|Information from Dr. René Carlson
AVMA & WVA Updates from Dr. René Carlson - March 2017 (in PDF format) (click here)
By Dr. René Carlson
March 8, 2017
Committee on International Veterinary Affairs (CIVA)
o Global Food Security Summit Washington DC in February 2017 Objectives were to:
Explore and define the role of animal source foods in enhancing global food security
Describe and define ways that improved animal health and well-being contribute to a more secure, sustainable, safe, and nutritious food supply
Identify and promote pathways to integrate veterinary expertise into current and future global food security programs
o Educational and cultural tours to Association Congresses
WVA Republic of Korea (South Korea) in August 2017 (http://wvc2017korea.com/)
WSAVA Copenhagen, Denmark in September 2017 (http://www.wsava.org/events/wsava-congress)
PANVET Uruguay in October 2018 (dates not available yet)
Compounding - Manipulation might include mixing, diluting, concentrating, flavoring, or changing a drug's dosage form to accommodate a specific patient's needs.
- Examples of compounding include:
Mixing two injectable drugs
Creating an oral suspension from crushed tablets or an injectable solution
Adding flavoring to a commercially available drug
- Discussion of compounding rules often centers on two issues:
compounding from FDA-approved drug products which is legal as long as FDA Extralabel Drug Use Rules and all state rules are followed; and
compounding from bulk drug substances.
What Is AVMAs Role?
o Ensure that veterinary concerns are heard in regulatory rule-making and in Congress, and that veterinarians are kept informed of the rules and compounding best practices.
o Communicate frequently with the FDA to safeguard veterinary access to compounded medications and ensure that the needs of veterinarians and our animal patients are protected.
o Educate Congress and regulatory agencies that compounding for animals is a complex issue, and that AVMA and our member veterinarians are available for consultation should other parties seek legislative changes.
o Educate veterinarians about the finer points of using compounded medications to prescribe medications conscientiously for patients and avoid inappropriate compounding practices. Learn more in the recorded webinar on compounding rules, regulations, and recommendations.
o Cultivate collaborative working relationships with pharmacy organizations, the animal drug manufacturing industry, and other affected stakeholders, building coalitions that advance and protect the interests of veterinarians and animals.
o Monitor the courts on issues of regulatory jurisdiction.
Fairness to Pet Owners Act the mandate for writing prescriptions still needs your continued communication with both our congressional representatives and senators.
Veterinary Medicine Loan Repayment Program Since first passed in 2003, 388 awards have been made to veterinarians in 45 states, Puerto Rico and on U.S. federal lands. The program provides selected food animal and public health veterinarians up to $75,000 in loan repayment for a three-year commitment to practice in an area of the country where they are needed the most. Unfortunately, when Congress created the VMLRP it tacked on a 39 percent withholding tax per award. The VMLRP Enhancement Act would remove the withholding tax on the program awards, giving the U.S. Department of Agriculture the ability to give more veterinarians the opportunity to practice in these designated shortage areas without Congress having to increase the programs annual federal appropriation. More info at USDA and the National Institute of Food and Agriculture. https://nifa.usda.gov/program/veterinary-medicine-loan-repayment-program
Ways to get involved:
o AVMA Members: Sign in to support the AVMA PAC
o Get updates on federal laws affecting veterinary medicine > Sign up to receive the AVMA Advocate newsletter.
Economics (Reports, Practice Management tools, Client Materials, and Insurance)
Reports available free under Economic Reports as a PDF download at https://www.avma.org/practicemanagement/businessissues/pages/default.aspx
Market for Veterinary Education - employment, unemployment and underemployment in the profession
Market for Veterinarians where 100,000 plus veterinarians are located, what type of work they do, how much they are compensated, or what factors contribute to explaining differences in incomes, and demographics
Market for Veterinary Services explanation and sources of excess capacity (vs. oversupply) from rising prices to the increasing numbers of new veterinarians
Early career online community
Veterinary Career Transitions
Veterinary Career Center
Resources for managing Cyberbullying https://www.avma.org/practicemanagement/administration/reputation/pages/default.aspx
AVMA Convention July 21-25, 2017 in Indianapolis, IN https://www.avma.org/Events/Convention/Pages/default.aspx
World Veterinary Association www.worldvet.org
Represents AVMA (and our interests) globally. Priority issues are:
World Veterinary Congress
Availability and Use of animal medicines
Zoonotic diseases (cytocercosis from pork tapeworms, rabies)
Partnerships OIE, FAO, WHO, HealthforAnimals (the global animal medicines industry), World Medical Association, etc.
o Animal Health Matters website
AVMA & WVA Updates from Dr. René Carlson - December 2016 (in PDF format) (click here)
Report on Activities of your AVMA and the World Veterinary Association
NWVMA meeting, December 7, 2016, Eau Claire, WI
René A. Carlson, Chair AVMA Committee on International Veterinary Affairs (CIVA)
President, World Veterinary Association
During the AVMA Convention this past August, the House of Delegates held an Informational Forum for representatives to discuss three priority issues of concern recommended by the grassroots members. They included 1) Support for our large animal practitioners, 2) Cyberbullying, and 3) Student Debt. Three of the AVMA activities below address those three areas, and two address items from the World Veterinary Association, of which we all have a vested interest since the AVMA is a voting member of the WVA.
#1 Food Security: Understanding the Role of Animal Health and Well-Being An AVMA Global Summit
This Summit is now open for registration in Washington DC on February 9-11, 2017. This Summit was organized by the AVMA Committee on International Veterinary Affairs with the purpose of proposing programs, initiatives and strategic partnerships to create and enhance global opportunities for AVMA and SAVMA members. The objectives of the Summit are to:
Explore and define the role of animal source foods in enhancing global food security
Describe and define how improved animal health and well-being contribute to a more secure, sustainable, safe, and nutritious food supply
Identify and promote pathways to integrate veterinary expertise into current and future global food security programs
For more information: http://atwork.avma.org/2016/10/17/registration-opens-avma-global-food-security-summit/
#2 Cyberbullying and Wellness Resources to Help Battle the Dark Side - Cyberbullying can have a significant impact on your business and add stress to your life. Social media is here to stay in some form. With 20% of AVMA members reporting they have experienced cyberbullying and false reviews, the AVMA has added resources to help veterinarians combat the emotional and financial damage caused by online detractors.
Yelp - currently the most prominent review site, has more than 170 million visitors per month through its app, mobile and desktop sites. Yelp users generate more than 26,000 reviews per minute.
Facebook, which remains a primary social media channel for veterinary clinics, continues to grow. More than 1 billion people around the world use Facebook daily.
AVMA has developed Resources to help veterinarians defend their online reputations.
Online Reputation Management resources on the AVMA website https://www.avma.org/PracticeManagement/Administration/reputation/Pages/default.aspx
A 24/7 hotline provided by Bernstein Crisis Management, Inc. to assist our member veterinarians and clinics who face attacks and cyberbullying. Members calling the hotline will receive up to 30 minutes of actionable consultation with an experienced crisis management team at no charge to you. If you need additional help, you can pay for additional consultation at a significantly discounted rate, as an AVMA member.
DVM Reputation Guard program offered at a significant discount for AVMA members also provided by Bernstein Crisis Management. This subscription-based service tracks and notifies participants of reputation threats before they are overwhelming, and then helps you respond. This discount offer is available to AVMA members through the AVMA Member Advantage Program, which also provides discounts on car rentals, clothing, framing and other services.
Visit the AVMA@Work blog to learn more about these new resources. http://atwork.avma.org/2016/12/05/new-resources-veterinarians-social-media-cyberbullying-reputation/?utm_source=smartbrief&utm_medium=email&utm_campaign=smartbrief-assoc-news
The last two classes of the AVMA Future Leaders Program developed Wellness Resources now available on the AVMA website.
Wellness and Peer Assistance (for self-assessment and awareness)
Setting Up a Workplace Wellness Program (for preventive measures). https://www.avma.org/ProfessionalDevelopment/Personal/PeerAndWellness/Pages/Setting-up-Wellness-Program.aspx
#3 Student Education Debt
A Summit called the Fix the Debt Our Future, Our Responsibility was held last April and identified how four different groups could contribute toward improving the 2:1 debt ratio. Since that time the AVMA has also been working on solutions in collaboration with the other groups. Highlights listed by group are as follows:
o To explore and implement a five-to-six-year program for students to earn a D.V.M. degree; by working with local undergraduate institutions on refining the curricula, this would enable students to have two extra years to earn income;
o To encourage creation of national partnerships and campaigns to raise funds for scholarships;
o To work with the AAVMC and AVMA in advocating for legislation to help reduce student debt; and
o To document actual educational costs and charge accordingly, which would, among other things, create greater transparency in revenue lines for research and education.
Employers of Veterinarians
o To reconsider compensation packages for new graduates/associate veterinarians;
o To improve the onboarding of new employees and create a toolkit for best practices;
o To promote a positive culture of preventative care within staff and beyond by engaging other areas of the profession in using resources as a guide to open more opportunities for recent graduates to earn more income; and
o To promote practice ownership as an attractive alternative career.
o To provide career awareness to students by delivering financial literacy materials and training, and developing a career guidebook for use by pre-veterinary students;
o To increase advocacy efforts to address student debt;
o To create a national campaign around student debt; and
o To include student debt as a regular follow-up agenda item at annual events such as the AVMA Economic Summit, AVMA Convention and AAVMC Conference; the purpose of this would be to monitor progress on efforts to reduce the DIR and to hold each other accountable.
o To personally engage deans, their peers and future students in conversations about financial literacy and student debt;
o To inform pre-veterinary students about the current student debt issue and discuss what is being done to address it; and
o To change their mindset from ownership to entrepreneurship, and work on developing a campaign where every veterinarian commits to being an entrepreneur.
World Veterinary Association
The Secretariat of the WVA is located in Brussels, Belgium. The AVMA is a member of the WVA which works on interests of the global veterinary medical profession with various partners. In my role as President, I work primarily electronically every day on WVA business with the Secretariat which is 7 hours ahead of our CST in Wisconsin, Chair the 17 persons WVA Council every 6 weeks, and travel several weeks a year to attend meetings around the world.
This year alone in 2016 I traveled to Brazil, Australia, Korea, Sweden, Mexico, France, Belgium, Thailand, Vietnam, and Panama. I have provided information on our Strategic Priorities, 1-2 of the many activities in each area, and upcoming international meetings that are great opportunities to travel as an AVMA group for education and cultural enrichment.
#4 WVA Strategic Plan 2015-2018.
Critical priorities include:
o Animal Welfare FactSheets - The WVA Working Group on Animal Welfare is preparing number of factsheets aiming to provide a short pithy document in lay language about a specific global Animal Welfare issues to draw attention of veterinarians and the public around the world. See the WVA FactSheet on Owned and Unowned Free-Roaming Dogs for use in client education. http://worldvet.org/uploads/news/docs/fact_sheet_on_unowned_dogs-nov24-2016.pdf
o Role of the Veterinarian in Animal Welfare Poster http://worldvet.org/news.php?item=309#prettyPhoto/0/
o WVA Representation at the United Nations General Assembly on Antimicrobial Resistance
o WVA Online Education Portal which the Wisconsin VMA has added to the website for CE
o WVA Community-based Rabies Prevention and Control (Pilot in Gambia) > End Rabies Now worldwide campaign!!
