vet practice march 2016

Digital innovation is changing the way vets work. Are regulators keeping up?

Success by designCan the colour of your

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MARCH 2016

Cover storyOnline vetting 20With more and more practices offering add-on video consults to services, how are regulators keeping up with the advances in digital pet care? We explore the world of FaceTime and Skype vet consults.

News + eventsThe latest in the veterinary world 4A feline virus outbreak, Queensland set to stop puppy farms, the latest on the greyhounds scandal, a new shark species discovered, the tropical reef fish most vulnerable to climate change and much more.

Your worldNot just a pretty face 12Celebrity vets are often derided, charged with being in it for the fame—this group of animal lovers and passionate vets set the record straight.

Your businessOutside perspective 16When you’re running a busy practice and falling behind on admin or short-staffed over the holidays, outsourcing can be a good way to get out of a jam.

Training day 24Training your staff might be the best investment you make in your practice. How to get started, from making a plan to measuring the outcomes.

Success by design 26Good practice design can boost your business, attract more clients, help owners and animals feel comfortable—and even increase pet adoptions!

Your toolsTools of the trade 42Reviewed by real-life vets around Australia.

Your lifeStraight shooter 46To be a champion rifle shooter, Dr Erica Young from Queensland utilises focus, patience and psychology.

Contents

C O N T E N T S

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PRACTICE Editorial Director Rob Johnson

Digital Director Ann Gordon

Contributors Angela Tufvesson, Kerryn Ramsey, John Burfitt, Sita Simons, Tracey Porter.

Commercial Director Mark Brown

For all editorial or advertising enquiries:Phone (02) 9660 6995 Fax (02) 9518 [email protected]

Vet Practice magazine is published 11 times a year by Engage Media, Suite 4.06, 55 Miller Street, Pyrmont NSW 2009. ABN 50 115 977 421. Views expressed in Vet Practice magazine are not necessarily those of the publisher, editor or Engage Media. Printed by Webstar.

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Sales Director Adam Cosgrove

4,883 - CAB Audited as at September 2015

Associate Editor Kate Balazs

Editor Erin Delaney

Art Director Lucy Glover

4

news + events

Victoria Vásquez, from the Pacific Shark Research Center in the USA, and her co-authors Dr Douglas J. Long and Dr David Ebert, have identified a new species of shark and christened it with the stealthiest of monikers. The newly named Ninja Lanternshark joins the 40 other bioluminescent lanternshark species that are already known.

The shark’s snappy aliases don’t end there, it’s scientific name—Etmopterus benchleyi—has its own back story. The species is named “in honour of Peter Benchley and the conservation work he did to counter the negative portrayal that the movie Jaws gave sharks (he wrote the book). His legacy continues through the Benchley Awards,” which recognise outstanding achievements in ocean conservation, says Vásquez.

“The suggested common name, the Ninja Lanternshark, refers to the uniform black coloration and reduced photophore complement used as concealment in this species, somewhat reminiscent of the typical

outfit and stealthy behavior of a ninja.”The Ninja Lanternshark is quite

diminutive in comparison to Bentley’s giant Great White. Vásquez sees the discovery as forging a path for understanding the wide variegation to be found in sharks ocean-wide.

“When we think of sharks as one type, we’re not understanding the true complexity of sharks and the roles they play in the ecosystem,” Vásquez said. “They’re not all apex predators.

“I’ve seen a few reports alluding to how dangerous and scary this shark might be, which is pretty funny to me since the largest one we found (a full-grown adult) was 515mm-long from head to tail. Since we don’t have a lot of specimens we can’t confirm if they grow larger. Nevertheless, since it lives in the deep sea a chance encounter with people is highly unlikely. You would need a submersible to better your odds at finding one, so I just wanted to clarify that there is no danger to people with this new species.”

Ninja shark found lurking beneath the shadows

The Special Commission of Inquiry into the Greyhound Racing Industry has been told that racing stewards were advised to downplay both deaths and injuries of dogs to avoid further bad publicity for the industry.

Clint Bentley, the chief steward of Greyhound Racing NSW, was revealed to have sent an email in 2013 to all stewards in NSW telling them to minimise details.

“It has been discussed at a recent management meeting and decided that it is in the best interests of all that we desist from providing too detailed information in our Stewards Reports with regard to injuries sustained by

greyhounds,” wrote Bentley in his email.“In order to do this we suggest that

you no longer report injuries such as fractures or breaks but rather just as injured: i.e. if a greyhound was to sustain a fractured hock we would report it as an injured hock... “

The inquiry’s commissioner, Michael McHugh QC, was not persuaded by the excuses for the policy offered by Brent Hogan, the former Greyhound Racing NSW (GRNSW) chief executive officer.

Hogan was queried on whether the policy had been deliberately designed to disguise the gravity and frequency of injuries. He claimed reporting was changed to increase consistency between

reports and simplify the process.However, McHugh was not swayed:

“I don’t find your explanations very convincing. It appears to me there was a deliberate policy to euphemistically describe injuries so it would not excite the interests of animal welfare groups.”

Mr Hogan said he was not attempting to “conceal the data”.

“I think I had a concern that, in the absence of context, that raw data could be open to various interpretations.”

Bentley gave further evidence that the misleading method of reporting had continued through to November of 2015, and it “never occurred” to him to report it.

Greyhound stewards’ ‘deliberate policy’ of misreporting injuries

The Ninja Lanternshark is so-called because of its stealth.

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The federal government’s proposed changes to Department of Agriculture and Water Resources veterinary staff may put both animal welfare and public health on rocky footing.

The government’s proposal would see an entry-level vets’ wages drop by $21,000 per annum, a reduction of opportunities for continuing professional development and increased difficulty for mobility within governmental employment.

In defence of it’s members, the Australian Veterinary Association (AVA) has expressed apprehension over the proposed changes. AVA president, Dr Robert Johnson voiced his concern, calling for the government to consider the role vets play in agriculture-related health and safety.

“Government vets provide services that protect biosecurity, health and food safety. They are as integral to government decision-making on agriculture as doctors are to policy in the medical system,” said Dr Johnson.

Dr Johnson’s concerns are not unfounded, the AVA’s workforce modelling report from 2015 found that the government could already expect a shortage of vets in their employ, even without changes to pay and conditions.

“Reducing pay scales and classifications for veterinary officers will only make this situation worse and it will be our livestock industries and public health that will pay the price,” said Johnson

“We believe the government needs to be proactively employing more vets. It’s also important to invest in the development and retention of those already working in Australian government roles so their expertise is not lost.”

Dr Johnson explained the important role Australian veterinary expertise played in food and livestock trade.

“Multi-million dollar decisions rest on the... signature of Australian vets. We’re very concerned about the impact these proposed changes will have on protecting livestock industries from disease, and our ability to respond when there’s an animal health crisis.

“Undervaluing these many contributions of government vets opens the door to risks that we just can’t afford to take.”

AVA opposed to federal government vet cuts proposal

Government vets provide critical advice on biosecurity.

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Simulator animals take their place in the herdMany vet schools are increasingly relying on animal simulators to train students. While this reduces the number of animals required for practice, questions have been asked as to whether simulators appropriately prepare students for real-life situations. Researchers at the University of Veterinary Medicine in Vienna have tested exactly this question. The team found that simulators provide a stress-free environment for training that works to allow students to efficiently achieve their learning outcomes.

Researchers Christina Nagel, Christine Aurich and a team from Vetmeduni Vienna’s Centre for Artificial Insemination and Embryo Transfer worked with a sample of 25 third-year vet students. The team worked to test how efficient simulator training could be in teaching large animal gynaecology.

The sample, separated into three groups, were instructed on palpation and ultrasonography of the equine genital tract of horse mares. The first group used a simulator box with rubber genital organs and were each trained four times. Group two were also trained four times but on teaching horses. The final group received only a single training session on horse mares.

The study found that simulator training was almost as efficient as using teaching animals. After a two-week gap, the sample students used their knowledge to examine and diagnose a horse mare.

The group who had the chance to train on horses four times received the best scores, but those who had trained on the simulator weren’t far behind, with those who had a single session coming in last.

“Simulator-based training prepares the students very efficiently for diagnostic procedures on live horses,” Nagel said. “Simulators are, however, not only an additional teaching tool for our students but also a contribution to animal welfare. Only when students have successfully finished the simulator-based training course are they allowed to perform the same diagnostic procedures in animals.”

news + events

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The secrets of wombatsFor the first time ever, researchers from the University of Adelaide have been able to non-invasively study the inner workings of wombat warrens, with a little help from ground-penetrating radar.

Despite being the faunal emblem of South Australia, very little is known about the burrowing habits of the southern hairy-nosed wombat.

As part of a larger study into wombat conservation, Michael Swinbourne, PhD candidate in the University’s School of Biological Sciences, set out to test a new way of mapping wombat warrens.

His research has been published in the peer-reviewed journal Wildlife Research.

“A major problem we are grappling with is understanding just how many wombats there are and whether their numbers are increasing or decreasing,” Swinbourne says.

“At the moment we use satellite imagery to count the warrens and then use that information to estimate the numbers of wombats living inside. This method isn’t perfect because we don’t know much about how wombats share their warrens.”

Using ground-penetrating radar meant Swinbourne and his team

were able to map warrens built underneath thick layers of hard limestone—which occurs throughout much of the wombat’s range.

