal messages of those with whom they are conversing and are willing to explore those messages verbally. Exceptional leaders understand the value in being fully present in the moment. As described by James Autry in The Servant Leader,8 being present means “having your whole self available at all times—available to yourself as you try to bring your values to bear on the work at hand, and available to others as you respond to the problems and issues and challenges of team members.” These leaders know that it is impossible to multi-­task and be fully present. They make a conscious decision to apply laser-­like focus toward the situation, be it an employee’s needs, a patient’s care, or a client’s wants. 4. Authenticity Remarkable leaders know who they are and what they believe in. They uphold their personal core beliefs and align their actions with their core values, regardless of

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how tempting it might be to compromise themselves for personal, professional, or financial gain. They are true to themselves. In being so, they set the standard within their organizations for others to live and honor their own values. 5. Seek Change The world around us is constantly evolving. Many leaders may embrace this change in their personal lives, but are reluctant to challenge the status quo within their own organizations. Outstanding leaders understand the value of being forward-­focused. While they are managing the present, they are actively planning for the future. These leaders understand the importance of maintaining a broad professional network, so that they may gain information and clarity around changes that are likely to impact their businesses. They are curious, seeking new ways of doing things. By challenging the status quo, they help to build a culture of innovation and possibility. Finally, these leaders are not afraid of failure. They establish a culture where employees are encouraged to try new ideas. When these ideas fail, the processes are dissected so that the failure becomes a valuable learning experience. They ask “what went well?” and “what could be better yet?” Team members are encouraged to apply these lessons and try again. 6. Followership As our understanding of leadership has evolved, so has an awareness of followers. Historically, leaders have used influence to persuade followers to achieve pre-­determined goals. What role do followers play in the leadership process? This question has formed the basis for a new field of research, Followership. This area of study has accelerated in the past nine years, when it became apparent that “leadership cannot be fully understood without considering the role of the follower in the leadership process.”9 It is important to recognize that leadership is impacted not by the role of follower, but as a result of “following behaviors.” Without this, leadership does not occur. As discussed by Mary Uhl-­Bien,9 “It is probably easier to recognize leadership in following behaviors than it is in leadership behaviors, as individuals attempting to be leaders are only legitimized in the responses and reception of those willing to follow them.” Millennials in the Workplace An understanding of the followership concept is important in developing awareness around evolving leadership models. The significance of this concept becomes even more critical with the presence of the millennial generation in our hospitals. Millennials, as a group, share some unique characteristics that will impact their preferences for leadership style. They are the most diverse generation, socially and racially. Due to their acceptance of variety, this generation views problems broadly, applying concepts that work

in one area to problems that arise in others. They have also been raised with an “elevated status,” where their opinions have been solicited and considered in decision-­making paradigms. Therefore, hierarchal boundaries are less clear. They will seek to collaborate with whomever can help in the attainment of their goals. A commonly used model of leadership in many hospitals is transactional leadership, when followers behave in ways defined by their leaders. This leadership style is incompatible with the needs of the millennial generation. To succeed, leaders will be required to flex and adapt, adopting leadership styles that are more transformational in nature. Transformational leadership is described as leadership that occurs “when one or more persons engage with others in such a way that leaders and followers raise one another to higher levels of motivation and morality.”9 Culturally, hospitals will need to adapt in ways that support the core values defined by this generation, such as collaboration, teamwork, transparency, and relational interactions. What changes can you make? Through carefully selecting and cultivating their hospital leaders, the organization described in the first paragraph nurtured a culture where followers and leaders worked hand in hand, where all team members were empowered and felt valued. This leadership approach is attractive to millennials, encouraging them to bring added value and innovation to the workplace. What changes can you make to emulate their success? References 1. Ward, S. Leadership, About Money https://www.thebalance.com /leadership-­definition-­2948275 2. Golemen, Daniel. Boyatzis, Richard., McKee, Annie. Primal Leader­ship: Learning to Lead with Emotional Intelligence. Harvard Business School Press, Boston, MA 2002 3. Fernandez-­Araoz, C. Great People Decisions. Wiley 2007 4. https://www.psychologytoday.com/basics/emotional-­intelligence 5. https://hbr.org/2004/01/what-­makes-­a-­leader 6. Brown, B. Daring Greatly, 2012 7. https://hbr.org/2016/07/what-­great-­listeners-­actually-­do 8. Autry, J. The Servant Leader, 2001 9. Balda, J., & Mora, F. (2011). Adapting leadership theory and practice for the networked, millennial generation. Journal of Leadership Studies, 5(3), 13–24.

Wendy Hauser, DVM, established Peak Veterinary Consulting in January 2015 after working as an industry Technical Services Veterinarian. With a DVM from OK State, she practiced for 30 years as an associate, owner, and relief veterinarian. She is highly engaged in AAHA leadership, having served as a member of the board of directors and as the board vice-­president; she is currently the AAHA Delegate to the AVMA House of Delegates. The co-­author of The Veterinarian’s Guide to Healthy Pet Plans, her most recent position is as AVP, Veterinary Relations, Hartville Pet Insurance Group. This is a restricted article sent to you for educational purposes only and may not be copied or disseminated without written consent from Peak Veterinary Consulting, LLC  n CVMA VOI C E 201 7 : 3  |   PAG E 2 9


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IN PRACTICE Millennials in your Veterinary Practice: Seeing Past the Stereotypes Rachel Teichberg, Practice Coach Veterinary Growth Partners

Millennials are commonly defined as the generation born between the early 1980s and the early 2000s. If you close your eyes and imagine a millennial, you may have a vision of this person with a cell phone glued to their hand, swiping through social media or snapping selfies. You may envision a wall of participation trophies in their childhood home and an inflated sense of entitlement. There is a lot of negativity regarding millennials in the workplace and the stereotypical demands they make of their employers. It’s time to see through the stereotypes and start harnessing the many overlooked talents of millennials in your practice. In addition, working efficiently with a new generation may mean changing the way you manage your team. If you are reading this article and are not a member of the millennial generation, I would like you to think back to when you were between the ages of 18 and 34, and the criticism the older generations spoke of your demographic: • Generation X: Born between 1965 and 1980; described as shallow, commitment-phobic, and self-absorbed.1 • Baby Boomers: Born between 1946 and 1964; described as self-righteous and self-centered. Often called the “me” generation.1 Does any of this sound familiar? Why not give millennials a break on the criticism that every generation prior has similarly faced and, instead, focus on the ways you can work together? Commit to harnessing their talents and by doing so, you can bring your practice to the next level. Here are some of the common millennial stereotypes. Cell Phone Obsessed Do you have that employee (or maybe several) that are always on their phones? Instead of creating policies about

