Estimate of the annual economic impact of treatment of cranial cruciate ligament injury in dogs in the United States

OBJECTIVE: To estimate the economic impact to veterinary clients for the medical and surgical treatment of rupture of the cranial cruciate ligament (RCCL) in dogs for the year 2003. DESIGN: Economic impact survey. SAMPLE POPULATION: 501 diplomates of the American College of Veterinary Surgeons (ACVS) indicating that their area of surgical emphasis was small animal orthopedic surgery or small animal general and orthopedic surgery and 4,000 veterinarians indicating to the AVMA that their professional area was small animal practice exclusive or mixed animal practice (at least 80% small animal). PROCEDURE: Veterinarians were surveyed concerning the cost for medical and surgical treatment of RCCL for 2003. The economic impact was calculated by multiplying the number of RCCL surgeries performed by the mean cost of surgery. This was added to the number of RCCL cases managed medically multiplied by the mean cost of medical management. This estimate for survey responders was extrapolated to the total number of veterinarians in the study population for the ACVS or AVMA. RESULTS: Estimates for the total cost of surgery were $171,730,134.72 and $1,020,167,907 for veterinarians in the ACVS and AVMA populations, respectively. The cost of medical management was $2,885,687.86 and $126,558,155.16 for veterinarians in the ACVS and AVMA populations, respectively. After combining the ACVS and AVMA populations, we estimated that owners spent $1.32 billion for the treatment of RCCL in the United States in 2003. CONCLUSIONS AND CLINICAL RELEVANCE: RCCL is a prevalent, costly injury. Results may motivate veterinary and consumer agencies to prioritize funding for a better understanding of the injury.     

An alumni survey to assess self-reported career preparation attained at a US veterinary school

The American Veterinary Medical Association (AVMA) Council on Education (COE) has challenged veterinary schools to improve self-assessment of curricular outcomes. One way to assess the quality of education is to gather feedback from alumni. To successfully gather feedback using a questionnaire, questions must be pertinent to veterinary education and include quantifiable responses. Several principles must be applied in questionnaire development to ensure that the questions address the intended issues, that questions are interpreted correctly and consistently, and that responses are quantifiable. The objectives of the questionnaire for alumni of Mississippi State University's College of Veterinary Medicine (MSU-CVM) were twofold: (1) to determine whether graduates were comparable to their US peers in terms of work opportunities and salary, and (2) to evaluate how well the CVM curriculum prepared students to begin their veterinary careers. Demographic categories used by the AVMA and published knowledge, skills, attitudes, and aptitudes of veterinary graduates were used in developing the questions. College-specific questions, such as those relating to student activities and impressions of college resources, were also incorporated. Questionnaires were mailed to participants, who could respond via the World Wide Web. Questionnaire results allowed leaders within the college to determine which aspects of alumni's experiences were exceptionally positive, which needed immediate response, and which might require further study. This article describes the application of principles in developing, administering, and analyzing responses to a questionnaire regarding veterinary education.     

The impact of AVMA COE's accreditation on veterinary medical education

Point 1: the American Veterinary Medical Association Council on Education's (AVMA COE's) accreditation pro-cess is aimed at minimum training for entry-level veterinarians. This has a two-fold consequence: 1. The opportunity to discover the absolute minimum number of necessary resources is opened. While this is a threat to the standard model of veterinary education, it might have value if it is cost-efficient and students graduate with minimal or no debt. 2. There is no mechanism to measure training,research, or service programs above the minimum or beyond the entry level. Point 2: the implication of the minimum entry-level general standard is also two-fold: 1. We must measure performance above the mini-mum. A separate process is necessary (a) to develop and implement objective metrics and (b) to publicize superior achievement as opposed to minimal performance. 2. We must measure and publicize institutions or programs that advance the field beyond training entry-level veterinarians. Service, research, and training aimed at advancing the field, providing leadership, and improving public health and safety(One Health) require separate measurement and advocacy in order to obtain and justify the necessary resources. I conclude that in the absence of a new process by which to measure excellence, market forces will push the entire profession toward the most cost-effective method of providing minimal training for entry-level veterinarians. But what about the far more expensive goal of providing a global public good of which our profession is so proud?The public health and safety mission of veterinary medi-cine, including the entire One Health initiative, requires separate measurement in order to give objective metrics to the institutions and components of the profession committed to those goals to pursue vigorous advocacy and obtain or retain the necessary resources.     