“The aim of this project was to map the extent of wombat warrens in different ground conditions; to gain a better understanding of the relationship between how they look on the outside and what goes on underneath,” he says.

They found warrens built under limestone differ substantially to soil warrens, being an extensive series of tunnels and chambers rather than simply a discrete tunnel underground.

“These findings have important implications for how we estimate the numbers of wombats, and also how we think about the social structure of a wombat colony. They might be more social than we previously thought,” Swinbourne says.

Wombats are considered an agricultural pest because their burrowing activity can cause damage to farm infrastructure and equipment as well as crops.

Lessening the southern hairy-nosed wombat’s impact on agriculture on one hand, while conserving it on the other, continues to be a significant challenge for conservationists.

In a bid to stop the state’s puppy farms from flying under the radar, Queensland MP Leanne Donaldson has this week introduced a bill she hopes will stamp out the problem.

The bill, if passed, will require compulsory registration for all dog

breeders. The agriculture and fisheries minister said that

the registration will allow for detection of previously hidden puppy farms.

“A new dog breeder registration system will, for the first time, make

it possible to locate and close down those dog

breeding facilities where profit is put before the welfare

of dogs,” said Donaldson.The government has worked with

the RSPCA to create guidelines. The guidelines were sanctioned in public survey discussions, in which 95 per cent of respondents were in favour of the compulsory registration of breeders.

“This will be backed up with compulsory standards and guidelines for breeding dogs developed in consultation with the RSPCA and Dogs Queensland,” said Donaldson. “Once finalised, the standards will be adopted as a compulsory requirement under the Animal Care and Protection Act 2001 and will apply to all dog breeders in Queensland.

Mark Townsend, the CEO of Queensland’s RSPCA, looks forward to the demise of puppy farms.

“It’s purely a money-making exercise and often the dogs bred there suffer from genetic conditions that will cost future owners thousands of dollars in veterinary bills,” he said.

“We’ve been forced to seize animals from conditions that were appalling.

“We wholly support this initiative. It is legislation that we believe will make it a lot easier to control irresponsible and illegal breeding.”

Qld laws set to stop puppy farms

“They might be more social than we previously thought,”

Swinbourne says.


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Study finds tropical reef fish vulnerable to climate changeScientists have identified the key drivers of why some species are absent from reefs in the Indian and Pacific oceans, and which species are most vulnerable.

Published in the journal Nature Communications, the findings are the result of an international collaboration involving a large team of scientists. Together they produced one of the world’s most extensive datasets of reef fish, analysing almost 10,000 records from over 900 locations.

“Our analysis of 241 fish species showed that larger-bodied fish, especially those with smaller geographic ranges, are especially vulnerable,” explains lead author Dr Camille Mellin, from the University of Adelaide’s Environment Institute and the Australian Institute of Marine Science. “In fact, these species are 67 per cent less likely to occur where human impact and temperature seasonality exceed critical thresholds. For example, these types of fish occur less commonly on reefs in the Coral Triangle (between the Philippines, Indonesia and Papua New Guinea), which is surprising given that this is a well-known biodiversity hotspot.

“In the Coral Triangle, coral reefs tend to be highly affected by human activity, such as fishing and urban development, in contrast to the less-impacted reefs in New Caledonia or on the Great Barrier Reef that tend to host more of these large, small-ranging fish species.”

Although these fish represent only seven per cent of all the species the team examined, they often provide unique and important functions on the reef.

“The greater sensitivity of these larger-bodied, small-ranging reef fishes to human pressure could have serious consequences for reef ecosystems if they are lost,” says project leader Dr Julian Caley from the Australian Institute of Marine Science.

Harlequin Sweetlips Plectorhinchus Chaetodonoides on a colourful

coral reef in Komodo, Indonesia


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news + events

Feline virus outbreak in SydneyTwo vet practices in Sydney have had suspected outbreaks of feline calicivirus-virulent systemic disease (FCV-VSD). A number of cats, suspected of having the virus, died between December 2015 and January 2016.

Vets should watch for the following signs and symptoms: oedema (limb and/or head), ear-tip necrosis, crusted nasal sores, purulent skin ulcers, oral ulceration, fever, dyspnoea and jaundice. These signs are known to have presented in strains of FCV-VSD found in overseas epizootic outbreaks.

FCV is known to present upper respiratory signs, transient lameness and oral ulcers, yet the severity of VSD is characterised by hepatocellular necrosis and severe systemic inflammatory response syndrome, in

combination with vasculitis. FCV is highly contagious, and can

survive unaided for up to a month. Vets should notify any owners with cats that present FCV-VSD symptoms to take precautions and wash items that have come into contact with affected felines.

Even vaccination against FCV may not be enough to protect cats from VSD. The Australian Veterinary Association (AVA) recommended the following safety precautions: “Vets who see pyrexic, systemically unwell cats who may have the disease must keep them isolated from other cats, and employ effective barrier nursing, good hand hygiene and wash down surfaces to prevent spread to other cats.

Effective disinfectants include

sodium hypochlorite (1:32 dilution of a five-six per cent solution) and potassium peroxymonosulfate.”

Cats that have been infected with field strains of FCV and concurrently with feline panleukopenia virus (FPV) may have ymptoms that imitate FCV-VSD, so the AVA are also recommending testing for FPV as well.

The University of Sydney have begun researching strains believed to have caused the current Sydney cases. If you believe you may have found another case, the AVA recommends to contact Professor Vanessa Barrs ([email protected]).

Symptoms are likely to present more severely in adult cats than in kittens.

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Vets in the spotlight

Future Vet Kids Camp observing dental surgery at

Balmain Veterinary Hospital.

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They are sometimes derided as “celebrity vets” more interested in self-promotion than animal welfare, but Australia’s television vets remain professionals eager to make a difference, Tracey Porter writes.

TWICE A YEAR AN ENTHUSIASTIC group of children and teenagers gather in Sydney’s eastern suburbs to study the human-animal connection.

With backpacks and sleeping bags in tow, they give up five days of their sacred school holidays to work alongside specialised animal handlers to be educated about responsible pet ownership and explore the realities of a career in veterinary science.

Growing in popularity each year, the Future Vet Kids Camp exists largely due to the good work done raising the profile of the sector via media personalities such as Bondi Vet doctors Lisa Chimes and Chris Brown, Harry’s Practice presenters veterinarians Katrina Warren and Harry Cooper, and Village Vets Australia workhorses Drs Anthony Bennett and James Carroll.

Dr Lisa ChimesHaving graduated from Sydney University in 2006, Dr Chimes—best known for her work on Network Ten’s Bondi Vet, where she is filmed carrying out her everyday duties as an emergency and critical care veterinarian at Small Animal Specialist Hospital (SASH)—says she feels humbled to be afforded the opportunity to teach people, in particular children, about animals.

“I always had in my head that one day when I become a vet it would be nice to

Vets in the spotlight

programmes. It really wasn’t like that when I was a kid and I feel very privileged that Bondi Vet is one of the driving forces behind that.”

Dr Chimes, who studied drama through school in addition to completing a television-presenting course during her studies, says her television career came about almost by accident.

Sydney-born and bred, she had already completed a year in Melbourne

teach kids about animals. I remember watching Harry’s Practice as a child and I learned so much, and I always thought ‘wouldn’t it be nice to teach kids one day and give back?’.

“When I was at school it wasn’t that common for people to consider becoming a vet. Now, because of Bondi Vet’s influence, there are so many kids that want to become vets they’ve got enough interest to stage school holiday

Dr Lisa Chimes gets a helping hand from Dr Andrew Marchevsky.

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in emergency and critical care upon graduating when she discovered a new accident and emergency hospital, SASH, was due to open in North Ryde. Unbeknown to her, at the same time makers of Bondi Vet had been in touch with the hospital and asked to film some stories there.

By coincidence she met one of the Bondi Vet producers through a friend who works at its production company and was asked to work on the show.

“It was just amazing timing. They were starting filming at the exact same time I was moving back to Sydney to work at SASH so all the ducks were lined up.”

Dr Chimes says most options for television work are not necessarily educational but the chance to appear on Bondi Vet and her other show Dr Lisa to the Rescue (where would-be pet owners are matched with pets from shelters) have allowed her to combine both her loves, while showing the realities of life in practice. “It’s teaching children empathy, science and responsibility—and I really feel so proud to be a part of that.”

Dr Katrina WarrenUnlike Dr Chimes, Dr Katrina Warren no longer works in practice but occupies several TV hosting roles, works as an ambassador for a pet treatment company, runs her own online training school and is also the resident vet for The Today Show.

Best known for her appearances on television show Harry’s Practice and for

“In addition we also get some ‘Bondi Vet tourists’ from all around Australia and the world—we’ve had people from as far away as Perth in Australia, and Wales in Great Britain. If I’m not operating, I’ll always give them a tour of the hospital. If they’ve made the effort to come and visit it’s a small thing that I can do. Often it’s the parents as much as the kids that wander around the hospital wide eyed,” he says.

Dr Diederik GeldermanDr Diederik Gelderman, the owner of veterinary consultancy service Turbo Charge Your Practice, says as well as raising the profile of the sector as a whole, the country’s best known vets are also helping to educate the wider public about what good vets are capable of.

