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F V M A ADVOCATE ISSUE 2 - March/April 2014 | www.fvma.org

&

Veterinary Medicine

the Law

How to Provide Good Care & Protect Yourself in the Process

Part III: Veterinary Malpractice Litigation

WHAT’S NEW IN FLORIDA

Workers' Compensation?

Call to Serve

Make a Difference to the Veterinary Community and our State

FVMA 2014

AWARD Honorees


7207 Monetary Drive Orlando, Florida 32809 Phone – (407) 851‑3862 Toll Free – (800) 992‑3862 Fax – (407) 240‑3710 info@fvma.org www.fvma.org

President's

MESSAGE

T

Officers Dr. Jerry L. Rayburn President Dr. Donald H. Morgan President-Elect Dr. Richard B. Williams Treasurer Dr. John R. Bass Past President Mr. Philip J. Hinkle Executive Director

his year has gone by much faster than I thought it would. It seems like yesterday I was asking members to get involved with their local associations. Honestly, 365 days is not long enough to accomplish all that one wishes to accomplish as president. When you factor in the unexpected challenges that pop up along the way, well you can imagine. I am excited about the great strides toward the future we have made together in this last year. The most important being the involvement of new and dynamic veterinarians in several leadership roles.

District Representatives Dr. Alex M. Steverson District 1–Big Bend Dr. Richard C. Sutliff District 2–Northeast Dr. Marc A. Presnell District 3–Central Dr. Rachel Klemawesch District 4–Tampa Bay Dr. Marc D. Pinkwasser District 5–Treasure Coast Dr. Ronald W. Todd Jr. District 6–South Florida Dr. Richard M. Carpenter District 7–Southwest Dr. Michael Epperson District 8–Northwest Dr. Christine M. Storts District 9–Space Coast Dr. Ernest C. Godfrey AVMA Delegate Dr. Stephen Shores AVMA Alternate Delegate Dr. Amanda House FAEP Representative to the FVMA Executive Board Ex Officio Dr. James W. Lloyd, Dean College of Veterinary Medicine

FVMA Staff

Sandra P. Brooks Accounting/Membership Director Amber Coon Executive Administrative Assistant Ralph E. Huber Industry Relations Director Alssa Mathews Multimedia Art & Design Director Beni Jean Price Financial/Membership Coordinator Diana Ruiz Meetings and Events Coordinator Ann Wade Communications & Public Relations Director

2  |  FVMA ADVOCATE

Around the state, veterinarians are aware of the need to become active in their communities’ affairs. The FVMA owes a debt of gratitude to the leaders of all our local associations and especially their Political Action Team. This year saw for the first time in Tallahassee the introduction of a bill by the FVMA. We learned how to get sponsors and co-sponsors, gather support, network relationships and build coalitions. We discovered the path and pitfalls of legislative committees, and more importantly how to graciously move on when further effort is futile. We now look ahead to next year and our next challenge. I personally am grateful to Dr. Dani McVety for her hard work in developing a template for our Young Veterinary Medical Council. Together we plan to visit local associations and try to bridge the gap separating our generations. As my term as your president ends, I have bittersweet emotions. I am sad that I was unable to finish all I had hoped to accomplish, but look forward to spending more time fishing with my grandchildren. It has been an honor to serve as your president. The young veterinarians I have met around the state have convinced me the future belongs to them and with our help they will cherish and preserve it. Most of all they remind me why I became a veterinarian so long ago. Yours in service,

Jerry Rayburn, DVM

In This Issue 4 | FVMA 2014 Award Honorees 8 | Florida Does Not Recognize that

Rabies Vaccine Protects Hybrid Pets 10 | What's New in Florida Worker's Compensation? 12 | Member Spotlights 16 | Legislative Action Days

19 | Our Brother's Keeper - FVMA

Peer Assistance Program 21 | UF Veterinarians Seek Dogs for Stem Cell Studies 22 | Practice Pulse 26 | Veterinary Medicine & The Law - Part III


for AVMA PRESIDENT-ELECT H

LARRY DEE

ollywood veterinarian, Larry G. Dee, DVM, has been actively involved in organized veterinary medicine his entire career. After 40 years, Dr. Dee is not about to stop as he is now offering his service to his profession for another three years, as president-elect of the AVMA (American Veterinary Medical Association). Dr. Dee and his opponent, Dr. Joseph H. Kinnarney of North Carolina, officially introduced themselves to the AVMA House of Delegates in January of this year. The two doctors had launched their campaigns earlier, just prior to last year’s AVMA Annual Convention which was held in Chicago. The election for president-elect will be held in July, at the 2014 AVMA Annual Convention in Denver. Dr. Dee is co-owner of Hollywood Animal Hospital, a companion animal hospital in Hollywood, Fla. He has been an FVMA member from 1969, the year he graduated as a DVM from Auburn University. He is married to Rita Carol Fisher and

they reside in Fort Lauderdale. As he served the veterinary profession in Florida over time, Dr. Dee was a member of the FVMA executive board from 1983-1986, and then 1997-2005. He was FVMA President from 1998-1999, and also was the association’s Delegate and Alternate Delegate to the AVMA House of Delegates from 1994-2008. His service also included being State director of veterinary disaster planning from 1994-2003, a member of the FVMA College Advi‑ sory Committee, and serving on eight other association commit‑ tees from 2000 to present. He has also been active nationally on the American Board of Veterinary Practitioners Council of Regents, American Animal Hospital Association Board of Directors, the AAHA Foundation and World Small Animal Veterinary Association, serving as its president in 2004-2006. Locally Dr. Dee has served as the President of Ridge Veteri‑ nary Medical Society, and Broward County Veterinary Medical Association. Dr. Dee’s distinguished record of service has also included being a member of faculty of the University of Florida Depart‑ ment of Medical Sciences. He has presented and published many scientific lectures and papers.

In Remembrance LOIS KATHLEEN SARGENT, DVM

D

r. Lois Sargent, 58, passed away on January 15, 2014, surround‑ ed by family and friends. She was Program Coordinator, Veterinary Technology, at Miami Dade College for the past 10 years. Dr. Sargent also practiced as a part-time veterinarian at Knowles Animal Clinics-Central where she primarily worked the emergency shifts.

Dr. Sargent graduated from the University of Florida in 1992 as a Doctor of Veterinary Medicine. She practiced in rural western Pennsylvania for two years before return‑ ing to her home in Miami. She studied acupuncture with the International Veterinary Acupuncture Society (IVAS) from 1997-1998, and was certified in 1998. In addition, she studied classical homeopathy with Dr. Richard Pitcairn, DVM from 2000-2001. She also studied independently, the field of traditional Chinese herbal formulas and western herbs, and integrated all these modalities into the treatment of her patients.

Dr. Sargent was active in organized veterinary medi‑ cine. In addition to her membership in the FVMA and AVMA, she was a member of the board of the AHVMA (American Holistic Veterinary Medical Association, 20022005), secretary of the VBMA (Veterinary Botanical Medical Association, 2001-2003), member of the AAVA (American Association of Veterinary Acupuncturists), and was a vol‑ unteer to the USDA VMAT (Veterinary Medical Assistance Team). She is survived by her daughter, Ashley, many friends, and colleagues from the college and Veterinary community. In memory of Dr. Sargent, her family has asked for contri‑ butions to Miami Dade College. Contributions may be made online at http://mdcalumni.com/Lois_Sargent_Memoriam, or checks can be made payable to Miami Dade College Foundation and mailed to Miami Dade College Foundation, 300 NE 2nd Avenue, Suite 1423-1, Miami, Florida 33132.

www.fvma.org  |  3


In

Grateful Appreciation

for

FVMA 20 1 4 AWARD H o no r ees distinguished service to Veterinary Medicine

Dr. Ernest C. Godfrey LIFETIME ACHIEVEMENT AWARD Dr. Ernest Godfrey is a practicing veterinarian of over 40 years, and he has dedicated many years in service to organized veterinary medicine. He has held various positions on the FVMA Executive Board on which he has served since 1987. He was the association’s president in 2005, and he is the current FVMA Delegate to the AVMA. He also is a member, or serves as an officer of several other organizations including the Central Florida Academy of Veterinary Medicine, the Pinellas Animal Foundation Board of Directors, Pinellas Animal Partners, Pinellas County VMA and SPCA of Tampa Bay, among others. Veterinary Medicine at the national level has benefited greatly from Dr. Godfrey’s long and distinguished service to the profession as well. He joined the AVMA (American Veterinary Medical Association) in 1968. He has dedicated 18 years to the AVMA Congressional Advocacy Network and is also a member of the AVMA State Advocacy Committee. Dr. Godfrey has employed his commendable organizational and managerial skills to enhance the profession in Florida. For 23 years he has chaired the FVMA Continuing Education Committee, and has been the driving force behind the development of the first-rate scientific programs presented at the FVMA’s Annual Conference, and since 2013, the GulfAtlantic Veterinary Conference, the new national veterinary conference. 4  |  FVMA ADVOCATE

The FVMA honored Dr. Godfrey in 1990 when he was named Veterinarian of the Year, and in 2001 he was presented with the Distinguish Service Award. Dr. Godfrey studied to be a veterinarian at Auburn University from where he graduated in 1968. He owns and is managing partner of Pinellas Animal Hospital. He also owns Seminole Boulevard Animal Hospital in Largo, and is the co-director of St. Petersburg Animal Emergency Clinic, Inc.

of the South Florida Academy of Veterinary Medicine for 31 years, leading a program that provided affordable, high-quality veterinary continuing education for South Florida practitioners. Dr. Shank is a successful practice owner and veterinarian in the Miami/Fort Lauderdale area. He owns and operates Shank Animal Hospital in Fort Lauderdale, an 8,300 sq. ft. fully staffed hospital that offers on-call services in Wellness Care, Soft Tissue Surgery, Orthopedic Surgery, Ophthalmic Medical and Surgical Care, Dermatologic Care, Allergic Ears and Skin Disease, Dental Cleanings and Surgery, Internal Medicine, and Gastroenterology.

Dr. Jerry P. Shank Distinguished Service Award Dr. Jerry Shank has served his profession as a supporter and a leader of organized veterinary medicine at the local and statewide levels throughout his career. In his years of dedication as a successful practice owner and veterinarian in the Miami/Fort Lauderdale area, Dr. Shank has devoted much of his time to organized veterinary medicine. He has been a longstanding member of the Florida Veterinary Medical Association, the American Veterinary Medical Association and the American Animal Hospital Association. He served on the FVMA Executive Board for ten years; six years as the District VI Representative and four years during which he was president-elect, president, and past president of the Association. He was FVMA President from 2009-2010. Currently he serves as president of Broward County Veterinary Medical Association. He also founded and served as the head

Dr. Stephen A. Shores Distinguished Service Award Dr. Stephen A. Shores is widely admired for his record of commitment and energetic dedication to the FVMA and its members. Nominations for Dr. Shores were submitted by two of his colleagues, Drs. James Pennington and E. Howard Acree, Jr., and his nomination received the endorsement of the Jacksonville Veterinary Medical Society and Alachua County Veterinary Medical Association. Often referred to by his peers, is the Shores’ ‘standard pitch’ used when he is working to strengthen the advocacy program of the FVMA - “Donate one dollar to the PC and I will give $2.00 worth of effort.” His level of commitment has been unmatched during the 40 years he has practiced in Gainesville, having moved


there from Texas in 1972. Dr. Shores has served on various committees of the FVMA since 1995. He served on the board of directors for over 10 years. He was president in 2005, and is currently the AVMA Alternate Delegate. He also presently serves as chair of the FVMA’s Legislative Committee and the Committee of Continuous Existence. Dr. Shores is most recognized by members of the FVMA for the aggressive and tireless leadership he provides to the FVMA’s advocacy program. His colleagues compliment him by saying, “He campaigns for what he believes in with his words, actions and financial contributions. We all sleep better at night knowing that he is out there fighting for us and our profession.”

