Most people would say building a brand-new practice, taking on business ownership just five and seven years out of school, and starting families all at the same time is crazy. But the owners of Tustin Legacy Animal Hospital in Tustin, California, say it made total sense to them. 

 Drs. Celine Hayek and
Kristen Negvesky

Saunders + Wiant Architects, Inc.; Newport Beach, CA

After meeting as associates at another practice, Drs. Celine Hayek and Kristin Negvesky became fast friends. They always talked of building a practice together sometime in the future. Fast forward a few years. They had both left the practice for various reasons. Dr. Negvesky attended the first WVC Women’s Veterinary Summit and heard a talk about starting your own practice. 

“It was perfect timing,” says Dr. Negvesky. “They gave us the tools to start a practice, and it just hit me: Now was the right time for us to build. I took back a lot of great ideas, and told Dr. Hayek we don’t have to wait, let’s do it now!” The two friends started planning, quickly hired a realtor, found a practice space, signed a lease, and started making designs for their dream practice. It all fell into place, but the build was not without its challenges.

“We had a steep learning curve, but we have complementary styles and ways of thinking about things,” she says. “I think it came together nicely.”

The 2020 dvm360 Hospital Design Competition judges agree that the practice came together more than just nicely. In fact, these first-time practice owners and builders earned Hospital of the Year honors for practices smaller than 8,000 square feet. The Hospital Design Competition judges praised the hospital for a nicely detailed interior, great finishes, and a solid, efficient plan. 

Drs. Negvesky and Hayek first found a realtor to help them choose a site. Having never owned a business previously, the two say they had a steep learning curve. Thankfully, their real estate agent helped lead them to the right people.

“Our agent had a lot of experience with veterinary hospitals and was a huge help, directing us where to go next,” says Dr. Negvesky. “We then met someone at Bank of America for our loans, and that person recommended a CPA to us. Each step of the way someone pointed us to someone else who could help.”

The two say dealing with contracts was the most difficult part. Understanding all the details and keeping up with reading all the contracts posed challenges. Securing loans and handling financing also proved challenging for these newbies, but they say Bank of America was a big help. 

“Our main goal was to design a place that gave people a really good vibe when they walked in the door,” says Dr. Negvesky. “At our place, client service is No. 1, and we wanted our hospital to feel approachable, with a clean, fresh style.”

There was also one more must-have: “A chandelier, a big one!” says Dr. Negvesky. 

The doctors got what they wanted with a fresh, clean vibe throughout their 2,685-square-foot practice with four exam rooms, separate dog and cat waiting areas, plenty of sunshine, and a view of two military hangars that are a big part of the area’s culture. 

The Hospital Design Competition judges praised Tustin Legacy Animal Hospital for its solid, efficient layout. The owners said their main goal when designing the practice was to have an easy-flowing plan. “We wanted enough exam rooms to be able to put clients in rooms quickly, and not have them waiting up front for long, and for the flow to allow for technicians to easily go back and forth,” says Dr. Hayek. “We also wanted to be able to see the back of the hospital from the front, without a ton of nooks and crannies and small hallways. This place was designed to be open and bright.”

Speaking of, Dr. Negvesky says she wanted a ton of sunlight, so she didn’t go into treatment and come out not knowing what time it was because she hadn’t seen the sky all day.

The doctors did want two-door exam rooms, but they had to scrap that idea. It took too much space from their tight floor plan.

Another strategic choice the doctors made was to not include boarding and grooming in their business. “We had heard a lot of stories of things not going well for others, and it seems that a lot of negative reviews online stem from boarding and grooming, which should not be a reflection of your medicine,” says Dr. Negvesky. “We wanted to just focus on medicine and not bring that into it.” 

As for the look of the practice, the doctors hired an interior designer to get the right vibe. Drs. Hayek and Negvesky told the designer the colors they wanted (blues and greens), the style they were looking for (upscale yet inviting), and the requirement of a chandelier in the reception area, then the designer ran with it. “She gave us a lot of cool options and came up with a design that was fantastic for us,” says Dr. Negvesky. The designer created accent walls in each of the exam rooms, suggested a textured wallpaper behind the reception desk that looks like wood, and other whimsical art ideas throughout the hospital. 

A week before the practice officially opened, the doctors held a grand opening event for the community to stop in and tour the practice, ask questions, and get to know them as a brand-new start up. They put up fliers, hung a banner and spread the word. Food trucks, activities, raffles and hospital tours brought in about 100 people.

On their first day of business, a dog appointment was scheduled for 8:30 a.m. with someone they knew to help start off the day in their new space. “We were super surprised, though, when someone we didn’t know walked in at 8 a.m. with a cat,” says Dr. Negvesky. “We were ready for a dog, so that first appointment threw us off, but we made it work. We were flying by the seat of our pants that day.”

Since then, business has been growing steadily, with many new clinets gained through word-of-mouth referrals and all five-star reviews on Yelp. With the shopping center building up around them, as well as 44 new homes being built nearby on an old military base, the opportunity for growth keeps coming. 