cell phones that we are constantly fighting with or against, think about ways to optimize a millennial’s cell phone addiction for your practice. If your practice doesn’t currently have an active social media presence, you may find that there is someone on your team who is quite capable of managing your social media and digital marketing platforms. Instead of sneaking around using their cell phones for personal use, give them a job and have them spend their social media time working for you by increasing the visibility of your practice. According to Zephoria Digital Marketing, as of April 2017, 29.7% of Facebook users are ages 25-34, meaning that millennials are also your primary target market on that platform.2 In addition to keeping social media feeds active, which is a great way to keep in touch with your clients, this employee could also keep your website current, focus on search engine optimization (SEO), monitor your google analytics, and manage your online reputation. Is there someone in your practice that likes to Snapchat or make live Instagram videos? Knowing that 65% of people are visual learners,3 harnessing this team member’s interest in documentation is a great opportunity to retire your dusty binder of SOPs and digitize them with videos. The videos can cover all areas of the practice and will be an invaluable training tool. A Sense of Entitlement Many people blame the stereotypical sense of entitlement of millennials to the receipt of participation trophies as children. However, I’m sure that life experience has shown you that entitlement does not discriminate by age. If employees seem to feel they deserve the same benefits as others for doing less, why not start with raising the bar for your team? You can achieve this with three easy steps: Clearly define roles and responsibilities, hold each member of the team accountable, and provide specific and helpful feedback. Sounds easy, right? Let’s take a closer look. You should start by ensuring you have clearly defined job descriptions for all members of your team, including practice managers and veterinarians. Next, be sure each person received, reviewed, and has a full understanding of their role and responsibilities. Job descriptions should clearly define the responsibilities of any role in the practice and should be presented upon hire. All job descriptions should be thought of as a living document so that as the practice evolves, so too will the positions within it. Another important document that goes hand in hand with your job descriptions is your accountability chart. This is slightly different than an organizational chart, which defines who reports to whom. An accountability chart dives deeper into who is accountable for each task. However, simply having an accountability chart is not enough. It is critical for the leaders in your practice to hold each member of the team accountable for their responsibilities. In addition, it is necessary for leaders to give real time

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IN PRACTICE manage all members of your team towards success. No matter which generation you are in, we were all once that age, and all know what it’s like to acclimate to a new workplace and work with people of an older generation. Let’s shift the focus from the things that divide us to things that can bridge the gap and help your practice reach its goals!

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feedback to correct issues that arise. Think of creating your own positive feedback loop in your practice. This starts with delegating a task to a member of your team with set expectations and deadlines. Next, monitor their progress with regular check-ins. During these check-ins, set your employee up for success by providing constructive feedback and help coach them through any issues they may be having. Once the task has been successfully completed, you can reward or recognize the achievement and start the process over again. Setting expectations will set the whole team up for success and will throw any pre-established entitlement out the window. The great news is that a positive feedback loop will have a tremendous impact on all members of your team regardless of their age. A leader’s role is to make the intentions for the practice clear to the team and ensure their success by creating direct communication channels.

CVMA partners with Veterinary Growth Partners (VGP) to provide an array of benefits to CVMA members, including preferred pricing, educational training programs, marketing tools, practice management tools, and 1:1 practice coaching. To learn more and become a member of VGP, visit www.vgpvet.com. References 1. Novak, Jill. “The Six Living Generations In America.” For Marketing Learners, Teachers and Professionals. N.p., 05 Mar. 2017. Web. 09 Apr. 2017. http://www.marketingteacher.com /the-six-living-generations-in-america/. 2. “Top 20 Facebook Statistics—Updated January 2017.” Zephoria Inc. N.p., 03 Apr. 2017. Web.09 Apr. 2017. https://zephoria.com /top-15-valuable-facebook-statistics/ 3. Bradford, William C., Reaching the Visual Learner: Teaching Property Through Art (September 1, 2011). The Law Teacher Vol. 11, 2004. Available at SSRN: https://ssrn.com/abstract =587201  n

Bringing It All Together Instead of focusing on the stereotypical negative attributes millennials may bring to your practice, shift your perspective to see how you can focus on the positive attributes a millennial can bring to the table. As a result, you will ultimately

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IN PRACTICE How to Encourage Considerate, Constructive Cell Phone Use in the Practice Wendy S. Myers, CVJ While you explain exam findings, a client’s fingers are pounding out text messages. Even though this insensitive use of technology is annoying, it may become commonplace as pet ownership demographics shift. Millennials check their smartphones 43 times per day.1 But we can’t discount this generation—they spend more on veterinary care than Generation X and Baby Boomers.2 Millennials will add 2.6 million pet owners between now and 2020, so it’s important that we learn how to manage inappropriate cell phone use rather than get frustrated.3 Regardless of generational differences, some clients may be addicted to email, text, and social media. Surfing Facebook can become intoxicating and stupefying. Don’t stay silent about bad mobile manners. Distracted clients may be incapable of making healthcare decisions, causing both patient care and hospital revenue to suffer. Here’s how to get clients to hang up and listen. Lead by example. If you have a cell phone tethered to your hip or in your lab coat pocket, vibrate is not silent. When your phone buzzes for every email, text, or social media notice, you’re demonstrating that cell phone usage during exams is acceptable behavior. Leave your cell phone in your desk or locker. If you’re expecting an urgent call or text, park your silenced phone in the lab/pharmacy hallway where you may glance at it between exams. Your hospital needs a consistent policy for all employees, whether a practice owner or kennel attendant. Veterinarians can’t constantly check their cell phones and expect employees to follow different rules. Researchers at Howard University and the University of Southern California found employees are especially bothered when managers answer cell phone calls during meetings.4 Employees should limit personal cell phone calls to breaks and lunch time. Lengthy conversations can affect productivity and disturb co-workers and clients. When making business calls, a business phone should be used. You don’t want clients calling employees back on their personal cell phones. Get tips for creating an effective cell phone policy at http://blog.hr360.com/bid/128885/7-Tips -for-Creating-an-Effective-Cell-Phone-Policy-for-Your -Workplace. Set expectations with signs. Post signs in your lobby and exam rooms that encourage the behavior you want such as, “During your appointment, we kindly request that you refrain from cell phone use.” (You can order signs from www. mydoorsign.com or www.safetysign.com). Place signs in prominent locations such as the check-in desk and at eye level of client seating in exam rooms.

