In an interview with dvm360, Angela Elia, BS, LVT, CVT, VTS (ECC), discusses ways to achieve efficiencies while managing a practice’s caseload. 

Managing practice caseloads

Angela Elia, BS, LVT, CVT, VTS (ECC), a training program manager with Pieper Veterinary Group, lectured on time management for veterinary technicians at the 2024 American Veterinary Medical Association (AVMA) Convention in Austin, Texas. During her talk, she discussed how improved efficiencies can lighten a heavy caseload for all members of the veterinary team. In an interview with dvm360, she elaborated some ways to achieve efficiencies for managing a practice’s caseload that might otherwise be overwhelming to staff.

The following is a transcript of the video:

The clinic, overall, has to understand that if you're not efficient or you're overwhelmed as a tech, it stems from the whole process—right from the front, all the way to the back. We're overwhelmed. Probably, it's not just me. My doctor probably feels overwhelmed, and my CSRS [customer service representatives] in the front feel overwhelmed. So I think one of the things that we have to look at is [what we’re doing] practice wide.

How many patients can we possibly treat the way that we would love to treat every patient? Are we talking 15 minutes appointments? 30 minute appointments? Do we have service pauses to let our [emergency] staff catch up with the flow that we already have here? So, are there things we can change systemically?

And then there are things that we can do, like just buy equipment. If I have a digital, awesome electric blood pressure machine, then I can hook up. If I have multiple of them, and I'm in the ICU, and I can hook up 3 machines to a patient—hit run—all of a sudden, I'm doing the work of, finally, 3 people.

Just buying equipment that makes me more efficient can help, but it really boils down to a change in mentality. I think, practice wide, to say ‘hey, what can we do from the top down to make people feel more efficient, better utilized and less overwhelmed?’

Videos

In an interview with dvm360, Angela Elia, BS, LVT, CVT, VTS (ECC), discussed some ways to achieve efficiencies for managing a practice’s caseload that might otherwise be overwhelming to staff.

Abdominal exploration in cattle may be necessary for various reasons. It is primarily needed to diagnose and treat conditions that cause colic, anorexia, or other symptoms of abdominal pain. In order to treat abdominal conditions in cattle effectively, it is important for veterinary professionals to possess proficiency in abdominal exploration surgery. At the 2024 American Veterinary Medical Association (AVMA) Convention in Austin, Texas, Andrew JT Muir, DVM, MS, veterinary associate at Nenn Equine Veterinary Services in Santa Rosa Valley, California, gave a comprehensive lecture on conducting flank laparotomies in cattle, as well as different surgical options.

Surgical options for abdominal exploration

During his lecture, Muir discussed the pros and cons of standing versus recumbent laparotomy surgery. According to Muir, abdominal surgery in cattle is generally performed standing, primarily to avoid the challenges and risks associated with general anesthesia and lateral recumbency for prolonged periods of time. “Standing for surgeries carry minimal complications,” Muir said. However, standing surgeries can also be more difficult to perform, given the movement of the animal, according to Muir. “If you're working on Brahman cattle…they have a tendency to lay down, which can be catastrophic if you have intestines exteriorized through the incision, and then she decides to lay down on you and… then decides to stand up again and steps on her intestines. That can be pretty problematic,” said Muir. Moreover, standing laparotomies have reduced uterine exteriorization compared to doing paramedian or ventral midline incisions.

Recumbent laparotomies have improved uterine exteriorization, with removed risks associated with standing surgery. This type of surgery, however, carries risks of general anesthesia. “Cattle under general anesthesia are predisposed to hypoventilation and ruminal bloat,” said Muir. Another concern with prolonged lateral recumbency is the possibility of neuropathies and myopathies. Additionally, the procedure more expensive than standing surgeries due to increased surgery time.

During his lecture, Muir taught attendees the surgical approach to a standing laparotomy, which involves sequential layers from the skin down to the peritoneal lining. Initially, the external abdominal oblique muscle is encountered first, followed by the internal abdominal oblique and the transverse abdominis muscles and finally, the peritoneal lining.

He also touched on laparotomy closure. “It's important to know what muscle bellies we go through when we get towards the abdominal cavity, because we want to close these muscle bellies in certain layers,” Muir explained. “When we do abdominal closure, I prefer to do the transverse abdominis with the peritoneum, do a second layer with the internal and external abdominal obliques together, and then ultimately the skin,” he continued.

