Registration is now available for our February Fetch dvm360 virtual conference.

Fetch dvm360 kicks off 2021 with new virtual conference

 is proud to announce that in collaboration with DVM Project, Vets: Stay, Go, Diversify and Veterinary Careers, we have joined forces with the Association of Veterinary Students UK and the Students of the Canadian Veterinary Medical Association to host our first-ever virtual global student career fair. The Big Student Careers Fair, a one-day live student-led event that will span across 3 continents, will be held on February 6, 2021.

“We couldn’t be more excited for the opportunity to partner with DVM project, VSGD, and Veterinary Careers and take part in their first global virtual career fair led by students,” says president and CEO of MJH Life SciencesTM, Mike Hennessy Jr, in a 

. “This incredible event is a one-stop-shop that will help veterinary students grow their careers worldwide. It is full of leading global speakers, panelists, and networkers ready to support them in their next career chapter.”

At this exciting event, attendees will have the unique opportunity to gain crucial skills tailored toward their career and job search goals while building an international network. Additionally, this career fair will feature informative workshops, tactical and practical talks for career building, a networking happy hour session, job boards, digital swag, Q&A sessions with potential employers, and much more.

“I am honored to be speaking and inspiring out future veterinary colleagues among an enormous talent of thought leaders in the industry,” says Chief Veterinary Officer Adam Christman, DVM, MBA. “We look forward to future collaborations with our friends both domestically and internationally.”

For more information and to purchase tickets, go 

Articles

dvm360 is partnering with the Association of Veterinary Students UK and the Students of the Canadian Veterinary Medical Association to host The Big Student Careers Fair.

dvm360® to host inaugural global virtual student career fair

Looking to learn the latest on veterinary cardiology, feline hyperthyroidism, or chronic kidney disease? Maybe you’re interested in making dentistry more profitable in your practice or want to know the best ways to serve your millennial clients. We’ve got you covered with 5 free 1-hour webinars coming soon to a screen near you.

All dvm360® webinars are free and offer 1 hour of RACE-approved continuing education credit. The lineup is impressive, the speakers even more so. Take a look at the offerings and register today!

Identification of inflammation and cardiac disease in everyday practice: CRP, SAA and NT-proBNP

In this webinar, veterinary clinical pathologist 

, will explain how C-reactive protein (CRP) and serum amyloid A (SAA) function in the body, the pathogenesis of their increased values, and how these biomarkers can be used to diagnose inflammation in the correct species. She will also discuss appropriate handling of N-terminal pro-brain natriuretic peptide (NT-proBNP), critical to correct measurement and potential error due to transport. Current information on decision thresholds specific to the Bionote NT-proBNP assay will be reported. This event is sponsored by Bionote.

 Tuesday, January 26, 2021 at 8:00 pm EST

20+ Ways to make your dental practice more profitable

, as he shares a host of tips for making dentistry more profitable in your veterinary practice. Bellows will review where the profession is now regarding dental fees and percentage of practice revenue, discuss how to dramatically increase the perceived value of dental services in the eyes of your clients, and explain how to properly treat all levels of periodontal disease, which affects more than 80% of dogs and cats seen in practice. This event is sponsored by Vetoquinol.

 Thursday, January 28, 2021 at 8:00 pm EST

On the border: Recognizing and confirming today’s hyperthyroid cat

, the “Pragmatic Professor,” as she discusses the various thyroid hormone tests, including the total T4, free T4, canine thyroid-stimulating hormone (TSH), and the up-and-coming feline TSH. Using case-based examples and recent literature, Kvitko-White will discuss occult hyperthyroidism and the effect of nonthyroidal illness on thyroid diagnostics. This webinar will increase your comfort in diagnosing not just the routine, but borderline, occult, and atypical hyperthyroidism, plus hypothyroidism in cats. This event is sponsored by Zomedica.

 Tuesday, February 2, 2021 at 8:00 pm EST

Catering to millennial pet owners: How to treat them, how to keep them coming back

Millennials in the US now own more pets than any other age group. To get the best from your millennial clients and capitalize on this growing market segment, veterinary clinics must understand the characteristics and motivations that drive these pet owners. Join millennial veterinarian 

as she shares her insight into the mind of the millennial pet owner by answering 3 vital questions: (1) How do millennials spend for pet health care? (2) How should you adapt your marketing and management for millennial pet owners? (3) How can you deliver the best clinic experience to your millennial clients? This event is sponsored by Servistree.

