John Ensign returns to veterinary practice

Only a veterinarian who has also been a U.S. senator could know the difference between handling soft tissue in cats and handling gnarly legislation in Congress. But the similarity is obvious in the way his voice rises. John Ensign, DVM, is passionate about surgery, and former Sen. John Ensign is equally passionate when he says of Washington, "I don't miss it at all."

It's natural that the former Nevada senator should feel strongly about life inside the Beltway. His 17 years there—with one brief interruption between elections—did not end happily. An extramarital affair and reports of a cover-up put him in the vortex of the 24-hour news cycle and led to his ignominious resignation in May 2011.

He didn't, however, spend a long time licking his wounds. After Sen. Ensign resigned, Dr. Ensign hit the books and regained his veterinary license in his home state of Nevada six months later. By January 2012, he was scrubbing for surgery at a nonprofit spay-neuter clinic, preparing to sharpen his skills and reacquaint his hands, as he says, with the feel of exposed tissue.

Then he went back to work seeing patients and performing surgery—this time as an associate veterinarian. He rejoined West Flamingo Animal Hospital, the Las Vegas practice he founded in 1987 after graduating from Colorado State University College of Veterinary Medicine. He sold the practice in 1994 when he went to D.C. for the first time as a freshman in the House of Representatives, part of the "Republican Revolution."

Much has been made in the press of Ensign's very public plummet: from senator to employee, presidential hopeful to animal doctor. Embedded in the DNA of the media is the love of such narrative. Here are some examples:

• "Senate missteps no longer dog veterinarian John Ensign"—Las Vegas Review Journal

• "From senators to animals: Lawmaker who fell from grace now working as a vet"—CNN

• "John Ensign, Bob Bennett, dogs, cats and K-Street"—The Washington Post

And the former senator's problems may not be over. A key figure in the protracted scandal pleaded guilty to misdemeanor charges in early June, giving rise to speculation that he would testify in a potential case the government is building against Ensign. So we can expect more headlines should that indeed happen.

It was Ensign who invited the senator-veterinarian comparison when he told CNN's Dana Bash in February, "This has been really, really good—first of all, to come back into a profession where you're humbled. I used to own this practice, now I'm working for somebody. That's sometimes a healthy thing to have happen in this life."

If Ensign was humbled then, he doesn't describe veterinary medicine as his fallback position today. He says he fully intends to build another practice in the near future. It would be his third startup. "I didn't leave veterinary medicine because I didn't love it," Ensign recently told DVM Newsmagazine. "I just thought I was supposed to do something else at the time."

The path back to practice

Ensign says coming back to the profession was an easy decision. The hard part was knowing how hard he'd have to study. And study he did, plowing ahead to regain his status as a licensed veterinarian and get back to doing what he'd been trained for.

Once the Nevada State Board of Veterinary Medical Examiners renewed his veterinary license, Ensign volunteered at Heaven Can Wait Animal Society, a nonprofit organization that includes a spay-neuter clinic. There he could get far more surgical experience than in private practice. One Sunday a month, he joined about half a dozen volunteer veterinarians who performed up to 400 spays or neuters in the organization's feral cat clinic.

"I really enjoyed that," Ensign says. "It's a great place and the volume of surgery you get is really good. The tissue handling is good for your hands. I did hundreds of surgeries there, and in a short period of time. It would have taken a long time in regular practice to get that much work in."

Surgery was one skill Ensign was particularly interested in sharpening. "Surgery is my favorite part of practice," he says. "When I got out of veterinary school, I thought about doing a surgery residency, but at the time it didn't make financial sense. You went for another three or four years of training and you made less than if you owned a practice. Today specialists do really well, but back then there weren't the big specialty practices."

Changes in the profession

Since returning to veterinary practice, Ensign's eyes have been opened to all the changes that have taken place in veterinary medicine since 1994. Those changes are evident at West Flamingo Animal Hospital, which now features a wider range of services, from a certified veterinary acupuncturist, a staff surgeon, an oncologist, dental radiography, ultrasound and echocardiography to a canine blood bank. Christopher Yach, DVM, who joined Ensign in the practice in 1990 and bought it from him when he went to Washington in 1994, also enlarged the facility while growing the staff to 47 during those two decades.

Underlying many of the the changes in the profession since he left for Washington, Ensign says, is increased specialization. "You refer a lot more than you used to," he says. "It's nice when you have a difficult neurology case to be able to pick up the phone and talk to a neurologist. Sometimes you ship the patient over there, sometimes they help you with the treatment, sometimes you send them over just for a CT scan. Having more options available is one of the great advances today."

Ensign also sees the enhanced role of the veterinary technician as a significant change in veterinary medicine since the 1990s. He says he hired the first licensed technician in Las Vegas when he owned West Flamingo Animal Hospital—the first veterinary hospital in Las Vegas staffed 24 hours a day, he says. Finding one licensed technician was hard in those days, he says, but today the city has two schools graduating veterinary technicians.

"Technicians do a lot more today," he says. "You get to do more of what doctors are trained to do. Technicians, or veterinary nurses, get to do more what they're trained to do. And we both enjoy our jobs more because of that."

However, better-leveraged staff skills doesn't necessarily mean Ensign treats more patients in a day. He's found in the past six months that he's actually seeing fewer patients "but working them up more." When he practiced in the 1980s and 1990s, he says, vaccines played a much greater role in small animal practice, along with declaws and spays and neuters.

