AAEP: Keynote Speaker Urges Veterinarians To Think About, Embrace Generational Differences

Between retirements, fewer veterinary students choosing equine and many of those who do leaving equine within five years after graduation, it is more important than ever for practices to embrace the unique strengths of the different generations within their practice. Doing so, according to keynote speaker Meagan Johnson, will help practices maintain outstanding service to horses and clients as well as facilitate the growth, satisfaction and long-term success of associates and interns.

Summarizing the strengths and work styles of each generation currently in the workforce, Johnson said:

Baby Boomers (born between 1946-1964) understand the importance of teamwork as the first generation for whom education became an expectation.

Generation X (1965-1980), as the offspring of parents who both worked outside the home, tend to be fiercely independent. They want to be given a task and the necessary tools, then be left alone to accomplish the task.

Millennials (1981-1996) tend to be interested in building their corporate “lattice” instead of climbing the corporate ladder. They value collaboration and want to know their manager is participating in their career development. Beyond feedback, they crave a sense of purpose: more than 85% of millennials who have remained with their employer for at least 5 years were happy with their sense of purpose at work.

Generation Z (1997-2012) is the first digital generation and by far the most diverse. They are values-driven and want to see diversity reflected in leadership. Nearly 60% of Gen Z job seekers rank their organization's social media presence as the reason they accepted the job. In light of that, Johnson recommends practices examine their website and social media to introduce their team, highlight success stories, share letters from clients, post about charity events and more.

Johnson also suggests practice's consider instituting monthly 15-minute conversations with younger employees to help advance skills, improve learning curves and facilitate satisfaction. The conversations should be built around four questions:

1. What's something you're better at now than you were last month?
2. What things would you like to get better at this month?
3. What is your plan for developing these skills?
4. What resources can I help you with?

Similarly, Johnson advises practices to consider replacing an employee's traditional annual review with periodic stay interviews to help ensure their professional growth and satisfaction, discover what they value and would like to improve, and identify any potential impediments that otherwise wouldn't be discovered until the employee's exit interview.

Finally, Johnson stresses the importance of young equine veterinarians feeling as impassioned as practice owners, who can expedite this process by not summarily dismissing ideas and suggestions from associates and new practitioners. Rather, practice owners should first explore how the ideas affect cost, quality, safety and service before making a determination.

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Why One Veterinarian Says There May Soon Be A Shortage Of Equine Practitioners — And How You Can Help

It's no secret that employers across all industries are hard-pressed for help right now. Dr. Debbie Spike-Pierce, president and CEO of Rood + Riddle Equine Hospital, worries that soon equine veterinarians won't just have a tough time finding people to work for them – their clients may have a tough time finding someone to treat their horse.

Spike-Pierce presented some unsettling statistics at the clinic's annual client education seminar last month and shared her thoughts on why equine practice is in particular trouble. She cited a study by the American Veterinary Medical Association that found only about 1 percent of veterinary students are planning to go into equine practice – down from 4 percent in the mid-2000s. In the population of existing veterinarians, equine vets make up 5.6 percent of the total. Spike-Pierce also said that within five years post-graduate, 50 percent of equine veterinarians will leave equine practice.

There are lots of reasons for this, but they all boil down to burnout. Spike-Pierce said that veterinarians surveyed by the American Association for Equine Practitioners (AAEP) report their physical health as pretty good – impressive, considering how physical their jobs often are. They self-reported their mental health as much less favorable, with 18% of male equine veterinarians classifying their mental health as fair to poor, and 25% of female equine veterinarians saying the same.

The Paulick Report ran an open letter from Dr. Rebecca Mears about the mental health of veterinarians earlier this year, specifically focusing on the “Not One More Vet” or NOMV movement aimed at preventing veterinary suicide.

(You can read that letter here.)

As Mears explained, recent veterinary school graduates begin their careers under a mountain of debt, often taking low-paying jobs in their first years out of school as they work to get established. Those who go into mobile practice for themselves (like many equine veterinarians) have even greater start-up debt.