Organizational Growth and Partnerships (OIE, WHO, FAO, WMA, WAP, GARC)
# 5 Major Conferences in Education Opportunities for group travel and education
WVA/WMA Global Conference on One Health Kitikyushu City, Fukouka, Japan November 10-11, 2017
AVMA Convention Indianapolis July 21-25, 2017
World Veterinary Association Congress Incheon, South Korea August 27-31, 2017
WSAVA Congress Copenhagen, September 25-28, 2017
World Veterinary Association Congress Barcelona, Spain May 6-8, 2018
PANVET Congress Montevideo, Uruguay October 2018
REPORT TO THE NWVMA MEETING
June 10, 2015
by Dr. Rene' Carlson
AVMA Update Director of International Affairs, and Chair of the Committee on International Affairs
Proposal for a Global Food Security Summit Ending Hunger - The Critical Role of Animal Health
o Approved in concept in November 2014
o Full recommendation with business plan for consideration at July 2015 BOD meeting
o Tentatively scheduled for Spring 2017
Economic Reports (http://atwork.avma.org/2015/01/20/avma-2015-economic-report-a-must-read-for-those-with-a-stake-in-the-profession/)
o January - The AVMA Report on Veterinary Markets: Provides data and information about general U.S. economic conditions, the markets for veterinary education, veterinarians and veterinary services, and workforce capacity utilization.
o February - The AVMA Report on Veterinary Employment: We surveyed veterinarians across the country and across the profession to better understand employment, unemployment and underemployment, as well as the factors affecting each.
o March - The AVMA Report on Veterinary Debt and Income: This report takes an in-depth look at salaries for new and existing veterinarians and their veterinary education debt load, as well as debt-to-income ratios and the net present value of a veterinary career.
o May - The AVMA Report on the Market for Veterinarians: Ever wonder where the 100,000-plus veterinarians are located, what type of work they do or how much they are compensated? This report explores the demographics of the profession.
o July - he AVMA Report on Veterinary Capacity: This report includes our excess capacity forecast and explores our capacity utilization survey, descriptive statistics for capacity utilization and the factors affecting capacity utilization.
o September - The AVMA Report on the Market for Veterinary Education: The market for veterinary education is the beginning of the pipeline to the market for veterinary services. This report looks at the types of students applying to veterinary school, and the supply of and demand for veterinary education.
o Internships - In the last decade and a half, the veterinary profession has seen some interesting trends in employment patterns, especially in the popularity of internships versus fulltime employment. (https://www.avma.org/PracticeManagement/BusinessIssues/economics/Pages/Discovery-of-a-New-Nerve-Internships.aspx)
In 2001, more than 70 percent of graduating seniors entered fulltime employment in private practice. That declined to a low of approximately 40 percent in 2012, then returned to 56 percent in 2014.
During that same time period, the percentage of students electing to complete an internship increased to mirror the decline in fulltime employment. Internship selection increased from approximately 20 percent in 2001 to a high of 50 percent in 2012, then declined to 37 percent in 2014
Four Key Findings from the May Report (https://www.avma.org/PracticeManagement/BusinessIssues/Documents/2015-20-04_Internships_A-tax-on-new-veterinarians_dvm360.pdf)
1. Internships are associated with lower perceptions of selfcompetence.
2. Internships are associated with unemployment.
3. Certain schools send more students into internships.
4. Internships cost graduates tens of thousands of dollars. (Difference between internship pay and FT pay ($40,000), added interest from student loans, and reduced income stream from delaying FT employment.
Antibiotic use & resistance: AVMAs efforts seen in federal initiatives (http://atwork.avma.org/2015/06/03/antibiotic-use-resistance-avmas-efforts-seen-in-federal-initiatives/?utm_source=home-rotator&utm_medium=web&utm_campaign=gen)
o Veterinary Feed Directive (VFD) final rule
o White House Forum on Antibiotic Stewardship to support the implementation of the White Houses National Action Plan for Combating Antibiotic-Resistant Bacteria (PDF).
AVMA Convention July 10-14, 2015 in Boston!!
WVA Update President (www.worldvet.org)
An International Network representing over 500,000 DVMs across 6 continents
o World Organization of Animal Health (OIE) and our MOU for AMR, Prevention and Control of Rabies, Education, and support for Regulatory national veterinary services
o World Health Organization
o United Nations Food and Agriculture Organization
o Non-governmental Organizations GARC, World Animal Protection, IVSA, World Medical Association
Four Strategic Priorities
o Animal Welfare
o Zoonotic Diseases (with initial emphasis on Rabies)
180 people die of rabies every day in the world, mostly in Asia and Africa, mostly children. In the Americas, the biggest problem yet today is in Haiti, which was bad to start with, but worse after the earthquake of January2010. The same scenario is expected to worsen in Nepal where hundreds or dogs were still being poisoned by strychnine out of fear of rabies before the earthquake in April.
World Veterinary Day Vector-borne Diseases with Zoonotic Potential
WVD Award > Costa Rica Equine encephalitis and West Nile Virus
o Education for all veterinarians Global Online Education Portal
o Pharmaceutical Stewardship Responsible Use and Disposal, Availability of good quality drugs, and decreasing Antimicrobial Resistance
Ketamine hearing at the United Nations Commission on Narcotic Drugs I was alerted to this issue by Dr. Charles Short, an AVMA member and anesthesiologist.
Collaboration with the WMA and WVA within 48 hours for opposition (as well as AVMA, WSAVA, and FVE)
One Health Partnership with the World Medical Association a model for national and regional medical and veterinary medical association collaboration
o Global Conference on One Health Madrid, Spain with WMA, Spanish VMA and MA
Your AVMA membership is important!!
Convention Continuing Education and Networking
Congratulations to Dr. René Carlson, elected World Veterinary Association (WVA) President, Nov 29, 2014
(click here to read more)
AVMA Update from Dr. René Carlson, March 2014
AVMA Update - March 2014 (in PDF format) (click here)
March 12, 2014
Dr. René A. Carlson
This is a summary of many activities going on at AVMA on our behalf. Thank you for being members of the AVMA or we could not have such an amazing staff in 12 Divisions working on professional issues that affect us personally every day in our workplaces.
If you have any questions about any issue, I will do my best to find the right people and the right answers for you.
1. Veterinary Leadership Conference in January 2014 538 veterinary professionals attended and is open to all members. This is an absolutely tremendous meeting, especially for those looking for more involvement with AVMA or learning about issues that affect our profession, like Economics.
2. Economics and Workforce - https://www.avma.org/PracticeManagement/BusinessIssues/economics/Pages/Exploring-Veterinary-Economics.aspx.
The AVMA Veterinary Economics Division was created in August 2011 and set to work on its first major projectthe U.S. Veterinary Workforce Study. The intent was to conduct an economic analysis of the current and future supply of, and demand for, veterinarians and veterinary services in the United States.
Released April 23, 2013, the workforce report said approximately 12.5 percent of veterinary services in the United States went unused in 2012, that is, the demand for veterinary services in 2012 was sufficient to fully employ just 78,950 of the 90,200 veterinarians currently working in clinical and nonclinical settings, resulting in an excess capacity of services equal to the labor of 11,250 full-time veterinarians.
Study results further projected that the nations veterinary services capacity is likely to be under¬utilized by 11 to 14 percent through 2025.
Three major factors that have caused excess capacity in the veterinary profession in the past five years:
1. A 7.5 percent reduction in gross domestic product since 2008 which resulted in a 7.5 percent reduction in your business. That means every consumer is less willing to spend money for services because of less income, so theres less demand.
2. In the past 10 to 15 years, prices for veterinary services have been increasing, even above trend, or faster than the per capita increase for all other services, including human health care services. Dr. Dicks said now, veterinarians have saturated demand at those prices. And because prices are above trend, theres a gap between the quantity of services veterinarians are willing to provide at a certain price and the quantity of those services demanded by consumers at that price.
3. While the number of U.S. veterinary students fluctuates over time, that figure has been increasing above trend since the 2005-2006 academic year. Just in the past five years, the total number of veterinary students has gone up by about 4.4 percent. And a recent Association of American Veterinary Medical Colleges survey indicated enrollment among U.S. veterinary schools is expected to increase by 6 to 8 percent, or 150 to 200 students, over the next three years.
What do we do, and which do we work on first? Everyone said less new veterinarians, but I wondered why new veterinarians didnt say we needed less old veterinarians, Dr. Dicks said as a humorous observation.
Three data research studies by the AVMA Veterinary Economics Division will commence in 2014. They are as follows:
1. An elasticity study will determine the effects of the price of veterinary services and customer disposable income on the demand for veterinary services.
2. An employment study will look at how many veterinarians have been unemployed or underemployed and for how long in addition to whether their status is temporary or permanent and why.
3. A capacity study will determine the difference in characteristics between veterinary practices operating at excess capacity and those operating at full capacity.
Other 2014 economic-related tactics involve the AVMA Early Career Development Committees Personal Financial Planning Packet, a budgeting tool for recent graduates to manage personal finance and debt. It is scheduled for launch early this year.
3. Partners for Healthy Pets - http://www.partnersforhealthypets.org/
a. 46 VMAs, 21-22 CVMs and a total of 110 member organizations
b. 3 year campaign
i. 2011 - Define consistent guidelines
ii. 2012 - Communicate guidelines to DVMs and give DVMs the tools to apply the guidelines
iii. 2013 - Direct to consumer campaign targeting women, 32-49 years old making $75,000/yr annual household income. They represent 40-50 million pets.
1) Over 50% of the pets considered active by the practices had not been in for a visit of any kind in over 18 months. It is these pet owners, who already have a relationship with you, that are the target of our advertising campaign.
2) The simple goal of the campaign is to get these pet owners to schedule an annual checkup with you.
iv. 2015 What next to solidify preventive care vs. emergency and sick care
4. Smithsonian Exhibit on Animal Connections http://www.sites.si.edu/animalconnections/
a. "Animal Connections: Our Journey Together" is a traveling exhibit on an 18-wheel truck that introduces visitors of all ages to the complex bond between humans and animals. Presented by the Smithsonian Institution Traveling Exhibition Service to mark the 150th anniversary of the American Veterinary Medical Association, the project is made possible through the generous support of Zoetis and is meant to inspire the next generation of veterinarians.
5. Advocacy https://www.avma.org/advocacy/national/pages/default.aspx
a. Farm Bill passed
i. FARAD (Food Animal Residue Avoidance Database) for $2.5 million
ii. NAHLN (National Animal Health Laboratory Network) for $15 million
b. Veterinary Medicine Mobility Act
i. Sponsored by Senators Jerry Moran (R-Kansas) and Angus King (I-Maine), S. 1171 would amend the Controlled Substances Act to permit veterinarians to carry controlled substances outside of their primary places of registration and across state lines to treat their patients. This means that licensed and registered veterinarians who treat patients on the farm, in the wild, at a clients home or in other mobile settings will be allowed to bring and use controlled substances to provide pain management, anesthesia or euthanasia.
ii. With the bill passed by unanimous consent in the Senate, we now look to the U.S. House to take up this important legislation.
c. Fairness to Pet Owners Act (aka Unfairness to Veterinarians Act)
i. On February 10, Rep. Jim Matheson (D-UT-4th) reintroduced the so-called Fairness to Pet Owners Act (H.R. 4023). Like its predecessor in the previous Congress, H.R. 1406, the legislation would require a veterinarian to provide a client with a written prescription for domesticated household animals, whether or not requested by the client. The veterinarian would be prohibited from charging for the prescription or asking a client to sign a liability waiver related to writing the prescription. AVMA has prioritized this act again for ACTIVE PURSUIT of DEFEAT
d. Prevent All Soring Tactics Act - Prevent All Soring Tactics Act (PAST), S.1406/H.R. 1518.
i. The bill seeks to eliminate the abusive act of soring horses by improving the U.S. Department of Agricultures enforcement capabilities and strengthening penalties against violators, among other provisions. Soring horses has been illegal for more than 40 years, but it's still happening. This bill would take important steps to penalize those who choose to sore their horses, and hopefully will finally bring an end to this barbaric practice.
6. Strategic Management Plan
a. A 3-year strategic operating plan for the AVMA budget process
i. Survey of 16,000 members by age and discipline to identify major lines of business to focus upon as prioritized by AVMA members. Please fill it out!!
b. Marketing and Branding of the AVMA
i. What does the AVMA do for me?
ii. What goods and services are available and most valuable to members
iii. What are the benefits that are for the greater good?
c. Digital Strategy to communicate more directly and effectively with members
Thank you for being AVMA members! It is so important!!
AVMA Report from Dr. René Carlson, June 2013
Date: June 12, 2013
TO: NWVMA members
FROM: René Carlson, Immediate AVMA Past President
RE: AVMA Update
The AVMA Executive Board met in April and this past week to review several Policy statements and various reports from various entities. They are all very important to AVMA members.
Compounding, consistent with the Food and Drug Administration (FDA) Extra-Label Drug Use regulations, is the customized manipulation of an approved drug(s) by a veterinarian, or by a pharmacist upon the prescription of a veterinarian, to meet the needs of a particular patient. Common examples of appropriate compounding in veterinary practice are mixing two injectable drugs, preparing an oral paste or suspension from crushed tablets or adding flavoring to a drug. Compounded preparations are required to be prepared from FDA-approved
animal or human drugs. The FDA and federal courts have held that federal drug laws prohibit compounding from bulk chemicals or raw pharmaceutical ingredients as such compounds are unapproved new animal drugs.
For more information on compounding from bulk drugs, see AVMA policies on Compounding from Unapproved (Bulk) Substances in Food Animals and Compounding from Unapproved (Bulk) Substances in Non-Food Animals.
Compounded preparations are not equivalent to generic drug products. Generic drug products are FDA-approved, which requires a demonstration of bioequivalence of safety and efficacy with the pioneer FDA-approved drug product. Generic animal drug products are identified by an Abbreviated New Animal Drug Application (ANADA) number on their label or in FDA drug references. In contrast to generic drugs, compounded preparations lack FDA approval.
