Pet owners waiting to receive care for the pet at a Street Dog Coalition event (Image courtesy of Jon Geller, DVM, DABVP Emeritus) 

Unlike many veterinary professionals, Jon Geller, DVM, DABVP, emeritus, from Fort Collins, Colorado, and founder of The Street Dog Coalition, did not want to pursue a veterinary career at an early age. He became a building contractor in his early 20s, but by his late 30s, he had realized that was not what he wanted to do in life. To Geller, that is the time in life when people have the chance at a second career, and he began to look into veterinary medicine.

"I loved everything about the idea of veterinary medicine: the compassion, the hands-on aspect of getting to work with so many kinds of animals, and the latitude that was in the profession. You can do so many things as a veterinarian, for example, that you can’t do as a physician,” Geller explained.

After graduating from Colorado State University College of Veterinary Medicine and Biomedical Sciences, in Fort Collins, Geller provided care for large animals and had plans to return to southern Colorado. He was working on mixed animal house and farm calls, but it was not working for him financially, he said. To earn extra money, Geller began working as a relief veterinarian at emergency hospitals, where he realized that was what he wanted to do with his degree. His love for emergency medicine eventually inspired him to open his own clinic. During his time in emergency medicine, he had noticed that although the clinic was providing excellent care, it came at a high price— and for some, the price was too high for them to afford the care their pet needed.

The reason I got into street medicine is that it’s in stark contrast to emergency medicine, where we have all the bells and whistles, we get paid quite well, and clients pay very high prices for our services. I felt the pain of so many clients who were facing economic euthanasia because they couldn’t afford treatment. Of course, we tried to work with them. I started a fund called the Ladybug Fund, which helped people pay for care and emergency hospitals. But then…a very specific thing happened,” Geller said.

In 2014, he was in Nashville, Tennessee, walking across a bridge, when he came across an unhoused man who was sitting with all his belongings and a pit bull. Geller locked eyes with the man and had a silent conversation, leading him to wonder whether he could find a way to help this man and his pet. A few months later, Geller founded The Street Dog Coalition.

Now, 10 years later, The Street Dog Coalition has expanded from its first team in Fort Collins to 61 teams across the United States. Each team offers street clinics in different scenarios in a wide variety of locations, such as near homeless and animal shelters, under bridges, in churches, and even in parking lots. Each clinic’s goal is to operate in a location where anyone who needs it can access to it. Geller explained that based on his studies, two-thirds of those experiencing homelessness stay in a shelter, leaving one-third of the population unsheltered— including people with pets because not many shelters allow animals other than service pets.

"Street medicine is providing care in a low-resource setting. We don’t bring x-ray machines, and we don’t bring laboratories with us. We use the tools that we have to use: our head, our senses, and then finally our heart because it’s all about taking care of both ends of the leash. The bigger challenge is on people’s end of the leash. And that’s where, we were surprised to realize, pet care is pretty straightforward, but people in that situation have so many challenges. And we can help them even if it’s just having a nice conversation with them. That’s the highlight of their day, but now we know we have resources…to help other people,” said Geller.

The Street Dog Coalition is also moving in a similar but new direction with its One Health Outreach. At its popup clinics, the organization will sometimes partner with human health providers to perform health screenings and dental exams. It also partners with social work teams, addiction and mental health counseling services, and more. For longer events, the coalition will provide food, clothing, haircuts, and other necessities. Geller said they will even invite bicycle repair workers to fix anyone’s bicycle to make sure they can get around easier, as most larger cities do not allow nonservice pets on public transport, making it hard for owners to get their pets access to care.

After being in “the trenches” for the past 20 years, Geller said, he knows what he likes best about the work he does with The Street Dog Coalition: Everything is free, which takes stress off the owners because they can get their pet the care they need. For the veterinarian volunteering their time, it’s an opportunity to give back and help their community.