Dr. Jacqueline S. Shellow VETERINARIAN OF THE YEAR Award Dr. Shellow is being honored by the FVMA for her high professional standards and aspirations, and her record of service to the veterinary profession and as a leader of the Florida Association of Equine Practitioners, the equine-exclusive arm of the FVMA. As a member of the FAEP Council, Dr. Shellow played a pivotal role three years ago in accomplishing the joining of the FAEP and FVMA to form one strong membership entity representing the interests of Florida veterinarians. She is a partner in the specialty practice for pleasure and thoroughbred race horses, Teigland, Franklin and Brokken, DVM’s P. A., of Fort Lauderdale, Florida. She was president of the FAEP Council in 2010, and is currently a member of the FVMA Legislative Committee. Dr. Shellow was awarded the FVMA Gold Star Award in 2010. Her peers say Dr. Shellow repeatedly goes beyond the call of duty to contribute to animal wellness while maintaining excellent client communication. She has kept the same clients for decades they point out, which is, a testament to an individual’s

commitment to the profession and its stakeholders.

Dr. Dani McVety

PRESIDENT’S AWARD The President’s Award is given by the FVMA President and Executive Board in special recognition to honor an FVMA member’s dedication and service to the veterinary profession and to the community. Dr. Dani McVety, the recipient of the 2014 President’s Award, is a hospice veterinarian, a speaker, consultant, author, and mother. With a deep love for the human-animal bond, Dr. McVety found her calling while volunteering with human hospice before veterinary school. She knew she wanted to bring the same passion for life and respect for death that hospice upholds into her profession. Just months after graduation, she formed Lap of Love Veterinary Hospice in Tampa, Florida and quickly joined forces with her friend and classmate, Dr. Mary Gardner. Dr. McVety frequently writes and speaks for professional and lay audiences in hopes of empowering both parties to seek the highest standards of care. She is a proud graduate of the University of Florida College of Veterinary Medicine and is the youngest recipient of the college’s Distinguished Young Alumni Award (2013).

Joanna Flower Team Member of the Year Award

Joanna Flower has worked for 14 years with Animal Care Center, Inc. which owns three clinics in New Port Richey. She worked as a veterinary technician at all three clinics, and then became practice manager for Best Care Animal Hospital. More recently, she took over management of Country Oaks Animal Hospital. Dr. Philip Richmond of Country Oaks who nominated Joanna Flower for this honor, was confident her other colleagues would endorse the sentiments he expressed when he said, “Whether it is putting clients at ease regarding anesthesia, delivering medications to a client’s home after hours, or taking extra time to genuinely get to know a client and his or her pet, she continues to go above and beyond. She has a sign placed high in her office at Country Oaks that states Everyday Counts.” Mrs. Flower finds time as a busy practice manager and mom, to volunteer at Hudson High School in New Port Richey, where she teaches veterinary assisting students.

Beth Crawford

CVT OF THE YEAR AWARD Beth Crawford of Bluffs Animal Hospital in Largo, Florida is the 2014 Certified Veterinary Technician (CVT) of the Year. Mrs. Crawford has worked as a CVT for fifteen years. She is qualified with an Associate’s Degree in Veterinary Technology and a Bachelor’s Degree in Applied Science in Veterinary Technology. She was nominated by her colleague, Dr. Douglas J. Spiker, who describes her as a deeply caring practitioner to her patients and their human owners alike, who provides “exemplary support to the veterinarians of our practice as well as the practice operations.” Other technicians at the hospital look to Beth Crawford for guidance, Spiker says, and she “is able to motivate those around her and at the same time provide a positive, guiding influence that encourages her peers to seek her assistance with anything they need.” www.fvma.org  |  5


Marni Bellavia Citizen of the Year Award Marni Bellavia is the manager of the Animal Assisted Therapy (AAT) program at the Humane Society of Broward County (HSBC), and she is being recognized for her work to develop community programs that further the human-animal bond in Broward County. As manager at the Broward County Humane Society, Ms. Bellavia developed, coordinated and implemented the AAT program and Wags & Tales Reading Program. The AAT program uses volunteers and their companion animals to provide social therapy to comfort children and adults with special needs or those experiencing life’s stresses. It is a well-known program in Broward, Dade and Palm Beach counties, where the teams visit over 100 facilities such as senior retirement homes, hospitals, hospices, mental health facilities, children’s facilities, foster homes and group homes, and also Broward County Public Schools and Public Libraries.

Wags & Tales Reading Program is a research-based reading motivation program for children in kindergarten through fifth grade. Certified AAT dogs and their handlers visit students at selected schools and libraries to help strengthen reading skills. An estimated 1,000 children are reached each year through this program. Presently Ms. Bellavia has over 100 certified dogs, 4 cats and a dwarf horse in the Broward County Humane Society AAT program. When reached for a comment about her award, Ms. Bellavia could not hide the excitement she felt when she said, “This is such a great honor. I've dedicated my life to animals and I do what I do out of pure love for them.”

Benny (Canine) FVMA Pet Hero Award

Gold Star Gerardo J. Diaz, DVM

Award Recipients

Dr. Gerardo Diaz served the FVMA as its president in 2004. His reaction to being chosen for this award is: “It is a privilege to serve.” And he continues to serve as a busy vet and supporter of organized veterinary medicine for over 24 years. Dr. Diaz practices at Briarwood Animal Hospital located on South Dixie Highway in Miami, a full-service facility offering care to the residents in his community since 1981. He joined the FVMA Executive Board in 1999, and served as District 6 Representative through 2001. Presently, Dr. Diaz continues to serve as an FVMA Political Action Team (PAT) Leader in South Florida. 6  |  FVMA ADVOCATE

Benny is a special canine who is being recognized for being of great benefit to humans and for improving the quality of life of his human companions. Benny is a 10-year old Golden Retriever whose owner/ companion is Mrs. Donna Smith of Sara‑ sota, Florida. He was a year and a half old when he was rescued by Mrs. Smith. She recognized his good nature and soothing energy and per‑ sonality soon after his adoption and decided to involve Benny in the community. Benny is a certified therapy dog. Since 2005, Benny has participated in reading enrichment programs through the local public library and school systems, and as a Hospice Therapy dog since 2006, he has provided comfort and support to hospice patients and their families. Due to the impact he has made in the hospice volun‑ teer program, Benny has been exclusively selected as the official greeting dog for the hospice program’s semi-annual celebration of life service in Sarasota. Benny also serves the Child Protection Service to provide comfort and support for children who testify in court.

Kimberly A. Donovan, DVM

Dr. Kimberly Donovan is the Medical Director of Oakhurst Veterinary Hospital in Seminole, Florida. Dr. Donovan is very active in organized veterinary medicine, with memberships in the FVMA, American Veterinary Medical Association (AVMA), Pinellas County Veterinary Medical Association (PCVMA) and Pinellas Animal Foundation. She has served as secretary and president of the PCVMA, and she is currently the secretary of the Pinellas Animal Foundation. She is also involved in Project Breath, which is a program that is supported by donations, to supply the Pinellas County Fire Departments with oxygen masks for pets and for educating the department staff on CPR and first aid with the use of the masks.


Timothy J. Holloway, DVM

George “Brad” Mackenzie, DVM, DAVCS

Dennis A. Nelson, DVM

Dr. Timothy Holloway currently serves as president of the Jacksonville Veterinary Medical Society. His professional affiliations also include the Florida Veterinary Medical Association, American Veterinary Medical Association, Veterinary Emergency and Critical Care Society, and the Veterinary Hospital Managers Association. He owns Southside Animal Hospital in Jacksonville, where his special areas of interest are Critical Care Medicine, and Orthopedic and Soft Tissue Surgery.

Dr. George Bradley Mackenzie is the surgical specialist at Affiliated Veterinary Specialists of Daytona Beach. He operates out of Orange Park, Clay County, and owns Affiliated Veterinary Specialists, a group of four regional surgical referral hospitals serving Daytona, Jacksonville, Gainesville and Orange Park. He is a UF CVM graduate. Despite his busy schedule, he finds time to volunteer and offer his services to the Jacksonville Veterinary Medical Society, the Jacksonville Zoo and other community groups.

Dr. Dennis Nelson is President of Operations at Purchasing Services, Inc. of St. Petersburg, Florida. Dr. Terry Clekis nominated Dr. Nelson for this award, and cites his tireless efforts over the last 8 years to provide continuing education opportunities for the Manatee County Veterinary Society. “Denni flies under the radar, and never takes any credit for the work that he does,” says Dr. Clekis. Dr. Nelson has managed Purchasing Services, Inc., a group purchasing organization for independent veterinary practices, for 10 years.

James A. Kanzler, DVM

Grant E. McMillian, DVM

Dr. James A. Kanzler served as FVMA president in 2011. Dr. Kanzler became a member of the FVMA when he graduated in 1978, and continues to provide an excellent example of selfless service to his profession and colleagues. He has served his local member organization in Manatee County, and has also served on the FVMA Executive Board as District 7 Representative and FVMA President-elect. He remains an active member of the FVMA, and continues to work in support of the relationship between the FVMA and University of Florida College of Veterinary Medicine.

Dr. Grant McMillian currently serves as FVMA Political Action Team Leader in District 2. He has served as president of the Jacksonville Veterinary Medical Society and devotes time to other community programs. He volunteers in Jacksonville as a youth soccer coach. A graduate of Oklahoma State University, Dr. McMillian practices in Jacksonville, and is passionate about improving the bond between people and their pets. His primary interest is in soft tissue surgery, gastroenterology, and general pet care.

Caroline Olausen, DVM

Dr. Caroline Olausen is the presidentelect of the Pinellas County Veterinary Medical Association. A 2005 graduate of The Ohio State University College of Veterinary Medicine, she serves the Tampa Bay area as a relief veterinarian focused on surgery and shelter medicine. She is also an adjunct professor with the St. Petersburg College Veterinary Technology Program. She was director of Veterinary Services for Pinellas County Animal Services from 2011-2013, during which she evaluated and cared for approximately 42 thousand animals. Dr. Olausen is also a featured speaker on FVMA continuing education programs. She serves on the Board of the Florida Animal Control Association which she joined in 2013. www.fvma.org  |  7


FLORIDA DOES NOT RECOGNIZE THAT Rabies Vaccine Protects Hybrid Pets

Rabies

What you should kn

ow....

A

lthough the incidence of animals in the state of Florida testing positive for rabies has continued to fall over the past ten years, last year’s total still topped over 100 cases. Ten years ago, state agencies were confirming over 200 positive cases a year, while the number for 2013 had fallen to 105. Last year’s count reflects only suspect rabid animals that had some contact with humans or domestic animals. By far the most positive rabies diagnoses were found in raccoons, followed by bats. Last year, only nine cats were diagnosed rabies positive while there were none in dogs. Safe to say the anti-rabies program is effective in the state, but with the growing popularity of hybrid pets, veterinary practitioners in the state and owners of these animals should be aware of the state’s rules in the event of a biting incident. Hybrid pets like the wolf-dog and coyote-dog hybrid is said to top 400,000 in the United States. But it is believed the popularity of these animals has not grown significantly in Florida. It is different however for cats. The statistics show that cat hybrids are becoming more popular, and this reality makes the discussion of the subject

8  |  FVMA ADVOCATE

of rabies in these animals and how the law applies to them, an important one. Classic wolf dogs are typically crosses between wolves and Alaskan malamutes or German shepherds. The most common cat hybrid is the Bengal, a cross between a shorthaired domestic cat, commonly an Egyptian Mau or Abyssinian, and an Asian leopard cat, which is not to be confused with the leopard. Other cat hybrids have been created by crossing domestic cats with wild jungle cats, servals, and even bobcats. The State of Florida does not recognize the protective nature of the rabies vaccine in any domestic/wild hybrids. This results in for an interesting discussion when considering the protocol for handling a report of a human being bitten, or scratched by a domestic hybrid pet. Dr. Larry Helm of Quincy Animal Hospital in Quincy, Florida, who represents the FVMA on the Florida Rabies Advisory Committee, Florida Department Of Health Division of Disease Control and Health Protection, brought this subject to FVMA’s attention after the Committee’s January, 2014, meeting.