 Thursday, February 4, 2021 at 8:00 pm EST

Chronic kidney disease: Changing a terminal disease to a chronic disease

CKD is among the most common chronic diseases seen in cats (primarily) and dogs. In this webinar, 

, chief medical officer at Rx Vitamins for Pets, will explain how early intervention, using the IRIS staging system, and the use of specific supplements can help manage this common but complicated chronic disease. This event is sponsored by Rx Vitamins.

 Wednesday, February 10, 2021 at 8:00 pm EST

Our webinars help you practice better veterinary medicine and run a more successful veterinary business. 

Up your game with these free webinars from dvm360®

One in 54 children in the United States is diagnosed with autism spectrum disorder (ASD), according to the Centers for Disease Control and Prevention. While studies have long shown that companion animals, especially dogs, can help provide emotional and social support for these children and their families, little is known about the impact of cats on this population.

According to a new study published in the 

, cats may increase empathy while decreasing separation anxiety in children with ASD. These findings can potentially benefit families considering the adoption of a companion animal for their child.

“Previous research has shown parents of kids with autism are more stressed than parents of kids with any other disability,” says lead investigator and former pediatric nurse Gretchen Carlisle, in a University of Missouri 

. “If a family is considering adopting a companion animal, we want to provide the best evidence-based information possible so they can make an informed decision, and cats might be more beneficial than dogs to some families.”

To explore the impact of shelter cat adoption on children with ASD, Carlisle and her team recruited families of children with ASD between the ages of 6-14 from the MU Thompson Center for Autism and Neurodevelopmental Disorders. All families were monitored closely after adopting a cat into their home; each cat was screened for temperament to ensure they were a good fit.

According to study results, cat adoption was associated with improved empathy and reduced separation anxiety for children with ASD, along with fewer problem behaviors including externalizing, bullying and hyperactivity/Inattention. Additionally, families reported a strong bond between their child and their new cat.

“We found the main benefit of these companion animals is their unconditional acceptance,” says Carlisle. “Some children with autism may have sensory issues or be sensitive to loud noises, so a cat may be an appropriate, comforting pet for some families due to their calming presence.”

A recent study suggests that shelter cat adoption may be beneficial to both children with autism spectrum disorder and their parents. 

Cats may increase empathy and decrease anxiety among children with autism

Obtaining a full-mouth series of dental radiographs can seem daunting for many veterinary technicians, especially in hospitals that do not incorporate the practice into daily routines. The easiest and fastest way to master the techniques required to produce diagnostic-quality radiographs is through in-person professional training. A veterinary technician with specialty certification in dentistry is a true expert with the education and experience to help your team succeed without the fear and frustration of practicing on anesthetized patients (

). In addition to helping your team learn the simplest positioning techniques, this person can help ensure that all team members are on the same page regarding client education, workflow during procedures, and interpretation of the images once obtained.

Training for dental radiography is best done on specimens or bone skulls to ensure a quality learning experience without the stress of caring for a live animal. We learn best from our mistakes; however, let’s not make them with a patient under anesthesia if at all possible.

Obtain the full-mouth series of radiographs early in the procedure, immediately after the patient is anesthetized and stabilized. Doing so helps get the diagnostic process started with some objective data.

Once you have the radiographs, you will likely find more pathology and need to call the client for treatment approval. If you wait to obtain radiographs until everything else is done with the patient’s mouth and the client doesn’t answer when you call for treatment authorization, the patient’s time under anesthesia may be extended unnecessarily.

Patients should be positioned in the same way each time a radiograph is obtained. With sternal and dorsal head positioning, ensure that the patient’s hard palate is parallel to the tabletop (

). If you wish to obtain the radiographs with the patient in a lateral head position, make sure the hard palate is perpendicular to the table. I prefer to obtain full-mouth dental radiographs with the patient initially in sternal positioning for the maxillary views and then in dorsal recumbency for the mandibular views.

Achieving consistent results can be very challenging if you are not using these specific patient head positions. If the patient’s head is oblique (not straight), you must position the beam using bisecting angles, a method many find troublesome, time-consuming, and prone to error.

Don’t depend on any one view to determine the presence or absence of pathology if something seems questionable. When you are unsure about what you may be seeing, obtain a second or even third view from a different horizontal perspective than the original survey view of that tooth or area.

Analgesia and anesthesia are critical when obtaining dental radiographs. Make sure the patient is adequately premedicated and then maintained under a surgical plane of general anesthesia (ie, unable to respond to stimuli) for the entire procedure.

