Banking on wellness. Practices try out monthly payment plans to promote preventive care.

Banking on wellness Practices try out monthly payment plans to promote preventive care By Katie Burns

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he recession took a little while to hit Encina Veterinary Hospital near San Francisco. When it did, the practice looked for answers in the 2011 Bayer Veterinary Care Usage Study. In one key finding, the study revealed that 45 percent of pet owners said they would visit a veterinarian more often if the practice offered a wellness plan billed monthly. Encina Veterinary Hospital rolled out its wellness plans in 2012. Within a year, the practice had enrolled hundreds of patients in the plans, which include various packages of preventive care services with charges billed monthly rather than at the time of each veterinary visit. The program is still going strong in 2014 as the practice continues to refine it. For Banfield Pet Hospital, wellness plans have been part of its philosophy since 1988, long before the original hospital grew into a national chain. Banfield leaders point to the plans as one reason for not having seen the decrease in patient visits that many practices saw in the past decade. At practices large and small, wellness plans offer the promise of enhancing preventive care for patients while improving finances for clients and veterinary clinics. In reality, the plans can be hard to create and maintain, and pet owners sometimes confuse them with pet health insurance. The 2011 Bayer study found that only 5 percent of practices

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“The consumer really is in favor of these plans. They like to be able have this comprehensive annual plan that they can pay out monthly.” Dr. David B. Goodnight, senior consultant for Brakke Consulting

offered a wellness plan billed monthly, although 29 percent would be willing to do so. Partners for Healthy Pets introduced free resources in 2012 to help practices implement monthly payment preventive health care plans. At least half a dozen companies now provide services to assist practices with plan development or administration. And more practices are trying out the plans with their clients.

Upsides of the plans

Dr. David B. Goodnight, a senior consultant for Brakke Consulting, said the veterinary community has taken a great deal of interest in wellness plans—partly because of the success of Banfield. When Dr. Goodnight was with Nestlé Purina, he developed the Partners in Wellness program as a turnkey system for practices to offer monthly payment plans for preventive care. He said pet owners who enrolled in the plans visited their veterinarians more often because they knew they had already paid for at least part of their pets’ veterinary care for the year. Purina later discontinued the program, stating that the decision was based on “economics and months of careful analysis.” “I’m a big believer in these wellness plans, and I believe they do hold a lot of promise for the profession,” Dr. Goodnight said. “The consumer really is in favor of these plans. They like to be able have this comprehensive annual plan that they can pay out monthly.” The mission of Partners for Healthy Pets is to promote preventive care through regular veterinary visits. Jessica Goodman Lee, a practice management consultant for Brakke, developed the coalition’s free resources on monthly payment plans.

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Goodman Lee did research with the few practices that had plans and looked at the Banfield model as well as payment options in human dentistry. She found that one popular aspect of the plans at certain veterinary practices, including Banfield, is the inclusion of additional examinations at no additional charge. “What people who have done them so far are finding is that they are making more money,” Goodman Lee said. “The client may be spending less at each visit, but they’re coming in more often, and the overall revenue is increasing— and the care is increasing.”

Dealing with the details

Implementing preventive care plans can be difficult, and sometimes they don’t take off at a practice. Dr. Goodnight is familiar with how challenging wellness plans can be for individual practices. The practice team must have the motivation to make the plans happen, he said. “The person in the hospital who is the champion has to keep the momentum going on these things and keep them ever present in the staff’s minds and in the clients’ minds,” Dr. Goodnight continued. “Things have a way of sliding, so the challenge there is just keeping the momentum going once the plans are set in place to reach some kind of a critical mass where they can have a positive impact on the practice.” In his experience, some practice teams became extremely motivated, despite the complexity of wellness plans. He listed components of the plans as including plan design, secure billing, tracking of usage, and annual renewals. He said practices can turn to service providers to alleviate the administrative burden. Goodman Lee said a major technical hurdle is a lack of

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Dr. Kristin Hussey, lead veterinarian at the Banfield Pet Hospital in Lake Oswego, Ore., examines Boo Boo, whose owner, Phyllis Lapainis, has had an Optimum Wellness Plan since 2010.

integration between most payment platforms and practice management software. She thinks the slow adoption rate for preventive care plans also results from other difficulties with implementation or from a wait-and-see attitude, depending on the practice. “A lot of people have signed on with a payment provider and done the research, and then have just stalled out because it takes a lot of work and time and training,” she said. To be successful, Goodman Lee said, a practice needs to sell the plans to at least 10 percent of clients to start and 30 to 40 percent of clients after a few years. Dr. Goodnight is an advocate for wellness plans to cover routine preventive care and pet health insurance to cover the risk of illness or injury. According to the Partners for Healthy Pets resources on preventive care plans, the prac-

tice team should explain to clients the difference between wellness plans and pet health insurance.

Encina Animal Hospital

Angela Linvill was hospital administrator for Encina Animal Hospital when the practice decided to try wellness plans to increase traffic and loyalty. The hospital is not only a general practice but also a specialty and emergency practice, she said, and the practice team wanted to change its reputation for providing good but pricey medicine. The practice team at Encina designed the wellness plans to be very flexible but still built in some savings. The plans provide for one or two examinations annually and basic laboratory work, with everything else being optional. The veterinarian who performs the initial examination of a pet checks off items on a menu to create a custom plan. Vol. 244, No. 9



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“The client may be spending less at each visit, but they’re coming in more often, and the overall revenue is increasing— and the care is increasing.” Jessica Goodman Lee, practice management consultant for Brakke Consulting

Service providers lend hand with wellness plans By Katie Burns About 92 percent of pet owners who enroll in monthly payment preventive care plans for their pets renew the plans annually, according to preliminary data from ExtendCredit. A variety of companies in the financial and veterinary sectors have begun working with veterinary practices to offer wellness plans. Some simply provide payment platforms, while others have developed turnkey systems. Many of these service providers are seeing early successes. ExtendCredit provides in-house financing plans for veterinary practices and other small businesses. The company introduced wellness plans for veterinary practices in late 2011 and now has more than 200 practices with more than 5,500 individual plans. In late 2013, H3 Financial Services and ExtendCredit created Veterinary CreditPlans to offer financial services specifically for veterinary practices. Bob Richardson, president of ExtendCredit, believes custom well-

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ness plans are what veterinary practices need to grow. While VCP has templates for plans, practices may tailor the templates or create completely original offerings and have the ability to update the plans from year to year. “If your plan’s total fees for the year are $360, our practices are seeing about another $360 in additional services clients consume when they come in for their visit,” Richardson said. He said wellness plans for adult dogs are the most popular by far. Then come plans for puppies and plans for senior dogs. Plans for cats make up a small fraction. Among participating owners of multiple pets, about 24 percent have a plan for more than one pet. The pricing of plans depends on demographics, Richardson said. Practices commonly charge $19.95 or $24 per month up to $34.95 or $39.95 per month, but some practices charge $50 to $99 per month. Implementation of wellness plans has picked up steam recently.

“It’s definitely gotten busier over the past six to 12 months,” Richardson said. “There has been a lot of talk around it, there is more out there, and so people are just finding the time to do it.” Veterinary Pet Insurance initiated its preventive care programs in mid-2012 and launched them fully in early 2013 as VPI Preventive & Wellness Services. Dr. Carol McConnell, VPI chief veterinary officer, emphasized that preventive care plans are not pet health insurance—a common misconception among pet owners. Both are financial solutions to help clients afford veterinary care, she said. For some pet owners, receiving a reminder card to schedule a routine veterinary visit represents the fear of a large bill, Dr. McConnell said. “Consumers have said loud and clear, ‘I love my pet. I like going to the veterinarian. I can sure afford to pay month to month,’” she said. Dr. McConnell said VPI Preventive & Wellness Services is a business-to-busi-

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“In order for the program to really be successful, you need doctors who completely believe in it and are comfortable talking about it in the exam room,” Linvill said. “Doctors do not want to ever feel like they’re selling something. They want to make medical recommendations.” Linvill said the administrative side of wellness plans is mountainous. The hospital started out with service provider ExtendCredit and now is trying TruePet. More clients actually pay for the wellness plans in full rather than monthly, but they often pay monthly for secondary plans for services such as dental cleaning. Dr. Wendi Aengus, an associate veterinarian at Encina, is a believer in wellness plans as a way to allow clients to budget for veterinary care. “You want your bonded clients to have the ability to afford the necessary preventative medicine services,” Dr. Aengus said. “They love their animal, and we love their animal. We all want what’s best. It allows the practitioner

ness service, so the clients never see its branding. The service helps practices put together the plans, train the practice team, and market the plans to clients. Then the service collects payments from clients and sends the payments to the practices, minus a fee.

to practice preventative medicine and to help diagnose potential problems early and extend the life span.” The wellness plans have been an adjustment for the practice, she said, but the response from clients has been very positive. In the first year, the hospital sold 700 primary plans and 124 secondary plans. In the same time frame, the hospital saw 1,932 patients for wellness examinations.