Redirect the conversation away from texting. While you might want to bark, “I’ll be back when you’re done with your text,” don’t just leave the exam room for 10 minutes, which is equally rude and could result in a bad online ­review. Reclaim control of the conversation. Tell the client, “I see you’re having an important text conversation with someone. Is your text about your pet’s care today? I’m happy to provide answers so you can consult with that person after you have all the information from me. Could we discuss your pet’s healthcare first, and then you could get back to your text?” Nir Eyal, author of Hooked, a how-to guide for building habit-forming products, believes technology should serve us—we should not serve it. 5 Don’t resign yourself to being ignored, he advises. Rather than accept ill-timed cell usage as a sign of the times, Sherry Turkle, an author and professor at the Massachusetts Institute of Technology, diagnosed the problem as “We expect more from technology and less from each other.”5 To win over clients, you must be more engaging than their smartphones. Involve them in exams, letting them listen to heart murmurs, having them peer into your microscope to see ear mites, and sharing their pets’ digital dental x-rays. Invite smartphone use for client education. Because 65 percent of people learn visually, encourage clients to take photos or videos with their smartphones.6 Let’s say you advise a pet owner to give subcutaneous fluids to her cat at home to treat its chronic kidney disease. Tell the client, “Let’s give your cat fluids together today so you will know how to do it at home. You’re welcome to record a video on your smartphone for reference. I will text you a link to our hospital’s YouTube video on how to give fluids. Giving your cat fluids three times per week will keep her hydrated and let us better manage her kidney disease together.” Use your practice-management software or a third-party texting service to text the link at the end of the visit. Appropriate smartphone use includes showing clients how to use your practice’s app, access your YouTube channel for helpful videos, or Like your clinic’s Facebook page for ongoing tips. Try a collaborative rather than confrontational approach when dealing with cell phone use. Watch my video on “Get the #$@&%*! Off Your Phone” at www.youtube.com/watch?v=zcyfu0g2hNo. References 1. Shupe, C. Quiz: Do you know millennials? Really? Firstline. Published May 2016. Accessed on April 26, 2017 at http://veterinary team.dvm360.com/quiz-do-you-know-millennials-really. 2. Phillips-Donaldson, D. Baby Boomers step aside: Millennials now own more pets. Pet Food Market Trends. Published April 1, 2015. Accessed April 27, 2017 at www.petfoodindustry.com/articles/5049 -baby-boomers-step-aside-millennials-now-own-more-pets. 3. Stewart, C. Millennial pet owners, future of the industry. MarketResearch.com. Published March 22, 2016. Accessed

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IN PRACTICE Combat or Succumb to High Turnover? Rebecca Rose, CVT What is a veterinary manager to do—aggressively combat, or succumb to, high turnover rates? There are many studies that evaluate the cost of turnover. Some calculations range as high as two times the annual salary of the team member being replaced,1 especially when the person is at an executive level (such as a veterinarian). Another equation, from the Center for American Progress,2 may be applicable to the majority of veterinary team members. “For workers earning less than $50,000 ­annually—which covers three-­quarters of all workers in the United States—the 22 case studies show a typical cost of turnover of 20 percent of salary,” You may be aware that veterinary hospitals experience team turnover at twice the rate of other industries.3 When managers begin tracking and calculating their team turnover rates, they may find their average annual turnover is upwards of 25 to 50%! Calculate your annual team turnover “The annual employee turnover rate is the ratio of total separations to the average number of employees. The U.S. Bureau of Labor Statistics defines separations as both voluntary and involuntary employee terminations, including retirements, resignations, dismissals and layoffs. Turnover rates may affect profitability and staff morale,” states Chirintan Basu in the article How to Calculate the Employee Turnover Rate on an Annual Basis. Let’s put pen to paper to determine just how much it may be costing veterinary hospitals when they gain and lose employees. Keep in mind, there is a financial equation AND an emotional equation. Turnover is simply stressful! For our calculations, we will use a veterinary hospital with 3 full-­time veterinarians and 12 support staff, experiencing a 30% annual turnover rate with an average salary of $50,000. From the reference above, we will select 20% of this salary as the typical cost to replace staff. Thus the veterinary hospital’s cost of turnover may conceivably be $45,000 per year (15 × 0.3 = 4.5 separations × $10,000.00 = $45,000). Costs associated with team turnover include:

• manager time in hiring (posting, reviewing applications, and interviewing) • tangible costs in posting and tracking job announcements • team time in training • inefficiency of new hires as they adapt into productive team members (it may take 1-­2 years to bring a new ­employee to the level of the exiting, experienced one) • stressful impact of team being in a state of morphing, ­especially if it’s over a long period of time Consider applying the cost of team turnover ($45,000 from the above example) to developing a team trainer (a team member who enjoys teaching, is organized, and invested in the vision of the practice). Or invest in benefits that are tailored to your team’s needs such as child care or a gym membership. Or invest in classes such as management training and leadership, embracing concepts in human relations, policies and procedures, or implementation of tools for success. Benefits associated with higher team retention include: • continuity in delivery of services positively impacting client satisfaction • continuity in delivery of patient care which can result in improved effectiveness and competence of patient care • efficient teams, positively impacting speed and trust Retain and grow your veterinary team by aggressively combating veterinary team turnover! Track your retention rate, participate in exit interviews, and ask your team what makes them happy in their work. Sources 1. https://www.zanebenefits.com/blog/bid/312123/employee -­retention-­the-­real-­cost-­of-­losing-­an-­employee 2. https://www.americanprogress.org/wp-­content/uploads/2012/11 /costsofturnover.pdf. 3. http://veterinarynews.dvm360.com/veterinary-­turnover-­rates -­higher-­national-­average Rebecca has worked in the veterinary profession for 30 years, first as a CVT before transitioning to association and hospital management. She writes books, peer reviewed articles, and presents locally and nationally on the topics of practice management and team development. Now, as the president and founder of CATALYST Veterinary Practice Consultants, she assists veterinary teams in reaching their highest potential. Learn more at CATALYSTVetPC.com.  n

Cell Phone Use continued from page 32 April 27, 2017 at http://blog.marketresearch.com/millennial-pet -owners-future-of-the-industry 4. Hedges, K. How to get people off their phones in meetings without being a jerk. Forbes.com. Published June 5, 2014. Accessed June 10, 2017 at www.forbes.com/sites/work-in-progress/2014 /06/05/how-to-get-people-off-their-phones-in-meetings-withoutbeing-a-jerk/#431ff22313ee. 5. Eyal, N. How to politely ask people to get the f*ck off their cell phones. TechCrunch.com. Published March 4, 2016. Accessed June 10, 2017 at https://techcrunch.com/2016/03/04/ how-to-politely-ask-people-to-get-the-fck-off-their-phones/.

