The Cat's Scratching Post
(Newsletters, Dr Tom Cat's Blog)

VCI SUMMER EDITION NEWSLETTER

So . . . happy season change - in USA it is at the solstice, in Australia it is on the first of the month (1 June started winter season - no snow in Brisbane, not even ice on the windshield) . . . in the UK, they also change seasons at summer solstice - 21 June - the longest day - and officially the first day of summer.  Summer ends and Autumn begins on the autumn equinox - 22/23 September, except in OZ, when 1 September starts the spring season.  No Problem Mate, it is on the calendar!    
While I am in Australia, my mobile (cell) is actually +61 416 285 975, unless you are in Australia and  dialing me, then it is 04-1628-5975 . . . they drop the '0' when international.

Tom Cat >*-*<  

Anesthetic Complications: Blood Pressure-Causes and Treatments
Instructor: Dianne Hudson, RVT, VTS (Anesthesia)
Course Open:
July 9-26, 2009
Real Time Session: Thursday evening, July 16, 2009; 9:00pm-10:30pm ET (USA)

Click on the hotlinked title above to view the entire course information page

Course Description:
This course is designed to provide a basic knowledge of hypotension seen in anesthesia patients. The discussion will include causes for hypotension, techniques to reduce the incidence of hypotension, and steps to address hypotension including the drugs used to treat this common anesthesia problem.  All members of the veterinary support staff may join the course and its discussions; however, this course is focused toward veterinary technicians and veterinary technician students involved with anesthetizing patients.

PLEASE NOTE: The course format is that of a VINgnette where interaction in the message boards discussing case scenarios will be required to enhance the single real time session. Participants should plan on this more intensive study.  Upon completion of this course participants will be able to identify and discuss

  • the definition of hypotension.
  • common causes of hypotension in anesthesia patients.
  • techniques for avoiding hypotension in the anesthesia patient.
  • steps to address hypotension.
  • commonly used drugs which address hypotension.

TEXTBOOKS: There are no required texts for this course; however, the instructor recommends the following:

Course Outline:
Library notes will cover hypotension in the small animal anesthesia patient. The course will discuss causes of hypotension and techniques for minimizing hypotension. We will then review the steps to addressing hypotension with a focus on inotropes and vasopressures.

CE Hours:
2.5

TUITION: $50 ($45 early bird special if enrolled before June 25, 2009).
*Students currently enrolled in and taking at least 2 classes or 5 units at an AVMA accredited or CAAHT approved Veterinary Technician Program may be eligible to receive a 50% discount off the regular rate for this course (upon verification of student status).

TESTIMONIAL (received 5 June 2009)
Tom Cat - You are right on the money.  I'm still practicing the things you instilled in me and we are up 20% this year while the hospitals around us are laying off vets.  Randy
 
RECENT INQUIRY:
Help Mr. Wizard
 

In a message dated 6/2/2009 9:00:03 P.M. Mountain Standard Time, Dr XXXX writes:

I am presenting to a group of 21 of the top vets in Japan doesn't really want Japanese solution to Japanese problem, they want the American solution to the perceived/real American Problem. Like Harley Davidsons, Marlborors and Zippos, they love U.S.A.....U.S.A!  Sorry I didn't clarify before, but how do we handle this challenge/opportunity in America? 

Tom Cat RESPONDED: 

In Stockton, CA, highest foreclosure rate in CA. my client dropped from 25% growth to 20% growth.

In BC, no growth in Association, with established BC rate guide. my client maintained 22% growth.

In Brisbane, 16 vets within 10 minutes of front door, community income at $500 per family per week, growth is at 20-25% (still, after four years of added programs), while other practices are bemoaning an on-going loss of income . . .

CONSULTANT'S ROLE:

Tracking procedures per transactions, AFTER establishing a written standards of care (SOC) for Risk Level 1 animals (young and healthy) - expectation of 110% consistency in offering  NEEDED care to clients for their pet . . . and I want to see improvement each month, NOT leaps and bounds, just IMPROVEMENT in procedures per 100 transactions . . . if you start with risk level 2 or above, we are into clinical freedom of ve terinarian (varies by school), and that is never an easy starting point.  After Risk level 1 consistency, then we move to protocols for Risk Level 2 and above (e.g., I.V. TKO (IOFs), minimum pre-anesthethetic lab screens, etc.) . . . I will attach an evolved Standards of Care . . .  

XXXX - you have the numbers and savvy:
- 85% of adult animals come into practice with some form of dental care needed
- 50% of all animals entering the practice have some form of nutritional need 
- 30% of long haired cats has PCK syndrome
- JPS candidates need screening at 14-16 weeks of age (ortolani is 75% accurate, penn-hip is 86% accurate), and JPS surgery before 18 weeks of age, - breed specific PCRs are available for 450 conditions
- 15% of animals on strategic deworming are still parasitized
- AAHA reported $639,000 per doctor per year being lost in wellness care/prevention because of POOR practice compliance, and clients NOT AWARE of sense of urgency
- Recommend is NOT sense of urgency => NEED is needed
- Annual is not www.npwm.com compatible, need to use NEXT in planning visits/contacts
- we moved from 1.9 client visits in July 2004 (roll out of THINK TWO VISITS A YEAR FOR LIFE) to 3.3 client visits after 4 years of semi-annual visit advocacy
- most effective practices have OPN precede doctor in consult room, doing a 3-5 asymmetry exam, with "Ï have made a  note for the doctor to talk to you about this", and then followed by OPN to do client education as prioritized by doctor
- all visits end with the 4 Rs - assuming an active problem list (recall, revisit, remind, and resolved); planning the next contact is started by doctor, reinforced by OPN, and tracked by client relations/veterinary software - at least one, and usually more . . .20

Hope this gets your juices flowing XXX.