“They’ve shown people what we can do—as in putting in hips and elbows and big cancer removals and chemotherapies. A lot of that is a bit unrealistic in a day-to-day vet practice but at least the clients are coming in with some knowledge of some of the stuff that is available and they may not have come in otherwise.”

Dr Gelderman says while this means some fresh graduates are inevitably disappointed when they discover most of their everyday work is unlike some of the sensational cases that cross Dr Chris Brown’s desk, the approach taken by Village Vets offers a fresh perspective.

“I know so many people that watch [Village Vets Australia], quite a few vets watch it as well… because that’s real life. Not every animal survives—some die, there are middle-of-the-night calls. So that adds a good dose of reality to the hoopla.”

Drs Anthony Bennett and James Caroll, stars of Village Vets.

the relationship she had with her border collie, Toby, Dr Warren says she works hard to use her profile to promote responsible pet ownership which she says is a win/win for all vets.

“I hope that I have had a positive impact on the profession and the way people perceive vets. The work I did with Toby definitely encouraged people to get out and do more training with their pets. I still meet people today who tell me they were inspired to get their dog after watching the bond Toby and I shared.”

Dr Andrew MarchevskyYet it’s not just the future custodians of veterinary science who are being influenced by the work being done by vets in the public arena.

SASH co-owner Dr Andrew Marchevsky says it is impossible to estimate the effect the show has had in terms of patient or staff numbers since filming began in 2007, but both have “obviously grown”.

“I do think it has made the public more aware of veterinary specialist services in general. People can see that there are facilities that offer the same level of care you might find in a human hospital with CT and MRI scanners, surgical theatres endoscopic equipment and intensive care. SASH has specialists ranging from surgeons, internal medicine specialists, neurologists, ophthalmologists and dermatologists to name a few. The level

of care that can be offered to our pets is fantastic.”

While initially concerned the show would seek to

sensationalise stories, Dr Marchevsky says while the producers have final control over what goes to air, this has never been a problem. Indeed there have been many positive outcomes

as a result of the hospital’s profile in the show including

an increase in the number of phone calls from pet owners.

“I still meet people today who tell me they were

inspired to get their dog after watching the bond

Toby and I shared.”Dr Katrina Warren,

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Y O U R B U S I N E S S

The task of owning and managing a veterinary practice is not for the faint-hearted—but nor is handing control over to a third party, for some. Tracey Porter looks at how outsourcing is changing the way vets operate.

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Outside perspective

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VETERINARY PRACTICE HAS COME a long way since the days when Dr Tony Thelander first donned a stethoscope and a white labcoat.

With little in the way of sophisticated equipment or smart drugs, the director of vet valuation and assessment service ValuVet says veterinarians operating in the late 60s and 70s had no option but to busy themselves being great all-rounders.

“We still controlled fleas on dogs and cats with sheep dip; there were no veterinary specialists or trained nurses; practice management and marketing were unheard of, and most veterinary clinics were operated from the veterinarian’s [private] residence.” However, with the advent of computerisation, the introduction of in-house clinical services and the corporatisation of many vet

consultancies, the business of running a practice is today a far more complex beast than it once was.

Bearing the loadDr Diederik Gelderman, owner of vet coaching service Turbo Charge Your Practice, says this is placing additional stress on already overworked vets—with many suffering physical and mental exhaustion as a result.

“I believe the suicide rate is six times the public rate— the divorce rate, the public breakdown rate, the suicide rate, the alcoholism rate and the drug abuse rate… they’re all overrepresented [by those in the veterinary sector].”

As a result, both doctors say they are seeing an increasing number of practice owners outsourcing functions from within the practice to ensure vets managing their own small businesses are able to focus on the area they understand best—treating sick and injured animals.

Dr Gelderman says while larger practices are usually able to ease the burden by employing practice managers to offload some of these managerial-type tasks such as IT, marketing, book-keeping and HR, too many “mum and dad” practice owners are still getting to grips with the demands of modern-day commercial practice.

He says most Australian vet practices run at approximately seven-to-eight per cent profit, whereas successful franchise operators, such as McDonald’s and Payless Shoes, are making “in excess of 20 per cent profit”.

In the past, very few vet practices have been run as actual businesses, he says, but the tide is slowly turning.

“Those vets running their own practices now are slowly starting to understand they need to make some money for their future and for their kids. They’re starting to realise that they need a lifestyle,

time off and better quality personal and professional satisfaction.

“The modern generation are not happy to do the 100-hour weeks anymore, they’re starting to see that they need to make money to put away for retirement.”

Dr Thelander says in addition to getting third-party contractors in to cover traditional business services such as accounting and legal, progressive practices are also seeing value in outsourcing clinical requirements such as specialist referrals, as well as contracting out ancillary services, including grooming and behaviour training.

“In the management area [we are seeing], HR services such as payroll and staff training, clinic design and fit-out and inventory management [being sub-contracted]. In more recent times, information technology, marketing, insurance programs and patient health plans are now being outsourced by practices.”

Non-routine and highly specialised services will remain the domain of external operators, he says.

Dr Thelander argues outsourcing services for the practice can be looked upon as a ‘leg-up’ to assist the business to grow.

A business investment“As a natural progression, as the practice prospers and is able to re-invest in its own business, the need for outsourcing can often be reduced.”

Dr Gelderman says while there are few disadvantages to outsourcing, the propensity by some vets to carry the burden themselves out of reluctance to contract out parts of their business could be due in part to their need to remain in control.

“One of the things I still see a lot is control freaks. So many of them employ managers or practice managers and won’t let them pay the wages, won’t let them see the figures of the practice and won’t

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confide in them. I say quite openly ‘you’re setting your practice manager up for failure’. I see it worse in the older vets but I still see it in the younger vets as well. I think it’s part of the way that we’re trained at university as well. We’re trained to be insular; to work autonomously, to make decisions ourselves. We’re not trained to function as part of a team. We learn to depend on ourselves.”

For Brookfield Vet Hospital practice manager/owner Bronwyn Toft, her reasons for outsourcing only the bare minimum of duties are not so much a need for control as they are a skill for delegation.

Toft, who alongside vet husband Richard, has run the surgery for the past 30 years, says she began as a vet nurse but was pushed into a management role as the surgery has grown.

Outsourcing internallyShe says the hospital has a lot of talented people among its 14 staff, and tapping into their skills saves time while offering variety to employees.

“I don’t outsource the practice often, but I will always look inside my team to

see who can help. If I have a creative team member, that person will get trained and aided to perform their role, e.g. advertising and marketing. If I have a team member who is interested in children, I will encourage them to help with PetPEP (the Australian Veterinary Association’s Pets and People Education Program). If I have a team member who is interested in behaviour, I will encourage them to help in puppy preschool. So, really, I’m good at delegating.

“The biggest issue with this is that when a staff member decides to leave it can disrupt the flow of the surgery’s operations until someone has been trained to fill the position, but this is to be expected.”

But while frequent outsourcing is not for everyone, there’s no denying that as demand for third-party services grow, so too will the way in which they’re packaged.

Dr Thelander says outsourcing within the vet sector has now come full circle, with many corporate practices large enough to have their own departments for IT, HR, training, marketing and finance.

This has led to a sub-group of service providers that supply specifically to the

smaller, privately owned practices to allow their clients to keep pace and compete effectively against the larger corporate practices that are more able to resource their managerial resources internally.

“Clearly the bar has been raised and outsourcing providers are the key to allowing private practices to compete effectively with corporate practices.

“The main challenge for smaller, privately owned practices is to keep up to date with business trends, to know when and where to seek help and to be prepared to re-invest in the business.”

Outsourcing secondary services like grooming can add value without

overstretching employees.

C O V E R S T O RY

With Skype, FaceTime and video calling more popular than ever, are online vet practices for common problems the service of the future? Angela Tufvesson reports.

Online vetting

20

21

JUGGLING VETERINARY CARE WITH THE DEMANDS OF life is a challenge for pet owners. Many wait until their animal is very unwell before visiting the vet, struggle to squeeze in routine appointments during work hours, or live in rural areas where veterinary care is difficult to access. Enter online veterinary consultations, which appear to offer quality care minus the logistical headaches.

Dr Claire Jenkins is a co-founder and the principal veterinarian at vetchat, Australia’s first online consulting service that isn’t attached to a physical practice. “Initially, as a practising veterinarian I found that a lot of my clients were bringing their pets in when they were really sick, and often after seeking help from Dr Google first. I thought by improving clients’ ability to seek accurate and up-to-date veterinary advice we could improve the way vet care is delivered in Australia, and shift the focus to optimising wellbeing and early intervention rather than just treating illness,” she says.

Launched in August 2015, the service offers 15-minute one-on-one consultations between client and vet using Skype and FaceTime. Appointments are booked online and cost $30 each. “All you can do is give your expertise,” says Dr Jenkins. “I’ve been a veterinarian for 10 years and I’ve done my membership in small animal medicine, so as far as dogs and cats and other small furry animals go, I don’t need much more than that. As part of improving our service we’ve been gathering feedback from our clients and the response has been overwhelmingly positive.”

Add-on serviceDr Liz Chmurycz, from Russell Vale Animal Clinic in NSW, also offers online consultations—to existing clients at no additional cost—to help increase access to quality veterinary care. “I could either complain about Dr Google or be available so people can ask me the questions online,” she says. “People do go to Dr Google for help—it really annoys me, but they do it because they have no other alternative.”