TION ACCINA ABIES V R ID. R R B O Y F AL H FO R M IM T N S A E D U IL R EQ AL OR W OWNER rid, ILD ANIM animal hyb W A F O al or wild (species),

vaccine. that my _ s), rabies I request (killed viru d te va ti inac receive an ame: Animal N

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following:

iveness their effect ic animals, st e m o d ective in . proven eff unknown animals refore , is have been e s e th in d cc an ated wild , va in d sk of vacc ted rabies een teste ri b va t le ti o b ac n ra in e as sh e consid 1. While eir hybrid . may still b me imals or th bid animal own, there n k n in wild an ans who co u is n) by a ra ss te e it n e (b iv sk to hum d ct ri se e ff o le e p b x e ra e e th if d se bies rabies. e consi 2 . Becau tr acting ra may still b exposed to l be ybrids con ave been own, there h n k at n th u um an wil or their h h s is d eir hybri at bites a ectiveness th th ff r e d ch o e ri s b al th y se ation in su ild anim or it s h 3. Becau commend ccinated w ild anim al re va w e h a h it , T n w . w ry unk no n histo in contact vaccinatio tiveness is for rabies. will the effec less of it s d se ar au g c re e e the brain er animal , B in d e am 4. at x n e ci d ites anoth ac an b -v al n at o im ch th n d an su d e biting ation in it s hybri considere commend animal or sacrifice th re d il to e h w e T b a . u , ld tion co ld n history u n k n ow n cases wou ropriate ac vaccinatio p veness is s ti it ap c f e e o ff th e ss t e se th tory, bu , regardle 5. B ecau ination his accinated d its vacc red non-v e an d n ies. si n te it co b be in for rab animal ine the bra ds on the am n x e e p e d d an s al case iting anim ifice the b be to sacr

I further ac

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S SI OWN ER DATE ADDRESS

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Dr. Helm reveals that while the Rabies Advisory Committee feels there is strong evidence of protection in these hybrid pets via vaccination, and currently recommends vaccinating these animals, there is insufficient evidence to ensure protective levels of antibody to viral challenge. Add to that, there is currently no data on incubation and virus shedding periods in these hybrids. This creates a conflict for Florida veterinarians, says Dr. Helm. He advises that if veterinarians recommend vaccinating these pets following the current state guidelines, practitioners must make it abundantly clear to owners that even though they are following current State of Florida recommendations regarding vaccination against rabies, there is no implied obligation of the State to recognize these animals as vaccinated should a biting incident occur. As the position currently stands, “the Department of Health (DOH) will recognize these patients as unvaccinated in case of a human-animal exposure.” The implications of this, explains Dr. Helm, is that in the event of a human being bitten by a hybrid pet, despite the fact that the animal had been vaccinated against rabies, it will be treated by public health officials as an unvaccinated animal. Animals that do not meet the definition of “currently vaccinated” include any wild animal, or wild and domestic animal cross.

The following is taken from the Rabies Compendium: Wolves and wolf-dog crosses, and wild cats (lions, pumas, bobcats, etc.), raccoons, wild cat/housecat crosses, and other wild animals are not recommended as pets. However, if owned, captive bred animals must be properly permitted through the FWC (Florida Fish and Wildlife Conservation Commission). Because of the possible protective effect of vaccination, veterinarians are encouraged to vaccinate these animals against rabies providing: 1) the owner signs a statement recognizing the current “offlabel” use of the vaccine; and 2) the owner understands that the animal will be euthanized and tested for rabies should it bite or expose a person or be exposed to a rabid animal.

The 2013 Rabies Compendium, Rabies Prevention and Control in Florida, 2014, provides an owner request form for wildlife or hybrid rabies vaccination (Appendix 15) for the vaccination of wildlife species kept in captivity. The form is reproduced for this article. The Advisory Committee recommends that all owners of hybrids sign this form in order to acknowledge that while the vaccine MAY be protective, there is no implication that these hybrid animals will be treated by the DOH as vaccinated should a human-animal exposure occur.

Below is the link to the Department of Health where information on Rabies may be found.

http://www.floridahealth.gov/ diseases-and-conditions/rabies/index.h

The link to the 2013 Rabies Compendium is below.

http://www.floridahealth.gov/diseasesand-conditions/rabies/_documents/ rabiesguide2014final2.pdf

www.fvma.org  |  9


WHAT’S NEW IN FLORIDA

Workers' Compensation?

W

hile there have not been major legislative changes to the Florida Workers’ Compensation law since 2003, there was a law change in 2013 which affects Limited Liability Companies (LLCs) . Effective July 1, 2013, members of LLCs in the non-construc‑ tion industry became employees of the LLC for Workers’ Com‑ pensation purposes. Prior to that date, the law was silent on this type of business owner in the non-construction industry. What does this mean for LLCs? It means that effective July 1, 2013, the LLC members of a non-construction industry LLC are counted as employees and could push the LLC over the thresh‑ old for providing the Workers’ Compensation insurance for its employees. The law states that the non-construction industry business must provide Workers’ Compensation insurance for all of its employees once it has four or more employees. If the business does not have a Workers’ Compensation insur‑ ance policy because prior to including the LLC member(s) in the count of employees there were fewer than 4 employees, the business needs to do another count. If there are now 4 or more employees, including the LLC member(s), then the business is required under the law to provide Workers’ Compensation insurance for everyone.

10  |  FVMA ADVOCATE

So, depending upon the LLC’s current situation there may be action that the business needs to take: 1) purchase insur‑ ance if the business has not maintained this coverage in the past; 2) include the LLC members on a current policy; or 3) file a Notice of Election to Be Exempt with the Division of Workers’ Compensation. A Notice of Election to Be Exempt allows a corporate officer or member of a Limited Liability Company who owns at least 10% of the business, to opt out of the Florida Workers’ Compen‑ sation system. This means that in the event of a work related injury, illness or death, the LLC member would not be eligible for any Workers’ Compensation benefits, including the payment of medical services. See the Division’s website for the filing of the Exemption. So take a minute and think about your business operation. If you are an LLC, count the number of LLC members that are in the business, then count the number of employees that are work‑ ing for your business; if the total is 4 or more, take the time to protect both your employees and your business. Should you have any questions, you may visit the Division’s website at www.MyFloridaCFO.com/division/wc, call Cus‑ tomer Service at 850-413-1609, or email Sheryle Birdsong at Sheryle.Birdsong@MyFloridaCFO.com.


EMPLOYER OR THE INDEPENDENT CONTRACTOR – Who Provides Workers’ Compensation Insurance?

T

he answer to that question is not as cut and dried as one may believe. After our membership helpline revealed to us in the past months that practice owners and managers sometimes grapple with the issue of workers’ compensation insurance and the application of the law when hiring relief veterinarians who are often regarded as independent contractors, we went looking for answers. Sheryle Birdsong of the Compliance Bureau in the Division of Workers’ Compensation, Dept. of Financial Services discussed the law for us.

loss for the work or service that it performs. There is one very important issue to consider when determining whether or not a person is an independent contractor, “does the person in question consider him or herself to be independent or an employee?” It is not the business entity that determines if the worker is independent, instead the Workers’ Compensation law allows the person in question to make the determination. If the person believes that he or she operates their own business and controls the work or service that is performed, including to whom Occasionally, a business in the non-construction industry will services or work is offered, then they can consider themselves to seek to contract with Independent Contractors to perform duties be independent. However, if the person believes him or herself which are a part of their business operations. Usually, people who to be an employee, then under the Workers’ Compensation law, perform these types of duties operate their own businesses and that person is an employee. Therefore, the business entity who offer their services to a number of other businesses, rather than that person considers to be their employer is required to provide performing these duties for one business alone. Workers’ Compensation insurance. For instance a business may contract with a bookkeeper to For a full list of specific criteria listed in the law, please see handle the billing or to perform payroll functions. Or perhaps the statutory reference above, which can be accessed through the a business will contract with another business to come into their Division’s website, www.MyFloridaCFO.com/Division/WC. offices to perform cleaning services for them. There are a number One last thing, the above discussion applies to Florida Workers’ of duties that would easily lend themselves to being “outsourced” Compensation requirements only. It does not apply to the issue or performed by an ‘independent contractor’. of independent contractor for tax purposes, whether payroll tax The question arises then, “Are these business entities really or unemployment tax. For a determination of the independent independent contractors and does my business need to include contractor issue for tax purposes please contact the Internal them on my Florida Workers’ Compensation insurance policy?” Revenue Service or your accountant, business advisor, or attorney. The answer depends upon whether or not the persons performing those duties meet the definition in the Florida Workers’ Compensation law for ‘independent contractors’. Florida Statutes, Chapter 440.02(15)(d), lists a number of criteria that persons must meet in order to be determined to be an ‘independent contractor’. In general, the independent contractor has its own business operation with its own work facility, tools, and equipment. It furnishes its own supplies for the performance of the work and incurs the principal expenses related to the service or work it performs. It usually performs work on a per job basis, or competitive-bid basis, or a completion of task basis as defined in a contract and performs those services for a specific amount of money. The independent contractor controls the means of performing the services or work, controls when and where it performs those services or work, and can perform services or work for any other entity with which it enters into contract. In addition, the independent contractor controls whether or not it can realize a profit or

www.fvma.org  |  11


Governor

Rick Scott Appoints

Spencer, Hase and Leonard to the Board of Veterinary Medicine

Governor Rick Scott has appointed three new members to the Board of Veterinary Medicine. The appointments were made and announced on January 30, 2014. The new members on the board are Dr. Terry Spencer, Dr. Robert Hase and Dr. Robert Leonard, Jr., all longstanding members of the FVMA. Dr. Terry Spencer, 59, of Gainesville, is the clinical assistant professor of shelter medicine at the University of Florida College of Veterinary Medicine. She was appointed to succeed Dr. Joann Helm for a term beginning January 30, 2014, and ending October 31, 2015. Dr. Robert Hase, 69, of New Port Richey, is the medical director at Bayonet Point Animal Clinic. He was appointed to fill a vacant seat on the board and his appointment runs through October 31, 2016. Dr. Robert Leonard, Jr., 59, of New Smyrna Beach, operates Coronado Animal Clinic. He was appointed to succeed Dr. Raul Figarola for a term that ends October 31, 2017.

12  |  FVMA ADVOCATE


D

r. Robert Hase is a 1970 graduate of Tex a s A& M University, College of Veterinary Medicine. As medical director of Bayonet Point Animal Clinic in New Port Richey, he has operated his companion animal medical practice with emphasis on dermatology, internal and preventative medicine, and ultrasound technology since 1972. Dr. Hase has been an active FVMA member for 44 years, as well as member of the American Veterinary Medical Association, Suncoast Veterinary Medical Association and the American Animal Hospital Association. He has served as FVMA Legislative

ROBERT HASE, DVM Chair, and was a long-standing member of the committee. He was one of a group of veterinarians that worked for the establishment of the College of Veterinary Medicine at the University of Florida. His service to veterinary medicine also includes providing expert testimony in court as an authority on animal abuse cases, and being the chairman of the Pasco County Animal Control Advisory Board for 30 years. He was honored by the FVMA in 1998 when he was named Veterinarian of the Year and in 2009, as recipient of the Gold Star Award. He is married with two grown children and two granddaughters. He and Margaret, his wife, share their home with two cats and two dogs. Dr. Hase is an avid outdoorsman and enjoys mountain biking and kayaking.