One last detail to mention: Tustin Legacy Animal Hospital opened in June 2018, and Dr. Hayek had her first child in early July. Dr. Negvesky also had her first child in late 2019. Talk about a labor of love. Who better to travel this journey with than a good friend and business partner who really understands your needs? 

Sarah A. Moser is a freelance writer in Lenexa, Kansas.

Articles

Two young doctors dove right into practice ownership and building a facility all at once and got the practice of their dreams, earning them top honors in the under-8,000-square-feet category of the dvm360 Hospital Design Competition.  

2020 Hospital of the Year—Jumping in, learning curve: First time’s the charm 

If the way in which you approach quality-of-life discussions is putting too much pressure on either you or the client, Mary Gardner, DVM, has good news: There’s a better way.

Instead of having the client fully rely on your professional expertise (as if the decision is always black and white) or telling the client to let you know when they’re “ready” (whatever that means), the cofounder of Lap of Love Veterinary Hospice advocates for breaking the conversation down into thoughtful categories that will allow for a more equal distribution of the decision-making load.

Here’s what she covers with the pet owner when assessing a pet’s quality of life:

“Look at the disease or ailment the pet is facing, because depending on that, the quality of life could change,” says Dr. Gardner. For example, the conversation around a dog in heart failure will be different than for a dog with arthritis. “What they experience—even the way they die—will be different,” she explains. In other words, discussing the pet’s quality of death is an important part of the conversation as well.

 Every animal is different, so we have to look at the pet’s personality and how it’s handling its ailments, says Dr. Gardner. Some questions to explore: How does the pet handle pain? Anxiety? How does it respond to the types of tools and treatments it would require (e.g. harnesses, subcutaneous fluids)?

 Every client is different, too, so you’ll need to get a sense of how they’re handling their pet’s ailments and whether or not they’re willing and able to manage the treatment regimen as well. For example, Dr. Gardner says some owners aren’t willing to administer subcutaneous fluids or strap their pet into a harness every time they need to go outside. “And some families want to say goodbye sooner rather than later,” she adds. That means you’ll need to find out if your client would rather euthanize their pet a week too soon or a day too late.

Don’t avoid the elephant in the room, even if it makes you cringe. A caring-but-cash-strapped client may even feel relieved to hear you bring it up and treat it as a valid part of the discussion. “But remember, it’s not just about the money. The other budgets to consider are time, physical and emotional. If an owner is tapped out of any of the four budgets, I support their decision to say good bye,” says Dr. Gardner.

In the figurative and literal end, the decision of when to euthanize will still be difficult. But by bringing together both the expert in veterinary medicine (you) and the expert on the pet (your client), that decision should be better informed and hopefully less burdensome to everyone involved.

Editor's note: This article is based on a dvm360.com video featuring Mary Gardner, DVM. 

Sarah Mouton Dowdy, a former associate content specialist for dvm360.com, is a freelance writer and editor in Kansas City, Missouri.

Lap of Love Veterinary Hospice cofounder Dr. Mary Gardner breaks the daunting discussion into thoughtful categories that ideally result in a more informed, less burdensome decision.



The anatomy of a better quality-of-life conversation

Like many veterinarians, I give “the flea talk” several times a day. In fact, most of us could probably do it in our sleep. Educating our clients on the importance of year-round parasite protection can be a frustrating and drawn-out process, especially when dealing with what I like to call "flea denial." 

As someone with a science background, I tend to reference science when talking with clients. I tell them about the 

2011 AAHA/AVMA Preventive Healthcare Guidelines

 for cats and dogs, which clearly state that every dog and cat should receive “year-round broad-spectrum parasite control with efficacy against heartworms, intestinal parasites, and fleas.” The guidelines also recommend a customized plan for tick control based on risk assessment.

Most of us have had a client say, “I don’t need to give preventives in the winter months.” I live and practice in rural Missouri, where the winters can be cold and long, but I see patients infested with fleas 365 days a year.

I can talk about the AAHA guidelines or go over the flea life cycle with clients until I’m blue in the face, but it seems to have little impact on whether they decide to protect their pets against parasites year-round. I try to reinforce that clients who only administer preventives on a seasonal basis are playing Russian roulette with their pet’s health, but despite my best efforts I still have clients like Mrs. Shay in the poem below. 

Doc Stroupe came into her clinic one morning,

outside clouds were gray and rain was pouring.

Dogs barked, cats meowed, cages shut with a clang.

Doc glanced at the schedule, and then the phone rang.



"Her skin is red, and she itches and scratches.

She even has hair coming off in patches!"

"Certainly, Mrs. Shay. Can you bring her at ten?

"I'll see you at ten. Thank you, goodbye."

The next couple of hours were kind of a haze

of trying to finish the neuters and spays.

she remembered her appointment with the dog with an itch.



She walked into the exam room and saw the Maltese.

"Yes, Doc. I simply don't know what to do,"

as she crossed her arms and tapped her shoe.

"She itches and scratches all day and all night!