6. Klingbord, J. Exam Room Communication for Veterinarians. AAHA Press © 2011; pp. 27, 29, 160-162, 34-35. Wendy S. Myers owns Communication Solutions for Veterinarians in Castle Pines. She helps teams improve client service, communication skills and compliance through consulting, seminars and monthly CE credit webinars. Wendy is a certified veterinary journalist and author of 101 Communication Skills for Veterinary Teams. She offers training packages for receptionists and entire teams. You can reach her at wmyers@csvets.com or www.csvets.com.  n

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IN PRACTICE “Are You Glad You Became a Veterinarian?” Casara Andre, DVM, cVMA Cultivate Veterinary Wellbeing “Are you glad you became a veterinarian, at least once every three days?” I believe the question was meant in jest. It was his way of inquiring how I was without being nosy. I could see the memory of his dear, kind face, notable beard and iconic glasses looking expectantly over a microscope in pathology lab—shaping my veterinary training, working diligently to instill in me and all of his other students a love of his (and soon to be our) profession. But as I contemplated his question, the series of images that ran through my head was tumultuous . . . I replayed the memory of watching countless sunrises after all-­night study sessions in preparation for test day and then celebrating with friends after surviving the exam. The feel of the fourth-­year “hallway”—anxiety, frustration, laughter, camaraderie and competition. In the span of a few seconds, I saw again some of the formative patients and clients encountered during my clinical years—the feeling of reaching out and affecting a pet and owner at a frightening and overwhelming moment to give them options and solutions, or at least helping them find some peace in the decision that needed to be made. I saw myself ready for my first job, excited but nervous, confident in my skills but also afraid to encounter a situation for which I wasn’t prepared. A dozen memories of veterinary school swam up before my eyes—all scattered along the path leading to this day. “I wish I was,” I replied. Did I really regret my career decision? Was my hard-­ earned career choice a choice I’d take back if I could? Have any of you, fellow caregivers, felt the same? Have you looked for the joy in veterinary medicine and found it missing? Wondered what happened to the fulfillment that we glimpsed as we fought our way through biochemistry class, impatient residents and interns, and late night ICU duties? Do you remember the first patient you lost and the support of your classmates who grieved with you? The first patient you saved and felt “on top of the world”? The first owner to squeeze the breath out of you with a hug and leave tears of joy on your shoulder? What happened in between? What happened to the dream of veterinary medicine? Veterinary school was difficult, but no more so than expected. My classmates and I walked through the school doors ready for a challenge. Today’s application process and screening tools bring an amazing array of applicants, all bursting at the seams with talent and life experiences— all ready to soak up new knowledge. And then comes . . . the “real” world. Today’s veterinary community is far different than the one my mentors experienced. Their stories described a PAG E 3 4   |   CV M A VOICE 2017 : 3

profession founded on collegiality, curiosity, compassion, and connection to both owners and patients. They fondly remember being mentored through tough decisions by older veterinarians, friendship between colleagues, and professionalism as everyone’s motto. They described a profession where veterinarians worked together to solve a clinical puzzle, where veterinarians were one of the most highly respected members of the community, and most of all, feeling that they contributed to and defended the wellbeing of the animals in their care every day. Our profession is experiencing a rapid culture shift. We are quickly losing the small-­business clinic in exchange for large-­ scale hospitals. The rise in specialists and availability of extensive testing and procedures is astounding. Some of these changes are extremely exciting—our world and our knowledge of it is growing by leaps and bounds. We are able to provide care for our animal patients as never before and offer a level of medicine unparalleled in our profession’s history. Articles such as those cited in 20161 are summarizing and scientifically characterizing the sharp decline that we are witnessing in the wellbeing of our professionals. Like an epidemic, the decline of the mental, emotional, and physical health of our veterinarians and technical staff has the potential to spread throughout our community. “Wellbeing” has become the catch-­phrase of the past few years. Conferences, articles, workshops, and programs all aimed at improving the wellbeing of our professional community are springing up all over the country. Is it helping? Do you, as a veterinary caregiver, feel supported by your community, surrounded by colleagues upon whom you can rely, and fulfilled by the medicine that you are able to practice? Technology, population, and client expectations are also much different for us than they were for our mentors. And perhaps, more importantly, the mentality of our industry’s leadership has shifted. Impressions and experiences from today’s workplace create their own set of memories for me, memories as vivid as those from veterinary school . . . The forcing of careful medical deliberation and critical thinking into 15-­minute timeslots and the daily bottom line. Profit-­oriented business models that promote profit more than medicine. Policies and management decisions that don’t promote the wellbeing of compassionate-­hearted staff in a complicated and stressful environment. In stark contrast to the compassion and care of my bearded pathology professor, how many veterinary professionals of our generation have been shaped during their career by dispassionate, burned-­out, or even toxic leaders and mentors? Why are we witnessing such a dramatic shift in the communities of our profession? And, more importantly, what is the secret to restoring the venerated atmosphere in which our mentors thrived? Continued on next page


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IN PRACTICE Continued from previous page

As members of this veterinary community, we have a choice. We can accept this cultural shift or we can make the decision to roll up our sleeves and rediscover, or better yet, work to create a new direction that honors the heritage of our mentors. Please allow me to share a vision for our veterinary community within the next 10 years. I am dreaming of a community where the wellbeing of its members is the foundation of all future directions and changes. I am dreaming of: • A profession that honors members who put family, personal health, and mental wellbeing above the invoice amount of a client visit. • A pervasive expectation that healthy practitioners are able to provide the highest and most consistent standard of care for their patients. • Healthy and profitable businesses and fulfilling careers being created by earning the trust and respect of, and maintaining long-­term relationships with, our clients. • A community that equally respects all of its members— veterinarians, technical staff, and others—as we all focus on the holistic wellbeing of the animals in our care. • Possibly most important, a move away from “profit-­only” motivated habits to explore “outside-­the-­box” solutions for valuing and protecting our most valuable asset—the individuals, the h ­ umans, on the team.

Whether your role is in reshaping the landscape of today’s clinic environment or investing in new, innovative, and non-­traditional veterinary roles such as house-­call practices, hospice care, relief work, industry positions, teaching, research, consulting, and others, your voice has power and your actions have meaning. Whether you entered our community this year, have retired from the workforce, or are somewhere in the middle like me, this veterinary industry is our community. It is our world. It is shaped and defined by us, its members. We have an obligation to push, prod, question and strive toward creating lasting change for our industry on a daily basis. It is not until every young graduate can look into their professor’s eyes and say, “Every day. It is every day that I’m glad I’m a veterinarian,” that we will have fulfilled our obligation to ourselves, our community, and to our mentors who set us on this path. Reference Larken, M. “Studies confirm poor well-­being in veterinary professionals, students.” JAVMAnews. 13 April 2016. https://www .avma.org/News/JAVMANews/Pages/160501c.aspx

Dr. Casara Andre is the owner of Cultivate...Veterinary Well­ being (www.cultivate.vet), a veterinary co-­working community, and Scheduled Relief (www.scheduledrelief.com), a networking community for relief veterinarians.  n