"When you take money out of the equation of veterinary medicine, it is liberating. Veterinarians love it because [money] never comes up, and I enjoy hearing the stories of people I know nothing about and hearing the stories of their lives with their pets.… They’re so appreciative of what we can do, even if it’s really basic stuff. It might just be vaccines and some parasite protection,” Geller said.

Lastly, Geller teased that besides the Street Dog Coalition, he has other projects in the works to help even more people get much-needed care for their pets. He plans to discuss more about these projects on an upcoming episode of 

Articles

Jon Geller, DVM, DABVP, Emeritus, is working to help ensure pets from all walks
of life can get the care they need while helping their owner along the way

Care for one, care for all

A new platform that healthcare practices can use to manage their business and improve their revenue cycle management has been introduced. The platform, called the ‘enterprise experience,’ was launched by Weave, a company that offers practice management software solutions for small and medium sized healthcare businesses, with its titular software.

The new addition of Weave’s ‘enterprise experience’ to its software was made with group and enterprise healthcare practices in mind, such as dental service organizations and vision, veterinary, and medical groups that have more than one location. The software aims to standardize these enterprises’ operations, achieve greater efficiency, and accelerate revenue cycle management, according to the company.

“Increasingly, healthcare practices have more than one location, through organic growth, consolidation or acquisition,” Branden Neish, chief product and technology officer at Weave, said in a news release by the company.

 “Weave is now optimized for enterprise organizations to empower practices to achieve operational excellence, drive revenue growth, and deliver an exceptional patient experience across all locations,” he continued.

The software contains features such as call pops, missed call texts, digital forms, automatic appointment reminders and confirmations, online review management, online scheduling, practice analytics, and more.

According to the company, a benefit of the new platform is an improved revenue cycle management, coming from the following features which allow enterprises to

Create and distribute digital forms to any or all locations to enhance first-time insurance claim processing, saving staff time and reducing errors associated with manual data entry.

Unify payment requests across all locations through a single admin login, including text-to-pay, online bill pay, and in-office terminals.

Improve case acceptance rates and reduce accounts receivable with multiple patient payment options, including buy-now, pay-over-time, and payment plans.

Additional features of Weave’s enterprise experience include

Remote work capabilities through mobile devices or browser access.

Comprehensive analytics and reporting tools which provide insight to evaluate trends, benchmark performance, and discover actionable data across locations.

Exporting data to the preferred system for further analysis and integration

Creating and managing automated messaging across locations for missed calls, recalls, reactivations, and appointment reminders.

Developing and delivering marketing campaigns with centrally managed bulk texting and email marketing.

Weave’s automated response assistant to improve online reputation.

A single login to manage all locations and settings.

Messaging tags and a centralized inbox for two-way text messages across locations.

Centralized management of reviews, faxes, forms, and appointment requests across multiple locations from one admin login.

Weave Launches New Platform for Multi-Location Healthcare Practices. News release. Weave. June 26, 2024. Accessed June 26, 2024.

Made for enterprise. Introducing the new Weave experience. Weave. Accessed June 27, 2024. 

https://www.getweave.com/weave-enterprise/dso/

Weave has launched a new ‘enterprise experience’ platform to standardize healthcare practices’ operations, increase efficiency, and boost revenue cycle management 

New platform to manage healthcare enterprises is announced 

Reassessment Campaign on Veterinary Resuscitation (RECOVER) Initiative unveiled its first major update to its global veterinary cardiopulmonary resuscitation (CPR) guidelines that were first launched in 2012. RECOVER Initiative hopes the updates to the guidelines will create a new life-saving standard based on scientific advancements and extensive community feedback.

“The publication of these new guidelines represents a pivotal event in veterinary resuscitation science. These updates incorporate new scientific evidence, feedback from the veterinary community, and the latest advancements, directly enhancing how we perform life-saving CPR on pets,” expressed Manuel Boller, Dr med vet, MTR, MANZCVS, DACVECC, co-chair of the RECOVER Initiative, in an organizational release.

According to the release, the revised guidelines introduce changes reflecting the latest advancements in science and practice in veterinary medicine based on a review of 1370 studies by 102 volunteer evidence evaluators.