Veterinary practices of all sorts have taken to social media in recent months, expressing that they are dealing with shorter tempers than normal from clients, combined with smaller staffs to help manage nursing care and caseloads. Social media has also enabled a dissatisfied client to put a practice on blast, whether or not their criticisms feel true or fair to the veterinarian. After a long day dealing with sick animals and angst-ridden clients, finding a negative review on social media can often feel like the last straw.

Equine practice can be even more demanding, since as Spike-Pierce points out, it doesn't have set hours the way a dog or cat clinic would.

“We are seeing these same issues in equine practice as we are seeing in general veterinary practice, but we're also seeing people leave equine practice and go to small animal practice,” said Spike-Pierce.

Oftentimes, she said she hears people dismiss these issues by saying that equine practice is “a lifestyle” – which she agrees is true.

“It is a lifestyle,” she said. “Actually it's one I pretty much enjoyed. What I loved about equine practice was feeling like I could take my kids with me. I went on calls with my dad growing up. The equine industry as a whole is very open to having kids be there. Oftentimes I think the reason we're working with horses is because we were there when our parents were.”

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But not everyone wants to buy into having that round-the-clock lifestyle for most of their lives, and telling young veterinarians that they should work seven days a week or get out of the business seems to result in many choosing the latter. Spike-Pierce said the culture around horses is your job is 24/7 because horses need care 24/7 – but that care doesn't always have to come from the same person.

One reason equine veterinarians may make the switch to small animal practice is that dog and cat clinics often share emergency duty, or allow clinicians to work a smaller number of longer days each week so they get some predictable off time. Spike-Pierce said there's some degree of client education involved in a set-up like that for horse veterinarians — clients need to know who's on duty for after-hours calls on a particular night, or they need to be ok with having their call forwarded to a different doctor sometimes. She has seen some smaller practices experiment with this, with some success.

“Our younger veterinarians are asking for time,” she said. “They want to have time away from work, but they're able and willing to work extra hard when they are working. They want that separation.”

Splitting up duties, especially emergency duties, by geographic region can be a game changer for veterinarians' stress levels, too —  and it can reduce the wait for a client who's dealing with an animal in distress.

“If you all have ideas, that's welcome,” Spike-Pierce told the audience. “It's something we're going to need to address in the future to be able to continue to serve animals.

“If you look at the numbers, it just doesn't work if it continues on the same trend. So please, thank your veterinarian, and please work with them to give them the time they need.”

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AAEP Publishes Contagious Equine Metritis Guidelines

Comprehensive guidelines to assist veterinarians with identification, diagnosis and control of Contagious Equine Metritis (CEM), a non-systemic venereal disease of equines that causes short-term infertility in mares and rare abortion, are now available on the AAEP's website.

Six outbreaks of CEM have occurred in the U.S. in the past 15 years, including a significant outbreak in 2008 to 2010 in which over 1,000 exposed horses in 48 states were required to be tested, resulting in 23 contaminated stallions and five infected mares ultimately identified and treated.

“Outbreaks in the U.S. have demonstrated the risk of incursions and the need for surveillance in the active breeding population to identify cases early and limit disease spread,” said guidelines co-author Dr. Abby Sage, Richmond staff veterinarian for the Virginia Department of Agriculture and Consumer Services. “Several of these outbreaks also demonstrated significant stallion-to-stallion spread of Taylor equigenitalis via fomites and inadequate biosecurity during semen collection and stallion handling.”

Dr. Sage and co-author Dr. Peter Timoney, the Frederick Van Lennep Chair in Equine Veterinary Science at the University of Kentucky's Gluck Equine Research Center, advise equine practitioners and stallion owners/managers to follow stringent biosecurity protocols when collecting and handling stallions and consider implementation of annual testing of active breeding stallions prior to breeding season as ongoing assurance of disease freedom.