Another difference now, he says, is an increased emphasis on pain management. In the 1980s awareness of pain management in animals was growing but veterinarians didn't "pay nearly as much attention to it." In an orthopedic case, for instance, where the veterinarian wanted to immobilize the leg for a period of time, "we thought, 'If it hurts, they won't use the leg,'" Ensign says. "Obviously you give them pain medication today."

Looking at ownership

For now, Ensign is content seeing clients and doing surgery at West Flamingo—an ophthalmic procedure and a tumor removal on a typical day recently. Does he plan to take the plunge into practice ownership again? "I think that's definitely in the future," he says. "There's just something about being an owner."

He's not sure what that something is, but he knows he's infected with it. "I love working here—it's a great hospital—but some people are just meant to be owners," he says. "You want to build a practice and run it and have your signature on it instead of just working in it. Some people don't like all that responsibility. And it is a pain in the rear end. Having to worry about hiring and firing and ordering and keeping costs down and maintaining the building ... they're things you always have on your mind.

"I don't know why, but the people who own these places like to do it," he continues. "Well, I don't necessarily think we like it, but we feel it's a part of us. Part of that entrepreneurial spirit."

In his next practice Ensign hopes to create a "culture of excellence." Such a culture, he says, emanates from the top. The owner has to set to the tone. "I don't care if you're General Electric, if the CEO doesn't buy into a certain culture, nobody else is going to," he says. "It's the same in veterinary practice. If the owner isn't committed to excellence, everybody else may do their jobs, but they won't be committed. If you believe in it—and I do—you get everybody to believe in it. You get everybody around you to believe in it. You get so that the culture is almost emanating from people's bodies—that sense of compassionate, high-quality care."

Owning a veterinary practice, let alone starting one from scratch, is tough work. Is he ready to take on that kind of task again?

"It's a huge challenge," he says. "But whatever God created in me wanting challenges in life ... it's like I'm not happy unless I'm challenged."

The politician is still present

The challenge of building two startups—West Flamingo Animal Hospital in 1987 and South Shores Animal Hospital in 1994, which he sold at the behest of the Senate in 2001—gave Ensign an important perspective as a legislator in Washington. "The vast majority of opportunities for people in America come through small businesses," he says. "Even Microsoft was small when it started. So understanding the obstacles for starting small businesses was big. If you want to create an opportunity society you need people who understand the challenge of creating a small business."

Life in the thicket of political Washington—Ensign battled for two excruciating years to stay in the Senate after his affair became public—represented a challenge of its own. "Yes, sir," he says. "And I don't miss it at all. I talk to friends of mine back there quite often and I stay in touch with people in political circles, and even in the year since I've been gone they tell me things have gotten worse. And it was bad then. But now it's just progressively getting so partisan and so nasty that nothing gets done. I don't miss that at all.

"You know, you go there to make a difference and to do things and when nothing is getting done, that's just frustrating," Ensign continues. "Anymore, people in Washington care way more about re-election than they care about doing what's right. I think the vast majority of people start with the right intentions. Then it becomes more about, 'I like doing this job and I want to keep doing it, so I'm going to do what's politically expedient and I won't hurt my numbers."

You can still hear the politician in Ensign when he talks about what's best for the animal population of Las Vegas. He says his "eyes were opened" by the work the nonprofit spay-neuter clinic is doing. Euthanasia at the city's animal shelters is down, he says, and the clinic's work may be behind it. (See "He's actually a pretty good surgeon").

"We should spend a lot more money subsidizing spay and neuter clinics instead of just housing animals and putting them to sleep," the former senator says. "We would kill a lot fewer animals and use the resources a lot better."

He almost sounds like he's making a stump speech.

'He's actually a pretty good surgeon'

Harold Vosko, co-founder and president of Heaven Can Wait Animal Society, contends the numbers for the just completed fiscal year show the positive effect low cost spay and neuter can have on euthanasia in a community. They show about 3,200 fewer animals euthanized in Las Vegas animal shelters between May 1, 2011, and April 31, 2012.

"That's a pretty amazing feat given how bad the economy is with people giving up their animals left and right," he says. "Their adoptions didn't go up 3,200; they went up maybe 100 to 200. It's not that they've adopted their way out. If you ask me, 12 years of 75,000 surgeries had a lot to do with it. And, at least 60,000 of those animals would never have been spayed or neutered without us."

The focus at Heaven Can Wait is on feral cats, plus the two breeds of dogs most likely to die in Las Vegas animal shelters, pit bulls and Chihuahuas. Vosko says Heaven Can Wait subsidized about 80 percent of surgeries.

"You can say this until you are blue in the face, but 90 percent of the resources go to shelters and 10 percent go to spay and neuter," he says. "We spend all this money on rescue and it really doesn't save a life."

Vosko lauds PetSmart Charities for what he describes as a change in focus to include grants for spay and neuter activities. "If we get a few more national groups like that who change their ways, it will be great," he says, adding he thinks you have to see the clinic in action to really get a feel for the value of its work. The Sunday feral cat clinic, which is 10-years-old and never refuses a cat, is "organized chaos at its best," he says, 60 volunteers, rolling racks with four shelves and four cats to a shelf. "We wheel them in 16 at a time and wheel them out," he says. "It's pretty amazing to see." He thinks seeing and doing the work made Ensign a supporter.

"You take a guy like John Ensign, who does his practice, then he winds up doing animals that come from the poorest of the poor, from people that cannot afford to get their animal spayed, and it's an eye opening experience," Vosko says. "I really didn't think he would be affected. He called up and said, 'Hey, I need some tissue time.' I said, 'Ok, come on down.' And we ended up paying him during the week to do surgeries for us. He's actually a pretty good surgeon."