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IN PRACTICE Real Estate: The Second-Highest Expense in Your Practice Kent Hildeband Broker, Southern Colorado | New Mexico Carr Healthcare Realty When it comes to managing expenses in your practice, there are dozens of categories to evaluate: equipment, technology, loan costs and interest rates, sundries, marketing, and on and on they go. Many practice owners are quick to shop-out what they believe are the most obvious expenses, but few understand the impact of one of the largest expenses and how it can be dramatically reduced to increase profitability. The highest expense for most practices is payroll, followed by real estate. Real estate encompasses your monthly rent or mortgage payments, along with the property’s operating expenses, maintenance fees, utilities, and janitorial costs. If you consider these top two expenses, payroll and real estate, only one of them is really negotiable. With payroll, you can either pay people their value or they usually find another job that will. You may decide that you can cut staff, but if you need people you need to pay them what they deserve or they will eventually leave. Real estate however, is 100% negotiable. You have the choice of leasing or owning, as well as being in an office building, retail center, a stand-alone building, or large medical complex with many other providers. You can choose the size of your space, the design, and the landlord you want to work with—or to be your own landlord. And if you do own, you get to decide whether to buy an existing building, an office condo, or to develop your own building from the ground-up. When negotiating the economic terms of a lease, you get to have a say in the length of lease, the desired concessions including build out period, tenant improvement allowance, free rent, lease rates, annual rate increases, and many other provisions. With this many choices to evaluate and understanding that each one affects the final economic outcome, why is it that so many practices fail to capitalize on their real estate opportunities? The short answer is that most practice owners and administrators simply don’t have the knowledge and expertise in commercial real estate to understand how to make the most of these opportunities. They view real estate as a necessary evil instead of an incredible opportunity to improve profitability, reduce expenses, and improve the quality of their patients’ experience. When the correct approach is taken, you may actually look forward to it instead of dreading your real estate negotiation. Let’s take a look at three key ideas that will help you make the most of your next real estate transaction.

Timing Every type of transaction has an ideal timeframe to start the process. When starting too early or too late, you communicate to the landlord or seller that you don’t really know what you’re doing. When that message is communicated, it hurts your ability to receive the best possible terms. For example, don’t wait for your landlord to approach you on a lease renewal negotiation. Start by consulting with a professional so you can understand the ideal timeframe to start your transaction, come up with a specific game plan for what you want to achieve, and then you be the one to approach your landlord with renewal terms. Representation Landlords and sellers prey on unrepresented tenants who don’t really know the market or what their options are. If the tenant was a Fortune 500 company, the landlord would approach them with a high level of respect, expecting that they either have a real estate broker hired to represent them or have a team of professionals internally that are well equipped to handle the transaction. In contrast, when a landlord or seller starts speaking with a tenant who isn’t represented, and who they don’t believe knows the market as well as they do, that tenant is not going to get the same level of respect through the process. This is because the landlord senses an opportunity to take advantage of a small tenant who is not an expert, doesn’t have a full complement of real estate knowledge and skills, and who doesn’t have adequate representation. When you understand that commissions are paid in commercial real estate just like they are in residential real estate—they are set aside in advance for two parties, not just one—then you understand there aren’t any savings by not having a broker. And if there aren’t any savings by not having a broker, then showing up without one only further detracts from your credibility. Leverage and Posture It is nearly impossible to emerge victorious from a negotiation without leverage and posture which are created by having multiple options in the market. If you limit yourself to one property, you are at the mercy of that owner. Since most landlords and sellers negotiate professionally, it is easy for them to know when you don’t have other viable options. Simply telling a landlord that you have a proposal from another landlord won’t give you a strong enough posture. Most landlords look at unrepresented tenants and assume they do not know the market, do not understand all their options, and are not really serious about making the landlord compete for their business. Leverage and posture are created when you have the right timing, professional representation, an understanding of all your available options, Real Estate continued on page 37

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IN PRACTICE Introducing the FRANK Communication Workshop Series at CSU Jane R. Shaw, DVM, PhD Veterinary Communication for Professional Excellence Colorado State University Effective communication with clients and colleagues is a critical skill for success of veterinary practices. The growth of the human-animal bond, client demand for high quality and compassionate care, and practice requirement for high-performing teams drives the need for enhancing client and team communication. The new FRANK Communication Workshop Series provides the opportunity for veterinary team members to enhance their communication toolbox and to learn how to mentor others. The FRANK Communication Workshop Series is made up of three highly experiential continuing education events: FRANK 1.0 –> FRANK 2.0 –> Communication Coaching Skill Workshops. All emphasize the importance of communication as a significant clinical skill for veterinary teams. Each workshop builds and reinforces the skills learned in the previous workshop. The learning is customized to foster each individual’s clinical communication skills. FRANK 1.0 focuses on communication skills for solid history-taking and FRANK 2.0 on explaining and planning, resulting in the development of a toolbox of 20 essential communication skills. The case scenarios present difficult communication topics, such as dealing with emotions, team conflict management, delivering bad news, financial conversations, disclosing medical errors, and end-of-life conversations. Participants take these newly honed communication skills back to their practices and find that applying tools such as asking open-ended questions and practicing empathy make a drastic difference in their client interactions and relationships.

Then the Communication Coaching Skills Workshop teaches how to mentor others in developing their own communication skills. The end goal at the completion of the FRANK Workshop Series is that an individual could serve as an in-house communication coach to teach their colleagues in the veterinary practice. The highlight of all the workshops is the communication laboratory, where participants interview actor clients, receive individualized coaching and feedback from their peers and simulated client, and reflect on a video-recording of their performance in a small group setting. Participants find the opportunity to practice their skills in a real-life clinical scenario with the support and feedback of their peers the most rewarding aspect of the workshops. Recent participants describe the environment as non-threatening, supportive, and very interactive and open, all of which promote hands-on learning in a non-judgmental setting. The FRANK Workshop Series is in full swing this year, with seats still available for the upcoming Communication Coaching Skills Workshop November 10-12, 2017. If you have taken the FRANK Workshop in the past, we would love to see you back! Stay tuned for the 2018 workshop schedule and register online at www.cvmbs.colostate.edu/ ce/frank-workshops.  n

EAT. SLEEP. NEUROLOGY. THAT’S RIGHT—We’re the Only Colorado Veterinary Neurology Clinic:

Real Estate continued from page 36

and a detailed game plan of what you want to accomplish in order to capitalize on the market. These three key ideas are the first of many factors that allow healthcare tenants and buyers to reduce their second highest expense which dramatically impacts profitability and cash flow. Carr Healthcare Realty provides commercial real estate services for healthcare tenants and buyers and is able to strongly advocate for healthcare providers and avoid conflicts of interest while saving their clients hundreds of thousands of dollars. Carr Healthcare Realty’s team of experts can assist with all types of real estate transactions, including lease renewals, expansions, relocations, startup offices, purchases, and practice transitions. Learn more at carrhr.com.  n

