Monday, October 18, 2010

The Mechanics of a Vet Med Web

Let's take a brief look into the veterinary practice/animal health insurance/animal pharmaceutical web. Veterinary practice in this brave new age has changed a great deal from the way it used to be. Spidey is old enough to remember the friendly neighborhood and simple country vets. They helped us take good care of our animals and pets, were efficient and effective and also affordable. They had good ole' common horse sense, too.

Today's modern vet, by contrast, often seems to demand we provide expensive procedures for our pets on a yearly basis. We are manipulated, whether we know it or not, to pay for yearly dental treatments for our dogs and cats whether they need them or not. Veterinary exams are the norm along with a battery of blood tests to check for anything and everything. It is not enough to keep up with requisite vaccinations, but now we feel guilty if we do not buy the latest anti-flea and tick medications, provide costly dental treatments, microchip them, or give them heartworm meds - even if those pets never go outside!
Spidey knows this, because a young whipper snapper vet informed me that my cat could get heartworm even if it never went outside because a mosquito, carrying the disease, could get into my house and infect my pet. Well, I guess anything could happen. This young vet was pretty hot under the collar because I challenged the need to buy an expensive product that I felt wasn't necessary. Spidey is reasonable and may have responded better if the vet would've had a more professional and persuasive attitude.

Another vet at this same practice told Spidey that an 8 month old miniature schnauzer was actually a 2 year old mixed terrier of some kind! She said she could tell the age because of the teeth. This dog's teeth are beautiful and white - not a speck of tartar on them. After consulting with a person that professionally bred this particular breed for the show ring for nearly 30 years, I was told how to determine if my pet was still a pup by checking the leg bones. The breeder was right and knew what the vet didn't. Not surprising, though, is it?

 Over time, the two owners of this practice have bought out any competitors or have incorporated offices of veterinarians that have since retired. This is the only vet practice for miles around and sad to say, most veterinarians are all the same nowadays. Spidey always dreads going to this veterinary hospital because of the pushiness, the expense and certain incidences like the two I mentioned above. There are many more such stories, but I wanted to tell you what I have learned.

I discovered that this vet hospital is accredited by the AAHA or American Animal Hospital Association, based in Lakewood, Colorado. Approximately 33,000 veterinary practices, hospitals and university veterinary programs are AAHA accredited. These include local and state humane society hospitals and the Friendship Hospitals for Animals.  Just check out AAHA Preferred Business Provider Programs website for more info.

The Friendship hospitals alone make up 18% of the AAHA accredited hospitals and the Friendship Fund for Humane Education was established to support the efforts of the Washington Humane Society . That support now extends to support the efforts of the Washington Animal Rescue League . (Many of the names listed as officers and board members of these two orgs should ring a bell or two. Like Holly Hazard, Andrew Weinstein, Mary Jarvis, Lisa LaFontaine and others.)  Friendship Hospitals also support and encourage that donations be made to the Marshall Legacy Institute , headed by former HSUS President Paul Irwin. Remember them? They use dogs to sniff out and detect landmines - humanely, of course, according to their website.

Looking over their position statements explains a great deal.  These include topics such as the frequency of vet visits and vaccination schedules; parasite control guidelines, their pharmacy compounding accreditation program, how to report animal abuse, use of Animal ID and microchips, dangerous animal legislation, *ear cropping/tail docking (*Veterinarians should counsel and educate pet owners that these procedures should not be performed unless medically necessary. AAHA also encourages the elimination of ear cropping and tail docking from breed standards. Why?  Looks like the AR crowd has been pulling their ears!) NAIA wrote this article about them: The American Animal Hospital Association Adopts the Cause of Animal Rights Veterinary Groups.

Check out excerpts [my comments in brackets] from an article from the Oct/Nov AAHA "Pets Matter" newsletter which is sent to clients of AAHA affiliate veterinary hospitals. [Back Issues of "Pets Matter."]
"Signs of an Animal Hoarder  written by Jan Thomas (with Thomas Hunt Associates Strategic Communications)

Animal hoarders can be overwhelmed caregivers [yes], rescuers [yes] or sociopaths [That is a bit harsh!]. Go inside their minds and learn what to do if you suspect hoarding. [This should be an issue dealt with by families - not outsiders, imo]

Just how long XXXX had been hoarding XXXXX is unknown. [Fill in the Blank] What is known is that she stored XXX like throwaway clothing in her garage in XXX., and that ultimately, it was someone from her local animal hospital who turned her in.  [The Nanny State strikes again.  Perhaps the animals needed to be taken - each case is different.  It is a great way to make a quick haul of adoptable animals though.  Just saying....]

According to court records, an unnamed veterinary hospital employee [we the people need to take back the right to confront our accusers and furthermore, those who bear "false witness" need to be prosecuted if the facts show that is the case] contacted the XXX Humane Society after treating one of the XXX that was “malnourished, dehydrated, severely underweight, anemic and had died.” [Just one animal out of how many?  How old was it?  Had it been sick?]