In his session, Muir lectured on how to distinguish between the different layers. He explained that external abdominal obliques run in a cranial to caudal direction, whereas the internal abdominal obliques “run from a caudal to cranial direction, and the transverse abdominis runs from a dorsal to ventral direction.”

Standing flank laparotomy provides access to the abdominal cavity for diagnostic and therapeutic procedures. Cattle tolerate standing abdominal procedures well, requiring minimal intense preoperative, intraoperative, or post-operative care. As such, these animals are good candidates for these types of flank laparotomies. Conditions like intussusception, cecal dilation and dislocation, abomasal displacement, and traumatic reticuloperitonitis frequently require exploratory laparotomy.

Moreover, timely intervention is critical, as delays can exacerbate complications or result in fatalities.

Muir A. Standing flank laparotomy in cattle: Techniques and applications. Presented at: American Veterinary Medical Association Convention; Austin, TX; June 21-25, 2024.

Articles

Andrew JT Muir, DVM, MS, gave a lecture on standing flank laparotomies in cattle, including alternative surgical options at the 2024 AVMA Convention

Abdominal exploration in cattle

In an interview with dvm360 at the 2024 AVMA convention, Melody Martínez, CVT, outlined a variety of nontraditional jobs for veterinary technicians.. 

Nontraditional jobs for veterinary technicians

There is a vast amount of nontraditional jobs for veterinary technicians and roles that rely on the skills these professionals have built. In a CE session at the 2024 American Veterinary Medical Association (AVMA) Convention in Austin, Texas, lecturer Melody Martínez, CVT, president of the Multicultural Veterinary Medical Association, discussed her career path to a nontraditional job in veterinary medicine, and options that are available to technicians who are interested in a different role.

 at the AVMA convention, Martínez outlined a variety of nontraditional jobs. These include roles in academia, administration, veterinary support industries, and more.

: Some of the typical nontraditional careers include insurance work [such as] a claim adjuster, an administrative role, an insurance company, industry jobs—whether it's sales, pharmacology work or administrative work in an industry role—academia, so teaching veterinary technology or teaching about careers in veterinary medicine. Some of those academic jobs also include campus recruiters or program recruiters, as well as administrative roles.

And then there's a wealth of jobs in animal welfare, whether it's shelter work or rescue work, that are really suited for technicians. They may not be jobs or roles written for technicians, but [jobs] where the skills and the education that a technician has come to bear really well. And then, recently, there's kind of been an uptick of a lot of telehealth and teletriage remote jobs, and grief support jobs or palliative care or hospice jobs that are nontraditional, whether they are remote or hybrid or mobile in nature.

There are also roles that are entrepreneurial. So a lot of technicians who go on and do relief services or do medical pet sitting or do some sort of concierge service that they're providing to their clients in the community or doing palliative care or death work.

[There are] just a lot of different options for technicians, and those aren't even the roles that are kind of in the network of veterinary health, like grooming and boarding or pet sitting or dog training, or any of those sorts of jobs that are kind of still within the realm of animals or veterinary health.

Melody Martínez, CVT, outlined a variety of nonclinical roles that are accessible and fitting for veterinary technicians, during an interview with dvm360 at the 2024 AVMA convention

A vast amount of nontraditional jobs provide options for veterinary technicians

The Animal Hospital at Steiner Ranch. (Image courtesy of CityVet)

CityVet, a network of 39 veterinarian-owned practices, announced today that it has acquired The Animal Hospital at Steiner Ranch in Austin, Texas. The clinic, located at 5145 Ranch Road 620 North, Suite F140, has been run by Tamera Cole, DVM, for the last 10 years.

“I am incredibly thankful for my patients and all the wonderful client relationships we’ve cultivated over the years. We are thrilled to join the CityVet network and transition our patients and team into the excellent care of the CityVet team who believes in putting people at the center of everything they do,” expressed Cole, in an organizational release.

“I will be transitioning out to seek further study and certification in Animal Behavior, and Heidi Moore, DVM, a long-time local resident, will assume ownership and leadership responsibilities at the clinic. I've had the pleasure of getting to know Dr Moore and I have complete confidence in her capacity to uphold the clinic's high standards, to which our clients and team have grown accustomed," she continued.