Veterinarians need to be aware that compounding, including formulation in a novel drug delivery system (e.g. transdermal), may impact the pharmacokinetics of a drug. This may result in drug concentrations that are above or below the therapeutic range and lead to the development of an adverse drug event, including therapeutic failure. In order to minimize the risk of adverse events associated with compounded preparations, the following actions are
1. The decision to use a compounded preparation should be veterinarian (not pharmacist) driven, and occur within a veterinarian-client-patient relationship. The veterinarian should make that decision utilizing evidence-based medicine.
2. Compounding should be implemented in compliance with the Animal Medicinal Drug Use Clarification Act (AMDUCA) and the FDA Compliance Policy Guide 608.400 titled Compounding of Drugs for Use in Animals. Use of compounded preparations in food animals may have food safety concerns that preclude their use unless information exists to assure avoidance of violative drug residues.
3. Use of a compounded preparation should be limited to:
a. Those individual patients for which no other method or route of drug delivery is practical; or
b. Those drugs for which safety, efficacy, and stability have been demonstrated in the specific compounded form in the target species; or
c. Disease conditions for which a quantifiable response to therapy or drug concentration can be monitored.
4. Use of a compounded preparation should be accompanied by the same precautions followed when using an approved drug, which include counseling of the client regarding potential adverse reactions, including therapeutic failure, and attention to the potential for unintended human or animal exposure to the drug. Further, clients should be informed that the compounded preparation has not been evaluated by the FDA for potency, purity, stability, efficacy or safety, and client consent should be obtained.
a. Veterinarians should report suspected adverse events including therapeutic failure and quality defects involving compounded preparations to the compounding pharmacist, the State Board of Pharmacy and the FDA Center for Veterinary Medicine. Instructions for reporting adverse events to FDA can be found at the FDA website. Pharmacists should instruct pet owners to contact both the prescribing veterinarian and pharmacist immediately if a compounded preparation is associated with an adverse event, including therapeutic failure, and quality defects.
5. Veterinarians should comply with all aspects of the federal extralabel drug use regulations including recordkeeping and labeling requirements and urge compounding pharmacies to do the same. The compounded preparation should be labeled that it is not FDA approved. It is not legal for compounded preparations to be developed in large quantities and sold to third parties (including veterinarians and companies) or wholesalers for resale to individual patients. However, the AVMA asserts veterinarians should be able to legally maintain sufficient quantities of compounded preparations in their office for urgent administration needs or emergency situations.
Advertising and promotional material from the compounding pharmacy should not be interpreted as FDA assurance of proven efficacy, safety or quality. One element in evaluating the quality of a compounded preparation is whether the compounding procedure follows
the guidelines of the United States Pharmacopeia (USP). These guidelines can be found in Chapter <795> Pharmaceutical Compounding Nonsterile Preparations, USP Chapter <797> Pharmaceutical Compounding Sterile Preparations, and specific USP drug monographs if available. The USP general chapters and drug monographs define good compounding practices and provide information about compounded preparations that have acceptable strength, quality, purity, and stability to minimize patient harm due to lack of sterility, excessive bacterial endotoxins, and content errors. Another element in evaluating the quality of a compounding pharmacy is whether the pharmacy is accredited by an independent accreditation body. For example, the Pharmacy Compounding Accreditation Board (PCAB) offers accreditation to compounding pharmacies that meet high quality and practice standards. Further information and a listing of PCAB-accredited pharmacies are available at www.pcab.org. Be aware that independent accreditation is different from association or professional training center memberships that may lack quality assurance programs and inspections.
AVMA advocates for quality assurance oversight of all compounded preparations to ensure that these preparations are prepared and evaluated in a manner consistent with current potency, purity and stability standards.
(Bottom line per René ask your compounding pharmacist if they use raw bulk pharmaceutical agents for compounding your medications! FDA maintains it is illegal to do so despite what compounding pharnacists will tell you.)
Compounding from Unapproved (Bulk)
Substances in Non-Food Animals
Compounding of drugs from unapproved (bulk) substances for use in animals is currently illegal under the Federal Food, Drug, and Cosmetic Act and the Animal Medicinal Drug Use Clarification Act. Unapproved bulk substances are the raw active pharmaceutical ingredients (APIs) that are used to make final drug products, and as such, they are not commercially available as FDA-approved finished drug products. Veterinarians cannot guarantee the potency, purity, or safety of these unapproved bulk substances in a compounded product.
The AVMA believes there are three general sets of circumstances in which compounding from bulk pharmaceutical ingredients may be medically necessary:
1. the approved product is not commercially available;
2. the needed compounded preparation cannot be made from the approved product; or
3. there is no approved product from which to compound the needed preparation.
The AVMA recognizes that compounding of drugs from unapproved bulk substances for use in animals not intended for food (eg, major and minor nonfood animal species) is medically necessary in certain situations and should be allowed in those circumstances as specifically indicated above. These actions should take place only within the context of a veterinarian-client-patient relationship.
Compounding from Unapproved (Bulk)
Substances in Food Animals
Compounding of drugs from unapproved (bulk) substances for use in animals is currently illegal under the Federal Food, Drug, and Cosmetic Act and the Animal Medicinal Drug Use Clarification Act. Unapproved bulk substances are the raw active pharmaceutical ingredients (APIs) that are used to make final drug products, and as such, they are not commercially available as FDA-approved finished drug products. Veterinarians cannot guarantee the potency, purity, or safety of these unapproved bulk substances in a compounded product. The AVMA recognizes specific circumstances wherein bulk compounds might be medically necessary in food animals, specifically poison antidotes and compounds for euthanasia or depopulation that are not approved or commercially available. These actions
should take place only within the context of a veterinarian-client-patient relationship.
The AVMA recommends that there be a publically available, current list of unapproved bulk substances that can be legally compounded within a veterinarian-client-patient relationship specific and limited to euthanasia, depopulation, and poison antidote compounds, for food animal species. If adequate scientific information is not available to determine a withdrawal time, the compound cannot be used in a food animal or the treated animal cannot enter the food supply.
2. The Workforce Study from the IHS Global Insight Group commissioned by AVMA, and with oversight by the Veterinary Economics Strategy Committee and new Veterinary Economics Division. See the articles below by Michael Dicks, AVMAs Director for the Veterinary Economics Division. These were posted on the AVMA website blog sites.
Excess Capacity or Oversupply
By Mike Dicks
May 8, 2013
In April, the American Veterinary Medical Association released a long-awaited study on the veterinary workforce. The major finding was that currently there exists a 12.5% excess capacity in veterinary services nationally and that the level of excess capacity varies by type of practice and location. Many in or associated with the industry noted that the report told them nothing new, that there was an oversupply of veterinarians. Do oversupply and excess capacity measure the same thing?
In agriculture, particularly concerning the major grain and oil-seed crops we often talk about excess capacity, the ability to produce in excess of the quantity demanded at an acceptable price. As described, there are three specific components to excess capacity.
Total capacity (potential supply)
First, is the ability to produce referring to the productive capacity of the industry. In agriculture, the ability to produce, or the total capacity is the total amount of land available for crop production times the yield possible when human and fixed capital available is put into action. When land, human or fixed capital is idled there is excess capacity. The ability to produce is not reached and the difference between what could be produced and what is produced is unused or idled productive capacity.
The second component of excess capacity is the quantity demanded. If the quantity actually produced exceeds the quantity demanded then an oversupply exists and this oversupply is an additional component of excess capacity.
The third component is an acceptable price. Most people know what this means, but few take the time to think about it from the perspective of both buyer and seller. An acceptable price is a price that the buyer and seller agree upon for the transfer of goods or services from seller to buyer to occur. This is an important piece of information because it identifies at what price the measurement of excess capacity occurs.
Assume that the total ability to produce (total capacity) is one hundred bags of rice. If only 90 bags are produced we have 10 bags of excess or unused productive capacity (10%). If we could only sell 80 bags at an acceptable price we would now have 20 bags of excess capacity (20%). If we took the 90 bags to a refugee camp and distributed them but had 10 left, we would have a 10 bag oversupply (11.11%).
Unemployed or underemployed
The importance of this distinction is more easily seen in the market for veterinarians and veterinary services. Historically the studies pertaining to the veterinary workforce have attempted to identify an oversupply of veterinarians. How many veterinarians are not involved in veterinary activities? Some studies indicated there are too many veterinarians and other studies indicated there were not enough. More often than not, the various studies were talking about specific types of veterinarians, such as not enough public health or food animal or too many companion animal veterinarians. But, government and industry data indicate that the unemployment rate of veterinarians in general is less than 2%, well below the natural level of unemployment.
The new workforce study, however, looked at excess capacity rather than oversupply and estimated a value of that excess capacity. In fact, the study points out of a total capacity of over 90,000 full-time equivalents ( FTEs) of veterinary service capacity, there is an excess of 11,250 veterinary FTEs. The difference is that the study looked at more than just whether the veterinarians were employed; the study measured how much of their available time is being used to provide services. From a national survey they found that 53% of all veterinarians in clinical practice indicated that under current conditions they could increase the amount of services they provide. As an average across all types of practices and all areas of the country the excess capacity in the veterinary clinics and hospitals was 17%. Thus, while all veterinarians are employed, a lot of them are underemployed. More importantly, because the number of veterinary students graduating and entering the workforce is increasing faster than the number of veterinarians are exiting and this difference between entrants and exits exceeds the growth in demand for services at currently acceptable prices, excess capacity is likely to increase into the future. The important question is what will be the impacts?
According to the Bureau of Economic Analysis the total output of the veterinary services industry has been flat over the last five years while the value of veterinary services has continued on its long term linear path upwards. The total number of veterinarians is increasing and the increase in value of output is being spread across more veterinarians with each (on average) grabbing a smaller share of the same size market. At some point the excess capacity within practices will become so large that net income will disappear and the excess capacity within practices will become unemployed veterinarians.
A persistent level of excess capacity in veterinarians or any other good or service is socially undesirable because the cost of producing the good or service now exceeds the willingness of consumers to pay for it and society has lost the value of those resources that could have been directed elsewhere.
Veterinary Services Industry Trends
By Mike Dicks
May 22, 2013
Previously I pointed out that the Bureau of Economic Analysis data indicates that the total output of the veterinary services industry has been flat over the last five years while the value of veterinary services has continued on its long term linear path upwards. With respect to veterinary compensation and the health of the industry, let me add a chart from the Bureau of Economic Analysis.
The chart shows that while the output of veterinary services has remained relatively flat over the last 5 years, the price of those services has increased; and except for a short period during the recession, the total value of services has increased. The increasing number of veterinarians are consuming the increasing value of services and contributing to excess capacity within practices as the demand for veterinary services are flat.
With the respect to the growing number of veterinarians and the current trends in Output and Price, what are the implications going forward?
If the growth in the number of veterinarians increases faster than the growth in value of service than average incomes will be declining.
If the growth in the cost of the services (e.g. costs of equipment, supplies) increases faster than the growth in the value of sales than average incomes will be declining.
Average annual rate of growth in value of output prior to recession was 7.3% and since the recession has been 3.3%.
Average annual rate of growth in veterinarians (NAVLE) prior to the recession was 3.1% and since the recession is 3.8%.
Given this evidence I would expect veterinary compensation to be declining since the recession. But, because of the changing demographics, with the percent of women increasing and the average age declining, average income for the profession will be falling and thus veterinary compensation for those already established may be flat.
3. The Task Force on Governance and Member Participation (TFGMP) Report
In receiving this report, the AVMA Executive Board supports in concept the four pillars of the proposed governance structure:
o Board of Directors - as the one body with fiduciary duty, management responsibility, and policy authority.
o Advisory Councils - supporting AVMAs core strategic areas, including Economics and Practice, Animal Welfare and Ethics, Education, Governmental and External Relations, Scientific Activities, and Membership and Governance.
o Volunteer Resources Committee - that will be the human resources department of AVMAs volunteer leadership to help identify and recruit the best candidates for various leadership positions.
o Veterinary Issues Forum - that will be an evolution of the HOD and provide the gathering place for in-person meetings with interested stakeholders, including state and allied veterinary groups.
Now is the time for AVMA members to provide input on the details of the proposal and share with us their feedback. Since the Task Force has delivered its report and therefore concluded its work, the Executive Board has formed a team of AVMA volunteer leaders named the Governance Engagement Team to communicate with members about the report, solicit feedback, and submit a final governance proposal to the Executive Board.
The proposed governance system will provide members with increased voting power while retaining an important voice for their respective veterinary organizations. Each member will have a vote and all organizations will have a voice.