After visiting [Oh, just here for a friendly "visit. That is a nice way to put it.  Did they have a warrant?] the premises, animal control officers removed 25 dogs and two cats from the woman’s care. [Did they threaten her with jail time etc?  Was she coerced to relinquish her animals?  Probably] Most of the dogs were found in the garage, where they lived [I doubt they lived their full time as this article implies.  It is common practice to crate an animal now and then but the report makes it seem this woman kept them in crates 24/7] in carriers and crates stacked one on top of the other and were caked with feces. [the animals or the crates?]

In the world of animal hoarding, where abusers often acquire hundreds of pets before judicial intervention, the XXX case is hardly extreme. However, it does cast a spotlight on the role that neighbors and friends can and should play in eradicating this confusing phenomenon.  [Oh really.  What business is it of theirs?  No, such advice only encourages neighbors with a grudge or vendetta against other neighbors to "cry wolf."]

Today, we understand animal hoarding to occur when someone is:
Unable to provide minimal levels of nutrition, sanitation, shelter and veterinary care [These are subjective judgments at best]
In denial about both his or her inability to provide care and about the impact of that failure on the animals, their home and other people who live on the property [Possibly, but not always.  Now that we have those dramatic TV shows about "hoarders" the general public will automatically believe the worst anytime people own more than the "approved" number of animals]

A one-size-fits-all approach does not work with animal hoarding. Nevertheless, hoarders do share some characteristics, for instance:
Most are female  [nurturing]
Most live alone  [this is why they call them companion animals]
Almost half are 60 years of age or older  [there is nothing wrong with owning animals.  Older adults often have the time to dedicate to caring for animals]
In almost 70% of investigated cases, animal feces and urine are present in the hoarder’s home [especially in litter boxes]
Sick or dead animals were discovered on the premises in 80% of the cases; and in 60% of these cases, hoarders denied there was a problem  [Animals can get sick and they can recover.  When an animal or pet dies, it is often buried on the premises.  These are often what the incriminating articles refer to!]

Gary Patronek, VMD, PhD and founder of the Hoarding of Animals Research Consortium (HARC) , [Remember him? Spidey wrote about him before!] cautions against generalizing based on gender or living conditions. Instead, he says most hoarders fall into one of the following categories:  [A label is a label]

Overwhelmed caregivers: These people begin rescuing or helping animals in a small way, acquire pets passively and become overwhelmed when their growing animal population combines with a significant negative change in lifestyle. People in this category tend to be the most willing to consider downsizing.

Rescuer hoarders: Most people in this group are driven by an extreme sense of mission. Patronek says they likely “have a profound fear of death and loss. Caring for animals provides a strong sense of identity; losing the animals or losing control is a loss of who they are.” Negotiated settlements, sometimes coupled with the threat of prosecution, work best here.

Exploiter hoarders: “These people may be true sociopaths,” Patronek warns. “They have no empathy for people or animals. They are manipulative, cunning, very shrewd and can be quite vicious. You’re probably going to have to prosecute them with every trick in the book to have any chance of successful intervention.” [Unfortunately, one AR's "rescuer hoarder" is another's "exploiter hoarder."  What is he talking about?  Manipulative, cunning, shrewd and vicious more aptly describes an over zealous, ego driven, publicity loving ACO or animal rights fanatic.]

In addition, the American Society for the Prevention of Cruelty to Animals (ASPCA) cites these signs that may indicate someone is an animal hoarder:

They have numerous animals and may not know the total number of animals in their care
Their home is deteriorated (i.e., dirty windows, broken furniture, holes in wall and floor, extreme clutter)
Animals are emaciated, lethargic and not well socialized
Fleas and vermin are present
They are isolated from the community and appear to neglect themselves

[Not a pretty picture and perhaps would apply to a very small percentage of people.  But the damage is done and this image will come to mind consciously or subconsciously whenever the public reads about yet another "hoarder."  The person with all those animals has been effectively de-humanized and made into a sick freak of society.]

If you suspect [a mere suspicion does not a fact make] a hoarding situation, call your local humane society, animal control agency, police department, animal shelter, animal welfare group or veterinary hospital to initiate the process. You may not want to get the person “in trouble,” but a telephone call may be [may be, could be but will it be?] the first step to getting that individual and the animals the help they need.  [Yeah, right.  Sorry but Nazi Germany does come to mind.  You know what they say about good intentions.  A person may or may not want to get another in trouble.] 

This article originally appeared in Trends magazine, published by the AAHA and which offers "big-picture perspectives and proven strategies that all members of your practice team can use to enhance patient care and operate your practice more effectively and profitably . . [offering] straight-forward, real world strategies, best business management practices, protocols, tips and techniques -- along with buyer’s guides, overviews of articles published in JAAHA, and in-depth analysis and discussion of industry trends that may affect your practice."  So, what does hoarding have to do with any of that?   Maybe it angers them that one person has all those animals that aren't getting yearly exams and buying all those expensive products and services.  Perhaps they just want to take the animals away and farm them out to those who can afford it?
So, let's see where this web will take us next. My initial search turned up John W. Albers DVM who was the executive director of the AAHA coalition for 23 years until 2009. He is now on the Veterinary Advisory Board of Veterinary Pet Insurance Co. (VPI) - the nation's oldest and largest pet health insurance provider. It seems to me, VPI could profit from selling "hoarder insurance" to those people who have many pets to care for. Talk about a new "industry trend!"