 The guidelines will be available in an open-access issue of Wiley’s Journal of Veterinary Emergency and Critical Care as well as the RECOVER Initiative website. 

Enhanced chest compression techniques for cats and small dogs to optimize survival during cardiac arrest

Adjustments to compression depths and techniques tailored to the animal’s size and chest shape to improve the effectiveness

Revised breathing support methods for non-intubated patients with a focus on the safety of the rescuer.

Updated medication dosages and procedures for more effective and precise treatment during CPR

“The 2024 RECOVER CPR Guidelines are the first veterinary clinical guidelines developed using a rigorous process known as GRADE. Most human clinical guideline organizations use this approach, including the International Liaison Committee on Resuscitation, which produces human CPR guidelines. We’re proud to continue RECOVER’s commitment to the highest standards for clinical practice across all species and are so grateful to the volunteers who helped make this happen,” explained Dan Fletcher, PhD, DVM, DACVEEC, co-chair of RECOVER Initiative.

Through these new guidelines, RECOVER Initiative hopes the RECOVER 2024 CPR Guidelines will improve the outcomes of veterinary patients who need CPR, mirroring advancements seen in the human medical field through the wide acceptance of evidence based CPR guidelines. Training courses and official certification processes combined with the guidelines share the importance of being prepared in case of an emergency, particularly within a general practitioner setting.

“Veterinary professionals from around the world have been highly anticipating the publishing of the updated guidelines. We are now working diligently on updating the online course materials, Rescuer certification workshop, and the Instructor certification process with the new information for the remainder of the year. Translations of the guidelines and course material into major languages are also planned so we can continue to serve the international community of veterinary professionals aiming for the highest standards,” Ken Yagi, MS, RVT, VTS (ECC, SAIM), RECOVER Initiative program director told dvm360® exclusively.

The RECOVER Initiative wants both veterinary professionals and clients to embrace the updated guidelines immediately to ensure the best results for pets in an emergency. RECOVER Initiative disclosed that further guidelines on Newborn Resuscitation, Prevention and Preparedness, and First Aid are predicted to become available in the near future.

RECOVER Initiative Unveils Major Updates to Veterinary CPR Guidelines, Elevating Emergency Care for Pets. News release. Reassessment Campaign on Veterinary Resuscitation Initiative. June 26, 2024. Accessed June 27, 2024.

The RECOVER Initiative is encouraging veterinary professionals and pet owners to implement the updated guidelines immediately 

RECOVER Initiative announces updates to CPR guidelines 

In an effort to safeguard the health of the nation’s livestock and poultry, and better understand and reduce the risks posed by the avian influenza A (H5N1) virus, the United States Department of Agriculture (USDA) announced it was allocating an additional $824 million in emergency funding from the Commodity Credit Corporation (CCC). Additionally, it is initiating a new voluntary H5N1 Dairy Herd Status Pilot program to offer dairy producers more options for monitoring their herds' health and help move cows faster while implementing ongoing testing to expand the USDA's knowledge of the disease.

Thomas Vilsack, United States secretary of agriculture, green lit the transfer of $824 million from the CCC to the Animal and Plant Health Inspection Service (APHIS) in May to bolster its rapid response capabilities. “We are investing an additional $824 million in our response efforts and standing up a pilot program to reduce the risk of H5N1 in dairy herds,” Vilsack said in an X post, formerly Twitter.

This funding will allow the APHIS to sustain its collaboration with state and local partners to swiftly identify and tackle cases of the highly pathogenic avian influenza (HPAI) in poultry and livestock. The allocated funds will help cover anticipated diagnostics, field response actions, pre-movement testing requirements and surveillance and control measures, including wildlife surveillance by APHIS. Moreover, the funding will support the Agricultural Research Service’s (ARS) work in vaccine development for HPAI in cattle, goats, pigs, and turkeys, along with food safety studies conducted by ARS and the Food Safety and Inspection Service. This move follows the USDA's earlier approval of $1.3 billion in emergency funds to tackle nationwide HPAI detections in wild birds and commercial poultry operations.