The dual DVM/MPH degree at the University of Wisconsin--Madison: a uniquely interdisciplinary collaboration

The University of Wisconsin-Madison (UWM) launched a new Master of Public Health (MPH) degree program in 2005. This 42-credit MPH degree consists of 18 core and 14 elective course credits, two seminar credits, and eight field project/culminating experience credits. Unique strengths of the program include its strongly interdisciplinary philosophy, encompassing both health science (human medicine, veterinary medicine, pharmacy, nursing) and social science units on campus, and its emphasis on service learning through instructional and field project ties to the public-health community of the state and beyond. To date, the program has admitted 87 students, including full-time students as well as part-time students who continue to work in the health care and/or public-health sectors. The program is currently proceeding with the process for accreditation through the Council for Education in Public Health. In 2007, a formal dual DVM/MPH program was approved to allow students to integrate DVM and MPH training and complete both degrees in a total of five years. Nine MPH students over the first three years of admissions have been individuals affiliated with veterinary medicine (five DVM students and four post-graduate veterinarians).     

Meeting the expectations of referring veterinarians

Veterinary teaching hospitals (VTHs) have traditionally obtained most of their patient and client base through the referral process. This worked well until the recent explosive growth of specialty practices, which compete not only for patients but also for faculty and graduating residents. Veterinary schools have had to meet this challenge by increasing both efficiency and the quality of services provided to referring veterinarians. Practitioners refer mainly because of discomfort with a case and the belief that clients will get better treatment at a referral hospital than they themselves can provide. Practitioners choose not to refer because of geography, perceived cost, or lack of confidence in the services offered. Referring veterinarians expect regular communication about services offered, access to receiving clinicians for consultation, convenient scheduling, and efficient communication and follow-up from the receiving veterinarian. They also expect the relationship between them and their clients to be maintained and enhanced. Receiving veterinarians expect a summary letter and copies of all relevant records, including radiographs. They also expect the client to have been informed about the approximate costs of referral. VTHs can develop better relationships with referring veterinarians through education, newsletters, referral guides, practice visits, and Web sites. Inadequate communication and lack of involvement on the part of the referring veterinarian are the major impediments to efficient referrals and practice growth.     

Accreditation of veterinary schools in Australia and New Zealand

Veterinary schools in Australia and New Zealand are assessed for accreditation purposes every six years by the Veterinary Schools Accreditation Advisory Committee (VSAAC), which is a standing committee of the Australasian Veterinary Boards Council (AVBC).1 Prior to undertaking an assessment, VSAAC requests a Self Evaluation Report from the school and subsequently spends a week on site to collect additional information. The committee also takes into consideration other quality assurance procedures within the university and aims for a process that complements other evaluation activities. Internal evaluation procedures within VSAAC are designed to reflect the process and outcomes of each visit and lead to annual revisions of the publication Policies, Procedures and Guidelines publication. The committee has close links with the Royal College of Veterinary Surgeons (RCVS), and there is a routine exchange of observers on all visits in the United Kingdom and Australasia. In recent years VSAAC has become increasingly interested in looking at ways to place greater emphasis on the outcomes of veterinary education and, eventually, to reduce our reliance on input measures. There has been good progress in identifying desirable attributes for veterinary graduates, but further work is needed to establish the reliability of assessment procedures. The Australasian accreditation system is very supportive of recent moves to achieve greater compatibility of veterinary accreditation systems in different parts of the world because we believe it has the potential to assist globalization of animal disease control and veterinary education.     