Banfield Pet Hospital

Dr. Jeff Klausner, Banfield’s chief medical officer, said the idea from the beginning of the Banfield chain was to make preventive veterinary care easier for clients by removing barriers. Banfield offers Optimum Wellness Plans at hundreds of hospitals across the country. The monthly payment plans feature twice-yearly comprehensive examinations, unlimited free office visits, and discounts on most services and

She noted that a Chicago veterinarian who has enrolled hundreds of clients in preventive care plans through the service particularly appreciated the revenue stream this past winter during days when the polar vortex drove temperatures so

low that almost no one came to the practice. Among the other service providers assisting practices with wellness plans are Payment Banc, Pay Pros Veterinary, Prevent Plans, and TruePet Wellness Program (see information box).

The following are among the service providers that assist with development or administration of monthly payment plans for preventive care. Payment Banc

TruePet Wellness Program

Pay Pros Veterinary

Veterinary CreditPlans (formerly ExtendCredit)

www.paymentbanc.com www.payprosvet.com Prevent Plans

www.preventplans.com

www.truepet.com

www.veterinarycreditplans.com VPI Preventive & Wellness Services

www.vpipaws.com

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products within and outside of the packages. Plans come in three levels with additional options. “When you don’t charge for exams, that just takes one barrier away, and people keep coming,” Dr. Klausner said. “It gives us the opportunity to educate clients about what is important for prevention.” Over the years, Banfield has updated the wellness plans to keep up with changing recommendations for preventive care. Currently, the plans largely follow the 2011 guidelines for preventive care from the AVMA and American Animal Hospital Association. Banfield clients with wellness plans bring in their pets much more often than other Banfield clients do, Dr. Klausner said. “What they really love is it’s a package of care. They don’t have to worry that something is missing, they don’t have to remember all these things because they buy the package, and it gives them peace of mind,” he said. “Most importantly, we can find things early.” Banfield veterinarians like the wellness plans for many of the same reasons that the clients do, Dr. Klausner said. “What the veterinarians really love is this builds the bond, it builds the partnership between the veterinary team and the client,” he said. For wellness plans to succeed at any hospital, Dr. Klausner said, the veterinary team needs to have a strong focus on preventive care. Then the team needs to educate clients about the value of preventive care.

Dr. Wendi Aengus, associate veterinarian at Encina Veterinary Hospital in Walnut Creek, Calif., poses for a photo with Alex, who was found to have lymphoma as a result of routine bloodwork. The hospital recently introduced monthly payment preventive care plans.

Resources and results

The Partners for Healthy Pets website features a toolbox Goodman Lee said most practices will find preventive full of free resources to help practitioners deliver preventive care plans to be worthwhile. “The ones that have really care. The resources on monthly payment preventive care plans are among the most frequently viewed tools. Whether taken the time to implement are very, very happy.” viewers use the resources is another matter, developer Goodman Lee said. The resources provide an overview of preventive care plans, an implementation manual with worksheets, and a team training manual with a customizable presentation. The implementation manual covers topics ranging from plan design to marketing. Partners for Healthy Pets For clinics and for clients, Goodman Lee said, preventive care plans are not just about the economy but also offers free resources at about the way many people like to do business. She said www.partnersforhealthypets.org many people look for a partnership with a service provider, regardless of the type of service. to help practices implement monthly The service providers that assist practices with wellness plans have proliferated over the past several years. Many payment preventive health care plans. of these companies are reporting good initial results (see article, page 994).

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AVMA Task force to develop proposal for compounding legislation

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new AVMA task force will develop a proposal for federal legislation to address issues related to veterinary compounding, pursuant to the Association’s policies on compounding. The AVMA Executive Board approved the task force during a Feb. 21 conference call. Issues related to veterinary compounding the task force will likely address include the legality of compounding from bulk substances, anticipatory compounding, maintaining office stocks of compounded products, and dispensing compounded products from office stocks. In June 2013, the board updated AVMA policy regarding compounding to help the Association advocate for inclusion of veterinary compounding in federal legislation then under consideration. In late 2013, however, Congress passed and the president signed the Drug Quality and Security Act without provisions addressing veterinary compounding. Nevertheless, the Food and Drug Administration is seeking to refine the agency’s approach to veterinary compounding. The Association submitted comments to the

FDA encouraging the agency to refer to AVMA policies as the agency moves forward. In 2014, the FDA plans to revise the existing compliance policy guide on “Compounding of Drugs for Use in Animals,” last updated in 2003. On the legislative front, Rep. Lee Terry of Nebraska spoke during a November 2013 congressional hearing about his desire for legislation to address veterinary compounding issues. In January, Congress asked that the Government Accountability Office prepare a report on the compounding of drugs for use in animals. The AVMA Legislative Advisory Committee recommended formation of the AVMA task force to lead a dialogue among veterinarians, pharmacists, drug manufacturers, and the FDA about how to address veterinary compounding in federal legislation and regulations. The International Academy of Compounding Pharmacists also has requested a formal discussion with the Association on the subject. The Task Force on Veterinary Compounding Legislation is a team of seven AVMA members knowledgeable in the compounding needs of practitioners along with invited participants from other organizations.

AVMA acting to assist FDA with jerky pet treat products The AVMA plans to take actions to assist the Food and Drug Administration with the agency’s investigation into illnesses associated with jerky pet treat products. The AVMA Executive Board approved the plan during a Feb. 21 conference call. The board was following up on a resolution submitted by member petition to the AVMA House of Delegates in January requesting that the Association adopt a position discouraging the feeding of jerky pet treat products. The HOD referred the resolution to the board with a recommendation that the AVMA instead encourage members to provide input to the FDA on illnesses potentially associated with pet foods and treats and to work with the FDA to protect pets through quality control of pet foods and treats.

The first step in the Association’s action plan is to collaborate on and promote an FDA webinar for AVMA members outlining the agency’s activities on jerky pet treat products and how practitioners can provide input for the investigation. The second step is to convene a virtual meeting, such as a teleconference or videoconference, for practitioners and experts to share experiences and knowledge. The third step is to convene an in-person meeting of experts to share information, brainstorm on the potential causes of the illnesses, review case data from new perspectives, and identify new pathways for determination of the cause. Information about the FDA investigation, including a “Dear Veterinarian” letter and a fact sheet for pet owners, is available at http://goo.gl/21Fu8b.

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Issues

At odds over welfare Swine veterinarians describe disagreements with AVMA AASV COVE R AGE