These services are part of a growing global shift towards technology-based consultations for animals and humans alike, which are becoming increasingly popular among vets in the US and UK. But local industry bodies are concerned that the legality and ethics of online consultations are murky at best, especially when it comes to diagnosis and treatment.

The concerns“The vast majority of information comes from your

history and physical examination, so if you’re not performing a physical examination

then you’re ruling out a large amount of material that you would normally use as a basis for forming a diagnosis,”

says John Baguley, a registrar at the Veterinary Practitioners Board of NSW.

“If you’re using an online consultation to develop

22

C O V E R S T O R Y

a diagnosis you have to be very careful that you’re complying with the current standards of veterinary practice in order to make that diagnosis. If a complaint was lodged in the future, the board would look to see if that particular methodology was suitable for that particular diagnosis, and whether it was a diagnosis made in accordance with current standards.”

Dr Robert Johnson, president of the Australian Veterinary Association (AVA), is especially concerned about the effect of virtual interactions on the development of face-to-face relationships and vets’ ability to make accurate diagnoses.

“Veterinarians who offer online services have to be acutely aware of the regulations in their own jurisdiction and, if they’re members of the AVA, the code of conduct as to how they behave,” he says.

“When you treat an animal it’s meant to be known to you, and the client is meant to be known to you, and you build a relationship. To be able to diagnose something, a very good lecturer when I went through vet school quite some time ago told me: “The best aid to diagnosis is the oft-repeated physical examination.” I ask, how can you do physical

examinations online? Maybe in the future things will change, but at the moment vets need to be able to treat an animal and dispense drugs through a direct relationship with the client and the animal.”

Confusion over which jurisdiction vets answer to also poses a dilemma for regulators. “If I’m a vet in NSW and I’m providing an online consultation to the owner of an animal in Victoria and there is a complaint, which board am I responsible to—the vet board in NSW, because that’s where I’m registered, or the vet board in Victoria, because that’s where the animal is located?” asks Baguley.

In case of emergency…But while vetchat deals with common complaints like allergies, vomiting, minor cuts and conjunctivitis, Dr Jenkins says in essence it offers an advisory service

designed to supplement existing face-to-face veterinary consultations. Importantly, vetchat doesn’t issue diagnoses or provide prescriptions for medication.

“Where appropriate, clients are referred to their local veterinarian for a hands-on examination or tests,” says Dr Jenkins. “If a pet is experiencing an emergency they need to head straight to their local surgery—we’re not an emergency service.

“Any online veterinary service is basically a supplementary service to ordinary vet care.

It’s never going to replace seeing your vet. Clients still need to have a relationship with their local veterinarian,

because hands-on examinations do need to be

done at the moment.”Dr Chmurycz agrees that the

online experience isn’t designed to replace or disrupt existing models of

animal care. “When you’ve got things like behaviour complications or dermatology, these are some areas that are viable to do as an online consultation. But there are a lot of things where it’s not viable at all, where you really need to be doing the skin scrapes and taking swabs.” She says the two consultation mediums offer different experiences and methods of communication that can work in combination, rather than opposition.

21st-century regulationAs yet, the industry hasn’t put in place any specific regulations to govern the online consultation space. “It’s never been challenged [legally] in Australia as far as I’m aware,” says Dr Chmurycz. “When I spoke to my practitioners’ board, there’s nothing there covering [online consultations] one way or another.

“The difference is in [whether] the vet [is] making a diagnosis online and offering a treatment based on a diagnosis online without physically examining the animal, or whether the vet is giving general advice as they would if a client rang the vet. The service I’m providing is no different to people ringing us up wanting advice.”

Dr Jenkins says she doesn’t expect vetchat to remain the only purely online vet clinic in Australia for long, so how will regulators then keep pace with technological change and a growing number of on-demand virtual vets?

“I can’t see there being a change to the standards, but what I can see is the need for more guidance in terms of what your colleagues would believe is acceptable and not acceptable in terms of current practice, and also how to go about performing these online consultations,” says Baguley.

“If online consultations are what the pet owners want we need to do that... we’re

in the service industry.”Dr Liz Chmurycz, Russell Vale Animal Clinic.

Pets facing an emergency need to go to a bricks-and-mortar

surgery, says Dr Jenkins.

“Increasing guidelines in terms of how you go about performing online consultations would be helpful for the profession to ensure vets are compliant with the legislation, as well as to assist vets to overcome the challenges and potentially realise the animal welfare benefits of this type of technology.”

Servicing clientsUltimately, whether online consultations

are offered virtually or alongside physical practices, free or at cost, Drs Jenkins and Chmurycz agree that they satisfy growing consumer demand for the convenience of online services.

“We’re really trying to give customers what they want—and that is advice from their home and time with the veterinarian when they need it, rather than just when they can get it,” says Dr Jenkins. “It’s difficult for a lot of people to pack up their

dogs and cats and pop them into the car and get down to the clinic. The benefit for them is they can contact a vet and get expert advice when they need it.”

And, importantly, online consultations may help to increase the number of people accessing veterinary services, as well as highlight the importance of preventative care. “A lot of people aren’t going to the vet—there’s still a large percentage of the general population who only see vets when their pet gets sick, and even then they will try everything they can at home,” says Dr Chmurycz. “As a profession we need to change that, otherwise people aren’t going to need us.

“We have to be where the pet owners are, and if online consultations are what the pet owners want we need to do that. Our goal is to always be there for the animal, but ultimately provide a service to the pet owner. After all, we’re in the service industry.”

“I could either complain about Dr Google

or be available,” says Dr Jenkins.

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PRACTICE

Through the keyholeWhy minimally invasive

surgery is gaining popularity, page 10

Bright futureWhat you need to

consider to future proof your practice, page 14

Taking the leadWinner of the recent Vet Nurse of the

Year Award, Tiffany Swift, shares what

it takes to be the best Social policyLearn how to manage your workplace social

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5/02/2015 12:10 pm


Staff training programs might prove the best investment you make all year, writes John Burfitt.

IT’S A TALE OFTEN TOLD BY DANISH leadership coach Peter Baeklund in his motivational talks, and is regularly repeated as an inspiring mantra about the value of effective training in the workplace.

In Bakelund’s story, a CFO says to the CEO, “What happens if we invest in developing people and they leave us?”

And the CEO responds, “What happens if we don’t and they stay?”

Yolanda Gerges of Identity Consulting, who has worked as a trainer within the veterinary industry for over a decade, also adopts the philosophy.

She has a tale of her own about practice owners when they claim they don’t have the time or finances to invest in training.

“My response is, ‘So you don’t have the money for training, but you do have the

Training day

24

funds to maintain untrained people on a long-term basis?’” Gerges says.

“It’s a matter of making the managers take another look at training and what it can add to the business and the eventual bottom line.”

Making a startThe first thing any company needs with a training policy is to actually have one in place. Melbourne training consultant Louise Davis admits she is always surprised by the number of medical practice clients who want the best out of their teams, but are unsure how to go about developing a program to deliver results.

“Before any training takes place, the practice manager needs to step back and

25

ask these questions: how am I engaging with my staff members, what motivates them in their work and how well do I know them as a person and an employee?” Davis says.

“Then, based on that, you have to decide what the things are they need in order to do their job better. It has to be a two-way conversation where you get to know your staff and know their capabilities, rather than just sending them off for a training session you hope will be the solution to everything.

“You need to do some work first in setting goals. If you are getting frustrated with staff performance, there needs to be better quality to the conversations you are having.”

Setting goalsWith the arrival of each financial year should also come an overall strategy, with plans for what the business will achieve. From those plans, goals for the staff to achieve them should be clearly identified.

“If training is needed to help people achieve those goals, then that is a good starting point,” Cameron Young, business manager of Peninsula Vetcare, says.

“There must be a clear purpose to the training. You have to consider just how effective your business is going to be if you are not training the team in the areas they most need direction.”

Rather than a one-size-fits-all approach with generic training, this is the time to be as specific as possible about goals and outcomes.

“You want any success the team achieves to be linked back to your core business strategy,” Young adds. “This is why you need to know where you are heading, and how you want to get there by the training you decide on.”

Getting technicalFor practitioners working inside the consulting room and surgery, ongoing technical training must be a priority to keep up to date with industry standards.

“This is about giving team members adequate time to attend training sessions, then the time to put into practice what they have learned,” Danielle Bliim, Training Manager for SASH vets in Sydney, says.

“The team needs the encouragement to move forward, improve their skills and any knowledge they can learn from training is paramount.”

Adds Young, “There’s been so much development in new medications, new equipment and new procedures, and at a rapidly increasing rate. You have to make time for your staff to take on those new skills.”

Having a good knowledge of the current capabilities of the team, as well as their ability to interpret and adopt new processes, is also an essential in deciding on which training programs should be developed, and how they should be offered.

“Programs may need to be altered depending on how the team members absorb content, as expecting everyone to learn at the same speed is unrealistic,” Bliim says.

It is the after-training guidance which can be just as important as anything learned within a session, and where the greatest improvements can take place. “This is why guidance is essential, as learning new skills comes with a level of uncertainty, so assurance and encouragement is always required,” she adds.

Front of houseWhile it is the veterinary skills of a practitioner that builds the reputation of a practice, it can often be the way clients are managed that can make or break a business.

