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Fajta-specifikus állatorvosi ellátás

Biztosan Veletek is elöfordult már az, hogy egy kutya vagy macska tulajdonos azzal jött be a praxisotokba, hogy értetek-e ahhoz a fajtához, tudjátok-e annak a fajtának a speciális igényeit (mert a tenyésztö az tudja), illetve tisztában vagytok-e a speciális altatási módszerröl (pl. agarak esetében). Sok tulajdonos kérdezi állatorvosát, hogy milyen fajtaspecifikus problémái lehetnek annak a fajtának. Az ismertebb fajtáknál néhányat fel tud sorolni az állatorvos, de általában nem sokat, a legtöbb speciális fajtánál meg talán egyet sem. Mi állatorvosok sokszor még nehezményezzük is azt, amikor az ilyen “tenyésztök által felvilágositott” állattartók ily módon “okoskodnak” velünk. Aztán csodálkozunk, hogyha nem hozzánk jönnek ezek az állattartók, hanem ahhoz mennek, aki felvilágosultabb azzal a fajtával kapcsolatban, akiröl aztán hamar elterjed a hir az állattartók és tenyésztök körében, hogy “ahhoz az állatorvoshoz menj, mert az XY fajta specialistája”. Nem kellene igy tennünk és fontoljátok meg az alábbiakat.

Az Egyedi Életmeghosszabbitó Állategészségégügyi Terv (ÉÁT)-röl már irtam. Most a Fajta-specifikus egészségvédelmi ellátásról (Breed-specific wellness care) szeretnék irni. Ezzel a cimmel jelent meg egy remek cikk a DVM Magazinban és megerösiti azt, amit én ezzel kapcsolatban irtam, vagyis, hogy az állatorvosi praxisoknak nem “általánosan”, hanem kutya- és macskafajták szerint kellene praktizálniuk. Erröl szól a cikk, mindenkinek a figyelmébe ajánlom. Néhány dolgot szeretnék kiemelni a cikkböl, a magam véleményét is hozzáadva:

1.) Azok az állatorvosok, akik bevezetik praxisaikba a Fajta-specifikus Wellness Programokat és Fajta-specifikus protokollokat, azok megváltoztatják klienseik felfogását az állatorvosi ellátásról. Amikor ugyanis egy állattartó egy “mindent egy kaptafára” való ellátást kap állata számára egy olyan praxisban, ahol a prevenciós beavatkozások csak a vakcinázásokra és a féregtelenitésre szoritkoznak, akkor gyakrabban váltanak át egy másik praxisra, amelyik olcsóbban kinálja ugyanezeket az alapszolgáltatásokat. A Fajta-specifikus protokolokat (és a 3-éves vakcinázási protokolokat) bevezetö állatorvosi praxisok alapvetöen különbözni fognak az ilyen “mindent egy kaptafára” történö állatorvosi ellátást biztositó konkurens praxisoktól.

2.) A Fajta-specifikus Wellness (egészségmegörzö) Program az más, mint a hagyományos, “minden kutya az kutya” ellátásra épülö praxis. A fajta-specifikus ellátás iránt alapvetöen nagy az igény a tulajdonosokban, a fajtatiszta kutyák egyre növekvö elterjedtsége miatt. A fajtatiszta kutyák tulajdonosait az internet elterjedésével még jobban érdeklik a kutyájukra vonatkozó specifikus fajta információk. Ezeket az információkat jelenleg NEM az állatorvostól kapják meg (akik sokszor nem tudják ezeket a fajtainformációkat, illetve nincs is rá idejük ezeket elmagyarázni), hanem a tenyésztöktöl, az internetröl, a szomszédtól. Miért ne kaphatnák meg ezeket az információkat az állatorvosoktól, a praxisban történö vizitek során?

3.) A Fajta-specifikus egészségvédelmi ellátás gondolata nem új, már évtizedek óta felmerült. Mégsem terjedt el általánosan a praxisokban, mert ez sok munkával jár:

a.) a fajta-specifikus betegségeket, elváltozásokat össze kell gyüjteni

b.) ezekre fajta-specifikus praxis protokolokat kell elkésziteni

c.) ezeket az információkat a kliensek számára jól érthetö formába le kell irni, hogy egy bizonyos fajta vizsgálatakor legyen mit odaadni a tulajdonosnak

d.) ezeket a fajta-specifikus protokolokat be kell tanitani a praxis teljes szeméyzetével is.