By Greg Cima

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could happen in the future regarding policymaking. He has heard similar concerns from colleagues in other areas of food animal medicine, he went on to say, and is not surprised that there is a diversity of opinions on livestock care and housing among the AVMA’s 85,000 members. He stressed, however, that AVMA policies are science-based, with consideration given to economics and social values, and emphasized that the AVMA seeks food animal veterinarians’ opinions through positions on councils, committees, and task forces. “But, just like any professional endeavor, there is room for debate and differences of opinion,” Dr. DeHaven said. “I think it is these differences of opinion that have led to the perception among some of our swine colleagues that their opinions aren’t respected.” Importantly, according to Dr. Gail C. Golab, director of the AVMA Animal Welfare Division, “Differences of opinion exist not only among the various practice segments that make up the AVMA but even among veterinarians within each practice area. As a result, reaching consensus can be difficult.” Dr. DeHaven also said AVMA staff have less influence in setting policy than suggested by Dr. Olsen’s comments. Staff members gather scientific background materials, but it is the Animal Welfare Committee’s 18 volunteers, not staff, who set the committee agenda and make policy recommendations to be considered by the AVMA Room for debate Executive Board. Dr. Ron DeHaven, AVMA executive Dr. DeHaven has encouraged staff to vice president and CEO, attended the meeting and said afterward that, while express professional opinions, “making sure the committee members know it was clear the speakers expressed the difference between the backsome angst, he was not aware of any specific animal welfare policy disagree- ground information staff provides versus professional opinion from staff.” ments. He spoke with Drs. Olsen and According to Dr. Golab, “Virtually Baker after their presentations and every issue we deal with is contenthinks their comments mainly reflect tious, and we often find ourselves concerns about what they have heard

peaking during the opening presentation at this year’s annual meeting of the American Association of Swine Veterinarians, Dr. Daryl Olsen, a past president of the AASV, told fellow swine veterinarians he does not think the AVMA is respecting their opinions on animal welfare and expressed frustration with the situation. “I know swine veterinarians are the redheaded stepchild, but I’m still a veterinarian—a part of the team—and would like my opinion heard and respected,” he said. “But if we continue down this path, I’m afraid there will come a day when the AVMA will no longer be an ally to swine veterinarians and the AASV, and, you know what? That really hurts me.” Three AASV leaders—Dr. Olsen, another past president, and the current president—said during the March 1-4 meeting in Dallas they see growing contention over welfare issues, particularly the use of individual stalls to house pregnant sows. The other past president, Dr. Rodney “Butch” Baker, indicated he sees the conflict as one between the AVMA Animal Welfare Division and veterinary organizations focused on food animal species. “It’s really creating a rift between those of us that are involved in producing food and veterinarians that are involved with companion animals,” he said.

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Dr. Daryl Olsen

Dr. Ron DeHaven

caught between those within the profession who believe the AVMA’s welfare-related policies are too aggressive and those who believe they are not aggressive enough. As the visible face of those policies, the Animal Welfare Division recognizes that it will often be subject to criticism.” Ultimately, however, the division’s role is to support decisions by AVMA’s volunteer leaders. “Within the context of that role, Division staff is fully committed to ensuring that veterinarians are seen as the absolute best resource for advice on animal welfare,” she said. Expertise, respect, and deference

The swine veterinarians’ meeting March 1-4 in Dallas followed two years during which dozens of national and international retail companies vowed to gradually stop buying pork derived from pigs born in the U.S. to sows kept in gestation stalls, which, according to the National Pork Board, are typically 2 feet by 7 feet individual housing for pregnant pigs. And little more than a week before the meeting, the Humane Society of the United States distributed video it said showed abuse at a Kentucky hog farm that, as the HSUS noted, uses gestation stalls. Dr. Tom Burkgren, executive director of the AASV, said the disagreements between AVMA and AASV are not insurmountable. But he worries that the AVMA has begun to drift away from the AASV’s evidence-based wel-

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Dr. Tom Burkgren addresses the AVMA Executive Board during discussion of federal legislation on egg-laying hen housing in 2012.

Board members agreed that the new standards were likely to improve animal welfare, and they took into consideration the fact that the egg industry supported the bill. Dr. Michelle Sprague, who became AASV president March 4 and is a member of the AVMA Animal Welfare Committee, said in an interview that she also has seen the AVMA and AASV grow apart on welfare issues and suggested that this is possibly a “natural progression” as a rising percentage of AVMA members have limited experience with livestock. ”As a profession and as an association, we really hope to be recognized as experts in our field,” she said. “We want the respect of other veterinarians who sometimes don’t understand what it is we do or maybe forget that we went through the same curriculum and took the same oath.” Asked about the AASV president’s and past presidents’ comments on respect, Dr. Burkgren said he thinks some AVMA volunteers and staff perceive that agriculture-oriented veterinarians are biased by close ties to agriculture industries. Although he sees those ties as a strength, he worries that this perceived bias decreases the weight given to a swine veterinarian’s opinion during discussions. Veterinarian oversight

Dr. Baker said in an interview that he and colleagues pushed in the 1970s and ’80s for clients to move sows indoors and into stalls to protect the animals from the dangers of Iowa winters and aggression from other sows,

as well as to improve management, piglet survival, owner and employee safety, and production. With the combined changes in swine housing, the survival rate of neonatal pigs, for example, has since risen from less than 50 percent to more than 85 percent. Dr. Olsen also described veterinarians as the most influential profession on swine farms, giving them the ability to make changes and the responsibility to give correct advice. “If there is something wrong with the industry, with pork production today, no other group has the ability or the influence to change it more than the AASV,” he said. “We helped design it.” Swine veterinarians have been doing what they see as right for pigs, Dr. Baker said, and they want to discuss and solve the disagreements with AVMA. But livestock-focused veterinary groups could conceivably leave the AVMA, a result he would hate to see. Dr. Burkgren thinks the AVMA and swine veterinarians can overcome differences through communication, respect, and understanding that agriculture veterinarians and other veterinarians face different issues. On the final morning of the meeting, AVMA president Dr. Clark K. Fobian said he had heard at AVMA meetings the same perspectives on swine housing, transportation, and antimicrobial use that he heard from the swine veterinarians. While swine veterinarians are a small part of AVMA’s membership, he noted that AVMA has volunteer positions reserved for them, and their voices are vital to the AVMA.

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fare positions and toward popular opinion. He cited the pending proposal from the AVMA Animal Welfare Committee that the Executive Board revise the policy “Pregnant Sow Housing” in a way that—while the AASV can “live with” it—he thinks could be interpreted to promote eliminating gestation stalls. The policy currently states, in part, that all sow housing systems have advantages and disadvantages, and the AVMA encourages research into housing that can improve sow welfare. While the AVMA and AASV can agree to disagree on some issues, Dr. Burkgren said, he would like deference for swine veterinarians’ conclusions—or for their advocacy to become an AVMA priority—when the AVMA makes decisions on gestation housing and other “foundational” issues. The draft policy was developed by a five-member topic subcommittee that was led by an AASV representative and included another food supply veterinarian and three other veterinarians with a range of views. The draft revision more directly addresses how much space pregnant sows should be given, compared with the current policy, and was sent for the Executive Board’s consideration only after it was voted on by the entire Animal Welfare Committee. The AVMA’s support for the Egg Products Inspection Act of 2012, which would have required housing egglaying hens in larger, enriched environments, also hurt the AVMA-AASV relationship, Dr. Burkgren said. In the February 2012 vote to support the bill, the Executive Board had considered opinions from the AVMA Animal Welfare, Animal Agriculture Liaison, and Legislative Advisory committees. The welfare and legislative committees indicated the legislation was consistent with AVMA policies, and the welfare committee suggested it would improve hens’ lives. The agriculture committee, however, like the AASV, opposed the bill because of the possibility that its passage could have set a precedent for legislating animal welfare standards for food animals.

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Issues

Diseases, outreach top issues for AASV president

lowing nearly a year of battles with Dr. Michelle L. Sprague said two viral outbreaks of porcine epidemic diarrhea, diseases deadly to pigs and animal wela viral disease estimated to have killed fare debates are the top challenges for millions of pigs. She expects knowledge swine veterinarians. about the disease will increase and Dr. Sprague, new president of spread among swine veterinarians at a the American Association of Swine rapid rate over the coming year. Veterinarians, said swine veterinar“There are dramatic and widespread ians are making progress in fighting efforts to try to put as many resourcthose diseases, and the evolving public es—both time and financial—forward perceptions of agricultural practices to assimilate as much information as we represent challenges that come with can to improve our chances of eradicatopportunities for swine veterinarians. ing this disease,” she said. “We also have the opportunity to tell Those efforts coincide with progress the story of the interactions between in the fight against porcine reproducour profession and production agricultive and respiratory syndrome, Dr. ture and detail the efforts that go into Sprague said. She expects research will safeguarding animal health and welfare continue providing better information as well as food safety and public health,” Dr. Michelle L. Sprague on PRRS and its effects. she said. “I will do my best in the comWhile the AASV has limited money to fund research, Dr. ing year to articulate that story as I live it in my daily pracSprague noted that the AASV Foundation provides scholartice life.” Dr. Sprague became president at the organization’s annu- ships to many veterinary students who perform research as well as grants to researchers. The AASV also helps the al meeting, which occurred March 1-4 in Dallas. Dr. Ron National Pork Board determine research needs. L. Brodersen of Hartington, Neb., became the AASV presi“I think it’s important that we continue to advocate for dent-elect; Dr. George Charbonneau of Stratford, Ontario, improving technologies, given the evolution of swine pracbecame vice president; and Dr. Matthew S. Anderson of tice,” Dr. Sprague said. “Everything is always evolving, and Algona, Iowa, is the immediate past president. we need to continue to keep up with that evolution and Dr. Sprague knew as a child she wanted to be a veterimake sure that we’re always at the forefront scientifically, narian. She liked to help her father work with pigs on the family farm in southwest Iowa, and she wanted to be involved anytime a veteriDrs. Michelle L. Sprague, AASV president; Ron L. Brodersen, president-elect; George narian visited. Charbonneau, vice president; and Matthew S. Anderson, immediate past president “I was drawn to the profession because of my love of pigs and my challenge-driven nature,” she said. She began attending AASV meetings as a veterinary student and appreciated the kindness, mentoring, and familial feel. Serving as an officer is helping her repay the organization and its members who have given their time and knowledge. She has worked at the AudubonManning Veterinary Clinic in Audubon, Iowa, since graduating in 2005 from Iowa State University and is now a partner and director of sow health. Dr. Sprague became president fol1000