ROBERT LEONARD, Jr., DVM

D

r. Robert Leonard, Jr. has practiced in New Smyrna Beach for 28 years. He has owned his small animal practice, Coronado Animal Clinic for 24 years. He currently serves as chairman of the New Smyrna Beach Animal Control Board. Continuously in service to the profession of veterinary medicine, Dr. Leonard is a past president of the Volusia County Veterinary Medical Society. He has also maintained a close relationship with his alma mater, the University of Florida College of Veterinary Medicine (UF CVM), from where he graduated in 1986. He is a charter member of the Dean’s Circle of Excellence at UF CVM and is a life member of the Alumni Association. He served as UF CVM’s

first Alumni Council president and as a member of the college Admissions Committee and the Dean’s Selection Committee. In his community, Dr. Leonard is active in the job mentoring program of the New Smyrna Beach High School chapter of the FFA, a national career and technical student organization. Dr. Leonard and his wife Terri are happy and proud parents of their two daughters, Carly Leonard and Paige Swenson.

TERRY SPENCER, DVM

D

r. Spencer has a unique background in both science education and veterinary medicine. She is currently Maddie's Clinical Assistant Professor of Shelter Medicine at the University of Florida, and is President and CEO at Creative Veterinary Solutions, Inc. During her first career, Dr. Spencer worked as a science educator for K-Junior College students, as well as a curriculum developer for the American Chemical Society and for National Science Foundation grants. She has also worked as a small animal veterinarian, owned a veterinary practice, and worked full-time as a shelter veterinarian for both open and limited-admissions animal shelters in California and Florida. She has experience with managing disease outbreaks in shelters,

conducting cruelty investigations, training volunteers to assist with disasters, providing testimony as an expert witness in criminal animal cruelty trials, working with victims of domestic violence and their pets, performing sterilization surgeries in high-volume shelters, developing standard operating procedures for busy animal shelters, and serving on advisory boards for the improvement of animal shelters. Dr. Spencer’s current mission is to develop distance learning programs to meet the needs of practicing veterinarians who desire to develop expertise in shelter medicine. She is a graduate of Colorado State University (DVM), the University of Florida (M.Ed, Science Education), and the University of South Florida (BA, Zoology) Dr. Spencer was honored by the FVMA in 2011 with a community service award and with the Gold Star Award in 2010, by the Salvation Army of West Pasco Domestic Violence Community Service Recognition in 2009, and with the Florida State Agriculture Response Team’s Community Service Award in 2009.

www.fvma.org  |  13


F THE YEAR AWAR D O M TEA

Y K-9 T N , FVMA PRESIDENT-ELECT N U A O G R PINELL AS C H. MO ALD N O D . R D – PRESENTED BY

responding to assist Pinellas County Deputies who were in a pursuit of armed robbery suspects, the pursuit ended when the suspects fled from their vehicle on foot. After deputies requested assistance from the St. Petersburg Police K-9 Unit, Officer Beauvois and his partner Timon responded to conduct an area search from where the suspects fled. When they passed the location were the vehicular pursuit ended, Timon alerted to a fenced yard, locating one of the suspects. Officer Beauvois Officer Donald Beauvois (right) and his partn er John Morroni (left) and FVMA President-e Timon (below) with Commissioner ordered the suspect to the ground. lect, Donald H. Morgan (center) The suspect complied and was taken In the past five years, Dr. Morgan into custody. Once the first suspect was informed, the team of Beauvois and Timon secured, Officer Beauvois and Timon very two years, the Pinellas County has made many arrests as a result of their continued to search for the second suspect. Veterinary Medical Association outstanding knowledge and intuition Several blocks away, Timon alerted to honors a K-9 Officer and his canine of criminal behavior. Their combined another fence and located the second partner with the county’s K-9 Team of the expertise in explosives detection is always suspect hiding in some bushes. Officer Beauvois ordered the second suspect to Year Award. The 2013 award was presented in high demand in Pinellas County. the ground. He complied and was taken to St. Petersburg Police Department Officer Officer Beauvois and Timon were into custody. The determination of Officer Donald Beauvois and his partner, Timon in January, during a luncheon ceremony presented with a plaque by Dr. Morgan. Beauvois and his K-9 partner Timon hosted by Pinellas County Commissioner They were also presented with a year’s produced a very successful conclusion to a heinous crime. supply of pet food by Hill’s Pet Nutrition. John Morroni.

E

The Pinellas County VMA has been collaborating with the Commissioner as a sponsor of the K-9 Team of the Year Award since 2008. FVMA President-elect Dr. Donald Morgan of Bluffs Animal Hospital in Largo, was on hand to present The K-9 Officer Jeffery Yaslowitz Outstanding K-9 Officer Award to Officer Beauvois and canine, Timon.

In making his presentation to the K-9 Team of the Year, Dr. Morgan mentioned the great value of canine members to law enforcement agencies, pinpointing that they sniff out drugs, weapons, bombs, and money, and track down dangerous criminals "without a thought of danger, things that humans could never do."

Other contenders nominated for the outstanding award were Deputy Matthew Aitken and Bosco, and Deputy Robert Cahoon and Hondo from the Sheriff ’s Department, and Officer John Sinni and Jet of the Largo Police Department.

One of the many instances of interdiction by Officer Beauvois and Timon which made them the choice for K-9 Team of the Year relayed by Dr. Morgan as he presented the award, was when

Outstanding Officer Beauvois has been with the St. Petersburg Police Department for over 25 years and has served as K-9 Officer for over 22 years. Timon is a Belgian Malinois. 14  |  FVMA ADVOCATE

The perseverance of Officer Beauvois and his K-9 partner Timon in their duties, and their dedication to professionalism and public safety "are unmatched,” said Dr. Morgan, as some 500 citizens, public officers and elected officials who attended the luncheon, witnessed the presentation.

Officer Beauvois (3rd from left) and his partn er Timon with Hill's Pet Nutrition Reps and Drs. Ernest Godfrey(3rd from right) and Morg(below) an(4th from right) of the FVMA


29.


LEGISLATIV

M

ost people think of “March M ad ne s s” a s t he h i g h ly anticipated college basketball playoffs leading to the NCAA’s National Basketball Championship game. Here in Florida the term could just as easily be used in reference to our annual Legislative Session. A fitting metaphor was published in a book by John A. Straayer entitled The Colorado General Assembly. Straayer portrays the state legislature as a basketball arena in which “a score of basketball games are progressing, all at one time, on the same floor, with games at different stages, with participants playing on several teams at once, switching at will, opposing each other in some instances and acting as teammates in others.”

Welcome to TallahasseeFlorida’s Capital City On March 12 and 13, 2014, FVMA Executive Board, Legislative Committee Members and FVMA Delegates from throughout the state converged on the State Capital for two days of intense Legislative updates, bill analysis and prioritization and Legislative Advocacy efforts. The first order of business was the FVMA Legislative Workshop on Wednesday afternoon. In this workshop all Delegates were briefed on the legislation that the FVMA Legislative Committee and Staff are monitoring. The priority level of the legislation was also decided, which in turn dictated what action the FVMA would take as it relates to specific bills. The top priority for this year was to secure the adoption of Senate Bill 534 and its companion bill, House Bill 257. As of Legislative Action Days, Senate Bill 534 was sponsored by Senator Jack Latvala (R) Clearwater, and co-sponsored by Senator Miguel Diaz de la Portilla (R) Coral Gables. House Bill 257 was sponsored by Representative Ed Hooper (R) Clearwater, and co-sponsored by Representative Larry

16  |  FVMA ADVOCATE

Ahearn (R) Seminole, Representative Keith Perry(R) Gainesville and Representative Gregory Stuebe (R) Sarasota. These bills reinstate an exemption from the sales tax on therapeutic diets, formerly referred to as 'Prescription Diets'. These specialty diets are only available through a licensed veterinarian. Similar to a prescription, these products are not designed for all animals and should not be consumed by otherwise healthy animals. If used indiscriminately, they can cause side effects – just like prescription drugs. For more than thirty (30) years, Florida’s pro-business climate exempted these diets from sales tax because of their therapeutic values, as cited in F.S. 212.08(2) Exemptions; Medical (h). These bills seek to restore therapeutic veterinary diets to their pre-2010 sales tax exempt status. The original language of this bill was interpreted to include over the counter drugs. This interpretation caused much confusion in the revenue estimation process where a fiscal impact, to State revenues, of $28 to $30 million was projected. This estimate stalled the progress of the bill. In an effort to salvage this bill, FVMA requested that Sen. Latvala submit a committee substitute bill to clarify that the FVMA was seeking a tax exemption for Therapeutic Veterinary diets only. As a result of this clarification, the Revenue Estimating Committee re-evaluated the estimated fiscal impact of the bill(s) and projected that it would be between $2.6 and $2.8 million dollars per year, which was more palatable to

legislators and allowed this bill to continue through the legislative process. Senate Bill (SB 534) was assigned to the following Senate Committees: Agriculture, Community Affairs, Appropriations Subcommittee on Finance and Tax and Appropriations. This bill went through three of these committees and received a unanimous vote in each. The bill currently is in the Appropriations Committee and will not be heard before the end of this session. In the House of Representatives, House Bill 257 was assigned to two committees: Finance and Tax Subcommittee and Appropriations. FVMA was not able to get this bill on the agenda for the Finance and Tax Subcommittee. Therefore the bill “died” in the House. While FVMA was cautiously optimistic about these bills being passed in both chambers, it was not to be this year. Members of the House leadership have led us to believe that next year will be a better year for this legislation to gain support in the House. A very encouraging outcome, of our Legislative Action Days efforts, is that


VE ACTION DAYS the following legislators have since joined in sponsoring this important legislation: Senator Darren Soto (D) Orlando; Representative Neil Combee (R) Lakeland; Representative Travis Cummings (R) Orange Park; Representative Amanda Hickman Murphy (D) New Port Richey; Representative John Wood (R) Winter Haven; and Representative Carl Zimmerman (D) Palm Harbor. The other 'High Priority' set by the Delegates, was FVMA opposition to House Bill 1213: “Pet Services and Advocacy Program” sponsored by Representative Barbara Watson (D) Miami Gardens. This legislation is almost identical to the bill known as the “Pet Trust Act” which failed in last year’s legislative session. The promising news is that as of this article going to press, there was not a Senate companion bill and it had not been scheduled to be heard before any of the three House Committees to which it had been assigned. HB 1213, Formerly Known as the “Pet Trust Act”, authorizes counties to establish Independent Special Tax Districts and levy Ad Valorem taxes to fund “Pet Services and Advocacy Programs”. It creates a governing body of 14 (including one non-voting member) to administer the 'program'. The members are appointed by the County Commission and are not elected; thus they are not accountable to the people who are being taxed. This is a local issue! Local governments currently have the authority to provide funding for

these special interest programs through their ability to create Special Tax Districts and/or allocate funds from Ad Valorem Taxes; which would be much more transparent and allow for accountability. Based on the 2013 Statewide Taxable Value at $1,313,088,962,719 (Source: Florida Department of Revenue, November 2013), the potential revenue that would be generated statewide by the .10 mill cap, established in this proposed legislation, is $131,308,896 per fiscal year. This does not include recurring revenue increments. To put this in perspective, the fiscal year 2013-2014 budget for the Florida Department of Veterans Affairs is $93,970,369 million. This is used for Veteran services statewide. The majority of the budget is funded by trust funds. This information is provided only to contrast the amount of funding allocated for Veterans' programs in Florida, versus the significant amount of taxpayer dollars that would be generated throughout the state for “pet service and welfare” programs if this proposal is adopted. Economic development is the most effective way of diversifying the tax base for all levels of Government in the state. Under this proposed legislation the business and industrial community could have an increased tax burden in any county where it is enacted. Even a small increase in Ad Valorem taxes could cause a potential property or business owner not

to qualify for a loan. In summary, the FVMA wholeheartedly supports charitable programs that make a significant improvement to the health and welfare of Florida’s animals. However, we do not support the use of tax revenue to fund activities of non-profit organizations (501(c)(3)) for which a taxexempt status has been granted. While the above was the top legislative priorities for FVMA, staff monitored 30 other pieces of legislation that had the potential of affecting veterinary medicine. To top off the workshop, the Delegates were given a demonstration of FVMA’s new Legislative Advocacy Network Software. This Grassroots Legislative initiative was launched for use by the Delegates just prior to Legislative Action Days. The General Membership has since been invited to become an “Advocate” and we are receiving an enthusiastic reception to the program.

