Response of a veterinary college to career development needs identified in the KPMG LLP study and the executive summary of the Brakke study: a combined MBA/DVM program, business certificate program, and curricular modifications

In the present market, veterinarians with a strong background in career development, practice management, and business skills have a clear advantage in achieving financial success. Although there is ample evidence that the scientific and clinical skills of veterinary college graduates are high, there are also data that suggest that additional capabilities in the business realm may promote greater economic success. As noted in the KPMG executive summary, the field of veterinary medicine must make changes in its "current business practices and attitudes" to be successful in the future. Furthermore, the KPMG study found that 36% of industry employers reported that some jobs within their companies had specific job requirements that were not met by a veterinarian with only a veterinary medical degree. The areas of additional training most often cited included business, administration, personnel management, sales and marketing, and financial skills. Yet, Lewis and Klausner found that veterinarians reported challenges in the business realm, such as "how business works and how business goals are translated into action. This challenge held true for veterinarians in industry, academia, government, and private practice." The present gender trends in the field of veterinary medicine provide additional impetus to make career development and business skills training more prevalent. Presently, women comprise >65% of the veterinary student population and approximately 45% of all practicing veterinarians. In some areas of practice, the rate is much higher. For example, in 2002, women comprised 48.2% of all small animal exclusive private practitioners. Unfortunately, the KPMG study found that female veterinarians in private practice report lower self-evaluation of business management and financial skills, compared with their male cohorts. Female veterinarians in nonprivate practice report lower self-evaluation in communication, personnel management, business management, and marketing skills than that reported by males. As a result of these pressing needs, CSU CVMBS has undertaken a major initiative to improve the veterinary practice management and business skills training of veterinary students by offering a variety of options to gain this knowledge: a combined MBA/DVM degree program, a Business Certificate Program for Health Professions, and core curriculum courses. In this way, students can select the amount of focus they want to place on career development and business skills as they earn their DVM degree, to best ensure that they become successful veterinarians.     

The cooperative University of Iowa / Iowa State University MPH program

Public health is an important component of veterinary medicine. In the last 10 years, there has been growing recognition of the need to increase the number of veterinarians trained in public health. The Center for Food Security and Public Health (CFSPH) at Iowa State University (ISU), College of Veterinary Medicine, received a grant from the Centers for Disease Control and Prevention (CDC) to support veterinarians working at CFSPH while pursuing the Master of Public Health degree. CFSPH and ISU administrators worked with the University of Iowa (UI) College of Public Health to establish three cooperative programs for veterinarians to earn the MPH degree. This article describes how these programs were developed and how they operate. (1) Between 2002 and 2005, CFSPH used funds provided by the CDC to support 15 veterinarians as they worked for CFSPH and toward the MPH degree. As the program grew, distance-education methods such as the Internet, Polycom videoconferencing, and the Iowa Communications Network (ICN) were incorporated. (2) A concurrent DVM/MPH degree is now offered; students can complete both degrees in four years. As of January 2008, three students have received their DVM and MPH degrees and 16 students are enrolled in the program. (3) In June 2007, the UI and ISU launched a distance MPH program for veterinarians working in private practice, industry, and government. Eight veterinarians are participating in the program, which includes two two-week, in-person summer sessions, with the remainder of the coursework taken at a distance via the Internet.     

Veterinarians:'Watch your affairs!'