VPI and VPI Pet HealthZone are registered trademarks of the Veterinary Pet Insurance Company with underwriters in Brea, California and by National Casualty Company in Madison, WI for all other states. The Canadian counterpart is called Petsecure. This insurance is primarily for pet and animal owner clients. Nationwide Insurance, a service mark of Nationwide Mutual Insurance Company covers various types of risk management for the veterinary practice though I have yet to find actual Professional Liability Insurance (malpractice) insurance offered, although the AAHA does recommend HUB International Midwest Ltd for this type of coverage. HUB's website states that they have "been the PLIT(rust) broker and consultant since 1962. . . and that HUB has leveraged the group buying power of AVMA members . . " More information can be found at the AVMA PLIT website.

John Albers also leads the efforts of his consulting and advising firm, Albers Veterinary Strategies which is based in Denver. He is a busy man with plenty of contacts. He also served on the panel that authored the Pew Foundation sponsored publication, Future Directions for Veterinary Medicine as well as providing input into numerous other papers regarding business initiatives and profit making strategies for his field of expertise.

Let's get back to Albers' original business venture - the AAHA MarketLink. A SEC/Edgar database search for J. W. Albers turned up filings for MWI Veterinary Supply, Inc.; Professional Veterinary Products of Nebraska (Currently in Chapter 11 proceedings) and Medical Media Television  (PetCare TV), based in Tampa, FL.

In 1994, MWI Veterinary Supply became one of AgriBeef's independent subsidiaries. MWI's non-controlled affiliate, Feeders' Advantage, L.L.C. is a buying group composed of several of the largest cattle feeders in the United States. Other MWI acquisitions include Northland Veterinary Supply, the Securos/International Veterinary Distribution Network, Inc. and nearly all the assets of Tri V Services. MWI Holdings, Inc. eventually took over ownership of all MarketLink business as well.

MWI is a leading distributor of animal health products to veterinarians across the United States. In 2008, more than 30,000 products were distributed and half those were already stocked in their distribution centers. Products include pharmaceuticals, vaccines, parasiticides, diagnostics, equipment, supplies, specialty products, pet food and nutritional products. MWI is not a manufacturer, but rather a distributor that maintains key business relationships with IDEXXLaboratories , Intervet Schering Plough , Mariel , Pfizer and Vedco.

Products are marketed to both veterinarians in the companion animal and production animal markets with 2/3 the market going to the pet market. For the fiscal years ended September 30, 2008, 2007 and 2006, their total revenues were $831.4 million, $710.1 million and $606.2 million, respectively.

MWI owns distribution centers throughout the U.S. including those located in Edwardsville, Kansas; Dallas Texas; Atlanta, Georgia; Phoenix, Arizona; Nampa, Idaho; Denver, Colorado; Orlando, Florida and Harrisburg, Pennsylvania.

All of the AAHA CEOs and Board Members are veterinarians with highly successful practices found nationwide. Not surprisingly, veterinary practices have accounted for over 85% of MWI's product sales. Needless to say, this is a highly lucrative arrangement that continues to expand and grow in profits, power and policy.

For over twelve years AAHA via MWI et al has also maintained distribution arrangements with Banfield, The Pet Hospital  ("Banfield"), which supplies veterinary services to PetSmart stores across the nation. There are several consumer complaints websites devoted exclusively to these.

Like its largest client, Banfield set up a non profit Trust. (The AAHA also has a charitable Foundation they give generously to the Morris Animal Foundation as well as fund scholarships to promising veterinary students.) According to the Banfield Trust's 2009 IRS 990, they gave $8,500 to the AZ Animal Welfare League, $10,000 to the Lollypup Farm in NY, Imagine it Children's Museum in Everett WA received $15,000 [Its President, Jason Cummings, is the Snohomish County Deputy prosecuting attorney], $10,000 to the Pet Orphans of California, The Companion Animal Foundation  in California, Basic Animal Rescue Training (BART) and many other non-profits. Who knows what other community connections more in depth searches would turn up?

It is interesting to note that despite all their warehouses full of veterinary supplies, the AAHA received $245,000 from HSUS and the ASPCA to help treat heartworm in pets displaced by Hurricane Katrina. A penny saved is a penny earned, I suppose, but they have yet to realize the long term cost of the damage to their own credibility. Interestingly, the Banfield Charitable Trust and Banfield Pet Hospitals are also known as Medical Management International, Inc., a unit of Mars.
What a complicated web this has turned out to be! First we have a large dues paying membership of veterinarians and vet hospitals. Then pet insurance is sold to their clients so they can be able to afford the higher priced services and products that are offered at these practices. Next, the veterinarians themselves must buy the products from the MWI distributorship network which no doubt offers them discounts. They in turn can sell the products at an increased price and make more of a profit. Yes indeed, it is a brilliant busine$$ strategy.  I bet they just hate the three year protocol for rabies shots!