Grassroots Advocacy FVMA staff secured appointments for each Delegate with their respective Senator and Representative, where possible, for Thursday, March 13th. The Delegates were then off to the Capital where many of our State Legislators experienced a day of handshakes, “hellos” and grass roots advocacy from FVMA members dedicated to their shared profession. In all, over 35 Legislators were reached by those present.

The Legislative Action Days for 2014 are over, but the legislative work of the FVMA continues!

www.fvma.org  |  17


OUR BROTHERS’ KEEPER – FVMA PEER ASSISTANCE PROGRAM

More Boots on the Ground Needed!

O

ne of the benefits of membership in the FVMA is its Peer Assistance Program that has worked quietly below the radar over the years. Dedicated members of t he FVM A Outreach Committee have been serving members for more than 20 years, providing assistance to those who struggle with addictive behavior and chemical dependence, primarily help‑ ing to get practitioners connected to the recovery process. When the FVMA instituted its outreach committee, its purpose was defined as “to formulate procedures for the Peer Assistance Program that will assist chemically addicted, impaired, injured or infirmed members and to assist families of deceased members to maintain or equitably dispose of the deceased member’s practice. The committee shall also act as the association’s liaison to the Physicians Recovery Network.” The outreach efforts of the association in 2014, are led by Dr. John “Steve” Woodby of Calusa Crossing Animal Hospital in Miami. He has chaired the Outreach Committee since 2010, but has been a committee member for 14 years, and has been assisting recovering professionals for over 20 years. “Most of the calls that I get really don’t know what the limits of help are and part of what I do is to let them know,” says Chairman Woodby. “Our primary function is to be supportive and helpful. We also have a concern underlying all of that, being the safety and welfare of the public.” The success of the Peer Assistance Program has registered great success with

little or no publicity, so that Dr. Woodby also receives calls for assistance from outside the state. The rank and file of the FVMA may not have heard of Dr. Woodby, the FVMA Outreach Committee and the services they provide because anonymity is an important element of this valuable work. The program has functioned long enough however, to create awareness among the groups and others in the state who are engaged in offering similar support to medical professionals. The years of quiet intervention by the FVMA Outreach Committee has enabled the development of a much relied upon network which allows the committee to provide the necessary service to those in need. Anonymity is most important to this service as its benefactors do not only face the stiff challenge of beating addiction, but also because of the stigma attached. An outreach program such as this has to contend with the fear stigmatization produces. “Publicity can be detrimental to the recovery process,” explains Dr. Woodby. It can be difficult to get people who need it to seek help if they question the program’s commitment to discretion and confidentiality. And secondly, Dr. Woodby points out, lack of anonymity can also serve as a deterrent to those who are in successful recovery who may want to lend their active support to the program. Having medical personal who are on the other side of the recovery fence involved in outreach is an invaluable resource to such programs. In the typical scenario, a staff member or another doctor in a practice calls, says Dr. Woodby. “It is a delicate balance between those with a problem needing to get help and wanting to continue to hide and be in denial, while there is the risk to patient care being an issue. As an example, if someone’s at risk to himself or to others, we need to try to get people to them quickly, and that’s where the boots on the ground comes in. Those needing help are a lot more open to listening to other veterinarians or health and medical people that are in the program.”

He explains that in the cities, the program is well serviced by volunteers and resources such as the Physicians Recovery Network (PRN). PRN is a nonprofit state program that was set up for the management of impaired practitioners. It provides treatment, support and referrals. The less-populated areas however, present a challenge, with available resources spread very thin. Volunteers are needed in those areas. Dr. Woodby continues, “Our challenge is getting people who need help to come in, and having people available to encourage them to seek help through timely intervention.” Having said that, Dr. Woodby informs that we want to invite help from all demographics; from cities and suburbs as well as rural areas, as more is better. Having two or three people to reach out to, helps eliminate lags due to one person’s availability.

A CALL FOR VOLUNTEERS “Boots on the ground allows us to get help to people quickly. Our challenge is getting people to come in, and having people in front of them when they do.” “Pain may be necessary, but suffering is optional. If we want to deny and not do anything and watch our colleagues get in trouble, suffering is coming. If we can create a situation where we make it easier, safer and less threatening, I think we might be able to increase the numbers of people we get out of trouble.” (Dr. John “Steve” Woodby) The FVMA Outreach Committee needs more boots on the ground. By volunteering to be of service, you will assist the committee to continue to be supportive and helpful to those in need. Volunteers are encouraged to contact Dr. Woodby at (305) 281-0257, who will explain the scope of your involvement as ‘boots on the ground” with an assurance of discretion and anonymity. www.fvma.org  |  19


It’s a soft chew. Kills both fleas and ticks. It’s prescription only.

NexGardTM (afoxolaner) is the protection you asked for, and patients will beg for. NexGard is FDA-approved to kill fleas, prevent flea infestations, and kill the American dog tick. NexGard is available only with a veterinarian’s prescription, and features anti-diversion technology monitored by Pinkerton® Consulting & Investigations.

®FRONTLINE is a registered trademark, and TMNexGard and FRONTLINE VET LABS are trademarks, of Merial. ®PINKERTON is a registered trademark of Pinkerton Service Corporation. ©2014 Merial Limited, Duluth, GA. All rights reserved. NEX14TRADEAD (01/14).

20  |  FVMA ADVOCATE

IMPORTANT SAFETY INFORMATION: For use in dogs only. The most common adverse reaction is vomiting.  Other adverse reactions reported are dry/flaky skin, diarrhea, lethargy, and anorexia.  The safe use of NexGard in pregnant, breeding, or lactating dogs has not been evaluated. Use with caution in dogs with a history of seizures.


University of Florida Veterinarians  Seek Dogs for Stem Cell Studies 

D

the studies. They should be showing signs of lameness or limping for at least six months. They should still be weight-bearing, taking antiinflammatory medication and be 2 to 10 years old. The treatment is free for study participants, but owners must cover the cost of initial evaluation. The UF Health release reports Dr. Pozzi as saying that dogs that have shown signs of lameness for less than six months would probably benefit most from surgery, but older dogs, or dogs with ongoing osteoarthritis may be better candidates for the stem cell treatment. The stem cell studies were made possible by a gift of $330,000 from donors Robert and Janet Sabes and the Sabes Foundation. More information about the UF stem cell studies in dogs may be obtained from Mary Bohannon at mebohan@ufl.edu or by calling 352-294-4639.

octors at the University of Florida College of Veterinary Medicine are engaged in two groundbreaking studies in the use of stem cells for the treatment of joint disease in dogs. They are focusing on using stem cells as an alternative to surgery in the treatment of chronic degenerative joint disease, and they are seeking up to 60 dogs to participate in the study. A release from UH Health Communications at the University of Florida (UF) explains that the doctors are exploring whether stem cells collected from healthy donor dogs can offer a nonsurgical option for dogs that suffer pain and stiffness from osteoarthritis of the knee and elbow. The release quotes Antonio Pozzi, DVM, associate professor of small animal surgery at UF who describes the project’s goal, saying, “The long-term goal is to try to effectively treat dogs with chronic cranial Cruciate ligament rupture and osteoarthritis without surgery.” The other key goal, he says, is to improve quality of life for the dog, decrease pain and improve limb function and mobility. One study is tracking the effectiveness of stem cells injected into the knee joints of dogs with osteoarthritis due to a ruptured cranial Cruciate ligament (ACL in humans). Another is treating elbow osteoarthritis secondary to elbow dysplasia, which is a common disease in large breed animals. Owners are being encouraged to sign up their eligible dogs in

CAUTION: Federal (USA) law restricts this drug to use by or on the order of a licensed veterinarian. Description: NEXGARD™ (afoxolaner) is available in four sizes of beef-flavored, soft chewables for oral administration to dogs and puppies according to their weight. Each chewable is formulated to provide a minimum afoxolaner dosage of 1.14 mg/lb (2.5 mg/kg). Afoxolaner has the chemical composition 1-Naphthalenecarboxamide, 4-[5[3-chloro-5-(trifluoromethyl)-phenyl]-4, 5-dihydro-5-(trifluoromethyl)-3-isoxazolyl]-N[2-oxo-2-[(2,2,2-trifluoroethyl)amino]ethyl. Indications: NEXGARD kills adult fleas and is indicated for the treatment and prevention of flea infestations (Ctenocephalides felis), and the treatment and control of American Dog tick (Dermacentor variabilis) infestations in dogs and puppies 8 weeks of age and older, weighing 4 pounds of body weight or greater, for one month. Dosage and Administration: NEXGARD is given orally once a month, at the minimum dosage of 1.14 mg/lb (2.5 mg/kg). Dosing Schedule: Body Weight 4.0 to 10.0 lbs. 10.1 to 24.0 lbs. 24.1 to 60.0 lbs. 60.1 to 121.0 lbs. Over 121.0 lbs.

Afoxolaner Per Chewable (mg)

Precautions: The safe use of NEXGARD in breeding, pregnant or lactating dogs has not been evaluated. Use with caution in dogs with a history of seizures (see Adverse Reactions). Adverse Reactions: In a well-controlled US field study, which included a total of 333 households and 615 treated dogs (415 administered afoxolaner; 200 administered active control), no serious adverse reactions were observed with NEXGARD. Over the 90-day study period, all observations of potential adverse reactions were recorded. The most frequent reactions reported at an incidence of > 1% within any of the three months of observations are presented in the following table. The most frequently reported adverse reaction was vomiting. The occurrence of vomiting was generally self-limiting and of short duration and tended to decrease with subsequent doses in both groups. Five treated dogs experienced anorexia during the study, and two of those dogs experienced anorexia with the first dose but not subsequent doses. Table 1: Dogs With Adverse Reactions. Treatment Group Afoxolaner

Chewables Administered

11.3 One 28.3 One 68 One 136 One Administer the appropriate combination of chewables

NEXGARD can be administered with or without food. Care should be taken that the dog consumes the complete dose, and treated animals should be observed for a few minutes to ensure that part of the dose is not lost or refused. If it is suspected that any of the dose has been lost or if vomiting occurs within two hours of administration, redose with another full dose. If a dose is missed, administer NEXGARD and resume a monthly dosing schedule. Flea Treatment and Prevention: Treatment with NEXGARD may begin at any time of the year. In areas where fleas are common year-round, monthly treatment with NEXGARD should continue the entire year without interruption. To minimize the likelihood of flea reinfestation, it is important to treat all animals within a household with an approved flea control product. Tick Treatment and Control: Treatment with NEXGARD may begin at any time of the year (see Effectiveness). Contraindications: There are no known contraindications for the use of NEXGARD. Warnings: Not for use in humans. Keep this and all drugs out of the reach of children. In case of accidental ingestion, contact a physician immediately.