Tom Cat  >*-*<

P.S.  Even with this type of success track record, we have practices that DO NOT accept changing their tracking systems, since veterinary software does not do the above easily, and they are fixated on GROSS and AVERAGE CLIENT TRANSACTION . . . I will attach an OZ spread sheet (their FY is July to June) which I provide to all practices - note the procedure tab and fiscal tab - they drive the ten trend graphs, and the budget stands alone to assess income to expense relationships (income - expense = net) . . . have fun.  TC

FDA Approves First Canine Cancer Therapy  
Pfizer Animal Health Receives Approval for PALLADIATM
MyStuff-Your Online Filing Cabinet!
We've all been there... after a bit of tinkering, your VIN Database Search produced just what you wanted to know now -- and likely will want to know, again, in the future.  Keep your results at your fingertips -- when you search the VIN database, you'll notice the "Add to MyStuff" link associated with each search result. If you look at the top of your search result list, you'll notice the "Add Search Results to MyStuff" link that lets you save the entire list of search results. Use MyVIN > MyStuff to find your saved results later. Are you a power VINner who refines your searches by selecting (clicking the check boxes) the best of the best from your Search results and displaying them as a custom Search result (Display Checked)? You too can stash your gold by choosing "Add Checked Results to MyStuff".

Almost every information-packed page on VIN is MyStuff enabled - just click the RED HEART on the page or choose Save to MyStuff and you are on your way.

  • Do a Search; save the results.
  • Want to go back later and review something you found browsing the Library? Store the link in MyStuff.
  • Find a favorite page in Associate; save the link.
  • Create your own categories and subcategories to help you stay organized.

You are not limited to VIN Content! ANY internet page can be stored and categorized within MyStuff.  Imagine the power of having all of your favorite links available to you on any computer you use -- home or office or even on a friend's computer.

MyStuff is easy to use. For external links, just copy and paste the URL for the page you want to save. To retrieve your MyStuff, click MyVIN on the VIN navigation bar - your MyStuff is there waiting for you from any computer, anywhere in the world.

 

Junk food can be addictive, an Australian study shows, indicating why for many people the habit can be hard to break.
Rats allowed to gorge on foods rich in sugar and fat put on weight during a two-month study, and also become "anxious" when this food was replaced.  University of South Australia post-graduate student Zhi Yi Ong found her furry test subjects would also opt to go hungry rather than eat a healthier pellet-based alternative. "It seems like the desire for junk food has overridden their hunger signals, they would rather eat nothing ... than consume the chow as their energy source," Ong said.  "... We've seen junk food can be addictive so it is possibly better to consume not too much junk food."

The rats were allowed to eat their fill of a variety of biscuits, hazelnut spread, peanut butter, sugar-loaded cereals along with cheese and bacon-flavoured snacks. They were then monitored over three days when this food was replaced with pellets.  Over this time, the junk food-fed rats ran around more than a group of control rats who had only ever eaten the pellets.  "When not with the junk food they became more anxious ... they were probably suffering from junk food withdrawal," Ong said.

While the initial research focused on the rats' behaviour, the next phase will look for signs of increased dopamine processing in their brains.  Previous studies have shown how foods high in sugar and fat can prompt the release of this neurotransmitter in the brain's central reward pathway - the same process exploited by illegal drugs.  "We're speculating junk food can down-regulate (desensitise) the reward pathway in our brains," Ong said.  "So if you have consumed too much, you have to consume more and more in order to feel the same happy feeling."  The research was released at an Adelaide meeting of The Australian Society for Medical Research. 

VeggieDent voluntary product recall

A voluntary product recall has been issued today for VeggieDent Chews for Dogs.  Virbac (Australia) Pty Ltd has received reports of dogs that have consumed the chews exhibiting signs suggestive of an acquired proximal renal tubulopathy including polyuria, polydipsia and glucosuria in the absence of concurrent hyperglycaemia. No causal link has been established and the voluntary recall is a precautionary measure.  All VeggieDent Chews for Dogs should be removed from sale immediately, and suspected cases reported to Virbac. Researchers in Sydney have also been compiling information and would like to receive reports of suspected cases. To report cases, contact:

  • Dr Gerard Lim, Virbac (Australia) Pty Ltd, on 1800 242 100
  • Aitor Arteaga, University of Sydney’s Faculty of Veterinary Science,
    02 9351 3437 or A.Arteaga@usyd.edu.au
     or Justin Wimpole, Small Animal Specialist Hospital 02 9889 0289, jwimpole@sashvets.com

The AVA will be releasing a media statement shortly advising pet owners to stop feeding VeggieDents to their dogs and to closely monitor the dog's health. If pet owners have concerns about other types of pet food, our advice is if the animal is well, they should continue normal feeding, and visit a vet if the health of their pet declines.   Product recall notice    Instructions for recall

COMING ON VIN
 
Anesthetic Complications: Blood Pressure-Causes and Treatments
Instructor: Dianne Hudson, RVT, VTS (Anesthesia)
Course Open: July 9-26, 2009

Real Time Session:
Thursday evening, July 16, 2009; 9:00pm-10:30pm ET (USA)
Click on the hotlinked title above to view the entire course information page

Course Description:
This course is designed to provide a basic knowledge of hypotension seen in anesthesia patients. The discussion will include causes for hypotension, techniques to reduce the incidence of hypotension, and steps to address hypotension including the drugs used to treat this common anesthesia problem.   All members of the veterinary support staff may join the course and its discussions; however, this course is focused toward veterinary technicians and veterinary technician students involved with anesthetizing patients.

  • NOTE: The course format is that of a VINgnette where interaction in the message boards discussing case scenarios will be required to enhance the single real time session. Participants should plan on this more intensive study.