The Task Force believes its proposed governance system will make AVMA more effective, efficient, and responsive to its membership and key stakeholders.
The Task Force believes its proposed governance model will better serve AVMA members, be more responsive and nimble; and create more opportunities for member involvement.
The model provides AVMA members with more opportunities than ever to participate in short-term projects and tasks that do not require long-term time commitments that many members cannot provide.
The report is the result of more than a year of extensive research surrounding issues facing U.S. associations today and the consideration of hundreds of comments made by AVMA members.
You can see all resources and information about this Task Force Report at https://www.avma.org/About/Governance/Pages/Concepts-for-Governance-Remodeling.aspx?utm_source=home-rotator&utm_medium=web.
4. Task Force on Foreign School Accreditation Report
A Message to AVMA Members Regarding Foreign Accreditation
As the Chair of the AVMA Executive Board, I want to take a few minutes out of your busy schedule to explain to you the Boards decision to continue the accreditation of foreign veterinary schools by the Council on Education.
First, please know that this decision was not made lightly, and that all of the comments and responses weve received from members have been heard and given due consideration. We understand your concerns because most of us, like you, are also working in the real world and facing the same challenges in practice.
After careful and deliberate consideration, including the advantages and disadvantages of continuing foreign veterinary school accreditation, your Executive Board decided that the benefits outweigh the risks. While there has been criticism about the philosophy behind accreditation (domestic as well as foreign accreditation), there has been no question among our members that COE accreditation is the global gold standard for quality assurance of veterinary education. And even when you take into consideration the challenges our profession is facing right now, the U.S. veterinary workforce remains globally respected. The world looks to the United States and to the AVMA for leadership in veterinary education. Allowing international schools to seek accreditation and recognition according to established COE standards improves the quality of global veterinary education. With the growing focus on One Health and the global community, its more important, now more than ever, that we foster international collaboration and communication; accreditation serves a vital function in this regard.
Its important to keep in mind a few basic facts. First, the same standards are applied regardless of the location of the school being considered. Foreign veterinary schools are evaluated by the exact same standards as U.S and Canadian veterinary schools. This will not change.
Second, despite concerns that foreign accreditation has or will lead to an influx of veterinarians into the United States, Id like to point out that in the 40 years that the COE has been accrediting foreign schools, there has never been a rush of foreign graduates to the United States. Foreign veterinary school graduates, including those who are U.S. citizens, comprise approximately 10% of the U.S. veterinary workforce. More than one-third (36%) of foreign graduates are, in fact, from schools with high proportions of U.S. citizens. Almost seven percent (6.9%) of our workforce are foreign veterinary graduates, and 27% of those foreign graduates have degrees from COE-accredited international schools (the remaining 73% graduated from non-accredited schools). These figures underscore what may be most important to remember; with or without accreditation, foreign veterinarians have a path to licensure in the United States. Stopping foreign accreditation will not stop veterinarians from seeking licensure and employment here.
As I mentioned previously, graduates from some of the biggest foreign institutions were already U.S. citizens before they began their veterinary education. Ross University and St. Georges University classes range in size from 320 to 375 and 130 to 150, respectively and are typically 85 to 97 percent U.S. citizens. Their graduates generally return to the United States to practice, regardless of accreditation status. Ross has been in existence since 1982 and St. Georges since 1999. Accreditation of these schools doesnt change the number of graduates returning to the United States; instead, it removes the additional expense and barrier of completion of the Educational Commission for Foreign Veterinary Graduates (ECFVG) process to practice in the United States, where they had always intended to return. The effect of accreditation on both schools has been the introduction of external accountability, quality assurance, and the expectation of continuous improvement. These graduates have much to offer our profession, and discounting their knowledge or contributions is a disservice to our profession.
I know that some of you may never support or agree with this decision. I also know that this explanation may not be acceptable to some of you. However, it is the responsibility of the Executive Board to garner input and advice from its volunteer leaders and its members, to then weigh that advice carefully and discuss it thoroughly, and to ultimately make sound decisions based on fact and on what will have the most positive impact on the veterinary profession as well as individual members. In this case, we felt the best decision was to continue the accreditation process.
Dr. Janver Krehbiel
Chair, AVMA Executive Board
5. AVMA 150th Convention Second to None in More Ways than One and a BIG Party July 19-23, 2013 in Chicago at McCormick Place West!
Smithsonian Exhibit Animal Connections, Our Journey Together Have you ever wished a popular Smithsonian exhibit could come to you rather than the other way around? Or that it could be made available to enthusiastic audiences in their own home towns? Thanks to an exciting collaboration initiated by the American Veterinary Medical Association and joined by the Smithsonian institution and Zoetis, Animal Connections: Our Journey Together will begin its nationwide tour this summer. Housed in a mini-museum inside an expandable18-wheeler, the exhibit introduces visitors of all ages to the human-animal bond. Whether youre an aspiring veterinarian, an animal lover, or a health care professional, you and your family will find something to capture your interest on the truck as well as in the myriad public programs that will accompany each stop.
Visitors are offered a variety of interactive ways to learn about the important roles that animals small and large, domestic and wild play in our society and in our lives. Exhibit sections focus on animals in the home, on the farm, at the zoo, and in the wild. A virtual veterinary clinic at the center provides opportunities to develop your diagnostic skills in the role of a veterinarian.
The free mobile museum will debut in Chicago at the AVMAs 150th anniversary convention at McCormick Place, and then head across the country, visiting 75-80 locations over the next two years. Check back with us often to keep track of the tour schedule, and be sure to share the itinerary with your friends around the country so they dont miss it, either.
Opening Session A live stage tribute to the comprehensive and entertaining history of the AVMA, its evolution, milestones and continuing mission, hosted by Chicagos legendary news anchorman Bill Kurtis.
AVMF's A Taste of Chicago at the Shedd Aquarium
AVMF's Our Oath in Action
7th Annual AVMA Concert Featuring Cheap Trick
Family Night at Lincoln Park Zoo
Fair Oaks Farms Tour one of the largest dairies in the country, run by five dairy farm families (in their third generation) and is open to the public for educational tours on the dairy industry and purchase of cheese, milk, ice cream, and butter.
6. How to stay in touch as AVMA members?
Visit the AVMA homepage once a day or once a week. Sign up for one or all of the AVMAs many newsletters, alerts, and information blasts under About AVMA. See the page below. Comment on the many blog sites and on the NOAH Discussion forums. The Blog sites are public, the NOAH Discussion Forums are for AVMA members only.
AVMA Member Newsletters
JAVMA News Bulletin (twice monthly) View sample
Veterinarians and leaders throughout the profession use JAVMA News Bulletin to stay current on developments in veterinary medicine, organized veterinary medicine, and other areas such as government initiatives. The bulletin features timely news in a concise format and complements JAVMA News by providing condensed versions of key Journal news stories.
JAVMA: In This Issue (twice monthly) View sample
Find out what's in each issue of JAVMA as soon as it's published. This expanded table of contents will help keep you from ever missing an article that's pertinent to your practice.
AVMA@Work (monthly) View sample
Interested in knowing more about what the AVMA is doing on your behalf? AVMA@Work gives you monthly insight into what the association is working on to better serve you, our members, and the entire veterinary community.
Animal Welfare Focus (quarterly) View sample
Get the latest information on animal welfare topics of current interest, as well as updates on AVMA's science-based advocacy, including: animal welfare-related legislative and regulatory proposals, upcoming animal welfare-related meetings, and reports from the AVMA Animal Welfare Committee and Division.
AVMA Advocate (monthly) View sample
Stay up-to-date on what the AVMA is doing in Washington, D.C., with crucial and timely information about legislation that affects how you do your job, the money you make, the money you're allowed to keep, and the rules and regulations that say what you can and can't do.
Access PAC (quarterly) View sample
Learn about legislative issues of concern to veterinary medicine; the AVMA Political Action Committee; what candidates the PAC supports and why; how good a job your senators and representatives are doing for you; and other information that can help make you a more effective advocate for your profession. (Due to federal election law, this newsletter is not available to student members.)
Health News Bytes (monthly) View sample
Learn about breakthroughs in veterinary research that have or will have applications to human medicine. This newsletter for health reporters helps the AVMA spread the word about One Health and the significant role veterinarians play in both animal and human health.
ERC Newslink (monthly) View sample
Information and resources to help executives of veterinary medical associations do their jobs and serve their members, including news updates and information on AVMA and other important programs.
State Legislative Update (monthly) View sample
Highlights of the most significant state legislative and regulatory bills and measures affecting veterinary medicine and animal health.
COE Standard (quarterly) View sample
The AVMA's Council on Education explains the accreditation process and reports on its own activities accrediting veterinary schools worldwide. Curious about what happens on a site visit? Confused about outcomes assessment? COE Standard can help.
CVTEA Semi-Annual Report (twice yearly) View sample
Learn about accreditation decisions involving veterinary technology programs, changes to the AVMA Committee on Veterinary Technician Education and Activities' Standards of Accreditation, and procedural information on becoming an accredited veterinary technology program.
AVMA Collections (quarterly) View sample
Find reliable information fast with AVMA Collections, an online monograph series of AVMA scientific journal articles organized by topic. Sign up now for email notifications of new collections and updates as they become available.
News & Issue Alerts
Alerts related to public or animal health View sample
Receive occasional alerts on serious issues that threaten public or animal health, such as major developments related to the H1N1 flu virus or extensive pet food recalls.
Legislative action alerts View sample
(To expand the list, click the button. To collapse, click the button.)
Receive occasional alerts from the AVMA Congressional Advocacy Network (AVMA-CAN) when action is needed to influence federal legislation or federal regulatory efforts. Expect about 1-2 alerts per month if you sign up for all issues.
AVMA policy alerts View sample
AVMA policy alerts will notify you when AVMA is seeking member comment on policies, and when our Executive Board or House of Delegates make significant policy changes. Expect no more than about 1 email per month if you sign up.
AVMA volunteer opportunities View sample
Would you like to know when AVMA is looking for volunteers to work on projects, or recruiting candidates for committees, councils and other leadership posts? Stay apprised with these periodic alerts approximately 4-6 emails per year. Even if a particular volunteer position isnt right for you, you might know someone else who could make a great contribution.
Information about AVMA Programs & Services
AVMA Annual Convention Updates View sample
Receive periodic updates on CE and events at the AVMA Annual Convention, along with key dates, discount offers, and registration information.
AVMA Products and Services Updates (monthly) View sample
Stay abreast of programs and products offered by the AVMA, including brochures and other client materials, webinars, videos, podcasts and more. Be the first to know when we offer something new, and receive special discount offers available just for email subscribers.
AVMF (American Veterinary Medical Foundation) (monthly) View sample
Get regular program updates from AVMAs charitable arm, the American Veterinary Medical Foundation.
AVMA partner emails
Receive occasional emails with information about programs or services from AVMA partners.
We are a new AVMA!! We are interactive, very busy on your behalf with Conventions, Leadership conferences, Policy decisions, Advocacy in Washington DC and acting as a resource for state VMAs, maintaining the quality of our veterinary medical programs and value of an AVMA COE accredited veterinary college DVM degree, advocating for Research, Animal Welfare, and for the Farm Bill and appropriations to support animal agriculture, programs to improve practice profitability, publishing JAVMA, providing educational materials for clients, and engaging the younger half of AVMA members. There is a LOT going on!
Be an active member, or at least be informed, and thank you very much for being a member!
AVMA Report from Dr. René Carlson, Dec 2012
DATE: December 12, 2012
TO: Members of the Northwestern Wisconsin VMA
FROM: René Carlson
RE: AVMA Update
First and foremost, thank you for your continued membership in the AVMA. We have several veterinary communities our local colleagues in our towns and the NWVMA, and our state WVMA for working together on issues that affect our work in the state of Wisconsin, like the Drug Monitoring Program that WVMA is working on to exempt veterinarians. Then there is our overall national community of veterinarians, the AVMA. Sometimes it does not seem as relevant or close to us as the others, but it is the organization that keeps the veterinary medical profession at its high level of public trust through advocacy, policy development, media relations, and supporting our state and allied associations.
In 2013, the AVMA will celebrate 150 years serving veterinarians!! AVMA started in 1863, during the historically difficult times of the Civil War when veterinarians saw the need for improved medical care for the horses injured during the war. We have a very proud history in equine care, food animal health care, companion animals, teaching and research. I hope you will celebrate our heritage at the 2013 AVMA Convention in Chicago next July. It will be a jubilant celebration for family, friends, and colleagues!
AVMAs message this year centers on practical services to help us in our every day work. It focuses on:
- Building your business and your career
- Promoting and protecting the profession and
- Helping us stay connected with each other.