Oral active control

N

% (n=415)

N2

% (n=200)

Vomiting (with and without blood)

17

4.1

25

12.5

Dry/Flaky Skin

13

3.1

2

1.0

Diarrhea (with and without blood)

13

3.1

7

3.5

Lethargy

7

1.7

4

2.0

Anorexia

5

1.2

9

4.5

1

Number of dogs in the afoxolaner treatment group with the identified abnormality. 2 Number of dogs in the control group with the identified abnormality. In the US field study, one dog with a history of seizures experienced a seizure on the same day after receiving the first dose and on the same day after receiving the second dose of NEXGARD. This dog experienced a third seizure one week after receiving the third dose. The dog remained enrolled and completed the study. Another dog with a history of seizures had a seizure 19 days after the third dose of NEXGARD. The dog remained enrolled and completed the study. A third dog with a history of seizures received NEXGARD and experienced no seizures throughout the study. To report suspected adverse events, for technical assistance or to obtain a copy of the MSDS, contact Merial at 1-888-637-4251 or www.merial.com/ nexgard. For additional information about adverse drug experience reporting for animal drugs, contact FDA at 1-888-FDA-VETS or online at http://www.fda.gov/ AnimalVeterinary/SafetyHealth/ProductSafetyInformation. Mode of Action: Afoxolaner is a member of the isoxazoline family, shown to bind at a binding site to inhibit insect and acarine ligand-gated chloride channels, in particular those gated by the neurotransmitter gamma-aminobutyric acid (GABA), thereby blocking pre- and post-synaptic transfer of chloride ions across cell membranes. Prolonged afoxolaner-induced hyperexcitation results in uncontrolled activity of the central nervous system and death of insects and acarines. The selective toxicity of afoxolaner between insects and acarines and mammals may be inferred by the differential sensitivity of the insects and acarines’ GABA receptors versus mammalian GABA receptors. 1

Effectiveness: In a well-controlled laboratory study, NEXGARD demonstrated 100% effectiveness against adult fleas 24 hours post-infestation for 35 days, and was ≥ 93% effective at 12 hours post-infestation through Day 21, and on Day 35. On Day 28, NEXGARD was 81.1% effective 12 hours post-infestation. Dogs in both the treated and control groups that were infested with fleas on Day -1 generated flea eggs at 12- and 24-hours post-treatment (0-11 eggs and 1-17 eggs in the NEXGARD treated dogs, and 4-90 eggs and 0-118 eggs in the control dogs, at 12- and 24-hours, respectively). At subsequent evaluations post-infestation, fleas from dogs in the treated group were essentially unable to produce any eggs (0-1 eggs) while fleas from dogs in the control group continued to produce eggs (1-141 eggs). In a 90-day US field study conducted in households with existing flea infestations of varying severity, the effectiveness of NEXGARD against fleas on the Day 30, 60 and 90 visits compared with baseline was 98.0%, 99.7%, and 99.9%, respectively. Collectively, the data from the two studies (one laboratory and one field) demonstrate that NEXGARD kills fleas before they can lay eggs, thus preventing subsequent flea infestations after the start of treatment of existing flea infestations. In well-controlled laboratory studies, NEXGARD demonstrated >97% effectiveness against Dermacentor variabilis 48 hours post-infestation for 30 days. Animal Safety: In a margin of safety study, NEXGARD was administered orally to 8- to 9-week-old Beagle puppies at 1, 3, and 5 times the maximum exposure dose (6.3 mg/kg) for three treatments every 28 days, followed by three treatments every 14 days, for a total of six treatments. Dogs in the control group were sham-dosed. There were no clinically-relevant effects related to treatment on physical examination, body weight, food consumption, clinical pathology (hematology, clinical chemistries, or coagulation tests), gross pathology, histopathology or organ weights. Vomiting occurred throughout the study, with a similar incidence in the treated and control groups, including one dog in the 5x group that vomited four hours after treatment. In a well-controlled field study, NEXGARD was used concomitantly with other medications, such as vaccines, anthelmintics, antibiotics (including topicals), steroids, NSAIDS, anesthetics, and antihistamines. No adverse reactions were observed from the concomitant use of NEXGARD with other medications. Storage Information: Store at or below 30°C (86°F) with excursions permitted up to 40°C (104°F). How Supplied: NEXGARD is available in four sizes of beef-flavored soft chewables: 11.3, 28.3, 68 or 136 mg afoxolaner. Each chewable size is available in color-coded packages of 3 or 6 beef-flavored chewables. NADA 141-406, Approved by FDA Marketed by: Frontline Vet Labs™, a Division of Merial Limited. Duluth, GA 30096-4640 USA Made in Brazil. 1050-4493-00 Rev. 7/2013

™NexGard and FRONTLINE VET LABS are trademarks of Merial. ©2014 Merial. All rights reserved.

www.fvma.org  |  21


PRACTICE Got a question? The FVMA can help.

One of the benefits of membership in the FVMA is our helpline, (800) 992-3862, available to members daily, Monday to Friday, 8:00 am to 6:00 pm. Our helpline also provides insight to the FVMA staff, of the challenges and concerns of our members. In this feature we will highlight topics from the questions we received in preceding weeks, in an effort to keep our members upto-date on current concerns as well as regulatory and legislative changes.

Question: Is Tramadol a scheduled drug in Florida?

According to the DEA office in Florida, Tramadol is not a federally scheduled drug. However, some states have considered it to be scheduled. Tramadol is CURRENTLY not a scheduled drug in the state of Florida. Thus far, Florida has adhered to federal law with this agent, which is not currently listed as a DEA-controlled substance under the Controlled Substance Act (CSA). However, as is often the case with agents that may be susceptible to abuse or misuse by humans, tramadol could be designated as a controlled substance at some point in the future. There have been some reports of tramadol abuse by people and, accordingly, some states have acted independently from the DEA and designated tramadol as a controlled substance. At this time, Kentucky, Wyoming, Massachusetts and Arkansas have classified tramadol as a controlled substance, with various designations but most commonly Schedule IV. Louisiana has classified it as a human 'drug of abuse.' In light of these on-going developments, additional states including Florida, as well as the DEA, may add tramadol to the lists of agents that are designated as controlled substances at some future date. The bottom line however, is that tramadol is not currently a controlled substance under Florida Statutes, but stay tuned for future developments.

Question: Are there limits to the quantity of scheduled drugs that can be dispensed at one time?

Schedule II drugs are not allowed to be refilled and can only be dispensed in 30-day supplies because of their severe potential for addiction, therefore a veterinarian must see the patient once per month for refills. With regard to limits on the quantity of controlled substances that can be dispensed, Florida Statutes (Ch. 893.04 and 893.05) establish the following specific limits and restrictions: Schedule II Agents

• a pharmacist may dispense substances ONLY on written prescription, except in an emergency situation (as defined by FL Dept. of Health under 465.0275) when it is allowable to dispense a 72-hour supply upon oral prescription. • prescriptions are limited to a 30-day supply and may not be refilled. Schedule III, IV or V Agents • a pharmacist may dispense these substances upon written or oral

prescription, although the latter must be reduced to writing or recorded electronically, if permitted by law.

22  |  FVMA ADVOCATE

• a pharmacist may not dispense more than a 30-day supply of a Schedule III substance upon an oral prescription. There are no other specific limits provided for written prescriptions. • prescriptions may not be filled or refilled more than five times within a period of 6 months after the date the prescription was written unless the prescription is renewed by the practitioner. In practice, this restriction would appear to place a maximum 6-month limit on the supply of controlled substances (CIII, CIV and CV) that may be prescribed. • for any controlled substance dispensed by a practitioner, the original container in which the controlled substance is delivered must have an affixed label on which appears: 1. The date of delivery. 2. The directions for use of such controlled substance. 3. The name and address of such practitioner. 4. The name of the patient and, if such control substance is prescribed for an animal, a statement describing the species of the animal. 5. A clear, concise warning that it is a crime to transfer the controlled substance to any person other than the patient for whom prescribed.

Question: When we dispense medications for ears, eyes or skin, that come in single tubes or bottles, are we required to, then put these tubes and bottles in child-safe vials, or can we dispense them in plastic bags with label or place label on boxes they came in?

The question about proper drug packaging touches on an important issue, but unfortunately, there is no clear definitive answer. There is no federal or state regulation or rule that requires veterinarians to dispense all medications in child-safe packaging. The established standard of care and best practice would be that if a product can fit into a special package or childresistant container, it probably should go into one. Obviously in a veterinary setting, giant tubes of products, special delivery systems, and blister packs do not always lend themselves to this type of packaging. If a veterinarian is dispensing loose tablets or capsules, there really isn’t an excuse for not putting them into a bottle that is child resistant.

Question: What’s new in continuing education requirements for license renewal in the 2012-2014 biennium? 61G18-16.002 Continuing Education Requirements for Active Status License Renewal.


(1) All licensed veterinarians shall be required to obtain continuing professional education which contributes to the advancement, extension or enhancement of professional skills and knowledge in the field of veterinary medicine. (2) Licensed veterinarians shall complete a minimum of thirty (30) hours of continuing professional education in veterinary medicine every biennium. Beginning on June 1, 2012, no less than one (1) hour of continuing education shall be in the area of dispensing legend drugs and no less than two (2) hours of continuing education shall be in the area of the laws and rules governing the practice of veterinary medicine. For the purposes of this rule, the laws and rules governing the practice of veterinary medicine are Chapters 455 and 474, F.S. and Rule Title 61G18, F.A.C. (a) One (1) hour equals a minimum of fifty (50) minutes and a maximum of sixty (60) minutes. Total hours of lecture time cannot be added up and divided into 50 minute intervals to obtain 1 hour credit for each 50 minute interval. (b) Not more than fifteen (15) hours shall be non-interactive, correspondence courses. Computer on-line programs that involve on-line, real time, live or delayed participatory questioning or responses are not correspondence courses. (c) Five (5) hours of continuing education in laws and rules may be obtained once per biennium by attending one full day or eight (8) hours of a Board meeting (whichever is shorter) at which disciplinary hearings are conducted by the Board of Veterinary Medicine by complying with the following: 1. The licensee must sign in with the Executive Director of the Board or designee before the meeting day begins. 2. The licensee must remain in continuous attendance. 3. The licensee must sign out with the Executive Director of the Board or designee at the end of the meeting day or at such other earlier time as affirmatively authorized by the Board. A licensee may receive continuing education credit for attending the Board meeting only if he or she is attending on the date solely for the purpose of obtaining continuing education; he or she may not receive credit if appearing at the Board meeting for another purpose. (d) Not more than five (5) hours in complementary and alternative medicine modalities shall be credited toward the required number of continuing professional education hours referenced above. (3) During the license renewal period of each biennium, an application for renewal will be mailed to each licensee at the last address provided to the Board. Failure to receive any notification during this period does not relieve the licensee of the responsibility of meeting the requirement. The application for renewal shall include a form on which the licensee shall state that he has completed the required continuing education. The licensee must retain for a period of not less than three years from the date the course was taken certificates of attendance or verification from the provider, to document completion of the continuing education certified on the renewal form. The Department will audit at random a number of licensees as is necessary to assure that the continuing education requirements are met. (4) Failure to comply with the continuing professional education

requirement shall prohibit license renewal and result in delinquent status at the end of the renewal period. (5) A licensed veterinarian shall not be required to complete a continuing education requirement prior to the first renewal of his license, but it shall be required prior to any subsequent renewal. (6) Failure to document compliance with the continuing education requirements or the furnishing of false or misleading information regarding compliance shall be grounds for disciplinary action up to and including license revocation.