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WWW.ROCKYMOUNTAINVETERINARYNEUROLOGY.COM A proud owner of VRCC, Veterinary Specialty & Emergency Hospital CVMA VOI C E 201 7 : 3  |   PAGE 37


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IN PRACTICE Pet Owner’s Perceptions and Use of Veterinary Mobile Applications Lori Kogan, PhD Professor, Clinical Sciences, CSU College of Veterinary Medicine and Biomedical Sciences Stacee Santi, DVM CEO/Founder, Vet2Pet App Builders Vet2Pet partnered with a Colorado State University professor, Dr. Lori Kogan, to survey pet owners on their views and experiences with using a mobile app for veterinary contact and services. What did they find? No big surprise . . . Pet owners like their apps! Mobile apps—it seems like they are everywhere, and can do nearly everything. Mobile apps are software applications designed to run on smartphones, tablets, and other mobile devices. They are typically available through app stores. As of June 2016, there were 2.2 million apps available at Google Play store and two billion apps available in Apple’s App Store, the two leading app stores in the world1. We have apps to listen to music, play games, shop, and stay in contact with friends and family. Given the ubiquitous presence of mobile apps in our lives, we feel it is important to know how pet owners feel about using a mobile app to connect with their veterinary care provider. The anonymous survey was distributed through Amazon Mechanical Turk, a crowdsourcing online labor market that coordinates the supply and the demand of cognitive tasks. The survey was made available between 10/5/16 and 10/23/16. Data from 610 respondents who met the inclusion criteria (i.e., live in the U.S., have at least one dog and/ or one cat, and have a regular veterinarian they had seen in the last 12 months) were included for analysis. Our sample consisted of mostly women (73% females and 27% males) between 18 and 40 years old (63%). The respondents tended to be college educated (38% had a 4 year degree and 18% had graduate degree). Here are some highlights of what we found. Pet owners and mobile app usage: No big surprise -­pet owners like their apps! • 86% of pet owners are comfortable with most apps • 74% of pet owners use at least one app daily As you might expect, pet owners lucky enough to have vets with mobile apps enjoy many of the features offered. Here is a glance at the percent of owners who use their veterinary mobile app to do the following: • Make appointments • Order medication • Check clinic hours • Look for vet articles • Look at their pet’s medical record • Use their vet’s loyalty program (if offered) PAG E 3 8   |   CV M A VOICE 2017: 3

69% 42% 73% 53% 57% 69%

Clients not only use the app for these tasks, they overwhelmingly prefer using an app over a phone call. Like app better Like app than equal to phone phone

Like app less than phone

Don’t use/ Don’t know

78 (50.3%) Make appointments

53 (34.2%)

19 (12.3%)

5 (3.2%)

Order medication

62 (40.0%)

47 (30.3%)

20 (12.9%)

26 (16.8%)

Order pet food

52 (33.5%)

36 (23.2%)

22 (14.2%)

45 (29.0%)

Checking clinic hours

104 (67.1%)

34 (21.9%)

9 (5.8%)

8 (5.2%)

Looking for vet info

89 (57.4%)

35 (22.6%)

10 (6.5%)

21 (13.5%)

Accessing pet medical record

85 (54.8%)

42 (27.1%)

8 (5.2%)

20 (12.9%)

We are in a new era. Pet owners are increasingly informed, having access to enormous amounts of information, yet the internet does not replace the trust they place with their veterinarian. And, like all of us, pet owners are increasingly stretched; they don’t have time to wait. This desire for speediness helps explain the recent addition of Google maps to show users actual wait times in stores in real time. This is just one more example of how apps are providing solutions to current challenges. Now, more than ever, pet owners are looking for efficient and creative solutions to help them care for their pets. The veterinary clinics that can deliver on these needs, and cater to owners’ desires to feel special, build loyalty. Client loyalty is influenced by several factors. It is about owners’ actual experience at the veterinary practice. It is about personalization and how easy the practice is to do business with. A veterinary mobile app can positively impact all these areas. If we look at the early, privately owned, small veterinary practices, those vets were experts at developing and nurturing the human-­animal-­veterinary bond. True, the medicine wasn’t as good, the equipment not as advanced, but client loyalty was exceptional. Now, unfortunately, that is often not the case. We have evolved to have very sophisticated services but loyalty is suffering and clients are leaving. Here are some reasons: 1) We have lost the personal touch. As our practices have grown into multi-­doctor centers servicing thousands of clients, it has become a challenge to “get to know” our clients and be good listeners. This is a critical part, though, of cultivating the owner/vet relationship where bonding occurs. It’s not an app, it’s not a pre-­visit form, it’s not an automated email with merge words. It’s actually the connection—the feeling that someone is listening and cares. Continued on next page


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IN PRACTICE Continued from previous page

2) It is becoming increasingly difficult to justify our costs and show value to the pet owner. This is especially true with the amount of comprehensive information available on the Internet. In order to “sell our product” to the pet owner, we are going to have to deliver what they value. It’s not a blood machine that can give results in 12 minutes, it’s not a digital X-­ray, or a brand new ultrasound machine (not that we don’t love these things), but the main value proposition to our clients is that we care. This is something Dr. Google can’t ­provide. 3) Veterinary practices are known for a lot of things, but being efficient is not one of them. Yet, efficiency is a key factor in loyalty and client experience. Most people don’t enjoy waiting for you to count 180 thyroid pills and get all the paperwork together. They are overbooked and stressed—and carving out an extra 10 minutes from their schedule is no small feat. Look at Starbucks: One of the most successful maneuvers they did was creating the ability to pre-­order and p ­ repay

for your coffee. It still takes 10 minutes to prepare your coffee, but you no longer care because you aren’t standing in line waiting. Results of this study support our hunch; pet owners want us to be more efficient and they want to be rewarded for being loyal. They want us to use modern technology to make their lives easier. By offering time-­saving methods to improve efficiencies in the hospital through the leverage of new technology, we can devote more time to listening and engaging with our clients. Bottom line It is critical we keep our eye on the ball. The goal is not to automate the client interaction, it’s to free up workload so we can focus on the veterinary-­client-­patient bond. When we build loyal relationships with our clients, they don’t want to leave just because someone is offering a cheaper vaccine down the road. And when we make mistakes (because we will), they are forgiving and understanding—­ because that’s what you do when you are loyal.  n

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UNDER ONE ROOF

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300 W. Drake Road, Fort Collins (970) 297-5000 csuvth.colostate.edu