Voluntary Dairy Herd Status Pilot Program

The Voluntary H5N1 Dairy Herd Status Pilot Program offers dairy producers alternative testing and movement options, aiming to boost the USDA's monitoring capabilities in curbing the H5N1 spread. The program aims to provide additional testing avenues for dairy herds testing negative for 3 consecutive weeks. It also strives to reduce H5N1 virus dissemination, increase surveillance and advance disease understanding.

Farmers who opt into the Voluntary H5N1 Dairy Herd Status Pilot Program will need to demonstrate their herds' H5N1-free status from a National Animal Health Laboratory Network (NAHLN) facility. The program then requires farmers to perform weekly bulk milk tests from that herd to affirm that status, which will enable them to ship their cows at their preferred time without individually testing animals. Herds not participating in the pilot program will still need to adhere to the interstate testing and movement requirements outlined in the Federal Order.

“As additional testing measures take place, USDA anticipates that it will see an increase in testing and positive test results, which will add to our knowledge of the disease and how it may spread between herds. At the same time, this pilot program will help to gather additional information on how producers with affected herds can document elimination of the virus on their operations and steps they can take to maintain an H5N1 virus-free herd,” wrote the USDA in a news release.

, Erin Sorell, PhD, MSc, senior scholar at the Center for Health Security at John Hopkins talked about the impact of HPAI on not only livestock, but on workers as well. “The stress... beyond this outbreak is thinking about improved occupational health and safety for agricultural workers, because this scenario could happen again,” he said.

 “We really need to be able to not only respond to the current situation but adapt and prevent future exposure risks.”

The USDA’s announcement on May 30, 2024, came the same day a 

 of H5N1 in a Michigan farmworker working with influenza A (h5) positive cattle was detected. So far, cases of HPAI in domestic livestock have been confirmed in 11 states. In the last 30 days, livestock herds have been affected in Minnesota, Michigan, Iowa, South Dakota, Wyoming, Colorado, Idaho, and Texas, with Idaho having the highest number of cases at 17, as of June 21, 2024.

USDA announces $824 million in new funding to protect livestock health; launches voluntary H5N1 dairy herd status pilot program. News release. Animal and Plant Health Inspection Service.May 30, 2024. Accessed June 3, 2024.

https://www.usda.gov/media/press-releases/2024/05/30/usda-announces-824-million-new-funding-protect-livestock-health

@SecVilsack. “Today @USDA announced additional steps we are taking to ensure the health of the nation’s livestock. We are investing an additional $824 million in our response efforts and standing up a pilot program to reduce the risk of H5N1 in dairy herds.” May 30, 2024. Accessed June 3, 2024. https://x.com/SecVilsack/status/1796341844688937328

Abene S. First case of HPAI A (H5N1) virus infection in US dairy farm worker. 

https://www.contagionlive.com/view/first-case-of-hpai-a-h5n1-virus-infection-in-us-dairy-farm-worker

HPAI confirmed cases in livestock. Animal and Plant Health Inspection Service. June 21, 2024. Accessed June 25, 2024. 

https://www.aphis.usda.gov/livestock-poultry-disease/avian/avian-influenza/hpai-detections/hpai-confirmed-cases-livestock

USDA is providing additional emergency funding to curb the spread of H5N1 and launched a new program to help dairy producers monitor their herds’ health 

USDA takes additional measures to contain the spread of avian influenza A 

When pets who need post visit care—such as bandage changing, movement exercises, etc.—leave the clinic, teams prepare clients with all they need to know for their pet. However, after sending them on their way with verbal or written instructions, how much are they retaining, or are those written instructions even making it out of the car? 

, host Adam Christman, DVM, MBA, Sarah Machell, BSc, DVM, Jill Clark, DVM, and Alex Ehrich, explain what PetPath is, and how it is helping providing 'white glove service' to clients and veterinary teams through a digital care companion. 