Building your business and your career
- Market research helps your practice with information on pet demographics and ownership (just published), veterinary compensation, and new graduate employment. The AVMAs data is well-respected and referenced by the U.S. government and other outside agencies. Currently, the AVMA Economic Strategy Committee is waiting for our own AVMA workforce study to provide important information on supply and demand of our services both currently and in the future.
- Professional Development helping members transition to new career areas and developing the future leaders for our profession
--- The Future Leaders Program a class of ten members within 15 years of graduation working together for a year as a team developing projects to help members and the profession. Our own Douglas Kratt from Onalaska is one of our Future Leaders.
--- Early Career Online Community focuses on the specific needs of recent graduates less than 5 years out of veterinary school. Ask me how you can get involved with this great community.
--- Veterinary Career Center - a national network for job seekers and employers
--- Veterinary Career Webinars given quarterly on career transition opportunities
- MyVeterinarian.com make sure you are registered with current information for free marketing of your practice to the public online through this AVMA sponsored website.
- Partners for Healthy Pets Go to www.partnersforhealthypets.org for great resources and tools for the entire veterinary team to improve client compliance for preventive care for pets. This is a large consortium of veterinary associations (including the WVMA) and allied partners that will be introducing a multi-million public education campaign in late 2013.
- Small Business Advocacy Our Governmental Relations office in Washington DC works tirelessly on our behalf to educate law makers on the veterinary side of so many issues.
--- Defeating the Fairness to Pet Owners Act This bill is still sitting in a U.S. House of Representatives Committee on Energy and Commerce subcommittee on Health. AVMA testified at an all day Federal Trade Commission hearing in October on why this bill is not good for small business or pet health safety.
--- Working with Congress and the DEA to allow veterinarians to legally carry controlled substances
--- Fair tax policies to address sales tax collection on Internet sales
Promoting and Protecting the Profession
- Animal Welfare Symposia AVMA is the professional and international leader in animal welfare policies for euthanasia guidelines, including for emergency depopulation, and slaughter practices. A symposium is currently being developed for a discussion on the great diversity of opinions about animal welfare within our own profession that will cover many species and many topics. It will be an excellent way to help each of us understand each others perspectives.
- Scope of Practice assistance with state practice acts and proactive legislative to retain veterinary medical procedures within the scope of veterinary practice for the benefit of the animals and owners, specifically livestock management an equine dentistry challenges.
- Drug issues on antimicrobial use, prescription writing, controlled substance regulation AVMA is fighting the policy of mandatory prescription writing, and working with Congress to legalize veterinary transport and use of controlled substances remotely.
- A traveling Smithsonian exhibit highlighting veterinary medicine. This exhibit will premier in Chicago at the AVMA Convention, and then tour the country for two years, including stops at many FFA and even NASCAR events.
Helping Veterinarians stay Connected
- Visit the new NOAH (like a free VIN) and state-of-the-art AVMA website with personalized content to your interests. It is much easier to search, and much easier to join discussion groups.
- You now have the ability to review and comment on Animal Welfare and several other policies up for review or as they are being developed. The policies are identified for you, so you can share your knowledge and influence the policy process.
- Governance review - this is the most exciting of all as the Task Force on Governance and Member Engagement presents its report to the House of Delegates in January.
Finally, there is just no way to truly appreciate everything that the 140+ staff members and 12 Divisions do for AVMA members unless you see it for yourself. I will sometimes hear complaints that AVMA doesnt do enough for large animal veterinarians, but I can tell you I spent most of my time on Capitol Hill talking about appropriations for our animal agriculture network. AVMA cares a great deal about animal agriculture and is actively involved in supporting both animal agriculture and large animal veterinarians. Come celebrate 150 years of pride and honor at the 2013 AVMA Convention in Chicago!! Have a wonderful Holiday and very Happy New Year!!
AVMA Report from Dr. Rene Carlson, Sep 2012
September 17, 2012
Well, once again, I cannot attend this weeks NWVMA meeting. I will be at the AABP meeting in Montr?al. Poor timing. I was asked to speak there in March of this year, and didnt expect it to conflict with NWVMA, although I probably would have had to commit to AABP anyway.
I have missed being at the NWVMA meetings for several reasons, but especially to see the great network of loyal people there, and to give a personal update on AVMA activities and how AVMA is truly getting better and better for benefits to members and serving our profession. I have attached an AVMA report for their information if you could please forward it by e-mail to the NWVMA member list. I was hoping it would be shorter, but there is just so much going on!!
Thank you for your continued service all these years. I hope to see you in December.
Rene A. Carlson, DVM
AVMA Immediate Past President
Chetek, WI 54728
"Our future is what we plan for, and that future begins today!"
Attached AVMA Report
DATE: September 17, 2012
TO: Members of the NWVMA
FROM: Rene A. Carlson
RE: Report from the AVMA
What a whirlwind two years as AVMA President-elect and President! I officially passed the official hat of that office to Dr. Doug Aspros, a small animal practitioner from New York, on August 7, 2012. However, life still seems very busy as I have several commitments that carry over from the last year. One of those obligations is speaking at the American Association of Bovine Practitioners meeting in Montreal, Quebec this week. So I am (again!) unable to attend what looks like a fantastic local meeting of the NWVMA this week. But I wanted to give you a brief (NOT!) report of what is happening at our AVMA. It is a very exciting time at AVMA and, until you have been in the shoes of an officer working each day with the AVMA Executive Board and directly with the Directors of the 11 divisions (and 140 staff members) at AVMA, you have no idea how hard they work for us, and how much is being done on behalf of members and this profession, both locally and internationally. Our AVMA has a $30 million operating budget that is tightly managed for our benefit.
I have told the story countless times; it all starts with our local and state associations. I thank you for allowing me to truly make a difference for our profession, and the animals and communities we serve.
For the last two years, I personally worked with a Task Force to update our AVMA Strategic Plan. It identified five areas of significance from member input > Economics, Education, Animal Welfare, Scientific Research and Discovery, and Member Engagement & Participation in their AVMA. I spent the last year communicating the visions of that Strategic Plan:
The American Veterinary Medical Association engages and empowers its members to be the premier authorities and leaders in veterinary medicine.
We specifically emphasized Economics, Education, and Engagement of members the three Es.
In search of making our Economic vision statement of Veterinary medicine is a personally and financially rewarding profession a reality, we created the Veterinary Economics Division to be able to continually track economic data and trends in the veterinary medical profession, instead of having to rely totally on outside resources and timelines to get that information. We established the Veterinary Economics Strategy Committee to analyze that information to better plan for our economic success by advising our Economics Division on strategies to implement.
We started a dialogue with the 28 Deans of our veterinary medical colleges to discuss challenges we face together as a profession, including the supply and demand of services in veterinary medicine, instead of facing them separately with our own agendas. Three issues we worked on extensively this past year were: Workforce issues, Educational Debt, and Increased Productivity by new graduates.
Under Workforce, AVMA commissioned a new, succinct, and timely workforce study to specifically address supply and demand issues. It is being done by a globally respected firm called HIS Global Insight and should be completed in 13 months from its start, or about April or May 2013. It has an advisory panel to be sure it is answering the questions we have, and their advisory panel has representation from the veterinary medical colleges so both AVMA and the Association of American Veterinary Medical Colleges (AAVMC) can trust and value the information this study provides to us.
Under Educational Debt, AAVMC took that project to heart, hired a Project Manager, and issued a full summary report on how to help veterinarians manage the current cost of a veterinary medical degree due to decreased legislative funding of veterinary medical colleges across the country, thereby causing significant tuition hikes and increased educational debt to our veterinary medical students and graduates. This report addressed financial resources and management plans for pre-veterinary students, veterinary students, and graduates during their professional careers.
Under, Increased Productivity, the new AVMA Veterinary Economic Strategy Committee hosted a workshop at the AVMA Convention with 10 Employers, 10 Educators, and 10 Recent Graduates on issues to help them make a more successful and productive transition from veterinary medical college to their first year of employment. The results will be published in JAVMA.
In Engagement of Members
The AVMA Task Force on Governance and Member Participation had its first meeting in April, and held a participatory summit in July under the guidance of Glenn Tecker, the world renowned author of The Will to Govern Well. The summit participants developed 8 models of ideal governance for AVMA. The Task Force is now asking for YOUR input on these eight models and will refine them down to a final three models to be submitted to your AVMA Executive Board and House of Delegates in November and January respectively. You can review those models and provide input at https://www.avma.org/About/Governance/Pages/Concepts-for-Governance-Remodeling.aspx. It is a huge undertaking and very exciting for the future of AVMA, our members, and veterinary medicine. Please take a look.
NOW, WHAT ABOUT THIS YEAR?!
Each year a new message is crafted by the AVMA leadership team. This year we are concentrating on even creating greater relevance now for us, the AVMA members.
1. Economics (still)
a. We are continuing to follow the current AVMA workforce study being done to answer the questions of where the demand for veterinary services will be and how to best address those demands, and how to match supply of veterinarians to meet the needs of society and animals.
b. Be sure you are registered on MyVeterinarian.com and keep your information updated and current. This has been a very successful means for the public to locate veterinarians whenever and wherever they are needed. I was doing up to 4 radio interviews a week on MyVeterinarian.com for radio audiences across the country.
c. Be sure to log onto and register for Partners for Healthy Pets at http://www.partnersforhealthypets.org/. This is a huge (and I mean HUGE) marketing effort to both our own profession and to the public on the value of preventive care on behalf of several for-profit and not-for-profit organizations to help pets get the preventive care they deserve with visits to their veterinarian. It is an expansive website with tremendous tools for you to improve compliance by owners to get their pets preventive care. It also has Best Managed Practice information on this site. DO check it out!
2. Animal Welfare
a. AVMA will host an Animal Welfare Summit to start a Professional Conversation among AVMA member veterinarians about Animal Welfare Decision-Making. This came about because of the increasingly diverse opinions about this subject between even our own members, for instance the most recent AVMA support of the United Egg Producers bill (with HSUS) to increase and improve egg layer hen housing VS how the swine and bovine practitioners felt about AVMAs support VS urban small animal practitioners.
b. AVMA continues to be more vocal about advocating for animal welfare and we must EACH do the same as much as possible, whether to our local legislators, the media of any kind, and in public speaking to any group we can get access to. We are the voices the public respects and needs to hear from us when it comes to animal welfare issues.
3. AVMAs 150th Anniversary
a. I hope you will plan to attend the 2013 AVMA Convention from July 20-23. It is in Chicago (nearby) and will be a great party to celebrate 150 years of AVMA.
b. This years convention was a huge success in San Diego, especially the Opening Night with Joan Embry and Jay Thomas (I got to help MC with them!) and the USS Midway Gala. We had 8,751 in attendance, including 3,774 veterinarians. We introduced a new Loyalty Program where you get a registration discount for each convention attended in a row. More details are available on request.
a. Check out the new AVMA website, custom designed to meet your specific interests. It was a two year project and has been very positively received.
b. Any member can now provide input and comments on policies that are reviewed regularly at AVMA. Go to https://www.avma.org/KB/Policies/Pages/aw-policies-open-for-comment.aspx.
c. If you are less than 5 years since graduation, check out the new Early Career Online Community at https://www.avma.org/Members/Community/Pages/early-career-community.aspx. This Facebook group, open only to AVMA members who have graduated in the past five years, lets recent grads connect with each other to provide advice and support.
Finally, many of you may still have questions about the GHLIT for health insurance update information. Again, the best information can be found on the GHLIT homepage in a very good video by Libby Wallace, the GHLITs CEO. It can be viewed at www.avmaghlit.org.
This is just a start! Please feel free to ask me anything about our benefits as AVMA members. We are a new AVMA, not your fathers AVMA anymore, more transparent, more engaging with members, more forward-thinking. Thank you for the opportunity to serve as your AVMA President!
And I hope to see you in December!
AVMA Report from Dr. Rene Carlson, June 2012
As we approach the AVMA Convention in beautiful San Diego, I hope you have received your materials for a peek at what a great meeting this will be for our members and their families. Our Convention and Meeting Planning Division and Committee have done an outstanding job organizing this large phenomenal event in a great city! Be sure to go to www.AVMA Convention.org under EVENTS for all the exciting details.