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CVMA NEWS CVMA Members Approve New Board and Leadership Council Structure Diane Matt, CEO-­designate Colorado Veterinary Medical Association “How do we preserve CVMA’s many desirable attributes and evolve to a more agile governance model?” That’s the strategic question CVMA’s Executive Committee and Board of Directors began to explore in October 2014. This July, CVMA members voted to approve the Board’s recommended changes in the organization’s leadership structure developed in response to that very question. The changes to CVMA’s Bylaws were approved by a 94% majority of those who voted! The vote made two significant changes that position CVMA very well for today’s fast-­paced decision making and policy development environment: 1. CVMA’s Board of Directors is now made up of the previous seven-­member Executive Committee. This change authorizes a small, collaborative group of highly engaged, well-­prepared leaders to take timely action on complex issues. 2. A new Leadership Council (formerly named the Board of Directors) was created. It includes representatives from each chapter, all commissions, and CVMA’s officers and is charged with performing the critical functions of environmental scanning and strategic thinking on emerging issues, building collaborative community across geography, and communicating between members and organization leaders.

Leadership Council to Hold Inaugural Meeting October 20-­21 At the CVMA BIG Ideas Forum | Fall 2017, the Leadership Council will make its debut. The BIG Ideas Forums focus on illuminating significant issues in veterinary medicine and are intended to provide opportunities for thoughtful inquiry and personal renewal. As the inaugural event for the Leader­ship Council, the BIG Ideas Forum | Fall 2017 will also offer a professional development workshop by Dr. Therese Lask, who is a certified Strengths Finder facilitator, and a workshop on “Developing Your Outreach Comfort Zone” led by our own membership ambassador, Garry Watts. Here’s how the weekend will unfold: Leadership Council Events Friday, October 20, 2017 Park Hyatt Resort and Spa, Beaver Creek, CO 1:00–4:30 PM

“Strengths Finder” Professional Development Workshop with Dr. Therese Lask

5:30–­6:30 PM

Welcome Reception

Leadership Council Events Saturday, October 21, 2017 Park Hyatt Resort and Spa, Beaver Creek, CO 7:00–8:00 AM

Hot Breakfast Buffet

8 AM to 12 PM

“Finding Your Personal Compassion Satisfaction” with Dr. Kimberly Pope-­Robinson

12:00 to 1:30 PM

Luncheon and Board Liaison Updates

1:45 to 3:15 PM

Commission Meetings

3:30–5:30 PM

Leadership Council Meeting “Developing Your Outreach Comfort Zone” with Garry Watts Commission Reports CVMA Chapter Development Dialogue Emerging Issues Dialogue

5:30 PM

Wrap up and adjourn

The new governance model has several functional and structural advantages: • Clarifies authority • Supports agile decision making • Sustains CVMA’s connected community of chapter leaders and organizational liaisons • Utilizes CVMA’s connected community in more engaging, satisfying, and productive ways • Provides personal development opportunities for members of the Leadership Council The model also expands and extends CVMA’s desirable leadership culture, which reflects: • Consensus and trust • Spirit of unity • Vibrant social fabric • Diverse perspectives • Grassroots communication flow • Engagement of chapter leaders • Engagement of organizational liaisons (CVMA has appointed 13 liaisons from selected organizations to advise the Board http://colovma.org/liaisons/)

CVMA Members Invited to Attend BIG Ideas Forum Remember! All CVMA members are invited to attend the BIG Ideas Forum on Saturday, October 21, 2017 for the educational and commission sessions. As a benefit of membership, Core Members can attend one BIG Ideas Forum each year with no registration fee, and Premium Members can attend both the Fall and Spring BIG Ideas Forums with no registration fee. Please reach out to your chapter representative with your ideas about chapter development. You can find your chapter representative’s contact information at colovma.org /chapters/.  n

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CVMA NEWS C O L O R A D O

V E T E R I N A R Y

M E D I C A L

A S S O C I A T I O N

Chapter Connections Welcome Chapter 2 | Larimer County! We are excited to welcome Chapter 2 | Larimer County! What can you expect from CVMA Chapter 2? In addition to the CVMA programs and services offered through your CVMA member­ship, you’ll also have access to education offerings and connections with colleagues in your backyard. Mark your calendar now for these upcoming events and watch you inbox for more details and location information! Thursday, October 12 | 6:30 PM DINNER AND EDUCATION: What You Need to Know About VFD & Honeybees Dr. Ben Golas and Dr. Katie Huebner Tuesday, November 28 | 6:30 PM DINNER AND EDUCATION: Shelter—Veterinarian Collaboration Including a tour of Larimer Humane Society’s new facility Are you interested in getting more involved with CVMA Chapter 2? Have an idea you’d like to share? Let your Chapter Leadership Team know! Dr. Brooke James james.brookejames@gmail.com Dr. Teva Stone tstone@wellingtonvets.com

CVMA Chapter 6 | Denver Area Upcoming Meetings and Social Events Join other Chapter 6 members at an upcoming event to connect in a non-veterinary environment to just have fun and get to know each other! Have a suggestion for an events or location? Email Dr. Ashley Ackley at aackley55 @yahoo.com. EDUCATION EVENTS Thursday, October 26 | 6:00–8:00 PM Industry Sector Careers in Veterinary Medicine Denver Animal Shelter 1241 W Bayaud Ave | Denver 80223 Join us for a roundtable discussion with Dr. Jennifer Sexsmith (Professional Services, Idexx) and Dr. Bev Chua (Laboratory Animal Care, Animal Care Systems) for a

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discussion of careers in the industry sector of the veterinary profession. Host: Dr. Casara Andre SOCIAL EVENTS Thursday, November 30 | 7:00 PM Wynkoop Brewing 1634 18th Street | Denver 80202 www.wynkoop.com Host: Dr. Ashley Ackley Come play some pool, have a beer, and socialize with your colleagues! TRIVIA NIGHTS Thursday, October 5 | 7:00 PM Alpine Dog Brewing Company 1505 N. Ogden St. | Denver 802018 www.alpinedogbrewery.com Host: Dr. Ashley Ackley Wednesday, November 8 | 7:00 PM Comrade Brewing Company 7667 E. Iliff Ave. | Denver 80231 comradebrewing.com Host: Dr. Ashley Ackley WELLBEING Finding Meaning in Veterinary Medicine FMVM meetings are held at 6:30 PM on the third Tuesday of each month and are hosted by Dr. H. Howells. For details and to RSVP, email hlhowells@gmail.com. Tuesday, October 19 6:30 PM | Cultivate 10474 W 38th Avenue | Wheat Ridge 80033 Upcoming Meetings November 16 | December 21 Note: meetings are subject to change, so please check your email for updates.  n


You’re invited to WVC’s 90th Annual Conference Please join us as we celebrate nine decades of veterinary education, innovation and inspiration.