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AASV COVE R AGE

By Greg Cima

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owners, she said. She and other AASV officers also have been meeting with state and federal lawmakers about swine veterinarians’ roles in promoting food safety and availability. “Anything we can do as individual members helps to further that cause,” she said.

AASV COVE R AGE

doing what’s best for the industry, for the animals, and for our clients.” Dr. Sprague also plans to promote local and national advocacy on animal welfare issues, including outreach by swine veterinarians. In their communities and travels, swine veterinarians can help improve public understanding of their work with pig

Bigger challenge than PRRS By Greg Cima Porcine epidemic diarrhea is the biggest challenge Dr. Luc Dufresne has faced in 25 years in practice. Dr. Dufresne, senior director of health assurance for Seaboard Foods, said challenges associated with PED outbreaks over the past year surpass even the challenges of porcine reproductive and respiratory syndrome, a viral disease that has caused deadly outbreaks and billions of dollars of damage since the causative virus emerged in the U.S. in the late 1980s. The PED virus entered the U.S. in spring 2013, and at least two strains had been found in herds in 27 states by late March 2014. Outbreaks with the first strain discovered have been particularly deadly for the youngest pigs, killing nearly all neonatal pigs in many herds. In March, Dr. Dufresne told fellow swine veterinarians that Seaboard Farms had some of the nation’s first outbreaks of PED during 2013, and 36 of the company’s 47 sow farms have had outbreaks. His presentation during the annual meeting of the American Association of Swine Veterinarians detailed the effects of the virus, which requires low doses for infection, is easily carried on people and vehicles, is difficult to remove from trucks through washing, and carries a risk that some animals will chronically shed the virus. Dr. Robert Morrison, a professor of veterinary population medicine at the University of Minnesota, said environmental sampling also showed that the virus is present in a variety of locations

on farms, including on doorknobs, in medicine rooms, and in areas where workers wash their boots. The likelihood a farm will have PED virus infections increases with factors such as the proximity of other farms, the frequency of rendering service visits, and the presence of wildlife such as rodents, feral hogs, and birds, he said. In written proceedings submitted for the meeting, Dr. Morrison and Dr. Dane Goede, a graduate student at the University of Minnesota, wrote that sow herds “are becoming infected at a disturbing rate despite best attempts at biosecurity.” The PED virus seems to be transmitted more easily than the PRRS virus, it is more environmentally stable, and sows have lower immunity to it, they wrote. Rigorous biological containment and sanitation are the only hope of preventing a larger outbreak when sows and litters have clinical signs. Dr. John Clifford, chief veterinary officer for the Department of Agriculture, said the Animal and Plant Health Inspection Service is developing its Comprehensive and Integrated Swine Surveillance Program to provide a federal structure for reporting the presence of livestock diseases of zoonotic or economic concern, and he needs swine veterinarians’ support. APHIS has to have agreements with state governments and industry so that farms can report where a disease is present and the agency can protect the confidentiality of those providing reports. “If it takes us one to two weeks to Vol. 244, No. 9

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identify a new emerging disease like PED—the way we move livestock, it’ll already be in multiple states,” Dr. Clifford said. “Just think for a moment how much loss we have with PED and think about foot-and-mouth disease, classical swine fever, and African swine fever—those diseases that we all recognize as foreign animal diseases.” Dr. Jerome O. Geiger, who works in the China operations of pig genetics company PIC, said it is veterinarians’ job to keep foreign diseases out of U.S. herds, protecting animals, clients, and the pork industry. But they can lose their global perspective when focusing on immediate issues such as PRRS, mycoplasmal pneumonia, antimicrobial resistance, and client education. Complacency about foreign diseases is understandable but not forgivable, he said. Dr. Rodney “Butch” Baker, senior clinician for veterinary diagnostic and production animal medicine at Iowa State University, expects swine veterinarians will have a better understanding of, and control over, the spread of PED by the time of the next AASV annual meeting. Better vaccines and management as well as records of interventions and outcomes will help control the disease. He noted that swine veterinarians have eliminated and conquered other diseases including pseudorabies and hog cholera. Those who started practice after those diseases were eliminated and want to build a legacy need to solve the PED problem, he said. JAVMA News: May 1, 2014

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Photo by Wendy Savage/NCSU

Practice Scientists develop method to detect pain relief in cats Scientists in the Comparative Pain Research Laboratory at the North Carolina State University College of Veterinary Medicine have developed a method to detect pain relief in cats with degenerative joint disease. “We used the commonly observed ‘placebo effect’ phenomenon from clinical practice and applied it to a clinical trial,” said Dr. Duncan Lascelles, the study’s lead investigator. A large placebo effect is often seen in trials for pain relief, even in pets. Dr. Lascelles said studies of treatments for pain in veterinary medicine frequently use subjective outcome measures, such as asking caregivers to rate the pet’s level of activity and pain relief. In the new study, cat owners rated their cat’s improvement on measures of activity both on and off of a daily nonsteroidal anti-inflammatory medication. “When we looked at levels of activity and pain relief in active medication versus placebo cats, we did not see a difference in caregiver rating. Both groups were much improved,” said Dr. Margaret Gruen, a veterinary behaviorist and the study’s lead author. “However, when we looked at the study’s blinded washout phase that followed a treatment period, we found caregivers clearly noticed the return of clinical signs after withdrawal of the active medication, but not after the withdrawal of the placebo.” Dr. Lascelles said, “We are excited about the potential breakthrough in the detection of pain relief and our ability

Dr. Margaret Gruen

to test new therapies for the many cats and dogs that suffer from chronic pain.” The study, “Detection of clinically relevant pain relief in cats with degenerative joint disease associated pain,” appears in the March/April issue of the Journal of Veterinary Internal Medicine.

Production canceled for flea and tick collars containing propoxur

FDA approves insulin pen for cats and dogs

The Environmental Protection Agency has reached an agreement with Sergeant’s Pet Care Products Inc. and Wellmark International to cancel production and distribution of flea and tick pet collars containing propoxur. A risk assessment by the EPA found risks to children from exposure to propoxur collars. The agency completed the risk assessment in fall 2013 in response to a petition from the Natural Resources Defense Council to cancel production of the collars. The risk assessment found, in some scenarios, unacceptable risks to children from exposure to propoxur collars on the first day of treatment. The major source of exposure is from absorption through the skin after directly touching the treated pet. The EPA published the cancellation order in the March 26 issue of the Federal Register. Under the voluntary agreement, the manufacturers may produce the propoxur collars until April 1, 2015, but may not distribute the products after April 1, 2016. The agency will monitor for incidents from use of these collars and take further action if necessary.

The Food and Drug Administration announced March 19 its first approval of insulin administration in dogs and cats by means of an automatic injection pen. The approval provides consumers with the option of using Vetsulin, a porcine insulin manufactured by Merck Animal Health, with the VetPen automatic injection pen. The refillable VetPen automatically measures out the prescribed insulin dose. Vetsulin is the only insulin product that has received FDA approval for the treatment of diabetes mellitus in dogs and cats. In 2011, Vetsulin was taken off the market because of manufacturing concerns. The product was reintroduced to the market in 2013, and the FDA continues to monitor its use. Merck Animal Health initially will offer the VetPen in veterinary clinics so the manufacturer can work with veterinarians on the pen’s use, helping to ensure that pet owners administer Vetsulin safely and effectively.