Az Egyedi Életmeghosszabbitó Állategészségégügyi Terv (ÉÁT) irásomban megemlitettem egy olyan praxis szoftver programot, amely ezt elvégzi, tekintsétek meg annak gyakorlati alkalmazását bemutató videót. Az asszisztens itt azt mutatja be nekem, hogy a kutya fajtabetegségek ismerete milyen fontos az Egyedi Életmeghosszabbitó Állategészségégügyi Terv felépitésében.

Ahogy a fenntiekböl látható, az egyetemen tanultakat, majd a könyvekböl, elöadásokból megszerzett információkat “át kell ültetni” a gyakorlatba, az állattartó számára, nem itt-ott elmondott információ-darabkák formájában, hanem szépen átgondolt, leirt, elmagyarázott protokolok formájában. Ehhez persze rengeteg idö, munka és energia szükséges, valamint a praxisban dolgozó asszisztensek csapatmunkája. A legtöbb praxisban éppen ezért sohasem fognak elkészülni az ilyesfajta információk és az azok hatékony átadását szolgáló rendszerek. Nem véletlenül van az, hogy a nagyobb állatorvosi praxis láncolatoknak (pl. a 978 azonos felépitettségü Banfield praxisok) van ilyen rendszerük, a kis, 1 vagy néhány személyes praxisoknak pedig általában nincsen.

DVM NEWSMAGAZINE

 

Smart businesses know that no matter what shape our economy is in, that which is new, better and different will continue to sell. If you doubt it, just witness the runaway successes of the iPad and smart phones. Neither is a necessity. There are cheaper, older technologies that perform the basic functions. Still, people are lining up to buy them.

In our own industry, advancements provide many exciting opportunities to offer clients new, better and different, from acupuncture and complementary medicine to laser therapy and stem-cell treatments. One of the most appealing new ideas is breed-specific wellness.

Veterinarians are changing clients’ perceptions of wellness care through breed-specific programs. When clients perceive that wellness care is limited to vaccinations and parasite control and then see those services offered at discount prices elsewhere, they have little incentive to select a veterinary care provider for any other reason than cost.

Breed-specific wellness is different. It helps clients see wellness care as “designer” medicine driven by the unique breed risks of their pets. These days, pet owners interested in learning more about their breeds turn to sources such as the American Kennel Club (AKC), online forums, dog clubs, breeders and dog park acquaintances for information. While most people consider veterinarians animal-health authorities, clients don’t necessarily see us as a “go-to” source for breed information. Offering breed-specific healthcare services can help us position ourselves squarely in the middle of this groundswell of interest.

The concept of breed risks is not new. What is new is the idea of building wellness programs around specific breeds. Some veterinary practice owners have already begun.

 

Breed, disease pattern

In the 1990s, little information was readily available to help veterinarians interested in pursuing breed-specific medicine, Cloud says. However, by 1999, the American Animal Hospital Association (AAHA) published Dr. Lowell Ackerman’s book, The Genetic Connection: A Guide to Health Problems in Purebred Dogs. A decade later, even though most veterinarians are aware of the risk of hip dysplasia in large breeds, Cloud says the idea of breed-specific care is just taking off.Dr. Dennis Cloud, of Cloud Veterinary Centers in O’Fallon, Mo., says he first became interested in the idea of breed-specific care in the 1990s. He had an opportunity to look at a database that tracked pet healthcare exams for healthy and sick pets. He soon spotted patterns showing associations between certain diseases and breeds. Immediately, he sought to use this information to help diagnose patients. For example, when he saw an 8-year-old female Scottish Terrier with blood in her urine, he tried to rule out bladder cancer early in the diagnostic process because the breed is known to have a high risk for the disease. On the other hand, when he saw an 8-year-old male Bison with bloody urine, he would seek to rule out calcium oxalate stones first because that breed and sex is known to be pre-disposed to that condition.

He reports that the most challenging part of implementing a breed-specific care program is the time constraint of organizing a practice around it. The idea of breed-specific risks is new to most clients, so it takes time to explain it to them in the exam room. A slower economy may be an opportune time to talk to clients about it, Cloud says.

However, there is great potential to help more pets with breed-specific wellness screenings. He practices breed-specific wellness informally now and sees clients’ readiness to embrace the concept. The next step is to formalize breed-specific wellness care and create supporting client materials.

Research can pay off


Dr. Nan BossDr. Nan Boss, a well-known veterinary author and owner of Best Friends Veterinary Center in Grafton, Wis., introduced breed-specific wellness care to her clients in 2007. She saw breed-specific wellness as a natural progression in her practice’s pet-wellness services, which she tries to update and improve each year. Today, her practice sees many patients that benefit from this new approach.