“The biggest angst I hear from practice staff is they don’t know how to manage the client-patient issues effectively from a communication perspective, or they don’t feel armed with good problem-solving skills,” Gerges reveals.

“A lot of it comes down to emotional

intelligence, which is about how much awareness that person has about themselves and how their behaviour impacts on others.”

Emotional intelligence has become a key part of practice training for Gerges and Louise Davis, and both claim the more confident a staff member feels in their job, the better they are when dealing with a client.

“Technical skills are essential, but it is the soft skills of dealing with clients that can be the glue that holds the practice together,” Davis says. “If a staff member feels more motivated and engaged in what they are doing, it is going to show in the client experience they offer.”

Adds Gerges, “When you have a team that communicates well, you will have a high-performance team who will take responsibility for their performance and help you grow the practice.”

Measuring outcomesThe success of good training procedures is not only about the effectiveness of the trainer or the length of the sessions. It is more about about how the learnings have been understood and then implemented into the workings of the practice.

“You identify that through regular monitoring of progress, so you know what your team are doing and the results they are achieving with their new methods,” SASH’s Danielle Bliim says.

Which is why the most important conversations about training are the ones that take place once

a program has concluded. “There is this expectation

that once people come back from training, everything will be different, but it will only be if you engage with the team and measure how they are going,” Davis says.

“Have that conversation on a weekly basis. The

critical thing is to have them show you what they have

learned, what they understood and importantly, how they put it into action.”


26

Success by design

27

Just as the principles of design are regularly updated in residential and commercial spaces, veterinary clinics are updating at a great rate. Sita Simons explores what makes good clinic design and how necessary it is.

“IT’S A DIFFERENT INDUSTRY TODAY than 20 years ago,” says business director Ian Shapland of specialist healthcare fit-out company, Elite. “And this has absolutely impacted on the design and fit-out of modern surgeries and practices. Whereas most used to be found in back rooms of houses, council regulations and the interests of neighbours have moved practices out of residential areas and into purpose-built spaces.”

The 2000s saw an explosion in marketing and branding, and the need for veterinary practices to distinguish themselves in a busy market. “This hasn’t been easy for many vets, as understandably they have studied long and hard to become vets, not marketers,” says Shapland. But there is an expectation now that centres will be task-specific, easily distinguishable, comfortable and welcoming. This is all encapsulated in the design. There’s a way to go in this sector, but many vets are embracing the changes and there’s no doubt getting it right has a definite impact on the overall success of the practice,” says Shapland.

Retail has also become part of the package, from offering a range of foods and take-home treatments, to the other extreme of pet accessories and ‘spa’ experiences, in no small part thanks to celebrity culture. The pet-care industry in Australia is estimated to be worth more than $7 billion annually, and though pet-ownership numbers show a slight decline, spend per pet is rising year on year owing to an increase in understanding of pet health, more pet owners taking up preventative treatment, advances in veterinary medicine and an increase in product and service options.

The need for retail space has very much driven the design process, says design manager for CBD Projects, Meow Lim.

“Everything to make the workspace ergonomic and effective is important, and systems are sophisticated for these processes. This applies to making things

each detail was carefully considered. RSPCA project manager, Karen Thorne, says it is a complex process.

“There is a definite need for updating,” Thorne explains, “as thinking on animal care and shelter has come a long way, in tandem with great leaps forward in medicine and treatment. Designing a new space is a mix of science, function and aesthetics. Adoption centres used to be quite confronting places, so it was important to tackle that. Making a friendly, comfortable space where people can hang out, have a coffee, and interact with the animals has a huge impact on successful adoptions.”

These are now ‘destination’ centres, where the whole family can come and enjoy positive interaction with animals. The use of colour and materials is inviting for the customer, and large retail selections of what people want and expect for their pets is a dominant theme.

“We consulted many experts,” says Thorne. “Making a space look really decorative is the icing on the cake, so to speak, and it works. Using glass and vinyls instead of concrete and steel is more appealing aesthetically, but also more expensive. All centres thinking about updating need to ask first if they can afford the upkeep afterwards, what the impact of the usual wear and tear will be on the space and materials, and if they can afford to refurbish again in five instead of 10 years.” Success

by design

smooth and efficient and comfortable for staff, customers and animals. From the height of the counter, to a separation of dog and cat wards, ease and comfort for the animal, the customer and the practitioner are carefully considered. But the retail side of things is a relatively new element that must be integrated well into the design. Good display equals good sales.”

Advances in technology mean better materials with which to design and create improved function. “Personalising the space and moving away from the clinical look that rendered all practices very similar is a common goal,” says Lim. “Taking the inviting neighbourhood feel that existed in home-based practices and bringing it to a very up-to-date practice can be done with timber-look vinyls, for instance, which are much more hygienic and require less maintenance than timber boards but look completely authentic.”

No matter how attractive though, the practicalities of running a clinic, hospital or practice are elements that never change. There is a lot of wear and tear on the space and facilities, and rigorous cleaning reduces lifespan. Striking the balance between aesthetics and longevity is something all facilities must factor in.

The RSPCA adoption centre in Rouse Hill, NSW, is one example of an animal-care centre that has taken on board the most up-to-date thinking and design principles. Three years in the planning,

“Getting it right has a definite impact on the overall success of the practice,” says Ian Shapland, from Elite Fitouts.

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P R O D U C T G U I D E

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A D V E R T O R I A L

Veterinary imaging guide

Take a closer look with the GE Logiq V2THE LOGIQ V2 IS THE LATEST release in the GE Logiq series of ultrasound systems. This system is an entry-level system but with

advanced imaging capabilities. The microconvex transducer, combined

with advanced image processing produces high-quality abdominal imaging.

The series of linear transducers include capabilities for detailed tendon and small parts scanning, while also being capable of equine reproductive work.

The new Logiq V2 has a 15” LCD screen image, large for such a portable system. The advanced capabilities of colour Doppler, power and PW Doppler are standard features on the system. The Logiq V2 has exceptional image quality, with technologies being migrated through the range from the Flagship Logiq systems.

Designed to handle workload efficiently with automated features and interactive

tools to help and support confident decisions. Fast, accurate information with a few strokes for Auto Optimisation, Auto IMT, SonoBiometry and Scan Assistant. This feature can enhance your skills and take your practice to the next level through real-time imaging.

The Logiq V2 gives you access to assistance to support exam efficiency and accuracy through Scan Coach and Onboard Help. The system has advanced imaging technologies including Coded Harmonics Imaging, Real-Time Speckle Reduction Imaging and Cross Beam. You can be confident about getting both high value and quality. The Logiq V2 delivers great value for your investment.

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even with the most difficult cases.The CX1A is built with its own wireless

access point (WAP) to give you the best range and connectivity from workstation to panel. It has a high quality clinical review

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32

5 questions to ask when buying small animal ultrasound systems

Purchasing an ultrasound is a large investment for most small animal practices therefore it is paramount to carry out thorough research. Below we have prepared 5 important questions to help you make a more informed decision.

Q1 Does the ultrasound system come with veterinary specific presets?Specific presets can be a major advantage in a veterinary application as it minimises the amount of adjustments needed to achieve a good image on a variety of different species.

For example, you can set up the system to look at a cat’s abdomen versus a dog’s heart and the algorithms behind the image will change appropriately. This will also choose the frequency, contrast, depth and focus settings to give you a good starting point so you are ready to go with minimal adjustment.

In addition to presets, probe selection is an important factor when purchasing ultrasound.

Q2 Is the ultrasound system easy to use?All ultrasound systems are different, some easier to use than others.

When trying the equipment, make sure you find it intuitive to use, looking

at how easy it is to add patient details, adjust, freeze and save the image as well as retrieving this information when you are done.

Q3 Should my ultrasound system be portable?Don’t be fooled into thinking bigger is better. Just think about how powerful laptops and mobile phones are these days?

One major advantage of portable ultrasound is that it is easy to move around. This means it can be put away

when not in use or when space in the clinic is limited, it can be shared between consult rooms and service is easy as it can be packed up and sent away. Of course if you like it on wheels,

most portable scanners can be optioned with a trolley also.

Q4 How much should a small animal ultrasound system cost?Budget is always something that is considered when purchasing any capital equipment and ultrasound is no different.

Black and white ultrasound systems can range from as little as $8000 up to $15,000. Ultrasound scanners with optional software’s like Colour Doppler generally range from $15,000 right up to $100,000 or more. When considering the price of ultrasound, you may want to decide whether or not you need Colour Doppler?

Generally the more you invest, the better the image quality you can achieve. The better the image quality, the easier it is to interpret the image. But don’t be fooled only by price, as we all know technology is fast moving which makes last year’s technology break through affordable for today’s general practice.

Q5 Which company should I choose when buying my ultrasound system?Things to consider here are the benefits that are provided to a customer as a whole package.Support – A company with in house service that can also provide break down loan systems if and when required to minimise any down time.Wide range of products – We feel it is important to seek partners that offer a range of ultrasound systems to find one that specifically suits your needs.Training – It is important to seek partners that have the equipment knowledge and offer the clinical training so you can gain the skills necessary in order to get the best out of your investment.