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Community

One health in action Veterinary colleges relate best practices, case studies By Malinda Larkin Photos courtesy of AAVMC

T

sions that include establishhe one-health moveing the Foundation for Food ment has been gathand Agriculture Research, ering momentum which will provide $200 for almost a decade, and a million in funding for new number of organizations research projects aimed at and interest groups have addressing key problems of taken up the mantle and national and international implemented the concept importance. in different ways. Veterinary schools and The one-health concept their universities have, too, is a broad one that unites been encouraging more veterinarians, physicians, research in one-health areas. and other scientific, health, Iowa State University is and environmental profescreating opportunities for sionals in a collaborative researchers to apply their approach that recognizes expertise and integrate eduthe vast interrelationships Keynote addresses at the AAVMC Annual Conference were given by cation and outreach through between human, animal, its Health Research Initiative. and environmental health. Catherine Wotecki, PhD (pictured), chief scientist and undersecretary for research, education, and economics with the Department Last year, the ISU-HRI funded The Association of of Agriculture, and Dr. Juan Lubroth, chief veterinary officer of the 12 projects that cover topAmerican Veterinary United Nations Food and Agriculture Organization. Dr. Wotecki said ics impacting the health of Medical Colleges’ Annual to attain sustainable food security, more needs to be invested in food science research, particularly regarding food safety. humans, animals, and the Conference, March 14-16 environment. ISU veterinary in Alexandria, Va., had a faculty received funding for eight of theme of “One health in veterinary Research in progress the 12. medical education” to highlight the Keynote addresses were given by And Auburn University’s Research work being done in this area. Ninety Dr. Juan Lubroth, chief veterinary Initiative in Cancer started in January leaders from academic veterinary officer of the United Nations Food 2013. With more than $3 million in medicine and related disciplines gave and Agriculture Organization, and funding from the state of Alabama, 60 presentations that touched on top- Catherine Wotecki, PhD, chief scienthe program has supported graduics such as controlling zoonotic infectist and undersecretary for research, ate fellowships in cancer research, tious diseases, protecting the global education, and economics with the seed grants ($20,000 each), and major food supply, improving clinical care for Department of Agriculture. people and animals, and strategies for Dr. Wotecki said pressing challenges grants ($200,000 each). As a result, clinical trials for bone cancer and two developing academic programs in one that can be addressed by one health types of skin cancer—melanoma and health. are population growth and demand “We live in the age of globalization, for food and other products. She ques- mast cell tumor—have been initiated at the College of Veterinary Medicine. and one-health approaches to meditioned whether a healthy diet will be Plus, partnerships have been formed cine and wellness are more important sustainable in the long term when internally with the Auburn University than ever before,” said AAVMC executhere’s an increasing demand for aniMRI Research Center and externally tive director Dr. Andrew Maccabe. mal protein, especially as developing with other universities, research cen“With its multispecies approach and countries transition. Sustainable food ters, and the biotechnology and pharbroad spectrum of biomedical activity, security requires more investment in veterinary medicine is uniquely qualifood science research, Dr. Wotecki said, maceutical industries. Another example is the One fied to lead in this area. We hope this particularly regarding food safety. Health Grand Challenge at Texas meeting will be a catalyzing event in She noted that the recent Farm Bill the evolution of this critical initiative.” is one health–focused, with new provi- A&M University College of Veterinary Vol. 244, No. 9

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Community Medicine & Biomedical Sciences. It creates collaborations among scientists and professionals in human health, animal health, and environmental health that amplify and broaden the impact of individual initiatives on global health. Four research initiatives were decided on early this year, and the research is to be conducted over the next 24 months.

building construction departments. Community interaction

Dr. Will Hueston, executive direc tor of the Global Initiative for Food Sys tems Leadership and a professor at All in one place the University of Dr. Lisa K. Nolan, dean of the ISU Minnesota, said veterinary college, said land-grant successful oneuniversities are uniquely qualified to health approaches solve one-health challenges, thanks demand dynamic to schools representing various disDr. Bernadette Dunham, director of the Food and Drug Administrapartnerships that ciplines being located on the same tion’s Center for Veterinary Medicine, talks with Dr. Juan Lubroth. span the public, campus. Dr. Dunham said in her talk at the AAVMC Annual Conference private, and acaA good example would be Master that addressing antimicrobial resistance is a shared responsibility demic sectors as of Public Health programs, including between human and animal medicine. She also said the FDA will joint DVM/VMD-MPH degree programs, well as various work with pharmaceutical companies for judicious use and labeling of antimicrobials. disciplines. which are gaining popularity worldMinnesota has wide and are growing both in number been part of the and participation. Other degree programs can also push one-health goals. World Organisation for Animal Health’s tion, detection, and response to zoonotic diseases. Funding for the project (OIE) twinning program in veterinary Washington State University and its has come through the U.S. Agency for education. This involves an exchange Paul G. Allen School for Global Animal Health have created a pathway leading of faculty, staff, and even students, plus International Development’s Emerging Pandemic Threats Program. to a professional certificate for selected the sharing of curriculum and proDynamic partnerships can work on a cesses to benefit each other. UMN has students who are seeking careers in local level, too. The University of Illinois a program with Chiang Mai University global animal health. To gain a certifiCollege of Veterinary Medicine’s Center in Thailand to support competency cate, students complete a minimum for One Health Illinois conducts a onedevelopment for veterinary graduof 15 course credits, including project health public engagement program ates. Minnesota also exchanges stuwork, completed concurrently with their four-year DVM-degree curriculum. dents with Uganda for the latter’s One that provides education and training Health Residency Program at Makerere opportunities for several segments of Or there’s Virginia Tech’s Center for the community, from the general pubUniversity and the UMN Veterinary Public Health Practice and Research, lic to public health professionals and Public Health Residency. housed within the Virginia-Maryland local health departments. In addition, Minnesota and Tufts Regional College of Veterinary MediOne way the center does this is by University, in partnership with cine. The center fosters interdisciplinsponsoring a series of lectures, discusary partnerships among communities, Development Alternatives Inc., the local health departments, medical and Training Resources Group, and Ecology sions, and question-and-answer sessions throughout the state. Subject veterinary organizations, government, and Environment, have been working matter experts provide information with universities and governments and other public and private instituon public health topics such as the since 2009 to create the Respond tions. Through the center, students legalization of marijuana, the safety of Project. can enroll in graduate certificate proenergy drinks, climate change, enviRespond seeks to provide students, grams, such as the graduate certificate ronmental toxins, and antimicrobial academics, and practitioners with in global planning and international resistance. competencies and tools that will predevelopment, offered collaboratively COHI has also been involved in the by urban affairs and planning, popula- pare them to work with a broad range of stakeholders to improve the preven- education and training of public health tion health sciences, geography, and 1004

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professionals by developing and hosting both on-site and Internet-based functional outbreak response training opportunities. Challenges to overcome

For all the enthusiasm and progress made within the one-health movement in the past few years, it hasn’t been without its setbacks. Turns out its expansive nature can be both a blessing and a curse. On one hand, one health has the potential to develop—or already has developed, in some cases—novel or innovative strategies for dealing with things such as pandemic threats and duplication of efforts for disaster response. On the other hand, one health’s encompassing scope has contributed to its awkward growth—with no clear goals or leader—and potential dilution of the initiative threatens its impact and long-term strength. In addition, the uncoordinated use of the one-health label by organizations and interest groups has the potential of creating confusion among other possible stakeholders, which may eventually lead to disinterest, according to Susan Sanchez, PhD, a professor at the University of Georgia College of Veterinary Medicine. She compared the evolution of one health to what has happened with the green movement, despite the promise one health holds. Adding to that, Anna Fagre, a DVM/ MPH–degree student at Colorado State

Breaking into small groups, conference attendees used interactive devices to share their perceptions regarding the personal and institutional inclination for change concerning one health. They also identified and weighted specific change strategies.