For example, a client’s Boxer recently received an ECG as part of his breed-specific wellness exam. The ECG showed PVCs, an early warning sign for cardiomyopathy. Boss was able to share this information with the clients and recommend ways to monitor and help the pet.

Boss says being able to find problems at an early stage has resulted in some rewarding surprises. Recently a client brought in a Goldie-Poo (Golden Retriever-Poodle mix) for a spay. One of the dog’s parents was a miniature Poodle instead of a Standard Poodle, so she wasn’t overly big, but the hospital’s protocols called for a hip screen along with the surgery. The owners agreed to have it done. The X-rays revealed hip dysplasia in the small dog. Boss was able to start her patient on glucosamine right away, rather than wait until she was older or had developed noticeable symptoms.

The hardest part of introducing breed-specific wellness was finding the time to research it, Boss says. To research breed risks took four or five months. After that, she had to determine the recommendations to offer clients for their pets. Finally, she had to decide on breed-wellness protocols, develop client handouts to support the new program and educate her staff. Talking to clients about it was the easy part, Boss says.

By the time she launched the program, everyone in the practice had become a believer in breed-specific wellness and felt confident talking to clients about it. Boss says she never had to promote the program formally. Her team just made a point of talking to clients about it in the exam room. Her clients instantly “get it” and seem to appreciate the fine-tuned, customized care it affords their pets.

 

Designer dog food sparks a breed-specific wellness venture

 


Dr. Jeff BloomberShannon Pigott, CVPM, AAC, a hospital owner and former AAHA accreditation consultant, first started thinking about breed-specific medicine in 2005, when the dog genome map was completed. She saw how pet food companies jumped on the idea of “designer dog food” for breeds and how quickly the demand for genetic breed testing grew. Pigott felt pet owners were ready to embrace breed-specific wellness plans. In 2009 she asked Boss to serve as a consultant on breed-specific materials for her new venture, Genesis Breed-Specific Health Care. Together, they developed training modules for veterinarians and their staffs and breed-specific client handouts to help veterinarians jump start their own breed-specific wellness programs and harness the opportunity.

Other veterinarians, such as practice owner Dr. Jeff Bloomberg, Schaumburg, Ill., also caught the bug early and have forged ahead. Bloomberg says he incorporated breed-specific wellness into his practice several years ago after hearing Cloud give a talk on the topic at a veterinary meeting.

He first turned to the AKC website to get a list of purebred dogs. He reviewed the information that the AKC had published on 140 dog breeds to learn what they were telling pet owners to look for in the different breeds. Next, he ran an online search and discovered the Cambridge University Inherited Diseases of Dogs database. He said he used the AKC list and the information he identified in the Cambridge database to create handouts on each of the AKC breeds in the list. His plan was to use the materials as discussion aids with purebred dog owners and with owners of mixed-breeds who had genetic testing information about their pets or knew their origins.

When Bloomberg finished his handouts, he bought his first veterinary hospital, about two years ago. He was reluctant to introduce breed-specific wellness care to his new clients until he knew them better. Now that he knows them, he has decided to focus on new puppy owners and explain the benefits of breed-specific wellness care to them as part of his puppy program. He says that new puppy owners are open to new ideas and interested in learning everything they can to ensure the health of their new puppies. Starting with puppies helps set the stage for a lifetime of care and is a manageable way for a practice to introduce the concept of breed-specific wellness to pet owners.

These practitioners are a few of the early pioneers in breed-specific medicine. They were driven by the desire to practice good medicine and offer new services that would both make sense to their clients and be financially viable for their practices. Along the way, they have discovered that breed-specific medicine can meet the market with medical satisfaction and financial success.

Today, purebred dogs are common and genetic testing for mixed-breeds is readily available. Researchers estimate that as many as 40 percent of dogs are affected by genetically predisposed conditions. Technology and new laboratory tests offer practical means of early detection. Breed-specific medicine may be just the new, better and different approach that brings your clients back to the office.

Karyn Gavzer, MBA, CVPM, is a veterinary business consultant and nationally known writer and speaker.She says her job is to help practices “go and grow” with training, marketing and new ideas. She is a Certified Veterinary Practice Manager, an adjunct instructor for AAHA, and a founding member of VetPartners (formerly the Association of Veterinary Practice Management Consultants and Advisors).

Forrás: How to design a program around a patient’s risks, history (DVM Maga…

Kategóriák: Praxismenedzsment

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