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34

Come for the products, stay for the serviceMedical Plus are known for having the best range in ultrasound technology, and we aim to have the best product at every price point. Great products and fast, efficient service are what we are all about. “We’ve been in the industry for coming up on 20 years and our in-house servicing sets us apart,” says Earl Rowland, Medical Plus’ national sales manager. “Vets come for the quality products, but stay for the service we provide.

“We’re fast and we’re efficient; people don’t have much down time with us. If your x-ray system goes down and it takes a week to fix it then you’re going to be in trouble. We make sure clients don’t have to worry by rectifying problems as quickly as possible.”

Just ask Dr Malcolm Ware, from The Vet Practice and Veterinary Integrative Medicine Centre in Whittlesea, Victoria.

“When on the lookout for up-to-date quality imaging equipment we always contact Medical Plus first. Over many years of dealing with them for ultrasound, and now CT, we have always found them to be excellent and reliable. Not only for the purchase, but for all aspects of after-sales service, from implementation to dealing with any issues that arise with the equipment.”

FidexThe Fidex is a 3-in-1 product—CT, x-ray and fluoroscopy; it’s the only of its kind in the world. The Fidex system is specifically designed for the veterinary industry, they don’t sell them in the human world. You can do CT, x-ray and fluoroscopy all on

the one unit and its relatively inexpensive.

While some of the really big practices can

afford to shell out

on a standard service contract, we know many smaller practices can’t. This system offers a more economical service contract. We think for medium-to-large practices, it’s the perfect fit.

Features• CT field of view of up to 23 cm diameter

x 54 cm length• Digital radiography (DR) – 17” x 17”

one-shoot imaging plate• Fluoroscopy (FL) – 5” x 5” (13 cm x 13

cm) imaging plate

• X-ray source 60 – 120 kVp; 0.6 and 0.3 mm focus

• Gantry and table – C-arm type gantry with motorized rotational positioning and large field of view (up to 23 cm diameter in volume CT mode)

• Interchangeable tables• Motorised table: up/down and in/out• Power source/consumption – standard

15 Amp,120 V/60 Hz outlet; optionally 240 V/50 Hz/60 Hz input. Average power consumption is less than 250 W, and

• Footprint – 8’ 10”(L) x 4’ 10”(W) x 6’ 2”(H).

CloudDR high definition digital radiography The case for direct digital radiography is compelling. In fact, widespread adoption of this digital technology will forever change veterinary imaging, in much the same way that digital cameras replaced film, smart phones displaced cell phones, and GPS marginalised paper maps. The case for delay has been refuted. The time is now. From today until your upgrade, every film taken effectively increases your costs. Every overdosed film exposure, retake, chemical, processor failure, and envelope storage of a film makes our industry less friendly to the environment. The only questions that remain are those of choice. Cuattro offers amazing imaging, all with the ease of multi-touch software—just like you use on your phone.

Features• Direct deposition cesium• 100-micron pixel size• HD pixel density. 18 Million (17x17),

15 Million (14x17)• Resolution of at least 5 lp/mm• 16 Bit A/D 16 Bit Grayscale Native• 16 Bit Multi-Frequency Tuning• Windows 8 Embedded – 64-bit OS• Multi-touch user interface• Cloud based PACS connectivity• Software upgrades and updates,

and 24/7 live technical support.

MyLab™Gamma veterinary ultrasoundMyLab™Gamma is the newly introduced model in the popular MyLab range. It has taken the next step in quality for ultrasound imaging. A best in class, highly portable, ‘green’ ultrasound system. The super-light, feature-packed portable system sets ultrasound free to be used in all rooms of the clinic or in the field.

The MyLab™Gamma ultrasound is fast and simple to use, it offers fast boot times and a rapid resume-from-standby mode, which means the system is ready to use within seconds.

It has a high resolution widescreen monitor that can rotate +90/-90 degrees, to help with reflection and to show colleagues what you’re scanning.

Features • Compact,

highly portable• Wireless

connectivity, one-click networking with other systems and local networks as required

• Remote service capabilities• High resolution widescreen with

+90/-90 rotation• Fully customised using eTouch™ feature• Two probe connectors on board, four

on the cart• Security lock• TEI™ – tissue enhancement imaging• VPan – panoramic imaging• 3D-4D imaging, and• Up to 18Mhz imaging.

AustraliaTel: 1300 368 809 Email: [email protected]

New ZealandTel: 09 2758205 Email: [email protected]

MRI

MRI

ULTRASOUND

PORTABLE ULTRASOUND

DIGITAL X-RAY

DIGITAL X-RAY

CT FLOURO & X-RAY

A4 FlyerFeb 2016_FINAL.pdf 28/2/16 7:26:25 PM



36

“After much deliberation for (I’m ashamed to say) a few years, I finally took the plunge and purchased the iM3 CR7 VET dental radiology unit & Port XII generator from IM3 this year in July.

I now can’t imagine life without it. EVERYTHING about performing dental procedures is better now. We can identify pathology quickly, easily and we make absolutely certain now that when we perform a COHAT (Comprehensive Oral Health Assessment and Treatment), we are able to address all of the patient’s pathology. I cringe to think of what used to happen before, when we would only treat what we could see or probe... how many of our patients were walking out of here still in pain from unidentified pathology? Now we are confident that we are doing a vastly superior job for our patients.

The reports that are able to be generated

are fantastic—clients love them and I have never once had someone say that the dental procedure was “too expensive” after seeing the reports. They really highlight to the owners that dental/oral surgery is a big deal and that all pets deserve a healthy, pain-free mouth.

We received the unit at the end of July and had it up and running in full swing for

August’s dental health month. Nicole’s training day was great fun and all of my staff have really bought in to oral health as a focus. It takes the

nurses only about 10 minutes to generate a full-mouth radiographic survey and they will happily point out pathology and make the appropriate excited “oooooooh!” noises when something cool shows up. All staff are very capable in using the physical equipment and the software post training.

And, of course, to mention the costs—we took enough income in the first two weeks of dental month from extraction costs alone to pay for the unit. I was absolutely stunned. My average COHAT charges have increased approximately 60 per cent, with NO COMPLAINTS (only compliments and thanks!) from clients and I have never charged a cent for taking the radiographs!

The increased revenue is simply from the increased work—the existing pathology that we were previously missing.

I know that I sound like I work for IM3 now... but honestly, I am a complete convert. My only regret is that I waited this long!

Dr Karen Teasdale (October 2015)Angourie Road Veterinary SurgeryYamba, New South Wales

For more information about dental x-ray, please contact iM3.

Dental X-ray—thought you couldn’t afford it?

And of course, to mention the costs—we took enough

income in the first two weeks of dental month

from extraction costs alone to pay for the unit.

iM3 Pty Ltd - Australia/Asia 21 Chaplin Drive Lane Cove NSW 2066 Australia

Ph: +61 (02) 9420 5766 Email: [email protected] www.im3vet.com

Portable Dental X-RayThe PORT-X ll provides total portability combined with the latest digital technology.

• Light and small, enabling total portability and use in any location.

• Small dose of radiation, ensuring patient and operator safety.

• High performance Tube and HFG, providing sharp and clear images.

• Designed for use with both digital sensors and CR image plates.

• Supplied with stand and remote operating switch.

• Fixed kV (60) and mA (2) means the only variable is the exposure time.

• X-ray tube manufactured by Toshiba.

• Complies with National Safety Standards and guidelines.

Revolution 4DC X-Ray• Smallest focal spot available 0.4mm - better image quality

• DC technology reduces radiation dosage compared to AC

• Wireless remote control - activate x-ray outside of room

• Approved for use in all states of Australia & NZ

• Max arm extension 230cm from wall

• Highest Resolution veterinary dental scanner available

• Flexible image plates in 7 sizes

• Largest HD plate 5.7 x 9.4cm available, suitable for extremities

• Images can be viewd throughout the clinic

• No service contracts, iM3 technical support for life of scanner

• Comes with 10 network licenses, 2 year warranty and iM3 support

CR7 VET - Small, compact Dental Scanner

The ultimate dental radiology package:Port X, Hand Held Dental X-Ray and the CR7 with size 2 & 4 plates and software including onsite training.

$16,995.00 +GST

The Veterinary Dental Company

iM3 Pty Ltd - The Veterinary Dental Company21 Chaplin Drive, Lane Cove, Sydney NSW 2066 Australiap +61 2 9420 5766 f +61 2 9420 5677 e [email protected]

OR

“After trying several dental X-ray systems I have found the simplicity and ease of use of the Genoray Port X-II combined with the CR-7 to be far superior than the others. With this system and the great support from iM3 there is no reason for any Veterinary Hospital not to be doing dental radiography.”

Dr Brad GarlickAsquith Veterinary ClinicSydney, NSW Australia

Dental X-Ray

Optional floor stand

Wireless remote with vet icons and setting

$17,300.00























$16,995.00 +GST

The Veterinary Dental Company


OR



Dental X-Ray



$17,300.00























$16,995.00 +GST

T h e V e t e r i n a r y D e n t a l C o m p a n y


OR



Dental X-Ray



$17,300.00























$16,995.00 +GST

T h e V e t e r i n a r y D e n t a l C o m p a n y


OR



Dental X-Ray



$17,300.00



38

Compact FireCR Flash Veterinary Readers combine crystal-clear image quality, speed and affordability.

DLC Australia Pty Ltd is proud to release the NEW FireCR Flash Veterinary Readers.