University, said concerns have been raised that the lack of funding, faculty and student time constraints, and, again, inertia because of the diverse usage of the one-health term threaten the sustainability of many of these programs. To keep up the one-health momentum, Dr. Keith Martin of the Consortium of Universities for Global Health said attention and public involvement spur action. He encourages veterinarians to tell their stories and use emotional impact to get their points heard. Interdisciplinary partnerships are vital, he added.

For more information about the educational sessions held during the AAVMC Annual Conference, visit

www.aavmc.org/Meetings/2014-AnnualConference-Summary.aspx. Vol. 244, No. 9

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“Share what you’re doing. You’re unsung heroes; the world needs you. Let’s make a difference together,” Dr. Martin said.

Making headway AAVMC Annual Conference attendees identified barriers for incorporating one health in veterinary education and prioritized opportunities for overcoming them. They are as follows: • Designating faculty champions and educating funding agencies. • Engaging students beyond veterinary medicine and strategically communicating one-health messages to key stakeholders. • Establishing partnerships across institutions and promoting teamwork to solve problems.


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Community

Research, public health leaders honored by AAVMC

The Association of American Veterinary Medical Colleges honored the 2014 recipients of four awards March 14-16 at its Annual Conference in Alexandria, Va. Dr. Yoshihiro Kawaoka, a professor of virology at the University of Wisconsin-Madison School of Veterinary Medicine, received the Excellence in Research Award. Dr. Kawaoka achieved global attention in 2011 when he and an international team of researchers showed that the avian influenza H5N1 virus could become transmissible to mammals after just a few genetic mutations. In 2013, Dr. Kawaoka and his team collaborated with the National Institute of Infectious Diseases in Japan to conduct a genetic analysis of the avian influenza H7N9 virus. The analysis revealed that the virus can evolve and adapt to human cells, prompting concerns about its potential to launch a global flu pandemic. Dr. Kawaoka earned his bachelor’s, master’s, and doctoral degrees, including a DVM degree, from Hokkaido University in Japan. Dr. John A. Herrmann (IL ’78) was honored with the Senator John Melcher DVM Leadership in Public Policy Award. At the University of Illinois College of Veterinary Medicine, Dr. Herrmann directs the DVM/Master of Public Health program as well as the Center for One Health Illinois. He also serves as a clinical associate professor in the Department of Veterinary Clinical Medicine. During Dr. Herrmann’s 25-year career as a private practice veterinarian in Freeport, Ill., he became involved in public health issues at the county and state levels. Eventually, he earned an MPH from the University of Illinois at Chicago and then spent a year as an American Association for the Advancement of Science/AVMA Science and Technology Policy Fellow in the office of Sen. Dick Durbin, D-Ill. Dr. Herrmann worked on policies designed to improve food safety, ensure humane treatment of animals, promote an adequate workforce in the areas of public health and veterinary medicine, and unite the efforts of health disciplines through the one-health concept. Since joining the U of I faculty 10 years ago, Dr. Herrmann established the DVM/MPH program. Since 2003, he has served as an adjunct professor at the University of Illinois at Chicago School of Public Health and at the University of Illinois at Rockford College of Medicine. Dr. Herrmann is a diplomate of the American College of Theriogenologists, specializing in reproduction of cattle and dogs. Dr. Matthew Mellema (CAL ’94) is the recipient of the Distinguished Teacher Award, sponsored by Zoetis. Dr. Mellema is an assistant professor of emergency and critical care at the University of California-Davis School

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of Veterinary Medicine, where he has taught since 2007. Colleagues and students note he Dr. John A. is respected for his Dr. Yoshihiro Herrmann creative and effec- Kawaoka tive teaching style as well as his dedication to being an involved mentor. Dr. Mellema has given numerous presentations on Dr. Matthew Dr. Joe N. Kornegay issues related to Mellema emergency and critical care and written book chapters on topics that include electrocardiogram evaluation, cardiac output monitoring, and initial management of poisoning in patients. Dr. Mellema has a doctoral degree in respiratory physiology from Harvard University. He is a diplomate of the American College of Veterinary Emergency and Critical Care. Dr. Joe N. Kornegay (TEX ’73), a professor of neuroscience in the Department of Veterinary Integrative Biosciences at Texas A&M University College of Veterinary Medicine & Biomedical Sciences, was chosen to deliver the conference’s Recognition Lecture. Dr. Kornegay’s lecture, “One man’s view of one health,” focused on his research on a canine model of Duchenne muscular dystrophy and diseases such as cancer, heart disease, and epilepsy, and how it relates to the broader concepts of one health. After receiving his DVM degree, Dr. Kornegay spent three years in private practice in Ohio and Texas, followed by six years in residency (neurology and pathology) and graduate (master’s and doctoral) training at the University of Georgia College of Veterinary Medicine. He then served on the faculty of the North Carolina State University College of Veterinary Medicine before moving to the University of Missouri-Columbia College of Veterinary Medicine, where he served as dean from 1998-2006. Before coming to TAMU in 2012, Dr. Kornegay served as a professor in the Department of Pathology and Laboratory Medicine and the Department of Neurology and as an investigator in the Gene Therapy Center at the University of North Carolina-Chapel Hill School of Medicine.

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AASV honors five for proficiency, contributions Dr. Matthew B. Turner (NCU ‘00) of Faison, N.C., received the 2014 Swine Practitioner of the Year Award during the annual meeting in March of the American Association of Swine Veterinarians. Dr. Turner was honored for proficiency and effectiveness in delivering veterinary services to clients. In addition to work as a practitioner, he serves as adjunct faculty and as a mentor at the North Carolina State University College of Veterinary Medicine. Dr. Aaron Lower (IL ‘09) of White Heath, Ill., received the Young Swine Veterinarian of the Year Award. He was honored for demonstrating the ideals of exemplary service and proficiency early in his career. Dr. Lower provides health, diagnostic, production, and research support to clients in three states. Dr. Darrell L. Neuberger (ISU ‘77) of Garner, Iowa, received the Technical Services/Allied Industry Veterinarian of the Year Award. He was honored

for proficiency and effectiveness in delivering veterinary services and for service to the AASV and swine industry. Dr. Dr. Matthew B. Turner Neuberger gives technical expertise to his company’s sales force and mentors veterinary students and recent graduates. Dr. Locke A. Karriker (MIS ‘99) of Ames, Iowa, received the Howard Dunne Memorial Award. He was honored for contributions and service to the AASV and the swine industry. He is director of the Swine Medicine Education Center at the Iowa State University College of Veterinary Medicine, an associate professor in the Department of Veterinary Diagnostic and Production Animal Medicine, a researcher, and a mentor. Dr. Harry O. Snelson (NCU ‘90) of Burgaw, N.C., received the Meritorious

Dr. Aaron Lower

Dr. Darrell L. Neuberger

Dr. Locke A. Karriker

Dr. Harry O. Snelson

Service Award. He was honored for service to the AASV, where he has worked as communications director since 2005. He served on the AASV board of directors from 1999-2004 and has worked on AASV councils and committees, which included chairing the Foreign Animal Disease Committee.

Kimberling honored for agriculture work Dr. Cleon V. Kimberling of Fort Collins, Colo., was inducted into the Farm Credit Colorado Agriculture Hall of Fame during the organization’s annual banquet Feb. 27 in Denver. The Colorado FFA Foundation selected Dr. Kimberling for induction into the hall of fame for his contributions to the state and nation’s agricultural industry. Dr. Kimberling (COL ’59) is known for his extensive work with dairy cattle, beef cattle, and sheep. From 19652005, he was a faculty member at the Colorado State University College of Veterinary Medicine & Biomedical Sciences, while also working as a university extension veterinarian. In addition to training veterinary students, Dr. Kimberling is credited with major innovations that have improved

herd health. He was a lead contributor in the development of brucellosis testing methods, invented a liver biopsy instrument, and co-invented the Kimberling-Rupp spaying instrument. On March 11, Rep. Cory Gardner of Colorado praised Dr. Kimberling on the floor of the U.S. House of Representatives for his many achievements. “The number of veterinarians he has trained, both at CSU and around the world, is countless,” Gardner said. “His caring, sharing and teaching are only a part of who he is. “His contributions to the health and productivity of Colorado’s livestock industry, along with his dedication to Colorado State University students and his overall improvement to mankind, are examples for all to follow.”

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The AVMA and AVMA Auxiliary will celebrate National Pet Week 2014 from May 4-10. Find resources at www.petweek.org.