June started off with a bang. On June 6, the AVMA and AAVMC leadership (the officers from each association) met for the first of two annual meetings. This was a very productive meeting because of the foundation we have established with our first two meetings with all the Deans of US veterinary medical colleges in January and March. We have developed a better rapport and trust through these larger facilitated meetings to discuss mutual economic and educational concerns for veterinary medicine, and are able to more frankly and less defensively discuss urgent issues. Areas we continue to focus upon include 1) the AVMA workforce study and recently released National Academy of Science/National Research Council Workforce study report, 2) immediate resources for management of educational debt from pre-veterinary years through their education years, and continuing after graduation, and 3) how to help build confidence and increase productivity in new graduates from the perspectives of employers, educators, and recent graduates. The AVMA workforce study will be completed next spring, and should enhance information already available from the NRC report released on May 30. The AAVMC has established a Task Force on Educational Debt with representatives from AVMA, AAVMC, SAVMA, and VBMA (Veterinary Business Management Association), a national student initiated organization. AAVMC has hired a Project Manager to specifically organize this Educational Debt Initiative. The Veterinary Economics Strategy Committee is planning a facilitated invitation-only focus group entitled Educating and Employing Successful Graduates during the AVMA Convention involving employers, educators, and recent graduates to develop conclusions/recommendations for publication. I wish we could make this an open forum, but it would not be as effective in such a large group.
The Executive Board met in Washington DC the first week of June. One day was entirely spent meeting with our representatives on Capitol Hill talking about the Fairness to Pet Owners Act (categorized for Active Pursuit of Defeat), and other veterinary medical issues relating to Appropriations for agencies imperative to our national security. Other items of significance discussed at the Executive Board meeting included:
A report from the Task Force on Governance and Member Participation. They should have a report for the Executive Board in November and the House of Delegates in January;
Establishment of an ad hoc Executive Board Task Force on the American Journal of Veterinary Research (AJVR) whose purpose is to develop a process to evaluate the quality and direction of the American Journal of Veterinary Research (AJVR).;
Several federal legislative bills forwarded for prioritization by the Legislative Advisory Committee for attention by our Governmental Relations Division;
A bold joint statement between AVMA and AAEP on the elimination of action devices and performance packages to further efforts to enforce cessation of the already illegal practice of soring in Tennessee Walking Horses; and
A report from the AVM Foundation.
On Wednesday, June 20, I participated in a forum at the Capitol Hill Visitor Center called From Fido to Food Safety: Roles, Responsibilities, and Realities Veterinarians Face in Protecting Public Health. It was sponsored by AVMA and the Animal Health Institute, and included a keynote address by Dr. John Clifford, Chief Veterinary Officer for USDA-APHIS, 4 panelists, and a moderator for questions from the very large audience. The panelists included Dr. Doug Meckes from the Department of Homeland Security, Dr. Christine Navarre from AABP, Dr. Terri Clark from the US Public Health Service and NIH, and myself as President of the AVMA and representing companion animal practice. It was an excellent session highlighting the importance and qualifications of our many roles in protecting public health.
Finally, I traveled to Utah for their summer meeting to meet with members there. I will have attended 11 state VMA meetings this past year upon receiving first-come, first-serve invitations, if I did not have another must obligation. It is a special opportunity to hear input and feedback from grassroots members. On the other hand, the District Representatives for the different geographic regions do an excellent job communicating with members at the state meetings on a regular basis over their six year term. I see visits to state VMAs by the officers getting fewer and fewer as the President takes more active roles in regional, national, and international meetings. I say that somewhat regrettably, however, it is imperative the AVMA officers stay fully engaged in participation at these larger meetings. Leadership, to me, means having and sharing a Vision and enacting Influence to achieve the Vision. That is urgently important for this profession given the many challenges we face, so we can initiate strategies and solutions to further achieve priorities in our Strategic Plan.
Finally, thank you for being AVMA members and continuing to engage with us on the AVMA@Work blogs! I am so thankful and proud to be a veterinarian!
December 14, 2011, AVMA Report from Dr. Rene Carlson
AVMA UPDATE FOR THE NORTHWESTERN WISCONSIN VMA MEETING
Eau Claire, WI
December 15, 2011
From: Rene A. Carlson, AVMA President
Much has been happening at your AVMA! I can truthfully say I believe this is one of the most effective years in AVMA leadership with an excellent Executive Board, Board of Governors (President, President-Elect, and EB Chair), and AVMA staff (Ron DeHaven, his Office of Executive Vice President staff, and Staff Leadership as Division Directors) that I have seen in many years.
Being President of the AVMA, and rising to this level of leadership from my first meeting at the NWVMA in 1979, is a hardly imaginable against all odds experience.
Key developments from November 2010 through December 2011
Updated Strategic Plan for 2012-2015 (on which I served)
Strengthen the Economics of the Veterinary Medical Profession
Strengthen Veterinary Practice Profitability and Financial Well-Being
Enhance the Veterinary Medical Workforce
Catalyze the Transformation of Veterinary Medical Education
Promote Animal Welfare
Increase Utilization of Veterinary Medical Services
Partnership for Pet Preventive Healthcare Initiative
MyVeterinarian.com resource site for the public
Promote Veterinarians as the Authorities and Advocates for Animal Welfare
Advocate Oversight for Veterinary Medical Procedures
Advance Scientific Research and Discovery
Enhance Membership Participation and Engagement
Economics Vision Steering Committee
With the obvious concern for the economic situation for our membership, we decided to make this the immediate priority. We appointed the Economics Vision Steering Committee (also on which I served) to plan an Economic Working Session for two days in August to specifically focus on a plan about how to tackle the Economics Goal. From that meeting came the National Economic Strategy:
An Economic Vision Statement - Veterinary medicine is a personally and FINANCIALLY rewarding profession (emphasis is mine).
A commitment of $5 million over 5 years from the AVMA Reserves Fund dedicated to a Veterinary Economics Strategy Reserve Fund for the purposes of funding activities to achieve this vision.
The commitment to establish a Veterinary Economics Division at AVMA. This would be the 12th Division at AVMA, including the Executive Division (OEVP).
The establishment of a Veterinary Economics Strategy Committee (you can see the full description of this Committee at http://www.avma.org/about_avma/governance/volunteering/committees/vesc.asp. This committee is currently in the process of being appointed by a structured and rigorous nomination process to get the best team available. Anyone interested in the details, just ask me. I also serve on this committee.
A national communication strategy for the economic strategy once designed.
Two Task Forces - both of these TFs were the result of resolutions passed by your House of Delegates last July in St. Louis.
The Task Force on Governance and Membership Participation this task force is currently being appointed by the same structured and rigorous process. It is charged with looking at modern association governance structures so AVMA can continue its relevance to members, the public, and the world in the decades to come. The full entity description can be seen at http://www.avma.org/about_avma/governance/volunteering/task_forces/tfagmp.asp.
The Task Force on Foreign Veterinary School Accreditation this task force is also currently being appointed by the same process. It is charged with evaluating the pros and cons of continuing accreditation of foreign veterinary medical programs. The full description of this TF can be seen at http://www.avma.org/about_avma/governance/volunteering/task_forces/tffvsa.asp.
These activities have taken most of my time this fall. January starts with a whole new set of high level activities starting with the Veterinary Leadership Conference, the North American Veterinary Conference, and the Western Veterinary Conference. I am also speaking at several state meetings, SCAVMA meetings, and the Center for Disease Control. Daily activities when I am home include:
E-mail communications> usually I schedule three times a day for that correspondence;
Scheduling travel arrangements for my weekly travel engagements;
Radio or printed interviews on various topics;
Preparation for various presentations and speaking engagements; and
Packing, laundry, and unpacking.
What should you be paying attention to?
1. Make sure we have your e-mail information at the AVMA Membership Directory. Enter it TODAY at the www.avma.org home page > MY AVMA > Update Your Information. Your AVMA membership # is on your JAVMA address label. If you need other login information, call me at 1-715-491-3540, or the AVMA at 1-800-248-2862.
2. Sign up for the AVMA e-newsletters of your choice. These are optional and you have to opt-in. The only one you get automatically each month is the AVMA@Work e-newsletter. Do this at the AVMA home page on the tool bar at the top way to the right > Newsletters. One of the most important newsletter is The Advocate, the national legislative newsletter from your Governmental Relations Division in Washington D.C.
The item of most interest right now is S. 1406, the Fairness to Pet Owners Act (you gotta love that name!). H.R.1406 was introduced on April 6, 2011 by Rep. Jim Matheson (D-UT-2). It was referred to the U.S. House Committee on Energy and Commerce's Subcommittee on Health. It has been categorized as Active Pursuit of Defeat which means the AVMA is putting a lot of personnel time and attention to defeating this bill. It was quietly sitting in the Subcommittee but has had new life breathed into it, so it as important as ever to contact U.S. Senators Kohl and Johnson about this bill (your for those of you in Minnesota, your two Senators Klobuchar and Franken. The primary contact for this bill is Dr. Ashley Shelton Morgan. You can reach her with any questions at a 800-321-1473,ext. 3210 or email@example.com.
You can contact your Senators easily by going to www.avma.org > Advocacy > Get Involved >AVMA-CAN Government Action Center and put in your zip code. You will find a list of pertinent bills, and click on the second one down, S. 1406. It will bring you to a template letter to send, but it is always better to personalize it with real life stories.
3. Go to the AVMA website home page once a day to view daily updates. Go to the @Work Blog site to follow my activities, other short updates, and plenty of opportunity to give comments and feedback. Join the conversation. If you see something of interest, great. If not, you can quickly exit out.
4. Go to www.MyVeterinarian.com to enter your practice information. This is a tremendous resource for animal owners to find a veterinarian in their areas and allows you to enter a lot of specific information about your clinic or hospital. The AVMA is doing a lot of marketing about this site. I have done four radio interviews this week about MyVeterinarian.com. But you have to keep it current and market your specific services and species you see.
5. Go to www.pethealthpartnership.org to sign up for the updates on The Partnership for Preventive Pet Healthcare. This is a huge initiative I mentioned earlier. It gives you consistent guidelines for preventive pet healthcare. This is about teaching veterinarians the value of wellness programs and providing them the tools to market it in their clinics BEFORE taking our message to the public to educate them on the value of wellness care for their pets. Be sure to get registered so you dont miss this valuable information. We are working with a professional public relations firm to market this message to pet owners.
6. Read your January 1, 2012 issue of JAVMA. I have a full interview there about what we are doing at AVMA for you and the profession.
Finally, it is a privilege and honor to serve you and the other 82,500 AVMA members as your President, especially being from northwestern Wisconsin!! I wish you all the most blessed holiday season with family and friends. This is truly the best profession in the world as Dr. Kathy Otto stated after her excellent presentation on the History of Veterinary Medicine in this 250th year. Please dont hesitate to call or e-mail me anytime with any comments or concerns, or put them on the AVMA@Work blog site!
Thank you all for your professionalism and friendship.
June 8, 2011, AVMA Report from Dr. Rene Carlson
DATE: June 8, 2011
TO: Members of the NWVMA
FROM: Rene Carlson, AVMA President-Elect
RE: Report from the AVMA
I send regrets that I cant be at the June NWVMA meeting this week but I will be thinking about your meeting Wednesday night. The AVMA has been a major sponsor of the AVMA Veterinary Leadership Experience to help train key student leaders and faculty in promoting orientation programs at our colleges to promote teamwork, collaboration, and EI (emotional intelligence) in our future veterinarians to teach communication and leadership skills. The AVMA VLE is held the second week of June in Post Falls, ID for 5 days with professional team facilitators and has up to 150 veterinary medical students and faculty members from the US. The AVMA Executive Board decided they should attend this 8th year to: 1. evaluate the program for themselves since we are major financial supporters; 2. show support and participation with veterinary students to develop a better connection between these future members and the AVMA through meeting some members of higher AVMA leadership; and 3. hopefully improve our own EB teamwork and effectiveness as a side benefit of participating ourselves in this excellent leadership program.
This is a potentially transformational time for AVMA and veterinary medicine, in a good and exciting way, IF we have the courage and determination to take advantage of many opportunities. At the June board meeting this week, we will be considering a number of issues of direct interest and with direct implication for you, our members. They include:
An updated Strategic Plan for 2012-2015. In the 2008-2011 Plan the issue of prime importance to members was Animal Welfare. This year there is no question the critical issue for our members is Economics and we are planning to attack that issue with full force. As you know, the cost of a veterinary medical education, workforce distribution, practice profitability, inability of younger veterinarians to purchase practices, scope of practice issues, and the Internet as a competitor for advice and products are just a few of the key elements that have created a progressively worsening economic situation for veterinary medicine over the past several years.
Many legislative bills that affect our small business owners. Last year during the 111th Congress Legislative agenda we assessed 19 different bills relating to small business issues, including getting small businesses (less than 50 employees) exempted from the Red Flag rule, and the repeal of Section 9006 of the "Patient Protection and Affordable Care Act" (PPACA) which imposed immense paperwork burdens on small businesses and would have subjected small business to data collection and information filing on virtually all business-to-business transactions they made aggregating $600 or more in a year.