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CVMA NEWS Meet Your New CVMA Secretary/ Treasurer-elect In its first-ever electronic online election, CVMA had two outstanding candidates for the office of secretary/treasurer-elect, Dr. Steven Arnold and Dr. Jackie Christakos. We thank them both for their willingness to run and serve, and are pleased to introduce you to your newest CVMA board member, Dr. Jackie Christakos. A 2012 graduate of CSU, Dr. Christakos works as an equine veterinarian at Littleton Equine Medical Center, a position she accepted after completing her internship there. She has been a CVMA member for eight years, and a member of AVMA for five. She currently serves as chair of CVMA’s Commission on Leadership and is a Power of Ten Leadership Academy graduate. During veterinary school, she was the vice-president of the 2012 PVM class and was a representative for the student chapter of AVMA. Dr. Christakos says “I am lucky to have a wonderful, supportive husband, Ty, a firefighter-paramedic in Arvada; two adorable dogs; and one amazing horse who will always be in my heart, despite losing him recently.”

Dr. Christakos says her philosophy is to lead by example and be of service to patients, clients, the profession, and colleagues. Of running for secretary/treasurer-elect, she states, “I am interested in the position for multiple reasons. Most importantly, CVMA has invested much in my development as a young professional, and I would like to provide a return-on-investment through service on the board, as I feel CVMA changes lives and truly has the best interests of Colorado veterinarians at heart. Secondly, Littleton Equine Medical Center has a rich history of leadership in organized veterinary medicine, and my mentors have instilled in me the important role we play as veterinarians in protecting our profession and in guiding its direction through involvement in organizations, councils, and government. This is important not only for continued success of the profession, but also for longevity and personal fulfillment as a veterinarian throughout my career. And, finally, it is important that women in our profession continue to ‘lean in’ to leadership roles. I take this on as a personal badge of honor and professional goal to help increase the number of women in leadership and to model leadership behavior for young veterinarians arriving in the profession in the future.” Dr. Christakos will be sworn in with the CVMA Board of Directors on Saturday, September 23, during the annual membership meeting at the Celebration Luncheon at CVMA Convention 2017. We hope to see you there!  n


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CVMA NEWS CVMA CE West Sees Success Once Again in Colorado Wine Country Kristin Payne, CMP CVMA Director of Learning Summer education has never been so beautiful, and once again we experienced success on the Western Slope! In early June, 87 veterinarians, technicians, industry supporters, and guests from across the state made the scenic trek to Palisade and the Wine Country Inn to participate in a weekend of high level education and outdoor fun in Colorado’s premier wine region. This year’s topics focused on small animal surgical oncology and equine wound management and featured Nicole Ehrhart, VMD, MS, DACVS and Dean Hendrickson, DVM, MS, DACVS. The presenters alternated between their topics, providing 12 hours of education that drew the interests of small, large, and mixed animal practitioners alike. Using case-­based examples, attendees enjoyed highly interactive sessions, which included discussions on Soft Tissue Sarcomas; Lipoma, Liposarcoma, and Atypical Fatty Tumors; Wound Care; and Bursoscopy, Tenoscopy, and Arthroscopy.

CVMA is very fortunate to have Dr. Ehrhart and Dr. Hendrickson as presenters for the CE West program. It is only through the interest and cooperation of experts such as these that CVMA has achieved recognition as a provider of superior educational programs. Their background and experiences speak volumes and we appreciate their sharing their knowledge with us. Along with outstanding education, attendees had opportunities to enjoy social activities, such as evening receptions featuring wine produced from grapes grown right on the hotel property, live music outdoors, and the ever-­ popular wine pairing dinner featuring chef-­inspired food with more local wines. Beautiful mesas and on-­property vineyards provided the setting for relaxing and enjoying time outdoors. Five industry supporters joined us for the weekend: Blue Buffalo Veterinary Diets, Henry Schein Animal Health, IDEXX, MWI Animal Health, and Vetoquinol—and were able to educate and connect with the attendees. A big “thank you” to our generous sponsors for helping make this event possible! Mark your calendar for June 1–­3, 2018 and plan to join us at the next CVMA CE West! Registration will open in early spring.  n

A partnership with you to provide the best care for them. At VRCC Veterinary Specialty & Emergency Hospital we consider ourselves to be an extension of your practice. Working as a team with you and your clients, we can help provide the finest specialized care for your patients. Our ongoing commitment to communicating with you and your client is key to building positive client and referral relationships. We endeavor to offer the best technology and highest caliber of specialists and technical staff in the Rocky Mountain region as a resource you can depend on.

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Specialists you trust. When you need them. CARDIOLOGY Christina Bove, DVM christina.bove@vca.com

EMERGENCY & CRITICAL CARE Shaila Raj, DVM, MS shaila.raj@vca.com

DENTISTRY John F. Huff III, DVM, FAVD, DAVDC john.huff@vca.com

Molly Comiskey, DVM molly.comiskey@vca.com

DERMATOLOGY David Beadleston, DVM, DACVD david.beadleston@vca.com

Jorge Alvarez, DVM jorge.alvarez@vca.com

INTERNAL MEDICINE Douglas Santen, DVM, DACVIM (SAIM) doug.santen@vca.com

Gina Kettig, DVM gina.kettig@vca.com

Ji-Yeun Rha, VMD, DACVIM (SAIM) ji-yeun.rha@vca.com Katherine Scott, DVM, DACVIM (SAIM) katherine.scott@vca.com William Whitehouse, DVM, DAVCIM (SAIM) william.whitehouse@vca.com

ONCOLOGY Anne Skope, VMD, MS anne.skope@vca.com

Shana Oâ&#x20AC;&#x2122;Donnell, DVM shana.odonnell@vca.com

Katherine Hebert, DVM katherine.hebert@vca.com

NEUROLOGY Kelli Kopf, DVM, MS, DACVIM kelli.kopf@vca.com

RADIOLOGY Debra S. Gibbons, DVM, MS, DACVR debra.gibbons@vca.com Benjamin Young, DVM, MS, DACVR benjamin.young@vca.com

SURGERY

Maggie Vandenberg, DVM, DACVIM maggie.green@vca.com Samantha Emch, DVM, MS, DACVIM samantha.emch@vca.com

CLIENT CARE COORDINATOR Diana Davila, DVM, DACVS diana.davila@vca.com

Lori Amos lori.amos@vca.com

John S. Stephan, DVM, MS, DACVS john.stephan@vca.com

Weston Buker weston.buker@vca.com

Specialty Line: 720.975.2804 vcaaevh.com Fax: 720.975.2854 www.facebook.com/vcaaevh 9770 E. Alameda Avenue, Denver, CO 80247


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