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Community

Oregon VMA

Event: Annual meeting, March 7-9, Corvallis Awards: Meritorious Service Award: Dr. Bill Young, Eugene, for exemplary servant leadership to the organization, veterinary profession, and community. A 1970 graduate of Colorado State University College of Veterinary Medicine & Biomedical Sciences, Dr. Young owns West Eugene Animal Hospital and Pleasant Hill Veterinary Clinic in Pleasant Hill. He serves on the Lane County Animal Services Advisory Committee and is active with the Greenhill Humane Society. Dr. Young is a past chairman of the OVMA Legislative Committee and a past president of the Lane County VMA. He mentors veterinary students at the Oregon State University College of Veterinary Medicine. Veterinary Service Award: Monique Balas, Portland. Balas is the pet columnist for The Oregonian. She also has a blog on the newspaper’s web site. Balas addresses a variety of animal health topics and educates owners on how best to care for their animals. Practice Manager of the Year: Gina Schluckebier, Springfield. Schluckebier is the practice manager at Oregon Veterinary Referral Associates in Springfield. Since 2002, she has also served as associate director of Banner’s Blood Bank, a nonprofit canine blood bank service. Schluckebier helped establish the Sew Dog Sew program, recruiting seamstresses who volunteer their services to sew coats for dogs living outdoors with their homeless owners. President’s Award: Dr. Tom Keck, Dallas. A 1982 graduate of Washington State University College of Veterinary Medicine, Dr. Keck owns

Ohio VMA Event: Midwest Veterinary Conference, Feb. 20-23, Columbus Awards: Veterinarian of the Dr. Robert Knapp Dr. David Koncal Year: Dr. Robert Knapp, Dublin. A 1992 graduate of The Ohio State University College of Veterinary Medicine, Dr. Knapp owns Knapp Veterinary Hospital, a small animal practice in Columbus. He is a past president of the Ohio VMA and serves as Ohio’s delegate to the AVMA House of Delegates. Dr. Knapp is co-chair of the Midwest Veterinary Conference’s pet animal education committee and has served as a liaison to the Ohio Veterinary Medical Licensing Board. Officials: Drs. David Koncal, Northfield, president; Brad Garrison, Wooster, president-elect; Tod Beckett, Dublin, secretary; Dave Bauman, Maineville, treasurer; and Patricia Haines, Wilmington, immediate past president

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Dr. Bill Young

Monique Balas

Gina Schluckebier

Dallas Animal Clinic. He was honored for his advocacy before the state legislature and regulaDr. Tom Keck Dr. Steve Amsberry tory agencies on animal health care and welfare issues. Business: Discussions were held on veterinary drug compounding; transport of controlled substances, veterinary prescriptions and retail and online pharmacies, oversight of nonprofit groups that rescue and care for animals, and licensure of veterinary facilities. Officials: Drs. Steve Amsberry, Corvallis, president; Charles Meyer, Grants Pass, president-elect; Jay B. Fineman, Newport, treasurer; and Todd McNabb, Clackamas, immediate past president

New officers elected for New Mexico VMA The New Mexico VMA recently installed new members of the board of directors. Dr. Manuel A. Garcia (ORS ’00) of Farmington, N.M., is president. He co-owns San Juan Veterinary Hospital, where he has been since 2004. Before then, Dr. Garcia practiced at Montana Veterinary Specialists and General Care. Dr. Emily Walker (OKL ’99) of Albuquerque, N.M., is president-elect. Dr. Walker spent four years after veterinary college practicing in a small animal clinic in Yukon, Okla., before returning to New Mexico, where she is originally from. Dr. Walker owns the Albuquerque Cat Clinic and is a member of the American Association of Feline Practitioners. Dr. Bonnie E. Snyder (CAL ’74) of Albuquerque, N.M., is secretary-treasurer for a second term. She is director of the Veterinary Technology School at Central New Mexico Community College.

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American College of Veterinary Surgeons

Obituaries

The American College of Veterinary Surgeons certified 77 new diplomates following the certification examination it held Feb. 3-4 in San Diego. The new diplomates are as follows:

AVMA member AVMA honor roll member Nonmember

Krista Adamovich, Austin, Texas Anna Aman, Glen Allen, Va. Melissa Arbaugh, Phoenix Karanvir Aulakh, Savoy, Ill. Heather Baginski, Colts Neck, N.J. Elizabeth Barrett, Lexington, Ky. Willem M. Becker, Salt Lake City Jitender Bhandal, Surrey, British Columbia Adam Biedrzycki, Madison, Wis. Jeffery J. Biskup, Knoxville, Tenn. Glen A. Bonin, Richmond, Va. Bianca Boudreau, East Lansing, Mich. Brian Bufkin, Covington, La. Jessica Carter-Arnold, Washington, Okla. Eric Chow, Los Angeles Kyle J. Clark, Pukekohe, New Zealand Kevin Coleman, Athens, Ga. Amie Csiszer, Springfield, Ore. Laura C. Cuddy, Summerhill, Ireland Sarah P. Daniel, Lexington, Ky. Mark L. Dosch, Danville, Calif. David Dycus, Chattanooga, Tenn. Russell W. Fugazzi, Calgary, Alberta Mark C. Fuller, Woodland, Calif. Steven Garnett, Bowie, Md. Zachary Goodrich, Monroeville, Pa. Jaime L. Green, Southbury, Conn. Galina Hayes, Lewistown, Pa. Marc Hirshenson, Rockville, Md. Rosaleen M. Hyde, Glanmire, Ireland Avtar S. Jandi, Surrey, British Columbia Daniel A. Jankovits, Chicago Sun Y. Kim, Davis, Calif. Alexander I. Krebs, Ames, Iowa Toni Wen-San Kwan, Lake Forest, Ill. Nathaniel Lam, Honolulu Megan M. Lamb, Schertz, Texas Jeffrey Little, Roswell, Ga. Abigail A. Lockwood, Cumming, Ga.

Ricardo J. Loinaz, Havre de Grace, Md. Cassie N. Lux, Knoxville, Tenn. Marina Manashirova, Omaha, Neb. Sarah Marvel, Fort Collins, Colo. Brad Matz, Auburn, Ala. Taralyn McCarrel, Lexington, Ky. Jayne McGhie, Alexandra Hills, Australia Kelly Might, Austin, Texas Thomas Monaco, Princeton, N.J. Jeremiah Moorer, Stillwater, Okla. Emily Mouat, Olympia, Wash. Beatrix Nanai, Naples, Fla. Bradley Nelson, Fort Collins, Colo. Samantha A. Nelson, Buffalo, N.Y. Lindsay L. Occhipinti, Gibsonia, Pa. James Perry, Seattle John Pigott, Oconomowoc, Wis. Cassandra Y. Prpich, Glen Iris, Australia Erin E. Reichert, Roswell, Ga. Wesley J. Roach, Nashville, Tenn. Inmaculada Roquet Carne, Barcelona, Spain Roman S. Savicky, Port Washington, N.Y. Chad E. Spah, Fishers, Ind. Jason Spina, Bothell, Wash. Rebecca E. Spivack, Carmel, Ind. Suzanne Stewart, Kennett Square, Pa. Elizabeth A. Swanson, Mississippi State, Miss. Tyler E. Tipton, Brock, Texas Bryan Torres, Athens, Ga. Michelle C. Trappler, Havre de Grace, Md. Kevin B. Wahl, Nampa, Idaho James Wignall, Temecula, Calif. Hadley Willsallen, Coolac, Australia David M. Wilson, Fort Collins, Colo. Collin Wolff, Albuquerque, N.M. Elizabeth H. Yorke, Auburn, Ala. Alanna Zantingh, Bibra Lake, Australia Cindy Zikes, Beaverton, Ore.

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Dr. Cryar (AUB ’51), 89, Atmore, Ala., died Nov. 11, 2013. A small animal practitioner, he was the founder of Green Springs Animal Clinic in Homewood, Ala., and served as a partner in Hoke Animal Clinic in Birmingham, Ala. Dr. Cryar was a past president of the Alabama and Jefferson County VMAs. In 1980, he received a service award from the Alabama VMA. Dr. Cryar served in the Army during World War II. His two daughters and three grandchildren survive him. Memorials may be made to Auburn University College of Veterinary Medicine, Auburn University, AL 36849.