Upon completion of this course participants will be able to identify and discuss

  • the definition of hypotension.
  • common causes of hypotension in anesthesia patients.
  • techniques for avoiding hypotension in the anesthesia patient.
  • steps to address hypotension.
  • commonly used drugs which address hypotension.

TEXTBOOKS: There are no required texts for this course; however, the instructor recommends the following:

Course Outline:
Library notes will cover hypotension in the small animal anesthesia patient. The course will discuss causes of hypotension and techniques for minimizing hypotension. We will then review the steps to addressing hypotension with a focus on inotropes and vasopressures.

CE Hours: 2.5 CEUs

TUITION: $50 ($45 early bird special if enrolled before June 25, 2009).
*Students currently enrolled in and taking at least 2 classes or 5 units at an AVMA accredited or CAAHT approved Veterinary Technician Program may be eligible to receive a 50% discount off the regular rate for this course (upon verification of student status).

This Week’s Hot Infection Control News
 
Survey of MRI Centers Finds Lack of Basic Infection Prevention
Peter Rothschild, MD, a radiologist and MRI expert, has released the paper, “Survey of Infection Control in the MRI Environment: Lack of Infection Control Procedures in MRI May Place Patients and Staff at Risk.” MORE

Partnership Aims to Reduce Infections Among Cancer Patients
The Centers for Disease Control and Prevention (CDC) Foundation, the CDC and Amgen today announced the launch of a three-year campaign to reduce infections among cancer patients. MORE

H1N1 Flu Cases in the U.S. Top 10,000
The Department of Health and Human Services and the Center for Disease Control and Prevention are reporting that there are currently 10,053 confirmed cases of H1N1 influenza infection in the United States and there have been 17 deaths associated with this strain of influenza. MORE
 
Avian Flu Virus Remains Infectious Up to 600 Days in Municipal Landfills
Amid concerns about a pandemic of swine flu, researchers from Nebraska report for the first time that poultry carcasses infected with another threat — the avian influenza virus — can remain infectious in municipal landfills for almost two years. MORE

Who's Who in Infection Prevention 2009
We present our annual list of exceptional individuals working in infection prevention and control, as nominated by Infection Control Today magazine readers. MORE

Sanofi Pasteur to Produce New Influenza A(H1N1) Vaccine
Sanofi Pasteur announced it has received the first of what is expected to be a series of orders from the Department of Health and Human Services (HHS) to commence production of a vaccine to help protect against the new influenza A(H1N1) virus. MORE

Study Finds Unexpected Bacterial Diversity on Human Skin
The health of our skin — one of the body’s first lines of defense against illness and injury — depends upon the delicate balance between our own cells and the millions of bacteria and other one-celled microbes that live on its surface. MORE
 
Common Antibiotics May be Best First Treatment for Children with MRSA-related Infections
Penicillin and other antibiotics in the beta-lactam family work as well as other antibiotics to treat methicillin-resistant Staphylococcuss aureus (MRSA) infections in the skin and soft-tissue of children and may help prevent further resistance to antibiotic treatment. MORE

Infectious Prion Strains Identified by Accelerated Method
Current tests to identify specific strains of infectious prions, which cause a range of transmissible diseases (such as mad cow) in animals and humans, can take anywhere from six months to a year to yield results – a time-lag that may put human populations at risk. MORE

Looking for New Antibiotics
As the best drugs become increasingly resistant to superbugs, McMaster University researchers have discovered a completely different way of looking for a new antibiotic. MORE

Scientists Develop New HIV Microbicide
In what could be a major pharmaceutical breakthrough, research published online in The FASEB Journal describes how scientists from St George's, University of London have devised a one-two punch to stop HIV. MORE
 
Common Antibiotics May be Best First Treatment for Children with MRSA-related Infections
Penicillin and other antibiotics in the beta-lactam family work as well as other antibiotics to treat methicillin-resistant Staphylococcuss aureus (MRSA) infections in the skin and soft-tissue of children and may help prevent further resistance to antibiotic treatment. MORE

Infectious Prion Strains Identified by Accelerated Method
Current tests to identify specific strains of infectious prions, which cause a range of transmissible diseases (such as mad cow) in animals and humans, can take anywhere from six months to a year to yield results – a time-lag that may put human populations at risk. MORE

Looking for New Antibiotics
As the best drugs become increasingly resistant to superbugs, McMaster University researchers have discovered a completely different way of looking for a new antibiotic. MORE

Scientists Develop New HIV Microbicide
In what could be a major pharmaceutical breakthrough, research published online in The FASEB Journal describes how scientists from St George's, University of London have devised a one-two punch to stop HIV. MORE
 
New Infection Control Requirements for Medicare-Approved ASCs
Included in the new Medicare conditions for coverage for ambulatory surgery centers (ASCs) that took effect on May 18, 2009 is a rigorous focus on demonstrated infection prevention and control knowledge and practice in an ASC. MORE

Selenium Could be Key to Developing New Antibiotics
A mineral found at health food stores could be the key to developing a new line of antibiotics for bacteria that commonly cause diarrhea, tooth decay and, in some severe cases, death. MORE

 
H1N1 Infection Still Viable; Handwashing is a Key Precaution
As H1N1 influenza infections continue, people around the world can take proactive steps to protect themselves. While wearing face masks and stocking up on over-the-counter flu medication can help you avoid this disease, the Centers for Disease Control and Prevention (CDC) is recommending a simpler measure -- frequent, thorough handwashing. MORE
 
PDI Champions the Fight Against HAIs with Toolkit
Continuing in its mission to prevent hospital acquired infections (HAIs), Professional Disposables International, Inc. (PDI), will fund and collaborate with leaders from the Association for Professionals in Infection Control and Epidemiology (APIC) and Safe Care Campaign, an advocacy group, to create “The Champion’s Kit.” MORE