All-purpose veterinary education: a personal perspective

The Recognition Lecture is an annual honor awarded by the Association of American Veterinary Medical Colleges (AAVMC) to an individual whose leadership and vision have made significant contributions to academic veterinary medicine and the veterinary profession. In 2011, this prestigious honor was awarded to Dr. Peter Eyre, Dean Emeritus of the Virginia-Maryland Regional College of Veterinary Medicine (VMRCVM). Dr. Eyre is a fierce advocate for veterinary medical education, with a clear vision of its value in ensuring that veterinarians are well positioned to meet societal needs. Dr. Eyre possesses an international perspective regarding the challenges and problems facing veterinary medical education and has a keen eye for getting to the heart of these challenges. He is known to ask hard questions and propose difficult choices. Dr. Eyre received his undergraduate veterinary degree (BVMS), bachelor of science degree, and PhD from the University of Edinburgh. He was Lecturer in Pharmacology at the Royal (Dick) School of Veterinary Studies for seven years before joining the faculty of the University of Guelph's Ontario Veterinary College, where he was Chair of the Department of Biomedical Sciences and Associate Director of the Canadian Centre for Toxicology. Dr. Eyre was appointed Dean of the VMRCVM in 1985, where he established the Center for Government and Corporate Veterinary Medicine in 1989. After retiring in 2003, he was named Interim Dean of the University of Calgary's new veterinary school. Among his many awards are the Norden Distinguished Teacher Award and the Sigma Psi Excellence in Research Award. In 2008 the American Veterinary Medical Association (AVMA) honored him with the President's Award, and in 2010 the University of Edinburgh awarded him the honorary degree of Doctor of Veterinary Medicine and Surgery. The Peter Eyre Student Leadership Award at the VMRCVM and the Peter Eyre Prize in Pharmacology at the University of Guelph are both named in his honor. He is a past president of the AAVMC, a fellow and former board member of the American Academy of Veterinary Pharmacology and Therapeutics, and a former member of the AVMA Legislative Advisory Committee. In the following article, Dr. Eyre offers his insights on the current debate about the future of veterinary medical education.     

Reaching beyond our walls: library outreach to veterinary practitioners

The Texas A&M University Medical Sciences Library (MSL) supports lifelong learning for Texas veterinarians and College of Veterinary Medicine and Biomedical Sciences (CVMBS) alumni through several ongoing outreach efforts. The MSL provides free document delivery and literature search services to practicing veterinarians in support of patient care. The MSL also responded to unique opportunities to expand services and increase its visibility through collaborations with the American Association of Equine Practitioners and CABI, provider of VetMed Resource. The MSL continues to explore ways to expand its mission-critical veterinary outreach work and market library services to veterinarians through participation in continuing education, regional meetings, and veterinary student instruction.     

From veterinarian to quality control manager. What is going to change in the Netherlands for the practicing large animal veterinarian under influence of the White Paper about food safety?

The work of farm animal practitioners will change in the coming years as a result of the White Paper on food safety. Both government and the Royal Veterinary Association of the Netherlands are working on an accreditation system for veterinarians. The veterinary practitioner is a link in the chain to achieve safe products. Where in the past emphasis was on the individual animal, it will now be on the herd or flock. The veterinarian will officially determine the health status of the farm, which in turn will play a role in the inspection procedures at the slaughterhouse. This form of farm management will become compulsory for all stockholders within the framework of the Veterinary Network for Supervision. In turn, these developments will affect the veterinary medicine curriculum. New subjects such as quality management will become increasingly important.     