A policy that would state individual states should be able to collect sales taxes for goods sold over the Internet to out-of-state customers. In many states, veterinary clinics selling drugs on site must charge a sales tax, while similar drugs sold by Internet pharmacies are not subject to the same taxes. Online retailers can obtain a significant price advantage over traditional retailers because they do not charge sales tax. This advantage can be 4% to 9.75% depending on the state and local sales tax of that state. Veterinarians are thus becoming less able to compete with Internet pharmacies and are losing out on potential revenue.
Education is a huge part of the picture for improved economics and the future success of veterinarians in this new marketplace. Engagement of our members at a much higher level is imperative to AVMAs future success, especially since 43% of AVMA membership has graduated within the last 15 years, and those members want communication, input and involvement right now. We will soon be looking at the NAVMEC Report (North American Veterinary Medical Education Consortium) and have just reviewed the Vision 20/20 Commission Report that looked at how to position AVMA for success over the next 10 years. Both of these reports should generate much discussion and action with many new initiatives.
AVMA has a great convention planned from July 16-20th in St. Louis. I will chair the upcoming House of Delegates meeting with some very interesting discussion on many issues on the agenda. I become AVMA President at a luncheon at noon on Tuesday, July 19, a day I will not soon forget. I have not forgotten how I got here, starting with becoming NWVMA President in 1992 (?) as a new associate in Chetek, WI, and a WVMA Leadership Conference as the NWVMA representative. All of us make a difference each day for the animals and people in our communities. No profession makes such an impact directly and indirectly in peoples lives each day with so little recognition. You have a direct connection with AVMA now (me!), so please dont hesitate to talk to me. Thank you for making it possible for me to make a difference at AVMA and for veterinary medicine.
AVMA knows we have to continue to work hard for our members, and we appreciate your membership and input. We have about 145 staff members and almost 700 volunteer members on various entities, but we want to engage hundreds more people. Be sure to go to www.avma.org at least once a month to read AVMA @ Work to get current updates on AVMA activities. There are also several blogs there where you can express your opinions on topics and be assured, AVMA reads and listens to those comments. I will be doing a blog there after my installation as AVMA President so I can communicate at a grassroots level with members about my schedule and the several issues we handle each day your AVMA dues @ work. Please let us know how we are doing. Thank you for your continued support and professional friendship.
PH: 715.491.3540 (cell)
June 8, 2011, AVMA Activities and Travel from Dr. Rene Carlson
DATE: June 2011
TO: AVMA Executive Board
FROM: Rene A. Carlson, President-Elect
RE: Meeting and Travel Report to the EB for April May 2011
AVMA/AAVMC Joint Committee meeting Schaumburg, IL April 10, 2011
This meeting is held twice a year, once in the fall at the AAVMC office in Washington DC, and once in the spring at AVMA headquarters. Attendees included:
Dr. Willie Reed, Dean at Purdue University, AAVMC President
Dr. Gerhundt Schurig, Dean at Virginia/Maryland, AAVMC President-Elect
Dr. Marguerite Pappiouoanou, AAVMC Executive Director
Dr. Michael Chaddock, AAVMC Deputy Director
Dr. Warick Arden, Provost at North Carolina State University, Past President, was not able to attend due to a previous conflict.
Dr. Larry Kornegay, AVMA President
Dr. Rene Carlson, AVMA President-Elect
Dr. Larry Corry, AVMA Past President
Dr. Ron DeHaven, AVMA Executive Vice President
Dr. Jim Nave, Director, International Activities
Dr. Dave Granstrom, Director of AVMA Division on Education and Research
The agenda included:
Issues of international veterinary medicine (Vet 2011 4th year veterinary medical student externship exchanges, the upcoming EAEVE General Assembly and World Conference on Veterinary Education, a CIVA update, and report from the International Accreditors Working Group which is the group working on joint site visits of international schools with COE, the Royal College of Veterinary Surgeons, and the Australasian Board.
NAVMEC update Input encouraged through May 1, 2011, Final Report due in June
Discussion of the AVMA EB establishing an Economics Vision Steering Committee to plan an AVMA EB retreat to start a long term process to evaluate and improve the economic status of the veterinary medical profession to deal with issues of education, workforce, and practice profitability, including information from the reports of the Vision 20/20 Commission, TF on Students and Recent Graduates, and TF on Internships, as well as the upcoming NAVMEC and National Academies of Science reports. This led to a follow-up discussion that AAVMC and AVMA need to speak with one voice when it comes to future concerns of veterinary medicine, such as class size, applicant pool, and recruitment. AAVMC presented data from Ms. Lisa Greenhill showing a rather static rate of increase in class size compared to previous years that should alleviate some concerns about plans for escalating class sizes. We will evaluate further data in our upcoming analysis of our professions economic plan. (IMHO the AAVMC seems to continue to be in complete denial of the plight this profession finds itself in economically and that we need to find a way to bring them into this overall plan for us to have a comprehensive transformation economically. Education is an important symptom of the economic concern and needs to be part of the treatment planl.)
Legislative agendas that we may have in common
Congressional Fellowship Selection Committee Washington, DC April 15-16, 2011
This committee traditionally includes an EB member as chair, an AVMA staff member, and a past Congressional Fellow. Committee members this year included me as Chair, Dr. Lynne White-Shim from the Scientific Activities Division, and Dr. Sarah Babcock, a past Executive Branch Fellow, who worked in the Dept. of Homeland Security, and is currently working on the Hill in the Senate Finance Committee.
We had sixteen excellent candidates. After the initial two phases of evaluation (their application packages and their writing assignments), we selected eight candidates for interviews, and chose three candidates for our 2011-2012 Congressional Fellows. They are Dr. Matthew Doyle, Dr. Richard Smilie, and Dr. Reid Harvey.
The day before meeting with the committee, I visited with Kirt Johnson, Chief of Staff Representative Sean Duffy of my 7th District in Wisconsin, at the Capitol Hill Club, the Republican private club.
Tour of the San Diego Safari Park Veterinary Medical Facilities San Diego, CA April 22, 2011
This visit was not at AVMA expense, but was part of a personal trip taken to San Diego. I met with Dr. Don Janssen, Director of Veterinary Care for both the San Diego Zoo and Safari Park. Dr. Janssen is a 1978 graduate of UC-Davis and has worked in zoo medicine for his entire career. This is a 60,000 sq. foot state-of-the-art zoo veterinary medical facility built ten years ago primarily with donated funds, and includes clinical, surgical, and laboratory equipment for handling just about any animal medical situation imaginable for a variety of patients from around the world ranging from hummingbirds to elephants and gorillas. Handlers are required to do a DAILY count of every animal at the Park and are trained experts in observation for any signs of abnormalities in the animals that would suggest a veterinary examination is necessary. Three nutritionists are on staff who are responsible for the specialized daily feeding rations for over 7000 animals. Examples of patients and medical conditions included:
Abscess in a rhinoceros (from a West Nile virus vaccine)
Uroliths in desert tortoises
Enteroliths in kiangs (Tibetan wild asses)
Quarantine of a red ruffed lemur as part of entry into their breeding program
Allergic conjunctivitis in a desert bighorn
Injured forelimb in a fringe-eared oryx
Hypothermia and hypoglycemia in a steenbok (small antelope)
Bumblefoot in a Demoseille crane
Semen collection from a Hawaiian crow (an endangered species in Hawaii from avian pox and avian malaria, and is at Safari Park in their conservation breeding program)
Wing drop in a lovebird
Zoos are accredited every five years for quality standards by the American Zoo Association, much like our veterinary medical colleges. The zoo has nine veterinarians, several RVTs, and accepts one resident in zoo medicine each year for a three year residency program.
After this visit, I personally have even a greater amount of respect for the exceptionally high-quality care provided to such an amazing diversity of patients, the tremendous amount of knowledge possessed by this world class zoo veterinary medical team and facility, not only in terms of laboratory and medical care, but in terms of handling and restraint in as least a stressful manner as possible for these skittish patients, as well as for the safety of all personnel. This includes remote controlled webcams in all animal areas, IV bags and pumps in external compartments on the enclosure doors so animals do not have to be disturbed after initiation of fluid therapy treatments, and specialized padded chutes and movable squeeze doors for movement and anesthetic recoveries. This facility was absolutely immaculate everywhere and appeared it was kept such at all times. All veterinary hospitals should be this immaculate.
1st of 2 Economic Vision Steering Committee Schaumburg, IL April 26-27, 2011
House Advisory Committee Conference call April 29, 2011
2nd of 2 Strategic Planning Task Force Schaumburg, IL May 2-3, 2011
Australia Veterinary Conference Adelaide, South Australia May 13-20, 2011
Before heading to Adelaide for the Conference, we took a detour to Tasmania to visit Dr. James Harris, whom all of us know as the current AAV delegate to the HOD. I mention this only because spending two nights with Dr. Harris on his farm on a mountain top outside Hobart was a unique experience. Dr. Harris went to an avian conference in Hobart in September 2001, and became temporarily stranded there from his home and practice in California because of the 9/11 terrorist attacks. In that interim, he decided to buy a home and practice there, and later bought this farm. Mark and I did farm chores with him at 6 AM for 1.5 hours feeding his chickens, rabbits, pigs, Clydesdale horses, turkeys, Indian runner ducks, geese, alpacas, sheep, goats, Scottish Highland cattle (including rounding a loose one or two up), and released one of his rehabilitated peregrine falcons. This was in addition to his three dogs, one cat, several house birds, and other members of the menagerie I am sure to have forgotten. He then goes to work at 9 AM full-time, and repeats the process at night. He is absolutely passionate about his clinical work, the diversity of our patients, working for public health, teaching students, and wildlife conservation. He is an inspiration to say the least! We then headed to Adelaide for the AVA conference.
The Australia Veterinary Association is an organization representing 8000 veterinarians, about 70% of the veterinarians in Australia. AVA is celebrating their 90th year as an association. This meeting attracts around 900 of those veterinarians. I attended:
The Policy Advisory Council (PAC) meetings - This group is made up of the 8 district representatives (6 states, and the 2 territories of the Northwest Territory and the Australian Capitol Territory), and 22 specialty interest group representatives (SIGs) which include Acupuncture, Alpaca, Animal Welfare and Ethics, Avian, Behavior, Cattle, Conservation Biologists, Dental, Embryo Transfer/Reproduction, Equine, Greyhounds, Holistic, History, Industry, Pigs, Poultry, Practice Management, Public Health, Registered Specialists, Sheep, Small Animal, and Unusual and Exotic Pets. This group develops and debates policy and position statements which include their respective member group comments for input. After the discussion, they decide on whether to accept the issue statement as a policy (where there is general agreement on an issue) or a position statement (where there is not general agreement, and is a less definitive statement on an issue), and it is presented to their Board of Directors (a nine member board) for review and a vote. Most of these issue discussions revolved around animal welfare topics including importation of aggressive dogs, transport of horses, racing of two-year old thoroughbreds, control of feral cats, control of wild rabbits (an introduced species), distal limb neurectomy in horses, farming of deer for velvet collection, use of whips on racing horses, humane slaughter (including ritual slaughter practices), circus animals, and pizzle dropping, a procedure done in wethers and weaners to prevent wool soiling, balanoposthitis and sheep fly strike). Other issues included vaccination protocols for dogs, cats, ferrets, and rabbits, and complementary and alternative therapies to name a few.
The AVA President is elected each year from within the Board of Directors, and can serve up to 3 one-year terms. The current President is Dr. Barry Smyth.
The dinner for the Policy Counsillors (the representatives from each SIG who sit on the PAC), Board members, various group representatives, senior staff, and international Presidents (myself and Dr. Richard Wild, New Zealand VA President).
Members Forum This was their second member forum, and a spirited discussion it was. The Aussies are not afraid to vividly voice their opinions! The three issues that had the more traditional members quite riled were:
1) Approval of a position statement for three year vaccination protocols (although it was a position statement vs. a policy, which acknowledges the differences of opinions and still placed the vaccination protocol for each animal within the recommendations of the individual veterinarian); interesting that one person blamed America for starting this idea when we have 70% compliance for vaccinations, and Australia was closer to 25%, making this a dangerous recommendation for their population of animals.
2) Approval of removing one of the PACs face-to-face meetings in October in favor of electronic communication. Reminds me of the time AVMA was making that same transition with a lot of resistance initially. Many members felt disenfranchised by this process. When asked how we did it in the US, I gave some encouragement that we had also faced the same transition with some resistance, but eventually it has been embraced and is much more green and efficient for communication.