According to the release, Moore attended the St Georges University of Veterinary Medicine for her veterinary education and spent her final year at the Louisiana State University.

 Currently, she is serving as the area veterinarian for Austin Zoo and has experience in mixed animal medicine. She practiced at Lakeway Vet Clinic for 10 years and held the medical director position for 2 of those 10 years. Her interests include emergency care, internal medicine, preventive medicine, mixed animal and exotic medicine.

“Cole and her team have a well-established clinic in Austin with a strong reputation as a trusted veterinarian in the community. Our partnership with Moore will bring added value and expanded services to their clients and staff with enhanced tools and support. We are excited about contributing to the continued legacy established by Cole and her team in Austin,” said David Boguslawski, CityVet CEO.

During the transition, the clinic will be adding extended hours during the week and weekends and Moore will begin offering surgeries and expanding dental services to patients in need. According to the release, the terms of the transaction were not disclosed and the acquisition went into effect May 10, 2024.

CityVet acquires The Animal Hospital at Steiner Ranch. News release. CityVet. June 24, 2024. Accessed June 24, 2024.

This clinic will join over 30 veterinary own practices in the CityVet network 

Veterinary network acquires The Animal Hospital at Steiner Ranch 

The American Association of Bovine Practitioners (AABP) and the American Association of Equine Veterinary Technicians and Assistants (AAEVT) have released guidelines that delineate specific responsibilities and different veterinary supervision levels for credentialed veterinary technicians (CrVTs) in bovine and equine practices. The documents, which were released this spring, are an effort to optimize the role of CrVTs.

Travis Otremba, LVT, RVT, president of AAEVT and CrVT at Ocala Equine Hospital in Ocala, Florida, underscored the lack of understanding regarding the capabilities of CrVTs and the scope of their education in a news release.

 “There is a lack of knowledge of what a trained, credentialed veterinary technician actually is, as well as what they are educated to do in school,” said Otremba. “These guidelines shed some light and educate doctors and practice owners and managers [on] how to utilize their technicians more effectively and thus potentially increase production significantly.”

According to the AABP, there is an underutilization of CrVTs in bovine and equine practice in comparison to their counterparts in companion animal practice “If we’re only using veterinary technicians to perform procedures, or they’re just riding along in your truck, they’re not improving your efficiency and revenue,” said K. Fred Gingrich II, DVM, executive director of the AABP in a news release.

AABP guidelines for bovine veterinary technicians

The “AABP Guideline for Credentialed Veterinary Technicians in Bovine Practice” was created to provide guidance on how bovine veterinarians can delegate more tasks to CrVTs in the practice.

 The guideline contains a task list outlining common tasks and procedures in bovine medicine, such as different anesthesia administration methods, surgical procedures, and recording tasks.

 The right side of the list contains a “Supervision Level” section that indicates the supervision level required for the respective task. The levels range from “CVT indirect supervision” to “veterinarian only.”

“If we can utilize technicians and delegate tasks to them so that the speed of animal care is improved, then that helps everyone from the veterinarian to the technician to the animal owner,” Gingrich said in the release.

 He also explained how recognizing veterinary technicians as veterinary professionals and providing them with tasks within their scope of practice can enhance retention and generate more revenue per doctor. This would allow veterinarians to perform more profitable procedures during their newfound time and result in CrVTs receiving a higher wage. The AABP is also now permitting veterinary technicians to join the association in an effort to recognize their importance.

AAEVT guidelines for equine veterinary technicians

In March 2024, the AAEVT created “The Guidelines for Utilization of EQ CrVT.” These guidelines were based on the 2023 American Animal Hospital Association’s (AAHA) Technician Utilization Guidelines and were developed in collaboration with the American Association of Equine Practitioners (AAEP). The guidelines are comprised of 3 different proficiency levels that contain lists of procedures that can be performed by veterinary technicians in each level depending on their training and capabilities.

A 2022 survey published by the National Association of Veterinary Technicians in America (NAVTA) revealed that only 4% of respondents were in equine practice.

 Moreover, 41% of respondents reported feeling utilized only “sometimes,” while nearly 20% said they do not feel utilized to their fullest potential at their workplace.

“If a technician or assistant is not used to their fullest extent, satisfaction in their job can wane,” Otremba said. “If a tech is not being utilized effectively and their skillsets are not taken into account, there is no competition and no need to increase wages or benefits... I think that if a practice is to utilize their technicians or assistants to the top of their education and offer competitive wages or benefits, we may see an increase in retention across equine veterinary medicine.”