Rulemaking Authority 474.206, 474.211 FS. Law Implemented 455.2177, 455.2123, 474.211 FS. History–New 11-14-79, Amended 11-1-81, Formerly 21X16.02, Amended 4-20-88, 11-2-88, 3-26-90, Formerly 21X-16.002, Amended 8-18-94, 2-6-95, 3-20-95, 9-24-96, 11-28-96, 12-30-97, 5-22-12, 6-9-13, 8-26-13.

Question: Should cold lasers be registered in Florida?

Yes, lasers have to be registered in the state of Florida. We have reproduced the statute that requires the registration and stipulates the form such registration should take. 64E-4.001 Registration. (1) Except as otherwise specifically exempted, all persons who receive, possess, acquire, transfer, own, manufacture, or use lasers which emit or may emit laser radiation shall register within 30 days after acquisition of a laser product and comply with these rules. Nothing in these rules shall be interpreted as limiting the intentional exposure of patients to laser radiation for the purpose of treatment or use commensurate with the licensed practitioner’s use of the healing arts. (2) A separate registration is required for each location with a laser device, on DH Form 1605 Jul 96, which is herein incorporated by reference and which is available from the department. Laser manufacturers must register on DH Form 1604 Jul 96, which is herein incorporated by reference and which is available from the department. Subsequent registrations for each facility or mobile laser facility are required whenever additional laser devices are installed or previously registered laser devices are disposed of, altered, destroyed or moved to new locations. Subsequent registrations for each manufacturer are required only when the description of the laser devices manufactured by the manufacturer changes. (3)(a) Laser products certified by a manufacturer to be compliant with the Federal laser product performance standard of 21 C.F.R. Part 1040 in effect at the date of manufacture shall be maintained in compliance with such requirements. Certified laser products which have been modified shall comply with these rules. (b) Uncertified lasers shall meet the requirements of these rules. (4) If any conflict arises between the requirements of these rules and the federal laser product performance standard, the requirements of the federal standard shall apply. Rulemaking Authority 501.122(2) FS. Law Implemented 501.122(2) FS. History–New 9-6-84, Amended 5-7-96, 12-12-96, Formerly 10D-89.101.

www.fvma.org  |  23


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Veterinary e h t o t e c ren Volunteer to Make a Diffe

V

alues formulated in 1929 for the FVMA continue to guide the association today. The heart of the charter that was written then and amended minimally in 1975, is what guides the association on a daily basis in the fulfillment of its mis‑ sion to promote animal health and well-being, public health, and the advancement of the veterinary profession. We need our membership’s continued involvement in our evolutionary process of growth and achievement through service, and invite you to seek out opportunities to volunteer and serve the needs of the veterinary profession in Florida. The FVMA provides the following opportunities for its members who wish to make a difference to the veterinary community and our state. Animal Welfare Committee – The purpose is to engage in activities approved by the FVMA Executive Board that involve or promote animal welfare and/or the human/animal bond. College Advisory Committee – The purpose shall be to promote cooperation between the membership of the Association and the University of Florida College of Veterinary Medicine and to advise and aid the college in student orientation programs, fund raising, student scholarships and loans, curriculum and client referral procedures, and to promote Association membership among staff and students. Committee of Continuous Existence (formerly PAC) – The purpose is solicit and expend funds in accordance with the guidelines established by and reflected in the CCE Bylaws. Continuing Education Program Committee – – The purpose is to secure guest speakers and be responsible for the arrangement and timing of the professional sessions of the annual meeting of the Association. Disaster Preparedness Committee – The purpose is to work with other animal support groups, animal welfare organizations and governmental agencies to ensure the most efficient and effective emergency response network to preserve animal life and to provide emergency care during a disaster. Food Animal Practice Committee – The purpose is to work through the FVMA on all developments related to food animal veterinary medicine, to coordinate practitioner activity, and advise on actions to be taken in order to safeguard the professional interest of food animal veterinarians in state.

Community and our State.

Legislative Committee – The purpose is to be responsible for studying proposed legislation emanating from any source whatever, to support by whatever means advisable, the passage of legislation favorable to the veterinary profession, the livestock industry and allied medical groups. Likewise, the committee shall exercise vigilance and attempt to suppress any legislation deemed undesirable or detrimental to the veterinary profession, the livestock industry and allied medical groups. The committee is encouraged to enlist the aid of the membership whenever deemed necessary to accomplish its responsibilities. One Health Committee – The purpose is to be responsible to appraise the membership of zoonotic and emerging disease events that may have an impact on the veterinary profession and the public it serves. The committee will also be responsible for developing veterinary public health information releases and, as directed, will maintain liaison with various public health agencies and various animal industries for the purpose of obtaining current disease information. Outreach Committee – The purpose is to formulate procedures for the Peer Assistance Program that will assist chemically addicted, impaired, injured or informed members and to assist families of deceased members to maintain or equitably dispose of the deceased member's practice. The committee shall also act as the association's liaison to the Physicians Recovery Network. Veterinary Technician Career Development Committee – The purpose is to promulgate standards of curriculum, ethics and certification of Veterinary Assistants and Technicians in Florida. Veterinary Technician Career Development Committee – The purpose is to work together with the accredited Veterinary Technician Program in Florida and the FVMA for the career advancement of Veterinary Technicians in Florida. This committee is composed of veterinarians and technicians. Young Veterinary Medical Council – The purpose is to provide encouragement, community, and services to FVMA members to aid in the transition from school to professional life in their final year of veterinary school through the first 5 years after graduation. If you’d like to serve, please email the FVMA at: info@fvma. org, indicating the committee(s) you are willing to serve on by the close of business on Wednesday, April 30, 2014. Volunteer and Be Involved! www.fvma.org  |  25


&

Veterinary Medicine

the Law:

How to Provide Good Care & Protect Yourself in the Process

Part III: Veterinary Malpractice Litigation

O

ver the last few decades, the number of U.S. pet owners has increased. According to the most recent National Council on Pet Population Study and Policy, in the last 30 years the number of dogs and cats in U.S. homes has more than doubled from 67 million to 164 million. In yet another major study, a majority of pet owners reported they considered their pets to be family members. As the number of pet owners and the emotion associated with ownership increases, so shall the likelihood of litigation. Where there has been an adverse outcome or death of an animal, your natural inclination may be to convey your sympathy. Expressing your sympathy is not an admission of guilt or liability, rather it conveys your understanding that this is a difficult time for all involved and that you empathize. When owners are faced with the loss of a pet, they often seek to find a reason for that loss, and in the absence of any reasonable alternative, they may seek to blame the veterinarian. It is appropriate to explain the adverse outcome to the client and express disappointment that better results were not achieved. In the face of complications and loss of a pet, the owner may also incur additional medical bills. Too often, a slight issue with care can become magnified when the owner receives the bill. Though it would not be cost effective to write off bills for any perceived slight, this is a good resource to consider from a customer service perspective that may also serve to avoid litigation. This allows the veterinarian to convey appropriate goodwill, again without admitting liability, and encourages the owner to return, knowing that medical bills will be handled reasonably. Despite best efforts, not all relationships are fruitful for the veterinarian or the owner. Some are toxic and need to be terminated, as those are not in anyone’s best interests. It may be that there is another veterinarian within the practice who is better equipped to deal with certain personalities and if willing, can provide a better experience for all those involved. If the relationship is terminated, make sure to document the reasons for termination. It may prove a more positive experience for the client if you make yourself available to provide emergent care to the patient for a limited amount of time during the transition to another veterinarian. When all other options are exhausted and the relationship

By Francys C. Martin, Esq. Claims and Litigation Coordinator University of Florida Health Center Self-Insurance Program

between the veterinarian and pet owner becomes irretrievably broken, the pet owner may seek to pursue litigation alleging negligence. Negligence is generally defined as a failure to act as a reasonable person would act under similar circumstances. The creation of the provider-patient relationship or provider-client relationship is the first step in establishing a negligence action against a veterinarian. This relationship is what establishes a duty to the patient by the veterinarian or the practice. The client must establish, either by implication or contract, that the veterinarian has created a professional medical relationship with the patient. This relationship may also be created with extenders of that provider, including other employees of the practice. Included in the veterinarian’s duty to the client is the obligation to provide care that falls within the standard of care provided by reasonably prudent veterinarians under similar circumstances. Given that it is defined by comparison with other veterinarians under similar circumstances, it is relevant where the veterinarian is practicing and what type of practice has been established. For example, a veterinarian that handles predominantly small, domesticated animals would not be held to the same standard as a veterinarian that deals exclusively with wild or exotic animals. Nor should a veterinarian in a small practice with limited resources and equipment be held to the same standard of care as that of a veterinarian in a large academic facility with state-of-the-art equipment. The standard of care is often established through the use of experts in that same field or specialty who can better articulate what is expected of a veterinarian in that same circumstance. The client must also establish that a breach of the veterinarian’s duty resulted in an injury. This must be established within a reasonable degree of medical probability to be the proximate cause of the patient’s injury. If the client is unable to establish that the injuries are as a result of the veterinarian’s breach of the standard of care, then causation cannot be established and there is no cause of action for negligence. Though an accident or incident may occur in the course and scope of the veterinarian’s treatment, it does not mean that the breach is causally linked to the resulting injury or damages.


Finally, the owner must establish that damages were suffered. Because animals are considered property under the law, the damages to the owner are rooted in economic loss as a result of the animal’s death or need for further medical care. Economic loss will usually include the fair market value of the animal if it died or the costs associated with veterinary care as a result of the injury. The market value of the animal often depends on its purpose. Loss of income may also be awarded where the animal provides some service or generates a profit for the owner. Under the laws of the State of Florida and most other states, animals are considered to be personal property. As property, the loss of an animal cannot result in damages rooted in emotional distress. Therefore, the value of the claim is measured by the value of the animal and, potentially, the value of the veterinary services in dispute. As a result, when these cases go to court they are usually relegated to county court, which handles matters with damages under $5,000. However, many animals in our society have a higher value because of either their purpose or breeding. The market value of some animals is exceedingly high because they are relatively rare and in high demand. Where pet owners seek to make a claim for emotional distress, they must show some physical impact. The typical exception to the “impact rule” is the presence of a familial relationship when, for example, a parent suffers emotional distress from the injury of a child as a result of malpractice. The courts have not gone so far as to extend that application to animals. For as much as many consider a pet to be a member of the family, Florida law does not. Like most states, Florida also has a Good Samaritan Act that limits the liability of veterinarians rendering care to an injured animal in emergent circumstances. The statute provides that, “Any person, including those licensed to practice veterinary medicine, who gratuitously and in good faith renders emergency care or treatment to an injured animal at the scene of an emergency on or adjacent to a roadway shall not be held liable for any civil damages as a result of such care or treatment or as a result of any act or failure to act in providing or arranging further medical treatment where the person acts as an ordinary reasonably prudent person would have acted under the same or similar circumstances.” Unlike the provisions of the Good Samaritan Act involving human patients, the protections do not include emergent care provided in a veterinary office or facility. Legal recourse is not the only avenue available to disgruntled veterinary clients. For some clients, there is greater satisfaction in pursuing disciplinary sanctions. Whether the complaint is valid or not, the Florida Board of Veterinary Medicine investigates most claims. Some insurance carriers may provide optional endorsements that would cover settlements or judgments rendered for veterinary malpractice, and they may also cover legal fees for the defense of legal actions or licensure investigations.