New study targets lymphoma in dogs and humans
US veterinary and human oncology specialists team up to study non-Hodgkin lymphoma in dogs and people.
More 

Salmonella top of EU food poisoning chart
The European Food Safety Authority (EFSA)’s latest annual report on food-borne illnesses reveals that Salmonella in eggs and egg products was the single largest cause, responsible for 14.6% of verified cases. With interactive charts.
More

Vets act as bridge for wider zoonotic infections
Veterinarian's risk of zoonotic infections is often higher than that of other occupational groups with extensive exposure to animals, such as farm workers, say US researchers.
More 

WHO dismisses theory that H1N1 was created in lab
W
HO dismisses the claim that a laboratory escape was “one of simplest explanations” for the appearance of H1N1. The virus is likely to have been created naturally, the organization says. More 

Lawsuit claims Smithfield Foods responsible for H1N1 The widower of the first US resident to die of H1N1 influenza files a $1 billion dollars lawsuit against Smithfield Foods for the wrongful death of his wife. More 

Chicken is largest source of Campylobacter food poisoning in Scotland
Retail chickens are the single largest source of Campylobacter infection in Scotland, according to a report published by the Food Standards Agency Scotland (FSAS). With interactive charts.
More

Vets question selenium dosage as cause in polo deaths => West Palm Beach News, South Florida Breaking News, Forecast, Video from WPTV
http://shar.es/a16w

New communications and PR tools offer marketers less costly (and equally effective) alternatives for building brand and product awareness.

Tough economic times are forcing many companies to cut back marketing and advertising budgets. According to figures released by the Publisher's Information Bureau in January, consumer magazine advertising pages dropped nearly 12 percent in 2008. While cost cutting may be necessary to remain solvent, forcing your marketing department to go on a crash diet can cause companies to lose the momentum and brand awareness they've built up through long-term campaigns.  Just because times are lean doesn't mean you have to sacrifice your hard-earned market share. Use this economic downturn as a chance to supplement your marketing and advertising activities with targeted public relations campaigns that capitalize on the practice awareness you've already cultivated.

Get Social
If your practice still hasn't made the leap into social media, now's a great time to establish a foundation for such activities. Research the top industry blogs, and if blogs aren't already included in your media outreach plans, integrate them. Get involved in the conversation. If you don't have the time to start your own blog, become an active commenter, or get involved in microblogging via Twitter, or better yet, find a GEN-Y on your staff that wants to be interactive in the Cyberspace community.  Check out how your community colleagues are utilizing Web 2.0 tools and familiarize yourself with the social media applications frequently leveraged by marketers -- Facebook, Twitter, Del.i.cious, YouTube, Digg, etc. These applications are rapidly becoming an essential platform for marketing and brand building as more and more consumers increase the scope of their activity on the web.

Make Your Press Release Interactive
Press releases have been traditionally used by marketers to announce larger campaigns, like product launches and sales events. Issued as a text announcement, a release would set the stage for more expansive and engaging communications efforts that would be used to ultimately entice the company's target audiences.  However, advances in technology have made the press release a much more dynamic, interactive multimedia communications tool, especially compatible with a veterinary practice's needs.  Today's press release is actually a multimedia news release, combining text with video, photos, social media elements and much more. Further, changes in the way people access and share information have prompted many companies to reassess how a marketing campaign can be executed and the tools necessary to make an impact in today's dynamic communications environment.  As a result, more communicators are turning to the multimedia news release because it's the most comprehensive.  With more people relying on web-based and social media-driven platforms as their first point of access to the world, the ability to package corporate messages, multimedia content and social media links in a single communications format is key. Moreover, this tactic not only presents strategic advantages for reaching one's target audiences, but also economic benefits through the consolidation of marketing and PR efforts.

Stand Out in the Veterinary Industry
The concept of thought leadership involves positioning people at your practice as expert sources available for commentary on issues related to your interest areas.  If done properly, thought leadership offers a valuable opportunity to position your practice as an important player in your animal-related field and generate marketable attention for your products and services.  Many publications and industry-specific websites accept articles from experts in the field.   These bylined articles can be a great way to position your spokespeople and generate further awareness of your practice.  Letters to the editor, which are accepted by many print and online publications, can be another great way to highlight your spokespeople and establish your practice staff as a leading authority on an issue or topic pertinent to the animal health industry.  In addition to promoting your practice's expertise, case studies offer an excellent vehicle for highlighting practice products or services. They're not only useful in hooking the interest of reporters; they can also be valuable collateral for your marketing team or website. Reach out to clients who have the most compelling stories to see if they'd like to share their stories. Often, they're happy to discuss the success that a product or service brought to their lives.
 
BEYOND THE USUAL
Traditional PR has been an important complement to marketing and advertising programs. The press that results from a successful media campaign can be invaluable in creating sustained practice and staff recognition. Remember, in these difficult times, there's no actual cost attached to getting an article published other than the time and effort required to develop a story and pitch a reporter.  Don't give up on your communications and marketing goals just because you have fewer resources. In this environment, the practices that make the most out of their resources and bring the most creativity into their communications programs will draw the highest return in community access.