Leanne K. Donovan Dr. Donovan (OSU ’91), 48, Stratham, N.H., died Nov. 20, 2013. A small animal veterinarian, she practiced at Dover Veterinary Hospital from 2009-2013. Dr. Donovan began her career at Midwest Bird and Exotic Animal Hospital in Westchester, Ill. She later worked at Ardmore Animal Hospital in Ardmore, Pa., and Animal Medical Associates in Saco, Maine. From 1996-2006, Dr. Donovan practiced at Gray-New Gloucester Animal Hospital in Gray, Maine. She subsequently worked at Stratham-Newfields Veterinary Hospital in Newfields, N.H. Memorials may be made to Dana Farber Cancer Institute, P.O. Box 849168, Boston, MA 02284; Cystic Fibrosis Foundation, 220 N. Main St., Suite 104, Natick, MA 01760; Wolf Haven International, 3111 Offut Lake Road S.E., Tenino, WA 98589; or The Seeing Eye Inc., 10 Washington Valley Road, P.O. Box 375, Morristown, NJ 07963.

Marguerite B. Gulick

@AVMAJournals

Dr. Gulick (UP ’44), 92, Great Barrington, Mass., died Oct. 30, 2013. Vol. 244, No. 9

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Community

Following graduation, she co-founded a practice with her late husband, Dr. William Gulick, in Great Barrington, where she initially practiced mixed animal medicine, later focusing on small animals. Dr. Gulick’s three sons survive her. One son and daughter-in-law, Drs. Donald W. Gulick (UP ’75) and Claire E.B. Gulick (UP ’75), have co-owned the Great Barrington practice since 2001. Memorials may be made to Berkshire Humane Society, 214 Barker Road, Pittsfield, MA 01201; or Purradise, 301 Stockbridge Road, Great Barrington, MA 01230.

Mary C. Hallenbeck Dr. Hallenbeck (COR ’47), 87, Branford, Conn., died Oct. 30, 2013. She practiced at Merryfield Animal Hospital in Hamden, Conn., for several years. Earlier in her career, Dr. Hallenbeck worked in New York. An avid outdoorswoman, she was a lifetime member of the Adirondack Mountain Club, a member of the New Haven Hiking Club, and a past president of the Sleeping Giant Park Association. Dr. Hallenbeck was also a member of the Yale Peabody Museum of Natural History. Memorials may be made to the Connecticut Players Foundation (Long Wharf Theater), 222 Sargent Drive, New Haven, CT 06511; or Branford Land Trust, P.O. Box 258, Branford, CT 06405.

Clyde M. Haller Dr. Haller (COR ’44), 90, Adams, N.Y., died Nov. 17, 2013. In 1948, he established a practice in Adams, where he worked until retirement in 1994. Earlier in his career, Dr. Haller practiced in LaFargeville, N.Y. He was a veteran of the Army. Dr. Haller’s wife, Audrey; a daughter and a son; and three grandchildren survive him. Memorials may be made to Adams Free Library, 2 N. Main St., Adams, NY 13605; or South Jefferson Rescue Squad, 38 Main St., Adams, NY 13605.

Bryan S. Johnson Dr. Johnson (UP ’63), 78, Osprey, Fla., died Sept. 26, 2013. A small animal 1010

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and exotic animal practitioner, he was the founder of Cranbury Veterinary Hospital in East Brunswick, N.J., and Bayview Veterinary Hospital in Toms River, N.J. Dr. Johnson also owned Animal Crackers Pet Supply in Toms River for five years and served 10 years as a conservation officer for the New Jersey State Department of Fish and Game. He retired to Florida’s Sarasota County in 1999. Dr. Johnson served on several committees of the New Jersey VMA and was a member of the Association of Avian Veterinarians, American Animal Hospital Association, and Metropolitan New Jersey VMA. Active in civic life, he was named Citizen of the Year by East Brunswick Township in 1980 and 1986. Dr. Johnson was a veteran of the Army. He is survived by his wife, Veronica; two stepsons; and a grandson.

Leland D. Kendall Dr. Kendall (KSU ’57), 81, Penn Valley, Calif., died Dec. 15, 2013. A small animal veterinarian, he owned Costa Mesa Animal Hospital in Costa Mesa, Calif., prior to retirement in the mid-1990s. Dr. Kendall was a member of his local Kiwanis club. He served as a captain in the Air Force. Dr. Kendall is survived by his wife, Patricia; two daughters and two sons; and four grandsons.

John R. Popish Dr. Popish (COL ’57), 84, Casper, Wyo., died Nov. 9, 2013. He founded Popish Veterinary Clinic in Casper, practicing there until retirement in 1992. Dr. Popish was a past president of the Wyoming VMA, served on the Wyoming Board of Veterinary Medicine for four years, and was Wyoming’s delegate to the AVMA House of Delegates from 1972-1975. Active in civic life, he also served on the Natrona County Health Board, Casper Chamber of Commerce, and Casper City Council, and was a past president of the Casper Kiwanis Club. Dr. Popish was an Air Force veteran of the Korean War, with the rank of 1st lieutenant. He is survived by two sons and two daughters, 12 grandchildren, and six great-grandchildren. Memorials may be made to St. Mark’s Episcopal Church, 701 S. Wolcott St., Casper, WY 82601.

Lois K. Sargent

Dr. Sargent (FL ’92), 58, Miami, died Jan. 15, 2014. She was a professor and program coordinator for the Miami Dade College Veterinary Technology Program for the past 10 years. Dr. Sargent also practiced small animal medicine part time at Miami’s Knowles Animal Hospital and Tropical Park Animal Hospital and owned a mobile, holistic practice. Early in her career, she John B. Peterman worked in a mixed animal practice in Dr. Peterman (UP ’45), 93, Willow western Pennsylvania. Street, Pa., died Jan. 26, 2014. He Dr. Sargent was a past secretary owned a small animal practice of the Veterinary Botanical Medicine in Pottstown, Pa., for 35 years. Dr. Association and a past member of the Peterman was a member of the American Holistic VMA board of direcPennsylvania VMA. He served in the tors. She was a member of the Florida Army during World War II and was a VMA, American Academy of Veterinary member of the American Legion. Dr. Acupuncture, and International Peterman’s wife, Ruth; two daughters Veterinary Acupuncture Society. and a son; and six grandchildren surDr. Sargent’s daughter survives vive him. Memorials may be made to Hospice of Lancaster County, 685 Good her. Memorial donations toward the Lois Sargent Veterinary Technology Drive, Box 1425, Lancaster, PA 17604; Scholarship may be made to Miami Bethel United Methodist Church, 950 Dade College Foundation, 300 N.E. 2nd Bethel Church Road, Spring City, PA Ave., Suite 1423-1, Miami, FL 33132, 19475; or Mathias J. Brunner Nursing http://mdcalumni.com/Lois_Sargent_ Education Fund, 600 Willow Valley Memoriam. Square, Lancaster, PA 17602. Vol. 244, No. 9

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Prepaid versus traditional Medicaid plans: effects on preventive health care.

Young mothers lack plans to receive preventive health care.

How wellness plans grow veterinary practice.

Regulations to promote healthy sleep practices in child care.

The annual wellness visit shared medical appointment: innovative delivery of preventive care to the elderly.

Children's Preventive Care Use Under Two Mature Medicaid Managed Care Plans in California.

Medicare's chronic care management payment--payment reform for primary care.

Effect of Medicaid payment levels on access to obstetrical care.

Do knowledge translation (KT) plans help to structure KT practices?

Physician payment incentives to improve care quality.

Caregiver education to promote appropriate use of preventive asthma medications: what is happening in primary care?

Health care professionals' knowledge, attitudes and practices relating to umbilical cord blood banking and donation: an integrative review.

Total audit of preventive practices.

Effect of physician specialist alternative payment plans on administrative health data in Calgary: a validation study.

Randomized controlled trial of a Wellness Action Plan to promote healthy diet and activity in pediatric primary care.

Moving survivorship care plans forward: focus on care coordination.

Individualized care plans.

Survivorship care plans redux.

Survivorship care plans.

Equity in out-of-pocket payment in Chile.

Preventive Care.

Little association between wellness policies and school-reported nutrition practices.

Quality of Care, Including Survivorship Care Plans.

Managed care plans & denial of care.