: This is not even a totally new, novel type of technology. What we've done is we've taken the learnings from the tools that exist in the human space that have been extremely successful. They're receiving FDA approval to be used with medical devices, and the outcomes are just so powerful that we're taking what is doing extremely well in the human space and bring it to vet med, where it's so necessary. Especially for you think of that client that comes in and they're stressed out, they're trying to figure out what's happening with their pet, and your team is doing all the things to make sure that they feel equipped and empowered for when they go home. But that the reality is, they're only going to absorb about 20% when they're in that state of stress. 

So we're just extending the care of that team into the home through what we would say is a digital care companion, essentially a teammate that is going to be in the palm of an owner's hands guiding them through what are these really stressful times that, again, is going to put people kind of their worst place. We want to help again just smooth that process out and make it that they have this incredible experience and feel this really white glove support from the vets and the care teams that are providing the care to their their loved ones.

Podcasts

Digital communication can improve patient outcomes, provide a great client experience, and streamline communication between clients and veterinary teams 

The newer normal of communicating with clients

The American Veterinary Medical Association (AVMA) House of Delegates (HOD) recently passed new revisions to the Principles of Veterinary Medical Ethics (PVME) during their yearly HOD session in Austin, Texas, which took place during the 2024 AVMA Convention.

 The PVME serves as forward-thinking code of ethical conduct that all veterinarians are expected to follow.

The updated document contains 3 core principles that serve as aspirational goals for the veterinary profession. According to an AVMA news release, these principles are elemental to the PVME. These principles are

: Veterinarians have an ethical responsibility to alleviate suffering, promote health, and act in the best interests of their patients in balance with the interests of their clients, the environment, and the public.

: Veterinarians have an ethical responsibility to be honest and truthful in all interactions with clients, patients, and their community.

 Veterinarians have an ethical responsibility to demonstrate respect to all patients, clients, and members of their community, including self and professional colleagues.

The AVMA House Advisory Committee (HAC) and the Board of Directors (BOD) advised delegates to approve the revised PVME, according to the release. The goal behind the revision was to clarify certain aspects of the document. In its proposal, the BOD stated that the PVME had been “restructured to improve clarity and usability.”

The original document was comprised of 3 different sections

The principles with supporting annotations

The first section consisted of 9 principles that veterinarians should abide by. For example, the 2nd principle reads: “A veterinarian shall provide competent veterinary medical care under the terms of a veterinarian- client-patient relationship (VCPR), with compassion and respect for animal welfare and human health.”

 Meanwhile, the second section elaborated on the 9 principles, such as circumstances under which a veterinarian might terminate a VCPR. The 3rd section contained definitions to terms such as ‘dispensing’, ‘legend drug’, ‘impaired veterinarian’, ‘receiving veterinarian’, and more.

The updated document revised some of its wording and included new sections and sentences. One of the new additions to the PVME is a code of conduct that contains another 3 sections: to provide competent medical care, prioritize patient welfare in balance with client needs and public safety, and uphold standards of professionalism.

Moreover, in the “principles with supporting annotations” section, under the supporting annotations for the 2nd principle, the wording was revised to include the scenario: "The client requested the veterinarian to act in an unethical manner."

Another revision, located under the ‘useful terms’ section, consisted of clarification on how to refer to veterinary specialists. The updated PVME now reads: “The terms ‘board eligible’ or ‘board qualified’ are misleading and should not be used by veterinarians.”

1. Nolen RS. House passes updated ethics document, new transport policy. American Veterinary Medical Association. June 23, 2024. Accessed June 26, 2024. 

https://www.avma.org/news/house-passes-updated-ethics-document-new-transport-policy?utm_source=delivra&utm_medium=email&utm_campaign=todays-headlines-news

2. Principles of veterinary medical ethics of the AVMA. American Veterinary Medical Association. Accessed June 26, 2024. 

https://www.avma.org/resources-tools/avma-policies/principles-veterinary-medical-ethics-avma

The AVMA House of Delegates voted to approve revisions to the Principles of Veterinary Medical Ethics