WINDOWS 7
We've covered some of the more important features of Windows 7 before -- including the improvements in security and speed -- but there are a host of other, lesser-mentioned features that make using Windows 7 much more pleasurable than Vista. Lifehacker, a must read here at the Switched offices, has compiled a list of its favorite less-hyped features in Microsoft's upcoming operating system.
One of these features is 'libraries,' which lets you break out of the standard file/folder paradigm with pictures by putting all your photos into a photo library -- even if they're in different folders. Also under-hyped are 'jump lists,' which gives quick access to commonly used files and features and limit how much menu digging we have to do.
You can check out the rest of
Lifehacker's list of underhyped Windows 7 features at the read link. [From: Lifehacker Related Links:

Intelligent Hospital Design Can Reduce Medical Errors

Evidence-based hospital design has the backing of more than 1,500 studies that show how design can be used to reduce medical errors, infections and falls and to ease patient stress. Rather than rely on semi-private rooms, many hospitals have single-patient rooms, which provide additional privacy, improve sleep, expose patients to natural light and lower infection rates. A new hospital being built by the University Medical Center at Princeton in Plainsboro, N.J., will feature rooms with locked cabinets containing only those medicines prescribed for the patient assigned to the room in an effort to prevent medication errors. Handrails next to the bed will prevent falls, sinks near the door will encourage nurses and doctors to wash their hands before entering, acoustical materials will reduce noise and additional space and storage will encourage visitors to stay longer. Bronson Methodist Hospital in Kalamazoo, Mich., saw infection rates drop 11 percent after sinks were repositioned and air flow was improved.

 
From "Health Outcomes Driving New Hospital Design"
New York Times (05/19/09) P. D5; Campbell, Carol Ann

To Change or Not To Change
That is the Question! 
 
As consultants, we discuss with clients the need to reinvent themselves or their practice in times of crisis or economic downturn.  The first thing to know about change is over 60% of the American people do not want to, and the second thing to know is understand that most people, when forced to, focus on "how" and less on the "why"; they want a step-by-step process to their new horizon.  However, it's absolutely critical they learn to know the "Why" first.  When you now the "why", the "how" becomes easier.  For purposes of brevity, we'll assume you know why the change you are seeking must take place (and certainly as consultants we have discussed this in other practices).  The"how" is influenced by several key beliefs to creating lasting change.  First of all, you must have certainty that your current situation is not working or is intolerable, and it has to change now.  The key word in that sentence is NOW.  As in all change, many people believe change is a process and will work towards change.  But in reality, what the latest science teaches us about change is that it is not a process but an instant, a moment, a blink, whereby:  (a) You STOP doing something you no longer want to do, and/or... (b) You START doing something you do want to do (or need to do).   If you plan for your change to happen in the future, whether  it is tomorrow, or next week, or next month, the way the brain really works is this: While it can cognitively think of and ponder the future, mechanically speaking and process wise, the brain works in only two time frames: now and not now.  So as long as you program something in the future, in reality, what that means to your mind is this, "I'm not going to do the change now."   Therefore, change Rule #1 is,  "This is not working, it's intolerable, and it has to change now." This is the first step to creating this lasting redesign and making it stick.  
 
Rule #2: "I must act immediately to change it."  Several key words are in this program command.  It implies it is not someone else, it's not the team, it's not anything else.  In order for your reality in the world to change, you have to take ownership and you must versus "I should" or "I need to" or "I want to". These are all "failure with honor" words.  I must act - meaning - when you wake up, the day you make your change and your shift and your redesign real, you must act immediately to change it.  This means that you must act immediately when you wake up to begin changing the things that you do, the things you are thinking about, the emotions you are holding..... everything must change! 
 
The final component to creating this lasting change is the fact that the only one who can change it is you, and you have the ability to do it.  "I can change it now.  I must change it now.  This redesign that I want is absolutely critical to what I want to create for myself."
 
When you think about the big changes you have created in your life or your organization, they generally came at the end of some amount of pain - chronic pain, massive pain or some amount of pleasure, or massive ability to have a vision for what you wanted.  So you either wanted that incredible part in a play, or captain of that sports team, or to make that sports team, or to learn that instrument.  Or, you were motivated by the pain, you couldn't tolerate an overweight body anymore, or you were going to a reunion, or you were going to appear in a wedding, or you were fired from a job, or you had someone leave you.  Something happened painful that you woke up and you said, "I've hit bottom, I'm done with this."
 
The "I can change" and the ability to wake up that day and begin focusing on the new thought patterns, massively, immediately, with all of your committed level creates the momentum for the change to be real and to stick.  With this momentum, even if it was a huge effort to change, you got through it.  The times you haven't changed generally lies in the arena that you believe that you can't change.  Or you believe that change is possible, that others can change, but that you really aren't able to do it that well.  You will then create a story as to why you can't change and hide that truth.  Or maybe you don't want to change.  Your current situation serves you in a way that allows you to create an equation that you have more fear attached to the changed state or there is less of a desire to do something NOW in order to change.  So you don't want to change - you also create a story to hide the truth.  Sometimes, we just tell ourselves "we don't know how to change," "oh, that's really hard," or "I'm not sure how I would do that," "I'm not sure how I would be that person".  In that space, you will not change.  You will create a story that will hide your lack of change. 
 
At the end of the day, what is critical to this process is that you look at the redesigned you.  You must be the redesigned you, the reinvented you, and you must be there absolutely now whether that's baby steps, big steps, a complete cold turkey-flip-of-the switch - "I must be that person today" -- whether it's motivated by pain or pleasure.  There will be a component of "now" and there will be ownership and responsibility that you are the one that has to do it.  You will not even worry so much about how you will do it because the why will be so big, that the "how's" will appear as you journey towards the destination of the new, reinvented you. 
 
Within all of the coachings, consultings and teachings I offer,  there is always a new chapter beyond this one.   I am committed to the fact that my client will win, they will find your peace, and they'll make something happen.  Look back five years in your life and look at the things that you worried about, that motivated you, that created your success or limited you and held you back from great achievements.  It doesn't matter today,  five years ago is almost laughable.  Five years from today, all your pain, all your worry, all your anxiety and all your fear will also be laughable.   There will be a new monster, five years from now that is busy chasing you, causing you to grow, causing you to change as you engage in this amazing journey called life!
 