Development of new canine and feline preventive healthcare guidelines designed to improve pet health

The American Veterinary Medical Association (AVMA) and American Animal Hospital Association (AAHA) have jointly introduced the first Canine and Feline Preventive Healthcare Guidelines. These consensus statements provide veterinarians with a new resource for improving patient care by emphasizing the value and scope of regular pet examinations. The two guidelines provide complete recommendations for comprehensive preventive healthcare programs, published as accessible, single-page documents. The guidelines are based on the subjective-objective-assessment-plan (SOAP) methodology of case management, a proven approach traditionally used with sick or injured patients. This logical and disciplined process is equally applicable to healthy patients and is designed to consistently deliver optimal patient care. The guidelines recommend visits for health examinations on at least an annual basis, recognizing that for many pets, more frequent visits may be appropriate, depending on the individual needs of the patient. The guidelines also provide detailed diagnostic, therapeutic, prevention, and follow up plans, to be accompanied by appropriate documentation. The inclusive content and concise format of the guidelines are designed to maximize their practical value and make them easy to implement.     

Failure to acknowledge high suicide risk among veterinarians

A high suicide risk has been reported among veterinarians in comparison to the general population. Postulated causes have included depression, substance abuse, work-related stress, reluctance to admit psychiatric problems, and access to lethal drugs and/or familiarity with euthanasia. Members of the Student Chapter of the American Veterinary Medical Association (AVMA), all veterinarians licensed in Alabama, and all US veterinary-association executive directors were surveyed regarding their attitudes concerning mental health issues, including veterinarian suicide. Only 10% of veterinary student respondents (N=58) believed that suicide risk is higher among veterinarians than in the general population. Of the 22 state associations' executive directors who participated in the survey, 37% believed that suicide is a significant concern for veterinarians and only 44% indicated that a veterinary wellness program was available in their respective states. Of the 1,455 licensed veterinarians in Alabama, 701 responded to the survey; 11% of respondents believed that suicide among veterinarians was a problem. In addition, 66% of respondents indicated that they had been "clinically depressed," but 32% of those with depression had not sought treatment. More females (27%) than males (20%) admitted that they had "seriously considered suicide" (p<.01). Female veterinarians were more likely than male veterinarians (15% versus 7%) to indicate that they were "not sure they'd made the right career choice" (p<.001), and 4% of all respondents indicated "definitely not being happy with their career." It is of concern that veterinarians not only have a higher risk of suicide but that they also have fewer support structures. The wide discrepancies between the published risk of suicide for veterinarians and their own views of their risk suggests an inadequate awareness of their own mental health vulnerability which could put them at higher risk.     

Research in veterinary environmental hygiene]

The course of development of the initial subject "Veterinary Hygiene" to the reduction and specialization limited to "Animal Hygiene" and the recent extension into the broad field of environmental hygiene is described. This is done with reference to books and other publications which point the way ahead for research of veterinary medicine in environmental hygiene and thus prove the increasing importance of that subject. A survey is given over current German research in that field, future demands as well as the necessary extension of environmental hygiene in graduate and post-graduate teaching of veterinary students as well as further professional training of veterinarians.     

The ECVP/ESVP summer school in veterinary pathology: high-standard, structured training for young veterinary pathologists

This article describes the ECVP/ESVP Summer School in Veterinary Pathology, a new annual two-week European training facility established by the European College of Veterinary Pathologists (ECVP) in collaboration with the European Society of Veterinary Pathology (ESVP). The aim of the Summer Schools is to provide Europe-wide, harmonized, top-standard theoretical and practical post-graduate training for veterinarians specializing in veterinary pathology. In particular, it aims to support trainees in veterinary pathology in their individual preparation for the ECVP certifying examination. Ultimately, it aims to provide young pathologists with the skills and knowledge necessary to participate in international, high-quality research and the tools for applying international standards to their own research and for independent study for the ECVP certifying examination, even if they do not work in comparable academic environments and do not have the same level of local support and training. The ECVP/ESVP Summer Schools take place in European countries, with local organization from a university department of veterinary pathology. Each event comprises modules provided by internationally recognized specialists in their specific fields of expertise on different organ systems, diseases of specific species, specific techniques, and specific topics relevant to pathology, forming a cycle of four events to cover all major topics. Every two years a mock exam is organized as a tool to monitor individual progress in preparing for the ECVP certifying examination.     