The compact FireCR Flash Reader product line offers crystal-clear image quality, along with fast scanning speeds and other key features to meet every imaging need.

The new FireCR Flash Readers feature technology advances pioneered by 3DISC Imaging, resulting in the highest possible signal-collection efficiency. This provides the high-image quality facilities need for diagnostic imaging applications.

The FireCR Flash Readers have been specially designed to deliver the exceptional image quality required for diagnostic imaging, while offering aggressive pricing to make the readers affordable for large and small-volume veterinary practices.

FireCR Flash Readers also feature a number of design and engineering innovations, in keeping with 3DISC’s mission to provide the latest in advanced imaging technology. They offer increased productivity, with a fast throughput of up to 70 plates per hour. They also are exceptionally small and lightweight, able to be placed on a counter or wall-mounted—ideal for even the most space-challenged radiology department or practice.

FireCR Flash Readers accommodate a range of cassette sizes to meet every imaging need—including a unique veterinary dental cassette accessory kit that allows veterinary practices to scan dental imaging plates using the FireCR Flash Veterinary Reader.

The cassettes feature advanced engineering that makes them strong and robust. A specially designed metal plate ‘carries’ the imaging plate through the system, reducing the chance of damage

Introducing Advanced FireCR Flash Readers and prolonging the life of valuable imaging plates. Also new is a convenient USB 2.0/ethernet interface.

With the FireCR Readers, there is no need for veterinarians to compromise on features and functionality—whether they are a high-volume but space-challenged clinic, a smaller low-volume veterinary clinic with a tight budget but plans to grow, or a busy veterinary clinic or practice. They can select a system that meets their exact needs and budgets—and also have flexibility that lets them grow.

The next-generation FireCR Dental ReaderIntroducing the new, affordable computed radiography system for veterinary dental use—the FireCR Dental Reader—with a number of new features and capabilities that enhance veterinary productivity.

Designed to provide rapid, high-quality reading of reusable dental imaging plates, the FireCR Dental Reader’s small footprint—about the size of a shoebox—allows it to integrate seamlessly into even the most space-challenged veterinary clinics.

The small size and unique features of the FireCR Dental Reader mean that it can be conveniently placed in each exam room, allowing for faster diagnosis and streamlined patient care, as there is no wait time required to leave the room to scan the images on a centralised scanner.

Contact details:

Southern OfficePO Box 4438,17-19 Horne StHoppers Crossing VIC 3029Phone: 03 9360 9700Fax: 03 9360 9994Toll free: 1300 785 405Email: [email protected]

Northern OfficePO Box 833,Unit 6/1 Lear-Jet Dr,Caboolture QLD 4510Phone: 07 5428 3666Fax: 07 5428 3777Toll free: 1300 785 401Email: [email protected]

For further information please don’t hesitate contact us.

1300 785 405 Email: [email protected]

www.dlc.com.au

In this increasingly competitive environment, show patient owners that your practice offers the latest in digital imaging technology for improved patient results. Whether you’re looking for a central reader that can distribute images throughout your facility, or an affordable exam room based solution, the next-generation FireCR Dental Reader is the natural choice for practices looking for a full-featured system that delivers high-quality digital images - along with the flexibility that helps them grow.

FireCR Flash Veterinary Reader Package Includes: »2 Sized Cassettes »Quantor Imaging Software »X-Ray Tube Table »Atomscope HF200A Gen-2

X-Ray Unit

Digital Imaging Solutions.

3 Speeds Available »FireCR Flash 30 Reader »FireCR Flash 50 Reader »FireCR Flash 70 Reader

FireCR_Flash_Dental_VetPrac_Ad_March_2016.indd 42/25/2016 12:07:47 PM



www.dlc.com.au


FireCR Flash Veterinary Reader Package Includes:

»2 Sized Cassettes »Quantor Imaging Software »X-Ray Tube Table »Atomscope HF200A Gen-2

X-Ray Unit


3 Speeds Available »FireCR Flash 30 Reader »FireCR Flash 50 Reader »FireCR Flash 70 Reader

FireCR_Flash_Dental_VetPrac_Ad_March_2016.indd 42/25/2016 12:07:47 PM



www.dlc.com.au


FireCR Flash Veterinary Reader Package Includes: » 2 Sized Cassettes » Quantor Imaging Software » X-Ray Tube Table » Atomscope HF200A Gen-2

X-Ray Unit


3 Speeds Available » FireCR Flash 30 Reader » FireCR Flash 50 Reader » FireCR Flash 70 Reader

FireCR_Flash_Dental_VetPrac_Ad_March_2016.indd 4 2/25/2016 12:07:47 PM



www.dlc.com.au


FireCR Flash Veterinary Reader Package Includes: » 2 Sized Cassettes » Quantor Imaging Software » X-Ray Tube Table » Atomscope HF200A Gen-2

X-Ray Unit


3 Speeds Available » FireCR Flash 30 Reader » FireCR Flash 50 Reader » FireCR Flash 70 Reader

FireCR_Flash_Dental_VetPrac_Ad_March_2016.indd 4 2/25/2016 12:07:47 PM



40

While setting up your professional practice is an exciting opportunity, it’s important to get it right from the outset. Tackling the project in a holistic manner can help you get one step ahead.

After all, the decisions you make around the types of surgical equipment you install, the layout of your practice, and even the look and feel of it will all impact your bottom line and contribute to your overall market competitiveness and ongoing success.

With the average cost of practice fit-outs ranging from $400k–500k for a veterinary surgery alone, it’s useful to have a steer on the type of assets which will be income-producing from the beginning and the range of financing options available to you. Similarly there will be some higher depreciating assets, such as software, where you may want to consider the flexibility of a shorter lease term.

If you are questioning the difference between a Ioan lease, chattel mortgage and a commercial hire-purchase, Dr Brett Robinson from BOQ Specialist helps with these top tips on getting it right:

Add as you goWith all the excitement and energy that goes in to setting up your practice, it’s natural to want everything in place from day one. However, it’s more important that your financing demands are in line with revenues, so you may want to give yourself a bit of breathing space before rushing out to buy everything at once. The real question to ask is whether that piece of equipment, or practice room, can be delayed for a few months? If it can then it’s best to hold tight—this will ease the pressure and help you navigate the first few months.

Look at the intangiblesIt’s very easy to think about the tangible, physical assets for your practice such as X-ray machines or examination tables, but the softer touches and ‘back office’ capabilities such as layout design or the latest cloud storage system can make an impressive difference to the effectiveness of your practice. Many banks don’t factor these intangibles into their financing options. We prefer to look at the bigger picture by encompassing broader aspects of your practice and taking the strength of your professional qualification into account.

Consider the equipment's life spanEquipment shelf-life and industry trends are all important aspects to consider. Taking into account the life-time of a product is essential, as well as assessing its impact on your cash flow. For example, will it be an income producing asset from the outset and will you need any further advice on managing your cash flow in the interim? We regularly conduct cash-flow projections with clients, considering factors such as how many patients need to be seen over the life of an asset to ensure it pays for itself.

Be smart with your spendConsider ways you can be smarter with your spend, like utilising your credit card to earn additional frequent

flyer points. BOQ Specialist recognises the benefits of combining business with pleasure, which is why we allow you to put select car or equipment finance payments on your BOQ Specialist credit card for a small fee and earn frequent flyer points to use towards your next holiday.

Partner with someone who understandsKnowing the market and the right questions to ask when dealing with suppliers can make all the difference. We often approve a small buffer as we understand costs can blow out.

BOQ Specialist’s Brett Robinson said, “looking beyond broad-brush leasing structures and understanding the right financing options available can make the world of difference. Whether just getting started or financing their fourth practice, our 25 years’ industry experience means we can tailor the solutions built around the strength of our clients’ qualifications.”

To understand financing options and enable practitioners to make an informed decision, speak to a specialist in the industry with experience in providing finance for healthcare professionals on 1300 131 141 or visit our website at boqspecialist.com.au

How to be practical about your practice fit-out

The credit provider is BOQ Specialist —a division of Bank of Queensland Limited ABN 32 009 656 740 Australian credit licence no. 244616 (“BOQ Specialist”). Terms and conditions, fees and charges and lending and eligibility criteria apply. BOQ Specialist is not offering financial, tax or legal advice. You should obtain independent financial, tax and legal advice as appropriate. We reserve the right to cease offering these products at any time without notice. Reward points are earned in accordance with the rewards program terms and conditions. For full credit card terms and conditions visit boqspecialist.com.au/credit-card-terms. A 1.5% processing fee applies on the purchase price. Points are earned on eligible purchases only. Fixed term finance contract is to be approved prior to purchase. If you elect to make loan repayments on your BOQ Specialist Credit Card a 1.5% processing fee applies on the amount of each repayment. Repayments on overdrafts and lines of credit are not available to be made via BOQ Specialist Credit Card

Dr Brett Robinson

Financial products and services are provided by BOQ Specialist Bank Limited ABN 55 071 292 594 (BOQ Specialist). BOQ Specialist is a wholly owned subsidiary of Bank of Queensland Limited ABN 32 009 656 740 (BOQ). BOQ and BOQ Specialist are both authorised deposit taking institutions in their own right. Neither BOQ nor BOQ Specialist guarantees or otherwise supports the obligations or performance of each other or of each other’s products.