Create a fantastic one!

Good Morning America correspondent Dr. Marty Becker and Mars Veterinary Chief Geneticist Dr. Neale Fretwell answer Dogster.com viewers questions about Dog DNA.

 

http://dogblog.dogster.com/2009/05/15/your-dog-dna-questions-answered-part-iii/

 

http://dogblog.dogster.com/2009/05/14/your-dog-dna-questions-answered-part-ii/

 

http://dogblog.dogster.com/2009/05/13/dna-questions-answered-part-one/  

Taking the Mystery Out of Mixed-Breed Dogs

Roughly half of all dogs in the United States are mixed breed and the bulk of owners (86 percent)*** are unsure of their pet's breed composition. The revolutionary Wisdom Panel MX eliminates the guessing game - and six out of 10 mixed breed dog owners2 feel that having this knowledge would help them understand their dogs in ways that may improve their relationships with their pets.   The test is administered by veterinarians during a routine veterinary visit - such as a new puppy vet visit or as part of an adult dog's annual vaccination visit - where a small sample of blood is drawn. Within just two to three weeks following the test, Mars Veterinary will provide owners and veterinarians a customized, comprehensive report that includes the dog's breed analysis and detailed information on the appearance and potential behavioral characteristics of the detected breeds. Dog owners can work together with their vets to interpret the test data and create targeted care and wellness plans for their dogs based on their test results.   "Wisdom Panel MX realizes that every dog has an important tale to tell," says Michael Price, General Manager for Mars Veterinary. "This test, now available at retail nationwide, offers mixed breed dog owners the unique opportunity to unlock the mystery behind their beloved mutts, which can ultimately strengthen the human-pet bond."  

The Science Behind the Doggie DNA Test

The state-of-the-art Wisdom Panel MX test from Mars VeterinaryTM is based on years of extensive research, drawing from the expertise of leading scientists, veterinarians, universities and breed organizations throughout the world.  Its development included the analysis of more than 19 million DNA markers from more than 13,000 dogs. As a result, the test is the most complete and comprehensive product on the market, able to detect the breed composition of a dog with unprecedented accuracy.  Wisdom Panel MX is available at PetSmart for a one-time fee of just $124.99.  For more information log onto visit www.wisdompanel.com.

Apologies Can Reduce Medical Liability Litigation

When healthcare providers say "I'm sorry" to patients and their families, the result is often a reduction in medical liability litigation and improvements in patient care, according to several Michigan-based healthcare systems incorporating this practice into their daily operations. The University of Michigan Health System has saved millions of dollars in malpractice fees and has improved overall patient care quality since implementing the policy six years ago. Officials say it has improved transparency and its ethical approach to medical errors. St. Joseph Mercy Health System in Ann Arbor, Trinity Health in Novi and Henry Ford Health System in Detroit have similar apology policies in place. Henry Ford attributes its 62 percent reduction in malpractice expenses to the error disclosure program implemented in 2001. According to Chief Quality Officer William Conway, Henry Ford's annual malpractice payouts went from $45 million to $17 million over an eight-year period, despite a 25 percent increase in patient volume.

 
From "Hospitals Find Confession Good for the Bottom Line"
Crain's Detroit Business (05/17/09) Vol. 25, No. 19, P. 18; Greene, Jay

WHAT THE AGENTS DO. . .AND DON'T!

Look as you may for Purell these days, you're probably going to find empty store shelves, a result of the frantic public effort to achieve an exalted state of "disinfectia."   Clorox, Lysol and a host of antibacterial products are having their golden moments.  But are you sure what the products do, how to use them, when they work, and when they don't?  Here's a sanitized description to help your central processing at home, work and play:
 
CLEANING with soap and hot water or certain detergents removes surface dirt.  For most situations, it will serve your purpose.  Use of antibacterial surface sprays on dirty surfaces is not effective.
 
SANITIZING reduces microorganisms to usually acceptable standards.  This again, can usually be accomplished with detergents, though will likely not be effective for surfaces exposed to meat, fish, poultry, eggs or contaminated produce.
 
DISINFECTING inhibits the growth of microorganisms, killing most of them or slowing their return.  It does NOT sterilize, which is defined as the complete absence of microorganisms.  Disinfectants vary in their targets, but are typically effective on the surfaces listed above that do not respond to sanitizers.
 
ANTIBACTERIALS used for personal use, on hands for example, are effective in killing and inhibiting microorganisms, except on very dirty "situations".  Use of these products has become widespread in public venues such as in markets, office settings and entertainment facilities.  Their use in hospitals is now universal, intermittently used by personnel to substitute for soap and water hand washing.  Hand washing compliance increases significantly when antibacterial stations are convenient and plentiful.  
 
Note: There is a fear that overuse of antibacterial hand washes could cause growth of resistant strains of bacteria.  In any case, whenever good hand washing protocols can be used, this is the preferred approach to hygiene.

Who knew???????
Before you read to the end, do you know what the main ingredient of WD-40 is?