Clinical and epizootiologic characteristics of dogs seropositive for Borrelia burgdorferi in Texas: 110 cases (1988)

Of 2,409 canine serum samples submitted to the Texas Veterinary Medical Diagnostic Laboratory between Jan 1, 1988 and Dec 31, 1988 and tested by immunofluorescent antibody technique for antibody to Borrelia borgdorferi, 132 (5.5%) had positive results. Clinical and epizootiologic characteristics of seropositive dogs from Texas (n = 110) were examined. Male dogs were more likely than female dogs to be seropositive for B burgdorferi. The most frequent clinical sign of disease described in seropositive dogs was lameness; neurologic, ophthalmologic, dermatologic, renal, and hepatic signs also were reported by referring veterinarians.     

Demographic profile of the veterinary profession in New Zealand, 1985

The demographic characteristics of the veterinary profession in New Zealand are examined using information supplied by registered veterinarians to the Veterinary Surgeons Board in their applications for annual practising certificates in 1985. Comparisons are made with the veterinary professions in other similar countries, and with the medical and paramedical professions in New Zealand. In 1985 1308 registered veterinarians were working in New Zealand and 304 were overseas, whereas in 1976 the equivalent figures were 748 and 182. This represents an increase of 73% in the number of registered veterinarians in the last 10 years. Eighteen percent of veterinarians were female. The mean age of veterinarians was 38 years, but females in the profession were on average much younger (32 years) than males (42 years). Clinical practice provides employment for 70% of veterinarians: of these 59% work principally with farm animals and 41% with non-farm animals. The remaining veterinarians are employed by Government (22%), University (5%) and Industry (3%). The current demographic structure of the profession has been markedly influenced by the opening of New Zealand's only veterinary school at Massey University in 1963. Differences from other medical professional populations in New Zealand and overseas principally reflect the marked change in the number and sex ratio of graduates entering the veterinary profession since that time. It will take about another twenty years before the population reaches a stable age and sex structure, assuming that current graduation patterns persist throughout that period. Because the structure of the population is changing, considerable caution is needed in predicting future employment trends from data for a single year.     

Demographic profile of the veterinary profession in New Zealand, 1985

The demographic characteristics of the veterinary profession in New Zealand are examined using information supplied by registered veterinarians to the Veterinary Surgeons Board in their applications for annual practising certificates in 1985. Comparisons are made with the veterinary professions in other similar countries, and with the medical and paramedical professions in New Zealand. In 1985 1308 registered veterinarians were working in New Zealand and 304 were overseas, whereas in 1976 the equivalent figures were 748 and 182. This represents an increase of 73% in the number of registered veterinarians in the last 10 years. Eighteen percent of veterinarians were female. The mean age of veterinarians was 38 years, but females in the profession were on average much younger (32 years) than males (42 years). Clinical practice provides employment for 70% of veterinarians: of these 59% work principally with farm animals and 41% with non-farm animals. The remaining veterinarians are employed by Government (22%), University (5%) and Industry (3%). The current demographic structure of the profession has been markedly influenced by the opening of New Zealand's only veterinary school at Massey University in 1963. Differences from other medical professional populations in New Zealand and overseas principally reflect the marked change in the number and sex ratio of graduates entering the veterinary profession since that time. It will take about another twenty years before the population reaches a stable age and sex structure, assuming that current graduation patterns persist throughout that period. Because the structure of the population is changing, considerable caution is needed in predicting future employment trends from data for a single year.     