When I give her a bath, she tries to bite!"



Doc Stroupe paused and asked with some trepidation,

"Does Louise happen to be on flea medication?"

Mrs. Shay replied, "No, but I know it's not fleas!

Now hurry and look at my dog, if you please."

Doc Stroupe saw the skin, and thought with a smile,

this is a classic case of flea denial.


Mrs. Shay was distressed and dismayed to learn,

that Louise had the Bermuda shorts skin pattern.

As Doc ran a flea comb through the dog's hair,

she saw tiny fleas jumping here and there.


"Fleas can't be the problem. There's only two or three,"

"Adult fleas are only part of it, Mrs. Shay—

You must know that when there's two or three,

Louise has fleas—she could no longer deny.

"If keeping fleas off your pet is your intention,

Louise needs year-round flea prevention.”



Louise looked up at her owner with pitiful eyes.

Mrs. Shay knew she must help to stop her dog's cries.

Doc Stroupe went over which products work best.

Soon they would be rid of this nasty pest.



As Mrs. Shay left with a supply of flea pills,

Doc Stroupe felt great about her education skills.

Months later, when Doc did her reminder call,

Mrs. Shay said, "I'm good on meds for a few months. It's almost fall."

as she sat at her desk, and did a facepalm.

Dr. Jessica Stroupe is a practice owner and mixed animal veterinarian in Missouri. A 2012 graduate of the University of Missouri College of Veterinary Medicine, she enjoys using poetry to commiserate in a humorous way with her colleagues about life as a vet. When she’s not working, she enjoys spending time with her husband and sons, running and weight lifting.

Talking about fleas and other parasites with your veterinary clients can be exasperating when your advice goes unheeded, but veterinarian Jessica Stroupe finds humor in her frustration about what she calls "flea denial."


'Louise Has Fleas': A poem about the frustrations of flea denial


The restrictions of having a valid veterinarian-client-patient-relationship (VCPR) significantly impact how we're going to be able to deliver telemedicine services, says practice manager Bash Halow, LVT, CVPM. That’s why he offers telemedicine as a free service to get clients in the door for an in-person visit.

“I’ve decided to introduce telemedicine as a not-charged-for service at our practices, as an introduction to talk to clients—in general terms—about what’s going on with their pet and using that to bring them in for the exam we need,” he said in an interview with dvm360.

A valid VCPR includes a physical exam, and for good reason, says Halow, adding that using telemedicine as a replacement for that hands-on exam is very risky.

Watch the video below to learn more about how (and why) Halow uses telemedicine at the practices he manages.

Veterinary practice manager Bash Halow offers strategies on how to use telemedicine as a way to fortify the veterinarian-client-patient relationship.

Scared to use telemedicine at your veterinary practice? Don't be

The American Association of Feline Practitioners (AAFP) is inviting the veterinary community to attend its first-ever 

, which will focus primarily on feline anesthesia and behavior.

The e-conference will be held Monday, April 6 from 11:00 a.m. to 4:30 p.m. EDT to accommodate busy veterinary professionals who may be unable to leave their practice.

Despite the online-only format, the conference will still offer the same real-time experiences found at a traditional conference, including networking, Q&As and engaging discussions with other attendees, all made possible through a chat functionality. Attendees will also earn four RACE-approved CE credits.

The first half of the virtual conference will be led by Sheilah Robertson, BVMS (Hons), PhD, DAVCAA, DECVAA, DACAW, DECAWBM (WSEL), CVA, MRCVS, senior medical director for Lap of Love Veterinary Hospice—a network of over 100 veterinarians that specialize in end-of-life care and in-home euthanasia.

The schedule for Dr. Robertson’s talk is as follows:

11:00 a.m.—Anesthesia for Senior & Super-Senior Cats

12:00 p.m.—Anesthesia and Analgesia: Real World, Real Cases

The second half of the conference will be led by Sarah Heath, BVSc, DECAWBM, CCAB, MRCVS, a veterinary specialist in behavioral medicine and an external lecturer in small animal behavioral medicine at Liverpool University.

The schedule for Dr. Heath’s lectures is as follows:

2:00 p.m.—Inter-Cat Tension in Multi-Cat Households

3:00 p.m.—Behavioral Considerations in Feline Obesity & Weight Loss

This virtual conference, hosted by the American Association of Feline Practitioners, will allow veterinary professionals to participate from the comfort of their desks or on the go.



AAFP to hold inaugural e-conference in April 

Hey, veterinary professionals. We know you’re busy. That’s why we’ve made it even easier for you to get the latest veterinary news.

Click the video below to view the top 3 stories of the week in 60 seconds:

Last week, Antech Diagnostics announced the development of the 

first diagnostic test for canine inflammatory bowel disease.

The Purina Institute has announced the imminent launch of 

 the first and only cat food that can reduce allergens in cat hair and dander.

 explains how hypothermia occurs, the negative effects it has on the body, 

 how to prevent it during anesthetic events.

Videos

Want to be in the know? Check out the veterinary news highlights from this week.