The most relevant results of a written questionnaire among veterinarians in the Netherlands are presented and discussed. The inquiry was performed by MarketResponse Nederland BV. The objective was to get an overview of the current perception and the future view of the profession. The response was 37%. Most respondents (66%) were practitioners, 7% were active in research or teaching institutions, 5% were governmental employees, 5% were employed in industry, and 17% did not belong to any of these categories (retired, unemployed etc.). Forty-seven per cent of the veterinarians practised mainly small animal medicine, 24% large animal medicine (cattle 15%, swine 8%, and poultry 1%), and 4% equine medicine; 24% worked in mixed practices. This division reflects the real-life situation. The percentage of female respondents was considerably higher in the group of recent graduates than in the other groups of graduates (increasing from 27% in the graduation period 1980-1989 to 56% in the period 1990-1999). Sixty per cent of the veterinarians worked more than 40 hours a week. Veterinarians considered themselves reliable, honest, professional, client-minded, and animal-friendly. According to them, the public perceived veterinarians as being animal-friendly, professional, and reliable. Veterinarians were less satisfied in their current position than other professional groups, particularly with regard to their income. Their current market position was considered indifferent or good. This position was influenced negatively by the decrease in the number of animals and competition from non-veterinarians and others. The situation could be improved by collaboration and practice fusions, specialization, and differentiation. More demanding and price-conscious clients and governmental regulations were considered important trends. Social, management, and marketing skills, increased knowledge and cooperation, and a vision of future developments were considered essential in order to be able react to developments on the market. About 60% of the practitioners and 50% of the other veterinarians felt that they lacked the right skills, and especially management and marketing skills, to react to these developments adequately. Most veterinarians (77%) considered that their training did not provide them with the skills needed for their current position. During training, more time should be spent on management, communication, marketing, and social skills. Based on the results, veterinary medicine in the Netherlands seems to be an introspective but good profession; however, the interesting aspects of the profession appear to be over-shadowed by less appreciated aspects and the income is moderate. Entrepreneuship is poorly developed, in part because this is considered taboo. The importance of skills that are not an integral part of veterinary medicine, such as management, marketing, and communication, is recognized, as is the lack of these skills. Despite this, emphasis is put on continuing professional education, species specialization, modernization, accreditation, and expansion of facilities and treatment possibilities as ways to respond to the market situation.     

An analysis of opinions from veterinarians in South Africa regarding business management skills

The changing role of veterinarians in the global market is a current topic of debate and discussion. Few countries including South Africa have formally examined the changing dynamics of this profession. Therefore, the present study addressed 2 objectives. The 1st was to examine basic information about veterinarians in South Africa including their age, gender and distribution across provinces, the percentage whose practice was urban, rural or periurban, the numbers working with specific animal species, and the extent of business management and skills previously gained. The 2nd objective was to obtain opinions and insights from veterinarians in South Africa about the challenges and opportunities facing their business practices to better understand what they considered important dynamics to their businesses today. Several areas of business on which they were questioned and which were included in this study were: marketing, vision, human resources, leadership, financial management, ethics, competition, day-to-day operations, interpersonal skills and information management. This is the 1st known survey to employ a questionnaire to gain insights and opinions from veterinarians about business management skills.     

Large animal practitioners' perspective of their patients and clients and their professional responsibilities

Veterinarians have obligations towards both the animals they treat and their clients, the owners of the animals. Veterinarians have complicated, and often conflicting, relationships with both groups. In this article, Q-methodology was used as a method for discourse analysis to determine how Dutch large animal practitioners conceptualize animals and their owners and their professional responsibilities towards both. The article focuses on four different perspectives that Dutch veterinarians have of their animal patients and their owners, and of their professional duties and responsibilities.     

Alternative diets

As pet owners become more conscious of their own diets and the impact it has on their health, they naturally become more interested in what their animal companions are eating and how that might be affecting their pet's health. Many are exploring alternatives to standard commercial pet foods, and some are asking their veterinarians for advice. Small-animal nutrition is an ever-changing field. What veterinarians were taught 10 years ago may no longer be sound advice. This article explores some of the reasoning behind the development of both conventional commercial pet foods and the alternative foods and diets. It questions some of the conventional dogma as well as some of the trendy assumptions in the current marketplace. The intent is to provide the veterinarian with some balanced information on which to base nutritional advice to clients, and to begin forming new opinions or at least asking new questions. Guidelines on formulating a homemade diet for dogs are included.     

A mixed methods inquiry: How dairy farmers perceive the value(s) of their involvement in an intensive dairy herd health management program

Background

Research has been scarce when it comes to the motivational and behavioral sides of farmers'' expectations related to dairy herd health management programs. The objectives of this study were to explore farmers'' expectations related to participation in a health management program by: 1) identifying important ambitions, goals and subjective well-being among farmers, 2) submitting those data to a quantitative analysis thereby characterizing perspective(s) of value added by health management programs among farmers; and 3) to characterize perceptions of farmers'' goals among veterinarians.