Once an owner takes the step of initiating a claim or lawsuit, contact your liability insurance carrier as soon as possible in order to avoid compromising the defense of the claim. Personnel at the insurer’s office will often handle the management of the claim and assign an attorney to represent your interests in any ensuing litigation. Make certain to keep all correspondence with your carrier and attorney in a separate place and not within the medical records, as you may possibly lose the protections afforded by the attorney-client privilege. In addition, though you may feel that you can resolve or address the owner’s concerns yourself, let your liability carrier and attorney handle the matter. Continuing discussion with the owner about a claim or litigation can only serve to add to the confusion and is unethical if the claimant is represented by counsel. As we have discussed in each segment of this series, communication is the cornerstone of a good veterinary practice. Begin with an informed consent that advises the owner of all likely risks and complications. This should serve to create reasonable expectations and advise the owner of their options. Document all relevant medical care in a timely and organized manner in the medical record. Where there has been an adverse outcome, inform and discuss this with the owner, and express your empathy. Proactive communication with the client and within your documentation is key to avoiding litigation and to the defense of good veterinary care. U.S. Pet Ownership & Demographics Sourcebook, 2012 Edition 2 Kennedy v. Byas, 867 So. 2d 1195 (Fla. Dist. Ct. App. 2004) 3 §768.13(3), Florida Statutes (2012) 1


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28  |  FVMA ADVOCATE


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www.fvma.org  |  29


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Mobile Florida.Owner leaving the country Selling a turn- key beautiful Mobile SOLD IN 6 MONTHS! Congratulations to Dr. Chris Thompson and his wife, Veterinary Clinic client list . fully equipped: laser, Florida full Idexx Kim, onwith the sale of Thompson Animal Hospital CO2 in Lakeland, to Dr. Dawnwith Morgan-Winter! (#FL23D) lab ( chemistry T4, bile acids), QBC, Electrolytes, I-Stat machine, autoclave, anesthesia machine,todental 2 centrifuges, Pulse SOLD! Congratulations Dr. Joe machine, Harper and his wife, Edda, on the sale of Animal Clinic of Dunlawton! Tom, MacPhail, the owner of Deland Animal oxymeter ( with esophageal cardiac Dr. probe rectal probe, multiple lingual Hospital, is the new owner creating a satellite office. (#FL50A) probes, doppler),doppler blood pressure, latest,otoscope all surgical you haveorthopedic a practice in equipment mind that youincluding may like toArthrex purchase, we instrumentsBUYERS—If needed with some help you. Contact us for a complimentary consultation to learn how. Acl repair kitcan and much more.For a vey attractive price.Serious inquiries Also, visit our website to be added to our buyer database and to view all Call 239-908-1343. (Exp. Issue 2&3/14:11640) listings nationwide. Practice for sale: Jacksonville, FL Solo. Small animal only. Real estate included. Call 904-724-8866 for details. (Exp. Issue 2.3&4/14:1110) 1610 Frederica Road * Saint Simons Island, GA 31522 Toll Free: 800.333.1984 * www.simmonsinc.com Equipment for sale

Email: southeast@simmonsinc.com Bowie (equine) veterinarian half box for 8 foot pickup Licensed Florida Real Estate Broker and hot truck. The style is a Crown Deluxe body. Has refrigerator water tank with hose. Good Condition $1,500.00. Call 863 602-0192.

Florida Practices for Sale NEW! Palm Beach County. 1.5 miles to beach. $157 average transaction charge. Solo doctor, small animal. Minimal boarding and grooming. $1.4M for Practice & Real Estate. (#FL22B) Winter Garden. 2013 revenues are up 11%. To $425K. Solo doctor, small animal. No boarding, grooming, or emergencies. Quaint, leased facility centrally located blocks from downtown. $220K for Practice (#FL35G) Polk County. Impeccable 3,000SF facility on busy 4-lane highway. Gross in excess of $2M with continual growth. New owner’s income to exceed $370K! $2.530M for Practice & Real Estate. (#FL72S) Panhandle. Enjoy the emerald waters across from this beautiful practice in a highly desirable beach community. No grooming or boarding. $562K gross on a 5 day work week. Affluent clientele. $1.115M for Practice & Real Estate. (#FL30S) SOLD IN 6 MONTHS! Congratulations to Dr. Chris Thompson and his wife, Kim, on the sale of Thompson Animal Hospital in Lakeland, Florida to Dr. Dawn Morgan-Winter! (#FL23D) SOLD! Congratulations to Dr. Joe Harper and his wife, Edda, on the sale of Animal Clinic of Dunlawton! Dr. Tom MacPhail, the owner of Deland Animal Hospital, is the new owner creating a satellite office. (#FL50A) BUYERS—If you have a practice in mind that you may like to purchase, we can help you. Contact us for a complimentary consultation to learn how. Also, visit our website to be added to our buyer database and to view all listings nationwide.

1610 Frederica Road * Saint Simons Island, GA 31522 Toll Free: 800.333.1984 * www.simmonsinc.com Email: southeast@simmonsinc.com Licensed Florida Real Estate Broker

(Exp. Issue 2/14:1102)

Florida Practices for Sale NEW! Palm Beach County. 1.5 miles to beach. $157 average transaction Florida Listings! charge. Solo doctor, Practice small animal. Minimal boarding and grooming. $1.4M for Practice & Real Estate. (#FL22B)

FREE PRACTICE CONSULTATION Winter Garden. 2013 revenues are up 11%. To $425K. Solo doctor, small animal. No boarding, grooming, or emergencies. Quaint, leased facility centrally located blocks from downtown. $220K for Practice (#FL35G)

New! East Coast– 4-5 Dr. Prx 2013 Gross $2.9mm, 8800sq. Polk County. Impeccable 3,000SF facility on busy 4-lane highway. Gross in ft. office, excellent great cash flow. excess of staff, $2M with continual growth. New owner’s income to exceed $370K! $2.530M for Practice & Real Estate. (#FL72S)

theprx emerald waters across from this beautiful lease practice in a N. CentralPanhandle. FloridaEnjoy 3 Dr. grossing $1.9mm 6800SF desirable beach community. No grooming or boarding. $562K gross on a space. Well highly est, nicely equipped & fully trained staff. 5 day work week. Affluent clientele. $1.115M for Practice & Real Estate. (#FL30S)

North Florida Solo Dr., well established SA prx $750K gross SOLD IN 6 MONTHS! Congratulations to Dr. Chris Thompson and his wife, in quaint small town. Prx & RE. Very profitable. Kim, on the sale of Thompson Animal Hospital in Lakeland, Florida to Dr. Dawn Morgan-Winter! (#FL23D)

Coastal Panhandle-Est prx w satellite. 2013 Gross $1.15mm SOLD! Congratulations to Dr. Joe Harper and his wife, Edda, on the sale of and growing! NewClinic equip & digitalDr.xray, solid staff. Animal of Dunlawton! Tom MacPhail, the owner of Deland Animal Hospital, is the new owner creating a satellite office. (#FL50A)

Pompano BUYERS—If Beach– Solo Dr. agreat location. Very welllike estabyou have practice in mind that you may to purchase, we can help you. Contact us forgross a complimentary consultation to learn how. lished w/ 2800 sq.ft. office. 2013 $734K. Owner Also, visit our website to be added to our buyer database and to view all motivated tolistings sell.nationwide. Prx & R/E. New! S.W. Florida Coast– Solo Dr., SA, Great semi-retirement prx, 20131610 gross ~$330k w/low overhead. Lease space. Frederica Road * Saint Simons Island, GA 31522 Toll Free: 800.333.1984 * www.simmonsinc.com Contact Dr. Richard Alker for further practice information. Email: southeast@simmonsinc.com Florida Real Estate Broker 850.814.9962Licensed or Richard@tpsgsales.com

Showcase Properties of Central Florida, Broker

30  |  FVMA ADVOCATE

Veterinary Practices for Sale Florida for7Sale (800Practices ) 6 3 6 -4 40 NEW! Palm Beach County. to beach. psb1.5romileske r.co$157 maverage transaction charge. Solo doctor, small animal. Minimal boarding and grooming. $1.4M for Practice & Real Estate. (#FL22B)

Alabama: Covington County - +3,000sf on +1 acre, real potential. AL2. Winter Garden. 2013 revenues are up 11%. To $425K. Solo doctor, small Florida: Charlotte County - +2,100sf with Prime real estate. FL70. animal. No boarding, grooming, or emergencies. Quaint, leased facility Florida: County on +1 acre, Unlimited Possibilities. centrallyDixie located blocks- 3,500sf from downtown. $220K for Practice (#FL35G) FL20. on +1/2 major hwy. FL71. Florida: St Lucie County - 3,000SF +2,200sffacility Polk County. Impeccable on acre busy on 4-lane highway. Gross in excess of continual growth. New owner’s income to exceed in prime location. FL68. $370K! Florida: S. $2M Palmwith Beach County - +3,600sf $2.530M for Practice & Real Estate. (#FL72S) Florida: Mobile Emergency Pet Transport Truck - F350. FL69. Panhandle. Enjoy the emerald waters across from this beautiful practice in a Idaho: Ada County with nearly double-digit ID2.on a highly desirable beach- +2,000sf community. No grooming or boarding. growth. $562K gross 5 day work Affluent clientele.on $1.115M for Practice Real Estate.ME5. Maine: Yorkweek. County - +2,000sf +3.6 acres prime & real estate. (#FL30S) Maine: York County - +2600sf on +1/2 acre prime real estate. ME4. SOLD IN 6Bay MONTHS! to Dr.acre, Chrisnice Thompson and his wife, Michigan: CountyCongratulations - +2,500sf on +1/3 family area. MI1. Kim, on the sale of Thompson Animal Hospital in Lakeland, Florida to Dr. Nevada: Clark County(#FL23D) - +2,400 on +1/3 acre, busy corner lot. NV2. Dawn Morgan-Winter! ER his in Central NewonYork! NY7. New York: Onondaga County - +2,400sf SOLD! Congratulations to Dr. Joe Harper and wife, Edda, the sale of AnimalCarolina: Clinic of Dunlawton! Dr. Tom MacPhail,on the Deland Animal +¾owner acre.ofStart-Up! NC9. North Winston-Salem - +5,500sf Hospital, is the new owner creating a satellite office. (#FL50A) Oklahoma: Oklahoma City - +4,500sf w/real estate in active area. OK2. BUYERS—If you have a practice in mind that you may like to purchase, we Texas: Jackson County - 2,500sf on +5.5 acres. Wonderful area. TX1. can help you. Contact us for a complimentary consultation to learn how. a prime location. Virginia: Central - 3,900sf onadded +1.5 acres; Also, visit our website to be to ourinbuyer database andVA6. to view all listings nationwide. West Virginia: Cabell County -Busy practice on +¼ acre, great area. WV1. Visit our website for new listings! 1610 Frederica Road * Saint Simons Island, GA 31522 > Buyer Representation Toll Free: 800.333.1984 * www.simmonsinc.com > Seller Representation Email: southeast@simmonsinc.com > PractBroker ice Appraisals Licensed Florida Real Estate

> Free Non-Binding, Confidential Consultation


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It’s the procedure you perform only once in your career. So it’s important to have the right people by your side. You wouldn’t walk into a complicated surgery without an expert team, so why do it for this once-in-a-lifetime event? Buying or selling a practice is the largest financial transaction of your life. That’s why you should partner with Simmons. As the most experienced brokerage firm in the business, we’ve helped more veterinarians realize their dream than any other firm out there. In fact, we wrote the book on it.

We really did write the book on buying and selling your veterinary practice. Scan the QR code or visit our web site to learn more. w w w. s i m m o n s i n c . c o m ©2013 Simmons, Inc.

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FVMA Advocate 2014 Issue 2  

FVMA Publication for 2014 Issue 2

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