I had a neighbor who had bought a new pickup.  I got up very early one Sunday morning and saw that someone had spray painted red all around the sides of this beige truck (for some unknown reason).  I went over, woke him up, and told him the bad news.  He was very upset and was trying to figure out what to do probably nothing until Monday morning, since nothing was open.  
Another neighbor came out and told him to get his WD-40 and clean it off.  It removed the unwanted paint beautifully and did not harm his paint job that was on the truck.  I'm impressed! WD-40 who knew?  'Water Displacement #40' The product began from a search for rust preventative solvent and degreaser to protect missile parts.  WD-40 was created in 1953 by three technicians at the San Diego Rocket Chemical Company.  Its name comes from the project that was to find a 'water displacement' compound.  They were successful with the fortieth formulation, thus WD-40.  The Convair Company bought it in bulk to protect their atlas missile parts.
Ken East (one of the original founders) says there is nothing in WD-40 that would hurt you.  When you read the 'shower door' part, try it.  It's the first thing that has ever cleaned that spotty shower door.  If yours is plastic, it works just as well as glass. It's a miracle!  Then try it on your stove top .... Voila!  It's now shinier than it's ever been. You'll be amazed. 
 Here are some other uses:
1. Protects silver from tarnishing.
2. Removes road tar and grime from cars.
3. Cleans and lubricates guitar 20 strings.
4.. Gives floors that 'just-waxed' sheen without making them slippery.
5. Keeps flies off cows.
6. Restores and cleans chalkboards.
7. Removes lipstick stains.
8. Loosens stubborn zippers.
9. Untangles jewelry chains.
10. Removes stains from stainless steel sinks.
11. Removes dirt and grime from the barbecue grill.
12. Keeps ceramic/terra cotta garden pots from oxidizing.
13. Removes tomato stains from clothing.
14. Keeps glass shower doors free of water spots.
15. Camouflages scratches in ceramic and marble floors.
16. Keeps scissors working smoothly..
17. Lubricates noisy door hinges on vehicles and doors in homes.
18. It removes black scuff marks from t he kitchen floor!  Use WD-40 for those nasty tar and scuff marks on flooring.  It doesn't seem to harm the finish and you won't have to scrub nearly as hard to get them off.  Just remember to open some windows if you have a lot of marks.
19. Bug guts will eat away the finish on your car if not removed quickly! Use WD-40!
20. Gives a children's playground gym slide a 20 shine for a super fast slide.
21. Lubricates gear shift and mower deck lever for ease of handling on riding mowers.
22. Rids kids rocking chairs and swings of squeaky noises.
23. Lubricates tracks in sticking home windows and makes them easier to open.
24. Spraying an umbrella stem makes it easier to open and close.
25. Restores and cleans padded leather dashboards in vehicles, as well as vinyl bumpers.
26. Restores and cleans roof racks on vehicles.
27. Lubricates and stops squeaks in electric fans.
28. Lubricates wheel sprocket s on tricycles, wagons, and bicycles for easy handling.
29. Lubricates fan belts on washers and dryers and keeps them running smoothly.
30. Keeps rust from forming on saws and saw blades, and other tools.
31. Removes splattered grease on stove.
32. Keeps bathroom mirror from fogging.
33. Lubricates prosthetic limbs.
34. Keeps pigeons off the balcony (they hate the smell).
35. Removes all traces of duct tape.
36. Folks even spray it on their arms, hands, and knees to relieve arthritis pain.
37. Florida 's favorite use is: 'cleans and removes love bugs from grills and bumpers.
38. The favorite use in New York, WD-40 protects the Statue of Liberty from the elements.
39. WD-40 attracts fish. Spray a little on live bait or lures and you will be catching the big one in no time.  Also, it's a lot cheaper than the chemical attractants that are made for just that purpose. Keep in mind though, using some chemical laced baits or lures for fishing are not allowed in some states.
40. Use it for fire ant bites. It takes the sting away immediately and stops the itch.
41. WD-40 is great for removing crayon from walls.  Spray on the mark & wipe with a clean rag.
42. Also, if you've discovered that your teenage daughter has washed and dried a tube of lipstick with a load of laundry, saturate the lipstick spots with WD-40 and rewash. Presto! The lipstick is gone!
43. If you sprayed WD-40 on the distributor cap, it would displace the moisture and allow the car to start.
P. S. The basic ingredient is ........ (scroll down)
   
   V
   V

FISH OIL.

SURVIVING THE CREDIT CRUNCH
 
FROM PURCHASING SUPPLIES and inventory to paying vendors and making payroll, the credit crunch has made even the simplest tasks more difficult for small-business owners.
For Tony Jeler, owner of Swift Signs, a corporate sign maker in Sunnyvale, Calif., the hardest nut to crack these days is getting customers to pay up. Last week, 25 to 30 of his 250 accounts were overdue, compared with just five to 10 overdue accounts under normal circumstances. That resulting $20,000 deficit weighs on everything else the business does. “I have to buy supplies before I get a sign up. Not having a constant cash inflow makes affording to even make signs tough,” he says.
Small businesses have to step up their efforts — and get creative — if they want to survive the credit crunch, says Peter S. Cohan, president of Peter S. Cohan & Associates, a management consulting and venture capital firm in Marlborough, Mass. Here’s how to overcome five of the most common credit crunch problems:

Reeling in Receivables

The best way to reel in wayward customer payments is to not let them unravel in the first place by introducing late payment fines or penalties to your payment policy, says Cohan.
If your business is already weighed down by a stack of unpaid debts, picking up the phone and persistently reminding your clients about their obligations is your next best option. If you’re going this route, consider hiring a collections agent, says Justin Kitch, a vice president at Intuit Small Business, a unit of the Mountain View, Calif.-based bookkeeping software firm Intuit (
INTU). Otherwise, you risk straining your customer relationships and losing future sales. But prepare to pay up: Collections agents keep 30 to 40 cents of every dollar they collect, Kitch says.
To circumvent the cost of hiring a collections agent and keep an arm’s length between him and his clients, Jeler brought in his wife to manage collections.