Methods

The subject was initially explored by means of literature, interviews and discussions with farmers, herd health management consultants and researchers to provide an understanding (a concourse) of the research entity. The concourse was then broken down into 46 statements. Sixteen Danish dairy farmers and 18 veterinarians associated with one large nationwide veterinary practice were asked to rank the 46 statements that defined the concourse. Next, a principal component analysis was applied to identify correlated statements and thus families of perspectives between respondents. Q-methodology was utilized to represent each of the statements by one row and each respondent by one column in the matrix. A subset of the farmers participated in a series of semi-structured interviews to face validate the concourse and to discuss subjects like animal welfare, veterinarians'' competences as experienced by the farmers and time constraints in the farmers'' everyday life.

Results

Farmers'' views could be described by four families of perspectives: Teamwork, Animal welfare, Knowledge dissemination, and Production. Veterinarians believed that farmers'' primary focus was on production and profit, however, farmers'' valued teamwork and animal welfare more.

Conclusion

The veterinarians in this study appear to focus too much on financial performance and increased production when compared to most of the participating farmers'' expectations. On the other hand veterinarians did not focus enough on the major products, which farmers really wanted to buy, i.e. teamwork and animal welfare. Consequently, disciplines like sociology, economics and marketing may offer new methodological approaches to veterinarians as these disciplines have understood that accounting for individual differences is central to motivate change, i.e. ''know thy customer''.     

Perceived importance and integration of the human-animal bond in private veterinary practice

OBJECTIVE: To determine perceptions of the human-animal bond (HAB) among veterinarians in private practice and evaluate how these veterinarians incorporate the HAB in their practices. DESIGN: Survey. SAMPLE POPULATION: 1,602 veterinarians in private practice in Washington state. PROCEDURE: Participants were contacted and asked to complete a survey. RESULTS: Response rate was 26% (415/1,602). Most respondents agreed that veterinarians will be more successful if they recognize and facilitate the HAB, that facilitating the HAB was important to their practices, that they actively evaluated the degree of bonding between clients and their animals, and that the bonding between a client and his or her animal affected the way they practiced medicine. However, > 50% of respondents did not train veterinary technicians and front office staff members in the HAB or encourage veterinary technicians or front office staff members to learn about the HAB. Fifty-one percent of respondents offered few or no HAB resources to clients. When asked to quantify the importance of 10 nontechnical skills associated with private veterinary practice, respondents ranked communication skills, ethical reasoning, and business management first, second, and third; the HAB was ranked fifth. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that for veterinarians in private practice in Washington state, there is a dichotomy between how important they consider the HAB to be in their practice and the degree to which they facilitate the HAB with regard to communication, training, and client resources. More research on the HAB is necessary to better understand what the HAB encompasses and its implications for private practitioners.     

Assessment of Owner and Veterinarian Awareness of Equine Insulin Dysregulation and Available Treatments in Southeastern United States

Insulin dysregulation (ID) refers collectively to horses afflicted with fasting hyperinsulinemia and insulin resistance. Although there is no current data indicating the percentage of equines afflicted with ID, it appears to be a common subject among equine enthusiasts. In order to gauge public awareness of ID in horses and its available treatments, 122 horse owners and 18 veterinarians, representing 25 states, participated in a self-administered online survey. Questions were postulated to ascertain participant's awareness of the symptoms, management techniques, current treatments and medications, and knowledge acquisition associated with ID. The study revealed more than half of participants were “moderately aware” (34%) to “very aware” (25%) of ID in horses; however, when identifying symptoms of ID, some reported symptoms of pituitary pars intermedia dysfunction as those of ID. Many owners recognized current management strategies for ID; however, actual implementation strategies did not reflect standard management methods. Treatments mentioned for ID include supplements (14% of owners), thyroid supplement Thyro-L (13% and 72%), and pergolide/Prascend (21% and 61%) of owners and veterinarians, respectively. Veterinarians recommended diet and exercise as their main management strategy. Both owners and veterinarians reported using published research and veterinarians as a main source of information. The findings of this survey suggest that although awareness and recognition of the condition is high, proper identification, treatment, and management of ID varies. Moreover, research addressing the efficacy of pergolide as a treatment for ID is lacking. Additional education and research is needed to address these shortcomings.     