The AAEVT also created an assessment tool

 that veterinarians can use in their practice. The tool servers as a resource to help equine practices better leverage their CrVTs.

J. David Sessum, LVT, program manager for the Veterinary Science Certificate Program at Texas A&M University offered his insight on the educational implications of these new guidelines. “I think this is going to show veterinary technology programs that large animal veterinarians are interested in their students upon graduation, and if they focus their efforts on preparing students for careers in other species, such as bovine and equine, that they’ll have a better pool of graduates or employees to choose from,” Sessum said in a news release. He also noted how the guidelines offer an advantage to veterinary technology programs by providing insight into the specific skills desired by bovine practitioners for CrVTs, enabling educators to integrate these criteria into the curriculum.

Bovine, equine groups create veterinary technician utilization guidelines. News release. American Veterinary Medical Association. May 20, 2024. Accessed May 29, 2024.

https://www.avma.org/news/bovine-equine-groups-create-veterinary-technician-utilization-guidelines

AABP Guideline for Credentialed Veterinary Technicians in Bovine Practice. American Association of Bovine Practitioners. March 2024. Accessed May 29, 2024. 

https://aabp.org/resources/AABP_Guidelines/VetTech2024.pdf

NAVTA survey reveals veterinary technician pay and education have increased, but burnout, debt are still issues. National Association of Veterinary Technicians in America. January 16, 2023. Accessed May 29, 2024. 

https://navta.net/news/navta-survey-reveals-veterinary-technician-pay-and-education-have-increased-but-burnout-debt-are-still-issues-2/

American Association of Equine Veterinary Technicians and Assistants. 2024. Accessed May 29, 2024. 

https://dnc58rl1j94r0.cloudfront.net/app/uploads/20240327105732/AAEVT-Guidelines-Assessment-Tool.docx

Guidelines created by bovine and equine associations help educate the veterinary community on the skills of credentialed technicians

Increasing veterinary technician utilization with new guidelines

The Polar Wet Food Feeder by PETLIBRO is a first-of-its-kind refrigerated wet food feeder for cats. The semiconductor cooling technology can refrigerate up to 3 portions of wet food (7.4 oz). Food can be stored in the feeder for up to 3 days before spoiling, and an automatic feed dispenser can be scheduled from the PETLIBRO mobile app.

Wag!, a pet service, product, and wellness brand, launched Furscription as a new digital tool for veterinary clinics to streamline the prescription process. Through a partnership with veterinary pharmacies across the country, Furscription enables clinics to electronically prescribe medications, eliminating the necessity and associated risks of handwritten prescriptions and traditional manual prescription management methods such as fax and phone calls. Owners can also receive prescription status notifications on their phone.

Erchonia created the first green and violet laser (GVL) for the veterinary market. The GVL works to improve outcomes with nonhealing wounds, chronic infections, pain and inflammation, postoperative healing, bone healing, anxiety, neurological trauma, and more. With 27 years of experience in the human medicine market, Erchonia designed this laser to have more power and energy than an infrared laser.

The new FitPaws K9 FitMat is designed to be used during any training, fitness, or rehabilitation exercise. The antislip mat is covered with sensory bumps to promote neural stimulation, paw grip, and resistance to damage from dog nails. This product was made to improve coordination with foot and place targeting, senior dog strengthening, and puppy confidence building.

In partnership with payment processor company Stripe comes the payment software Digitail Secure Payments. This new, all-in-one cloud-based operating system aims to streamline the billing process and tackle the challenges associated with missed charges. Gather payments via an integrated terminal within a clinic’s premises or dispatch invoice links through text, email, or the Pet Parent App.

Royal Canin has expanded its veterinary gastrointestinal portfolio with 5 new diet offerings. The new food options include Canine Gastrointestinal Low Fat + Hydrolyzed Protein, Gastrointestinal Low Fat Small Dog, Canine Gastrointestinal High Fiber Loaf in Sauce, Feline Gastrointestinal Hydrolyzed Protein, and Gastrointestinal Fiber Response Thin Slices in Gravy. Each new diet has been created through collaboration between Royal Canin researchers, specialists, and veterinary practitioners.

Here's our regular rundown of new and notable veterinary products