Equipment and fit-out finance / Credit cards / Home loans / Commercial property finance / Car finance / Practice purchase loans SMSF lending and deposits / Transactional banking and overdrafts / Savings and deposits / Foreign exchange

We’ve been working so closely with vets for so long that you might think we’ve become something of a ‘vet whisperer’

Certainly, we’ve come to recognise and know many of the challenges you face in building a veterinary practice.

This understanding has served us well.

Unlike a conventional bank, we’ve been able to develop a range of products that are specifically suited to your professional and personal needs.

So when you’re raring to go, we’ll know to let you off the leash.

Visit us at boqspecialist.com.au or phone our finance specialists on 1300 131 141

You’re straining to get ahead. We’ll never hold you back

42 42

A new pain-relieving medication, stethoscope, otoscope and much more are under review this month…

TOOLS TRADE

of the

Bupredyneby Dr Alice Robinson, Aldgate Veterinary Clinic, SA

This product contains buprenorphine and is used for pain relief in cats and dogs. In the past, it was always supplied in small vials, but now we are finally able to purchase it in a bottle. This makes things much more convenient.

What’s good about it?Buprenorphine was only available in 1ml vials and that made it difficult to draw up the drug without wasting any. We have to record what happens to the drug in our Schedule 8 book, and each time there was any wastage that had to be recorded too. What should have been a fairly simple injection became a very time-consuming process.

Now, with Bupredyne, we can draw the drug from the bottle and there is no wastage. This means that things move much quicker in an emergency situation. We can just grab the bottle and give the injection, rather than trying to break open a vial and then have difficulty in drawing up the drug.

We’ve only been using this product for the past month, but it makes the whole process easier and faster. Other vets have mentioned to me that they also have difficulty with the vials. Buprenorphine is quite expensive, so any wastage is a bad thing from an economic standpoint.

What’s not so good?The only negative is that some products are only licensed for cats and not for dogs. It took us a little time to find a product that was licensed for dogs and cats, but we eventually found Bupredyne.

Where did you get it?Jurox (www.jurox.com.au).

Oesophageal stethoscopeby Sharon Gray VN, Sutherland Veterinary Clinic, NSW

This stethoscope goes down the oesophagus until the sensor is positioned in the thoracic cavity. It consists of a thin, flexible tube with a number of holes in the side-wall, covered by a plastic membrane to prevent fluid entering the lumen of the tube. It allows you to monitor the heart rate, rhythm and character of the heart sounds. It’s also a good way to measure the respiratory rate of the animal.

What’s good about it?Accurate monitoring of the cardiac rate enables appropriate corrective measures to be taken to ensure adequate tissue perfusion if bradycardia or tachycardia develop.

It allows monitoring of the heart without disturbing surgical drapes, and when access to the chest area is difficult.

An oesophageal stethoscope gives a true indication of the condition of the animal under anaesthesia, whereas app alerts and monitors can sometimes give false readings.

I’ve been in situations when the monitor has given a respiratory rate of 18bpm, but the oesophageal stethoscope has shown the actual rate to be 9/10bpm. Purely trusting the monitor would indicate that the animal is in a light plane of anaesthesia causing you to increase the isoflurane and taking the animal into a deep plane of anaesthesia. This can become extremely dangerous very quickly.

Other factors like eye positioning and pupil reflexes, and the jaw tone of the animal, must also be taken into account and monitored closely for a nice, safe surgical plane of anaesthesia. I have found too many discrepancies to ever rely solely on monitors or apps. I really believe the oesophageal stethoscope is a must-have item for all veterinary practices.

What’s not so good?If used carefully, the technique is very safe—though it can cause reflux oesophagitis. Care should be taken to avoid passing the oesophageal stethoscope into the trachea by accident. Traumatic damage can occur if the oesophagus is unusually fragile, and it should not be placed in animals with suspected oesophageal foreign bodies.

Where did you get it?We purchased this from Provet (www.provet.com.au), though most veterinary suppliers carry oesophageal stethoscopes.

Y O U R T O O L S

Y O U R T O O L S

continued from page 42

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Digital Macroview Veterinary Otoscope by Welch Allynby Dr Kristie Mientka, Potts Point Veterinary Hospital, NSW

We routinely use this otoscope for ear infections that are very common at this time of year. We are also seeing a lot of dogs with allergies, so the otoscope is used nearly every day.

What’s good about it?This digital otoscope allows us to pull up a video and show the client exactly what it looks like down the ear canal of their pet. It’s a live image and we’re able to capture still images as well. The image quality is very good and I can easily ensure that the canal is intact while identifying any debris or inflammation.

The otoscope definitely helps with client compliance. When they actually see the problem in their pet’s ear—and some of them get quite grossed out—it makes them much more likely to follow through with the medication we’ve prescribed. A picture really is worth a thousand words.

Another great benefit is when you’re in a multi-doctor practice and another doctor is seeing that patient for a follow-up. They are able to look back at the images attached to the file, see exactly what it looked like and keep track of the progress. It’s also great for showing clients the progress their animal has made.

There’s a bit of a learning curve as you have to look at a screen versus down the actual ear. I’ve found the animals tolerate it very well—you just have to be nice and gentle.

What’s not so good?Some of the newer models are wireless, which I think would be quite helpful. This one has a long cord, but a wireless feature would enable it to be moved easily around the room. It would also be great if there was better integration between the otoscope and our software. Right now, it takes a bit of time to save the images to the computer and then upload them to the patient’s file.

Where did you get it?Vetquip (www.vetquip.com.au).

LigaSureby Dr Charles Kuntz, Southpaws Specialty Surgery for Animals, Moorabbin, Vic

LigaSure is a vessel-sealing device. In the past, it was necessary to clamp blood vessels on either side, cut in-between and then put in sutures or ligatures around each end. It was a very time-consuming process.

With this device, you simply clamp it on the vessel, squeeze a button, wait a few seconds, and pull a small lever. The vessel is neatly cut and sealed.

What’s good about it?Its big advantage is that it makes surgery must faster. Procedures that would have taken one-and-a-half hours can now be completed in 20 minutes.

The device uses bipolar electrocautery. It runs an electrical charge through the vessel that causes the collagen within the tissues to fuse. A blade then cuts between the two fuse points.

The other really nice thing about this system is that it measures the electrical impedance of the tissue. When a vessel is thicker, it automatically runs the current for a longer period to ensure a complete seal.

It is particularly useful when removing a tumour with a cluster of vessels, say a thyroid tumour or something like that. As they are so vascular, the animal can die of blood loss during surgery. Using the LigaSure allows you to work your way around the tumour without significant blood loss.

Even though it is quite expensive to purchase, it’s an amazing piece of equipment. It’s probably the biggest advance in veterinary surgery in 20 years.

Whats not so good?There are limits to what it can do. Although the device claims it can seal vessels up to 7mm, I wouldn’t go over 5mm. It is also not designed to seal things like bile ducts. As long as you don’t ask too much of it, it’s a great piece of technology.

Where did you get it?Medtronic (www.medtronic.com).

66231 Blackmores FishOil Advert A4.indd 1 2/03/16 9:31 AM

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Y O U R L I F E

“When I’m competing, my particular discipline requires me to shoot in the prone position. I lie on my stomach and chest, and shoot off my elbows from a single fixed point over multiple distances. The targets are positioned at 300 yards back to 1000 yards, in 100-yard increments. Telescopic sights are allowed in certain grades of our discipline, but I prefer not to use them.

“I use the same rifle in all competitions—an RPA Quadlock action. It’s a British make, extremely accurate, and fitted into a Jericho stock with a Madco barrel.

“One day, when I was about 13, a friend dragged me along to the rifle club at my school in Armidale [New South Wales]. I liked it straight away—it’s a precision sport rather than a physical one. Eventually, I became club captain in my senior high school years.

“I’ve competed as an individual and as part of a team. As an individual, you have to make all the decisions. In a team, a coach sits behind you and helps you adjust accordingly. Your job is to settle into position, fire good shots and repeat—the rest is up to your coach.

“As an individual, I’ve ranked in the top 50 during state competitions and won some smaller local competitions, but I’ve been more successful as a team member. During the National Under 25 Teams Championship held in Adelaide in 2012, I was the top shot on range. I’ve also been a member of five Queensland Under 25 teams between 2008 and 2014, and a member of the NSW Under 25 team in 2007.

“As part of the Queensland team, we’ve ranked second by a very narrow margin for multiple years in a row. I was also a member of the Australian team that came third at the World Long Range Target Rifle Under 25 Team Championships in Canada in 2007.

“Qualifying for the Commonwealth Games is an aspiration of mine, but it takes a lot of commitment in terms of time, money and travel—so maybe I’ll leave that for down the track.

“To be a good shooter requires focus, patience and some tinkering skills. You need to understand the physics and mathematics behind the sport—it’s not just speed and agility. For me, it’s also a really good escape. I’m outdoors and you have to forget about everything and focus. It’s a nice way to relax.” In

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To be a champion rifle shooter, Dr Erica Young of Jimboomba Veterinary Surgery in Queensland utilises focus, patience and psychology.

Straight shooter

Time changes everythingGiving patients the highest Standard of Care is your life’s work. Major advances in technology have made enhancing practice productivity easier than ever. The next generation in-house diagnostic analysers from

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