Current attitudes to,and use of,peri-operative analgesia in dogs and cats by veterinarians in New Zealand

AIM: To investigate the attitudes of veterinary practitioners in New Zealand to pain and analgesia, and their use of analgesic drugs, in dogs and cats.

METHODS: A questionnaire posted to 1,200 practising veterinarians was used to gather information about the use of analgesia in dogs and cats, assessment of pain, attitudes to pain relief, analgesic drugs and procedures used, factors affecting choice of analgesic agent, and veterinary demographics, continuing education and staffing.

RESULTS: Three hundred and twenty questionnaires with useable data were returned, a response rate of 28%. Male and female veterinarians were evenly represented. The analgesic agents most commonly used were morphine (opioids) and carprofen (a non-steroidal anti-inflammatory drug; NSAID). Use of peri-operative pain relief ranged from 50% for castration of cats to 91% for fracture repair in dogs. For most procedures, female veterinarians scored pain at a significantly higher level than their male colleagues. Fifty-eight percent of respondents considered their knowledge in the area of assessment and treatment of pain was adequate.

CONCLUSIONS: This survey was considered representative of veterinarians working in companion animal practice in New Zealand. Results indicated a relatively high use of peri-operative analgesia, including both pre-emptive and multi-modal analge- sia, in cats and dogs, although there was still some disparity between the perception of how painful a procedure was and the consequent use of pain relief.

CLINICAL RELEVANCE: The establishment of current attitudes and practices indicates to practising veterinarians how their own use of analgesics compares with that of their colleagues. It also provides information to educators on potential areas of focus, given that 42% of respondents felt their knowledge in the area of assessment and treatment of pain was inadequate.     

Current attitudes to, and use of, peri-operative analgesia in dogs and cats by veterinarians in New Zealand

AIM: To investigate the attitudes of veterinary practitioners in New Zealand to pain and analgesia, and their use of analgesic drugs, in dogs and cats. METHODS: A questionnaire posted to 1,200 practising veterinarians was used to gather information about the use of analgesia in dogs and cats, assessment of pain, attitudes to pain relief, analgesic drugs and procedures used, factors affecting choice of analgesic agent, and veterinary demographics, continuing education and staffing. RESULTS: Three hundred and twenty questionnaires with useable data were returned, a response rate of 28%. Male and female veterinarians were evenly represented. The analgesic agents most commonly used were morphine (opioids) and carprofen (a non-steroidal anti-inflammatory drug; NSAID). Use of peri-operative pain relief ranged from 50% for castration of cats to 91% for fracture repair in dogs. For most procedures, female veterinarians scored pain at a significantly higher level than their male colleagues. Fifty-eight percent of respondents considered their knowledge in the area of assessment and treatment of pain was adequate. CONCLUSIONS: This survey was considered representative of veterinarians working in companion animal practice in New Zealand. Results indicated a relatively high use of peri-operative analgesia, including both pre-emptive and multi-modal analgesia, in cats and dogs, although there was still some disparity between the perception of how painful a procedure was and the consequent use of pain relief. CLINICAL RELEVANCE: The establishment of current attitudes and practices indicates to practising veterinarians how their own use of analgesics compares with that of their colleagues. It also provides information to educators on potential areas of focus, given that 42% of respondents felt their knowledge in the area of assessment and treatment of pain was inadequate.     

The role of social work in a veterinary hospital setting

Social workers can assist veterinarians and their clients in dealing with such difficult situations as euthanasia decisions, grief reactions, and professional stress. They are already at work at The Animal Medical Center, where they counsel clients individually and in groups, consult with veterinarians on client relations and how to cope with their own stress, and develop educational programs for employees and others.     