3) In an evidence-based medicine professional association, how could AVA condone having members representing Holistic medicine and Acupuncture on their Policy Advisory Council? It was a strong discussion on whether the veterinary profession should continue to foster these modalities purely on client demand until they could produce the scientific evidence that it was justified and effective treatment. Some saw this as an animal welfare issue. Others thought if it was going to be done based by public demand, it should at least be a practice limited to veterinarians for regulatory purposes. (D?j? vu?)
Presidents Official Opening and Plenary Session The recipient of the Guiford Award was Dr. Jim Whittem who spoke on Entropy in the Veterinary Profession, aimed primarily at how Complimentary and Alternative Medicine did not deserve to be part of an evidence-based profession. The plenary speaker was Dr. Nathan Swan, who also spoke on how evidence-based medicine must always be used to advise consumers despite some consumers not being willing to believe any evidence presented. His was an interesting presentation on the psychology of emotionally driven decision making, and that complementary and alternative therapies, including acupuncture have no business being advocated in any way in human (and therefore veterinary) medicine since there is absolutely no evidence of their efficacy other than a placebo effect.
(**This whole conference had a consistent conflict between the advocates for complementary and alternative therapies and those who thought they were hogwash from the PAC discussions, the Member Forum discussions, and the Plenary speakers. The PAC is not sure how to handle it at this point. The middle ground group believes the public will demand such therapies and so they should be done by veterinarians rather than unregulated non-veterinary medical providers.)
Overseas Presidents Meeting In addition to myself, this meeting included:
o Dr. Barry Smyth (AVA President) as host
o Dr. Richard Wild (New Zealand VA President)
o Julie Hood (New Zealand VA CEO)
o Dr. Shane Ryan (Singapore VA President and WSAVA Treasurer)
o Dr. Peter Thornber (Commonwealth Veterinary Association Treasurer, representing 54 commonwealth countries)
o Dr. Mark Lawrie (AVA Past President)
o Dr. Steve Atkinson (AVA Director)
o Dr. Julia (AVA Director)
o Dr. Peter Gibbs (AVA Vice President)
The agenda included discussion of five current issues of interest to our individual associations (I listed the critical issues of our current strategic plan and issues of interest for our forthcoming updated strategic plan), regulation of para-veterinary service providers, veterinary medical education, veterinary remuneration, Vet2011 events, veterinary workforce data, regulation of drugs and international trade issues, and how IVOC can have more impact in moving issues of common ground forward internationally?
VIP dinner at the State Library We were seated with President Smyth, His Excellency Governor Kevin and Elizebeth Scarce (who is appointed by the Queen of England), Senator Chris Beck (the first and only veterinarian to be elected as a Senator among 76 senators in their Parliament), Dr. Gail Anderson (Dean at the new College of Veterinary Medicine at the University of Adelaide, and Dr. Robert Labuc (Australasian College of Veterinary Scientists).
Annual General Meeting with AVMA Awards Ceremony, and where Dr. Thornber, Dr. Wild, and myself addressed the AVA general membership
Presidents Reception, and Voyager du vet Gala dinner in honor of World Veterinary Year 2011 This was an enormous and formal sit-down dinner/dance (with individual placards for assigned seating) and tremendous entertainment with d?cor indicative of Paris. Quite an event.
Summary: Three key summary points I would highlight:
1. The AVA members and leadership are quite concerned over the opening of three new veterinary schools in addition to their 4 current established schools (3 COE-accredited, 1 in the process of COE-accreditation) for a population of 30 million people in a largely rural country. Dr Smyth stated most graduates have a debt to income ratio of 3:1, with many having a $125,000 to $150,000 student tuition debt at the end of their course and a starting salary of only $40,000 to $45,000. Where will these graduates find jobs? How will they service their debt? Sound familiar?
2. The AVA leadership is struggling philosophically with the fact they have Acupuncture and Holistic medicine represented on their Policy Advisory Council when they pride themselves on science-based medicine. This was a very spirited and opinionated debate as to how veterinary medicine can continue to condone holistic and alternative therapies with no scientific evidence of its efficacy. Interesting dilemma.
3. During our International Presidents meeting, it was hoped we can move the International Veterinary Officers Meeting (IVOC) meeting to one of brainstorming solutions and strategy together rather than one of citing problems from each association without any real action or communication to other associations. Can we take a further leadership role on these issues?
House Advisory Committee, by speaker phone, May 21-22, 2011
2nd of 2 Economic Vision Steering Committee, Schaumburg, IL, May 26-27, 2011
AVMA EB Meeting, Post Falls, ID, June 4-6, 2011
March 10, 2011, comments from Dr. Rene Carlson
I have attached a copy of my comments from the AVMA last night for your reference if you so choose. You can either forward it to members, or edit for inclusion in the minutes.
In addition, I am very receptive to the comments from Dr. Earl Monson (and Dr. Eric Bohl afterwards) that AVMA does not seem to give enough time to food animal issues, most specifically in JAVMA. He does not have an e-mail address apparently for me to follow up, but for the NWVMA membership in general, I might include a brief list as follows for their interest. The time and resources that AVMA has, and continues to expend, for food animal veterinary medicine is way out of proportion to our majority small animal membership, however that does not lessen by any means the importance of food animal practitioners, food animal medicine, and food safety to the AVMA or their importance to an American and global society for that matter.
1. The 38 page AVMA response to the Pew Commission report focused primarily on antimicrobials and animal welfare (housing). AVMA had a dramatic response.
2. The Veterinary Services Investment Act which AVMA authored - to
promote programs that support veterinarians in food animal medicine. This
almost flew in the 111th Congress and we will pursue it with the 112th.
3. The Veterinary Medical Loan Repayment Program, 90% of which is focused on food animal veterinarians in shortage areas, would not exist without AVMA efforts.
4. The Food Animal Vet Recruitment and Retention Program is our pilot and privately funded food animal veterinary medical loan repayment program.
5. Consider the number of committees and councils that focus primarily on food animal issues (FSAC, COBTA, AALC, CPMRVM), or others that have disproportionate representation from the food animal side.
6. Speaking of disproportionate, the time our GRD and Scientific Activities Division spend on food animal issues is very hard to justify to our companion animal members.
It is a constant balancing act to provide balanced service to the incredibly diverse membership of the AVMA, however, we are still one relatively small family of a profession that loves our very important work that needs to continue to work together toward common goals for the benefit of veterinary medicine.
BTW, I loved last nights small roundtable discussions, partly for what I learned, but even more for the opportunity to meet, mingle and visit with so many of our members. I thought it was great!!
Rene A. Carlson, DVM
2774 - 11th Avenue
Chetek, WI 54728
"Our future is what we plan for, and that future begins today!"
March 9, 2011, from Dr. Rene Carlson, presented at membership meeting
DATE: March 9, 2011
TO: NWVMA members
FROM: Rene Carlson, AVMA President-Elect
RE: AVMA Update
This is an exciting time for veterinary medicine and the AVMA. As you know, this is World Veterinary Year celebrating 250 years of veterinary medicine since Sir Claude Bougelat founded the first veterinary medical college in Lyon, France in 1761. As a result of his fruitful collaboration with surgeons in Lyon, he was also the first scientist who dared to suggest that studying animal biology and pathology would help to improve our understanding of human biology and pathology. 2011 marks the 250th anniversary of the concept of comparative pathobiology, without which modern medicine would never have emerged.
There are several events going on around the country and the world with 78 countries celebrating World Veterinary Year, including an entire day symposium entitled World Veterinary Year: 250 Years of Improving Animal and Human Health" at the AVMA Convention in St. Louis from July 16-19. Registration is now open and if you havent been to an AVMA Convention in recent years, you will be very surprised at the breadth and depth of CE presentations and family friendly entertainment. This will be an exciting convention, as even though St. Louis may not seem like the most obvious and exciting tourism destination city in all of the United States, to us in the Midwest, it is a great family city with tremendous history and everything will be close and accessible for a great convention and family vacation relatively close to home. More information on World Veterinary Year and the AVMA Convention can be found on the AVMA website at www.avma.org by clicking on the icons on the right side of the page.
Almost 1000 comments were received about possible revisions to the Model Veterinary Practice Act. We greatly appreciate the feedback and comments. After the comments are reviewed, the Task Force will develop recommendations for revisions of the Act. Our past Executive Director of the WVMA, Leslie Grendahl, serves on that Task Force representing non-veterinarian public members.
The draft report of the North American Veterinary Medical Educational Consortium (NAVMEC) has been approved by the Association of American Veterinary Medical Colleges (AAVMC) and circulated to stakeholders for review. This is a critical effort, and your feedback is appreciated. The report can be viewed at www.aavmc.org/navmec.htm. NAVMEC has extended the comment period, and comments will be accepted until May 1.
The AVMA 20/20 Commission, charged with establishing a vision for the Association in 2020, is working on its report with the goal of presenting it to the Executive Board at the April meeting.
On the legislative front, Its already another busy year in state legislatures. In 2010, there were more than 90,000 bills introduced with more than 30,000 adopted over the course of 2010. The AVMA Legislative and Regulatory Affairs Department (within the AVMA Communications Division) tracked and sent over 1200 bills related to the practice of veterinary medicine to state veterinary medical associations during the year. So far in 2011, they are already tracking a number of bills and have sent more than 800 alerts to the state VMAs. Several big battles are being waged over scope of practice of non-veterinarians attempting to get authority to work on livestock and horses independently. Currently, they are assisting a number of state VMAs, including Arizona, Iowa, Georgia and Maine with legislative drafting and analysis of essential legislation. For more on Scope of Practice issues around the country, read the article in the March 15 issue of JAVMA, also currently available on line.
The AVMA continues to act on behalf of the profession and maintain dialog with numerous regulatory agencies with the goal of minimizing burdensome regulation of veterinary practices. Our rapport with the FDA, EPA, USDA, and other agencies allows us to advocate for the profession and shape the development of regulations that affect our practices every day. We are able to practice with a relative minimum of government interference, largely thanks to the efforts of the AVMA on your behalf. The most recent example is the AVMA appointed Steering Committee for FDA Policy on Veterinary Oversight of Antimicrobials, a new AVMA committee which will work with the Food and Drug Administration on policies and regulations governing veterinarians' involvement in antimicrobial use in animals. The board's decision to create the committee fits with actions taken July 30 by the AVMA House of Delegates, which voted unanimously to enact two resolutions regarding antimicrobial use in animals. One of the resolutions created a policy indicating veterinarians should be involved in decisions regarding antimicrobial use in animals, regardless of whether the drugs were purchased over the counter or through another distribution channel. The second resolution created a policy indicating the AVMA should be involved in decisions that could affect the availability of antimicrobial drugs.
An educated animal owner can be our best client, but a misinformed client can be our worst nightmare. AVMA materials, including client education brochures, the Frequently Asked Questions (FAQ) documents, and reference guides provide members of the public with science-based, accurate information. In response to questions AVMA receives from the public as well as from veterinarians, AVMA developed a FAQ about pharmacies and prescriptions. AVMA has been expanding its presence in the public arena, including social media sites such as Twitter, Facebook and the WebMD Healthy Pets Community. Audiences on those sites have been steadily increasing if youre on Twitter and/or Facebook, please join us! Links to all of our social media sites are posted on our home page.
To educate a variety of audiences, AVMA is producing more videos about animal health and welfare. A series of educational videos is in progress; the videos are designed to demystify common procedures, promote good animal welfare practices, and assist in the implementation of AVMA animal welfare policy. The first video, dehorning of cattle, was released on AVMAtv and YouTube in January 2011.
You should have received a blast e-mail newsletter from AVMA called AVMA @ Work. If not, go to the AVMA website and sign-up for it as it is the most comprehensive, yet concise source of information with everything happening at AVMA on your behalf. Be sure to update your e-mail address as AVMA only has about 60% of its members correct e-mail addresses. This is especially important if AVMA needed to reach all of us at the time of an emergency situation or for relevant e-alerts. Please be sure we have your current e-mail address. You can update it on the AVMA website under My AVMA on the homepage.
Finally, congratulations to Dr. Chester Rawson from Wisconsin who was elected to serve as the District VI Representative on the Executive Board, which represents WI, IL, and IN. See the article in the March 15 JAVMA.
These efforts are just the tip of the iceberg when it comes to the AVMAs activitiesand lets not forget the AVMAs core programs when we evaluate the overall value of AVMA membership and service to the profession. JAVMA and AJVR always feature cutting-edge, relevant research. More than 81,500 strong, the AVMA cannot serve the profession without active participation by its members. It is a honor to serve you in my capacity as AVMA President-Elect. I am the AVMA. You are the AVMA. Together, we are the AVMA!
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