Joint degree programs in public health

Public health and veterinary medicine share a focus on population health and primary prevention, along with a commitment to preparedness, response, and recovery in the event of disease outbreaks. Public-health and veterinary professional degree programs share commonalities in their educational accreditation requirements related to epidemiology and public-health practice. The initiation of a number of joint professional degree programs over the last five years, including the joint Doctor of Veterinary Medicine and Master of Public Health (DVM/MPH), represents an exciting development for inter-professional education for veterinarians interested in public health. Various models for joint DVM/MPH educational programs are discussed, including pre-veterinary public-health credentialing, integrated programs, and post-DVM executive programs. Collaborations between colleges of veterinary medicine and schools of public health show great promise in both educational and research innovation.     

A survey concerning the equine fescue toxicosis malady

The objective of this research was to determine the scope of equine fescue toxicosis, current procedures to control the disease, and to gain veterinary insight to possible new therapies. A survey was developed with help form experts in the area of fescue toxicosis. From a list of members of the American Veterinary Medical Association (AVMA), a sample was obtained by selecting large animal/equine veterinarians from states where fescue toxicosis is common. These states included: Alabama, Arkansas, Georgia, Illinois, Indiana, Kentucky, Missouri, Mississippi, North Carolina, Ohio, South Carolina, Tennessee, Virginia, and West Virginia. One-fifteenth of the veterinarians (515 total) were mailed questionnaires; 207 responded. Veterinarians were grouped into regions based on latitude. Region 1 included veterinarians practicing north of 39.0° latitude; Region 2 included veterinarians practicing between 36.5° and 39.0° latitude; and Region 3 included veterinarians practicing south of 36.5° latitude.A majority of horse pasture in the area of the survey is comprised of at least 50% fescue, with approximately 70% of the pasture being at least partially comprised, of fescue.Almost 50% of the brood mares in the area of the survey are exposed to endophyte-infected fescue. Many gravid brood mares in the area of the survey were suffering from acute and subacute symptoms, with over 43% warranting some kind of management technique to prevent toxicity from occurring. A large majority of veterinarians in the area of the survey feel that fescue toxicosis is, to some level, a problem. Current management techniques can be tedious and expensive. New management techniques and/or therapies are needed to handle the problems associated with equine fescue toxicosis. A large majority of veterinarians in the area of the survey feel an effective drug therapy would be valuable in treating equine fescue toxicosis. If a drug therapy were developed, a daily feed additive or an oral gel would be the most popular method of dosing with veterinarians.As a result of trends noticed in the rates of equine fescue toxicosis in different areas, statistical analyses were conducted on data generated from this survey along regions that seemed to have different infection rates. There was no difference (P>0.05) in levels of fescue in pastures, mare exposure to the endophyte, and mare expression of acute or subacute symptoms between regions 2 and 3. There was a difference (P<0.05) between region 1 and regions 2 and 3 for all of the factors tested except for number of mares seen by veterinarians.     

The Queensland Poisonous Plants Committee: its history and functions

SUMMARY The Queensland Poisonous Plants Committee was established in 1937 with Professor HR Seddon as chairman. It has functioned since that year, interrupted by two periods of inactivity in 1951–9 and 1962–8. Professor Seddon, first Dean of the Queensland Veterinary School, and Dr Selwyn Everist, Queensland Government Botanist after the Second World War, provided the main impetus for committee activities in its early and middle years, respectively. The strength of the body has been its multi-disciplinary approach using contributions from veterinarians, chemists and botanists. The research work of the committee members and their associates has provided most of our current knowledge of the toxins and effects of poisonous plants in Queensland. Much of the information generated is of international significance. In equal partnership with the United States Department of Agriculture, the committee initiated a series of international symposia on plant poisoning of animals, hosting the second. This group held its 4th gathering of world authorities in the field in 1993. The committee's activities have long influenced the veterinary profession in Australia through the close involvement of its members in undergraduate and post-graduate teaching in the Queensland Veterinary School since 1951. The present committee has members from the Departments of Primary Industries, Health, and Environment and Heritage, CSIRO and the University of Queensland.