Soft tissue application of lasers.

Despite increasing numbers of veterinarians incorporating lasers into their clinical practices, little information has been published about laser clinical applications in soft tissue surgery. This article reviews soft tissue interaction, describes laser equipment and accessories commonly marketed to veterinarians, and discusses clinical applications of the carbon dioxide laser in a systems-based approach. A table of recommended laser tips and settings based on the authors' experiences using a carbon dioxide laser (AccuVet Novapulse LX-20SP, Bothell, WA) is provided.     

Teaching veterinary students beef production medicine with student/producer teams

Veterinary colleges face difficulties in meeting the demand for rural veterinarians with the scope to practice quality production medicine. Increasing population density around veterinary colleges, retaining the interest of students with a background in animal agriculture, and educating students without a farm background requires that veterinary colleges consider innovative ways to not only teach traditional food-animal practice but give future veterinarians the advanced skills the food industry demands. This article describes a three-year elective program, Beef Records Analysis, in which beef production medicine is taught by teaming a student and a beef producer together early in the student's veterinary education. These producer/student teams complete risk assessments, balance rations, collect financial and production information, and evaluate back-grounding and feedlot enterprises. Students learn how to evaluate their producers using industry benchmarks and past performance records and how to communicate their findings back to their producer. Producers often make management decisions based on the students' findings, and, because the students maintain their relationships with producers for three years, they can assess the outcomes of the producers who follow or ignore their recommendations and interventions. Students share recommendations and outcomes associated with their herd with the entire class. This allows students to learn how to establish best management practices through objective analysis of outcomes of recommended practices of all herds represented in the class. While a formal assessment of the course is needed, the students rate the program very high on evaluations.     

Perceptions of veterinarians and clients to expressions of clinical uncertainty

OBJECTIVES: The aim of this study was to explore the attitudes of veterinarians and clients towards expressions of clinical uncertainty. METHODS: Questionnaires that assessed the respondent's attitudes towards expressions of clinical uncertainty were completed by clients at six small animal practices. In addition, questionnaires that evaluated what veterinarians thought their client's attitudes would be towards expressions of clinical uncertainty were completed by veterinarians. The responses from clients and veterinarians were statistically compared. RESULTS: Veterinarians significantly underestimated the desire of clients to be told about uncertainties in treatment and significantly overestimated how the expression of uncertainty would generally reduce client confidence. Veterinarians significantly overestimated the loss of client confidence resulting from saying "I am not sure about this" and from asking a nurse for advice. Both clients and veterinarians considered that verbal expressions of uncertainty would lead to a greater reduction in client confidence than behavioural expressions of uncertainty. CLINICAL SIGNIFICANCE: This study suggests that most clients want to be told about their veterinarian's clinical uncertainties, and how this uncertainty is expressed can markedly influence client confidence.     

Assessing bioterrorism preparedness and response of rural veterinarians: experiences and training needs

Veterinarians play a unique role in emergency preparedness and response, and federal agencies and academic institutions therefore allocate considerable resources to provide training to enhance their readiness. However, the level of preparedness of veterinarians in many rural regions is yet to be improved. This article reports an assessment of the bioterrorism preparedness, specifically the experience and training needs, of rural veterinarians in North Texas. The study employed a cross-sectional design with a study population that included all veterinarians (N = 352) in the 37 counties within Texas Department of State Health Services Regions 2 and 3. Data on veterinarians practicing or residing in the target region were obtained from the Texas State Board of Veterinary Medical Examiners. The response rate was 35% (n = 121). Results indicate that chemical exposure was the condition most frequently seen and treated, followed by botulism and anthrax. The majority (80%) of respondents indicated that they had not previously participated in training related to bioterrorism preparedness, and many (41%) also indicated a willingness to participate in a state health department-initiated bioterrorism response plan. However, only 18% were confident in their ability to diagnose and treat bioterrorism cases. These results suggest that many North Texas veterinarians practicing in rural regions could benefit from additional training in bioterrorism preparedness and response. An area in particular need of further training is the diagnosis and treatment of Category A agents. Federal, state, and local health agencies are urged to increase training opportunities and to make additional efforts to involve veterinarians in bioterrorism preparedness and response.     