CEM is an internationally reportable disease. When the carrier status of a stallion or infection of a mare is suspected, practitioners should contact their state and/or federal animal health official, who will provide current collection and response procedures for suspect cases.

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The CEM Guidelines were reviewed and approved by the AAEP's Infectious Disease Committee and board of directors. View the guidelines or save them to your mobile device for future reference here.

Besides CEM, AAEP guidelines for 22 additional equine infectious diseases are available here.

Read more here.

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Research Confirms Bisphosphonates Can Linger In Horses’ Bones For Years

Bisphosphonates continue to be a topic of concern in the racing world, most notably raised by a report of a positive test from John Salder trainee Flagstaff, but researchers are still learning about how to find and regulate the drugs in horses. Although two drugs, sold under the trade names Osphos and Tildren, were approved by the Food and Drug Administration for use in horses several years ago, research into the drugs' action in young horses and the length of its life inside the equine body is still catching up. (FDA-mandated testing is focused on safety and efficacy of a new drug, not necessarily the ability of a state racing commission to detect it in a post-race sample from a young racehorse.)

Read more about bisphosphonates in our archives here and here.

Dr. Heather Knych, renowned equine pharmacologist at the University of California-Davis, gave an overview of current research on bisphosphonates at the most recent, virtual convention of the American Association of Equine Practitioners (AAEP).

A few takeaways:

  • Bisphosphonates may be new to the horse world, where they are FDA-approved for the management of navicular syndrome in older horses, but the drug class has actually been in use in different settings for a couple of centuries. Knych explained that the substance was first used in the detergent industry in the 1800s as a water softener, anti-corrosive or anti-scaling agent. Their action on calcium carbonate made them effective in these settings. They were adapted as therapeutic drugs for human bone conditions in the 1970s.
  • While we've most often heard of bisphosphoantes in humans as part of osteoporosis treatment, they've also been used in metastatic bone disorders, and multiple myeloma.
  • We know that after an administration, bisphosphonates disappear from blood fairly quickly – their half life is one to two hours in plasma, but they can linger on bone surfaces for months or years.
  • Bisphosphonates seem to prefer settling in trabecular bone – bones like skulls and ribs that take less mechanical stress – over cortical bone, like the long bones in limbs. It withdraws from bones based on the amount of turnover in that bone, which can vary depending on age, exercise, and trauma.
  • Concentrations of bisphosphonates continues to increase as concentrations of it elsewhere decreases. It can also release from bone back into blood in small amounts and move into other bone surfaces, though we don't know a lot about why and when it does that.
  • Knych presented the results of a two-part study led by researchers across multiple universities to learn more about how long bisphosphonates linger in the skeleton. The first part of the project required administration of the two FDA-approved bisphosphonates – Osphos and Tildren – to a total of four horses in university research programs who were already slated for euthanasia for unrelated reasons. Bone samples were taken after euthanasia, which came four days or 30 days after administration in each drug group. Samples from the radial bones showed detectable amounts of both drugs four days after administration, with levels of Tildren being higher in both samples. Thirty days after administration, both drugs could be found in all bones sampled, even right and left molars. Concentrations of both drugs were highest in the tuber coxae (hips).
  • In the second phase of the study, researchers tested blood and fluid samples from four horses euthanized due to on-track injuries in California – three whose connections said they'd never had bisphosphonates, and one who had a treatment 18 months prior. The team could find no evidence of bisphosphonates in the three horses with no treatment history. The horse who had been treated 18 months before had no detectable amounts of the drug in serum, urine, or synovial fluid, but did have a detectable level in a sample from the radial bone.
  • These results suggest, in line with what veterinarians had expected based on human data, that the drug does linger on the surfaces of bone for considerable periods of time, and lives on different bones in different ways.
  • Knych acknowledged that both parts of the study came from extremely small sample sizes, as is often true in academic research with horses, and that further study is needed to better understand how bisphosphonates work in the equine body.

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