Paying Bills On Time

When there isn’t enough cash to go around, paying one’s own bills naturally gets tougher, says Cohan. He suggests prioritizing: First, pay the costliest bills — those with late payment penalties — and the ones that impact your credit. Then, work down the debts you need to pay to keep your company afloat. For the rest, try negotiating payment arraignments, suggests Bob Fifer, president of Fifer Associates, a business management consultancy in Great Falls, Va. For instance, if you offer to pay cash, vendors may be willing to extend your payment schedule. If you’re in really bad shape, they might even accept less than what you owe, Fifer says.

 

Winning New Business

Since getting new customers takes money, business owners are dispensing their limited marketing dollars more discriminately these days. Rather than advertising in newspapers, for example, Patti Styka, owner of Foster City, Calif.-based Elegant Lagoon Cruises, is tapping into her existing customer base for added sales and referrals with the help of an email marketing service. For just $15 a month, she can send an email highlighting a special promotion or discount offer to up to 500 current and potential customers. On average, she says, about 50% of the people on her list open her emails and about 12% click through to her site for more information. “Compared to the cost of newspaper advertising, it’s a no-brainer,” she says.

 

Making Payroll

While many firms have laid off employees to reduce payroll expenses, doing so can cost more in the long run. Not only do employees contribute to a company's productivity, they're trained to your company’s specific needs. To avoid the cost of retraining new hires down the road, implement employee furloughs or unpaid vacation days, suggests Cohan.

 

Expanding Operations

It sounds counterintuitive, but as commercial rents have nosedived and business valuations are scraping the floor, now may be an ideal time to expand, says Gregg S. Fisher, president and chief investment officer at New York financial advisory firm Gerstein Fisher. “Proactive business owners are working toward positioning themselves for growth,” he says. “They are thinking about making investments in the business.”
Of course, expansion is largely contingent on getting a loan, which is difficult in today’s tight credit climate. However, businesses with a solid track record that can prove their future profitability will be in better shape.

"SUCKER BET" ADVERTISING
(An ad going around on e-mail)

DID YOU KNOW - According to one industry survey, on average, veterinarians are seeing 10 fewer patients per week than in the past!

How's your practice doing?

  • A recent report published by Dunn & Bradstreet cites, "demand for Vet services will likely level through 2015, due to an aging population that is less likely to keep pets."
  • According to the Bureau of Labor Statistics, "the number of working veterinarians in the field is expected to increase by 35% between now and 2016, much faster then average for all occupations."
  • According to the US Census Bureau, there has been a 45% increase in employment in the Veterinary field in the past 10 years.
     
  • Vetrinarian

    The American Veterinary Magazine is conducting a poll of industry professionals like you, to help private practice veterinarians tackle challenges in growing your practice.

    Your answer to this simple poll question and follow up questions will be used to help us deliver ideas, solutions and articles that will help keep your practice thriving.

    Would you be willing to give pet owners discounted services in exchange for a guaranteed flow of new business?

    TOM CAT'S PERSPECTIVES:
    NOTE: Google American Veterinary Magazine and you will find there is NO SUCH PUBLICATION - can you believe an ad as above when it starts with a fabrication?
    FACT 1) patient visits are NOT dropping in practices where staff are having nursing consults
    FACT 2) client vaccine visits have dropped about 5%, but NO ONE has tracked if that is due to extended DOI vaccines or the economy
    FACT 3) D&B defined "services"under the 1970 definitions, not including PCRs, JPSs, dentistries & other new modalities, as well as by client visits NOT patient visits
    FACT 4) Increases in 'working veterinarians' (Labor & Statistics) did not appear to differentiate between part-time, full-time, and the overworked, extended hour, paradigms of the past.
    FACT 5) increased workforce in veterinary medicine is a factopr od expanded leveraging using staff . . . we all know that 10 years ago, three staff per FTE doctor was the norm, while now we are closer to 5.6 staff per FTE doctor.
    FACT 6) the average practice has only 9-15% pure net after clinical compensation of owner, fair rent, and reasonable ROI for tangible asset return . . .
    FACT 7) slanted reporting of statistics is designed to set uninformed veterinarians into a panic, and have them grasp at straws . . . puppy clubs (guaranteed discounts for new clients) have been offered for years, and virtually none have survived.
    SUMMARY - Rather than succumbing to the above attempt at induced panic, answer these four questions with honesty:
    #1 - what is the PCR Standard of Care in your practice, and what has been the acceptance rate?
    #2 - 85% of adult animals need some form of dental care, what is the Standard of Care in your practice for each of the four dental grades, and what has been the acceptance rate?
    #3 - about 50% of all animals entering your practice need some form of nutritional care, what is the Standard of Care in your practice for referring these cases to a veterinary nurse for monitoring, and what has been the acceptance rate?
    #4 -  about 90% of puppy owners entering your practice believe they need some form of behavior management assistance (covered very well in Linda White's new text by AAHA), what is the Standard of Care in your practice for referring these cases to your own veterinary nurse for puppy clubs, kitten kindys, and family fit consults, and what has been the acceptance rate?
     
    SOLUTION - Our VCI Partners in Progress three day consultation (www.drtomcat.com) addresses these and other common practice shortfalls in wellness medicine . . . we teach you how to increase income without discounts and without arbitrary fee increases.   In Australia, we have been sharing these ideas with the MEDFIN Capital City Seminar Series each year.  In the USA, we have done it at the Wild West Veterinary Conference Wellness/HAB Track seminars (held in Reno, every Oct) . . . this year at the Wild West Veterinary Conference, we will also be offering the TEAM-BASED TRAINING, for advanced registered four person practice teams, the first true and proven full-team training program since the VPC Shirt Sleeve Seminars were put into moratorium. REGISTER NOW AND ENSURE YOUR TEAM HAS A SPOT at THE NEW WWVC TEAM-BASED TRAINING!
     
    Smile - the best is yet to come.  Tom Cat  >*-*<