The need for public-health veterinarians as seen by future employers

Future employers of veterinarians working in public health see a fast-growing demand. Emerging zoonotic diseases, bio-security threats, and food-safety problems all require the expertise of veterinarians with a focus on complex, global problems that span both human and animal health. The Public Health Task Force of the Association of American Veterinary Medical Colleges convened a group of stakeholders representing various branches of the US federal government, state and local governments, and professional societies to discuss their needs for public-health veterinarians. This article discusses those needs, the broader societal needs that require veterinarians with public-health expertise, and the implications of these for educational programs to train DVMs in public-health issues.     

Preparing students for careers in food-supply veterinary medicine: a review of educational programs in the United States

The real and/or perceived shortage of veterinarians serving food-supply veterinary medicine has been a topic of considerable discussion for decades. Regardless of this debate, there are issues still facing colleges of veterinary medicine (CVMs) about the best process of educating future food-supply veterinarians. Over the past several years, there have been increasing concerns by some that the needs of food-supply veterinary medicine have not adequately been met through veterinary educational institutions. The food-supply veterinary medical curriculum offered by individual CVMs varies depending on individual curricular design, available resident animal population, available food-animal caseload, faculty, and individual teaching efforts of faculty. All of the institutional members of the Association of American Veterinary Medical Colleges (AAVMC) were requested to share their Food Animal Veterinary Career Incentives Programs. The AAVMC asked all member institutions what incentives they used to attract and educate students interested in, or possibly considering, a career in food-supply veterinary medicine (FSVM). The problem arises as to how we continue to educate veterinary students with ever shrinking budgets and how to recruit and retain faculty with expertise to address the needs of society. Several CVMs use innovative training initiatives to help build successful FSVM programs. This article focuses on dairy, beef, and swine food-animal education and does not characterize colleges' educational efforts in poultry and aquaculture. This review highlights the individual strategies used by the CVMs in the United States.     

Our time is now – how companion animal veterinarians can transform biomedical science

Over the past decade, there has been growing interest in the “One Health” agenda, defined by the One Health Initiative to be “a worldwide strategy for expanding interdisciplinary collaborations and communications in all aspects of health care for humans, animals and the environment.” The concept has spawned numerous conferences, under‐ and post‐graduate courses and has been the topic of dozens of articles that have discussed how medical doctors, scientists and veterinarians can work together to improve the health of both animals and humans. Although there is widespread agreement about the potential benefits of medical doctors and veterinarians working more closely together, this is far from routine practice for most companion animal veterinarians. This article reflects on why the topic of “One Health” is attracting such interest at the moment and discusses some of the reasons why the “One Health” agenda offers companion animal veterinarians a chance to be centre stage in the global drive to improve the health of both animals and humans.     

Aggressive clients in Dutch veterinary practice

Aggressive clients seem to be becoming more common. This article describes a study in which questionnaires on client behaviour were sent to veterinary assistants and veterinarians in randomly selected practices in the Netherlands. Results showed that 26.4% of the veterinarians and 29.3% of the assistants had experienced aggressive clients in the last year. Age, experience, and sex of the veterinarian or assistant did not influence the frequency with which aggressive clients were encountered. The same was true for the type of veterinary practice (companion animals, farm animals, horses, etc). The risk of encountering aggressive clients was higher among practices in large towns and in practices with a small turnover Of the veterinarians who had encountered aggressive clients at least once in their career, 31% has taken some kind of action after the aggressive encounter Nearly a quarter (24.9%) of veterinary practices have adopted a Risk Inventarization and Evaluation (RI&E) approach to preventing client aggression and 26.6% of practices have adopted another approach. While veterinarians tend not to consider aggression a big problem, they are often open to the suggestion that more attention should be paid to aggression in veterinary practice.