Avoiding sensor damage involves having an exceptional understanding of analgesic principles and how to determine a patient’s depth of anesthesia properly, observing constantly and adjusting depth accordingly while preventing hypotension and other complications. Do not place the sensor in the mouth of a patient that is not fully anesthetized and intubated.

A patient’s jaw tone and reflexive mouth closure can cause significant destruction of the sensor. To avoid sensor damage, particularly by dogs, wedge a bite-block object—such as an old section of endotracheal tube (larger size for dogs) or a dental wedge—between the molars on at least 1 side of the mouth. This will prevent an unexpected bite down by the patient (

Once you have training and a repeatable technique, your speed will improve. But at first, prioritize technique over speed. Dental radiographs must contain the tooth or teeth and bone surrounding them as desired; there must not be elongation or foreshortening distorting bone or tooth. Some parts of mouth (eg, tooth root, alveolar bone) cannot be seen with the naked eye. These, in particular, are of the utmost importance. With practice, you will be able to expose about 1 image per minute and, with daily practice on every dental patient, every time, you will become even more efficient and consistent.

It’s important to have a thorough understanding of what can cause problems when obtaining dental radiographs. This comes down to 3 variables, which I call the ABCs: A—animal, B—beam, and C— sensor, phosphor plate, or film.

The operator must objectively measure each of the 3 ingredients in the formula to get consistently diagnostic radiographs. When you get an image that isn’t diagnostic, ask yourself what caused the error. Was it the animal’s head position (A), the beam’s angle or rotation (B), or the sensor’s location in the mouth (C)? When you determine what caused the issue, fix that and try again (

The bottom line Learning dental radiography is challenging, but don’t give up. Becoming proficient involves at least 1 serious learning opportunity, practice without added stress or pressure from your team, and ongoing evaluation of what is working well and what you still need to learn and practice more.

Benita Altier, LVT, VTS (dentistry), began her business, Pawsitive Dental Education, with the goal of bringing professional dental instruction to veterinary hospitals and conferences across the United States and Canada. She currently resides in Washington. 

To consistently obtain diagnostic intraoral radiographs, keep these important points in mind.

Tips for mastering veterinary dental radiography

This week, we will be posting a wide array of veterinary news content including:

the second levothyroxine sodium product approved as replacement therapy for diminished thyroid function in dogs.

An article detailing everything you need to know about #veterinary relief work.

A new article about how to enhance curbside care protocols.

Stay tuned to dvm360.com to stay up to date with the latest industry news.

This week on dvm360: A new FDA approval, plus more veterinary news

Years ago, I took a hiatus from clinic ownership. I sold my practices to spend more time with my young family. I did not want to exit clinical work entirely but wanted to regain control of my schedule in hopes of seeing more kid baseball games and planning trips to amusement parks. So, I became a relief veterinarian. Was I in for a surprise. I placed a small classified ad in the state veterinary society magazine and, before I knew it, I had more relief gigs than I could handle. I soon discovered that relief veterinary work is a great way to earn a living. But to prosper and avoid big problems, you must be smart.

The significance of a relief service contract

Plenty of relief veterinarians think gig worker status is based on a simple arrangement between the veterinarian offering occasional services and the clinic that responds. Legally, 4 parties are involved, and each has its own interest. Of course, there are the relief veterinarian and the clinic owner—the former wanting the highest price per shift, and the latter the lowest possible cost per day for the services.

But 2 other partners—the Internal Revenue Service (IRS) and state government—have perpetual needs that must be recognized and satisfied. Both want the same thing from the relief doctor and the clinic owner: regulatory compliance.

I quickly recognized during my brief gig career that perhaps the only way to satisfy all 4 parties was to have a written contract between the relief provider and the clinic for which the veterinary work would be done. Consider these risks of not formalizing the relief services relationship in this way.

Unless the relief practitioner requests and receives payment at the end of each shift, there is an underlying risk that a clinic may later neglect or refuse to pay for past services. This is particularly likely if there has been a misunderstanding (unintentional or not) about work schedule, pay rate, or whether lunchtime is compensated. Sometimes, the practice owner runs short on money. Without a written service agreement, such disputes end up in court, possibly leaving the gig veterinarian on the losing side.

In the absence of a written agreement, unanticipated disputes can arise regarding whether commuting time is included in the provider’s hourly rate calculation and whether a fee will be charged for mileage (and the amount per mile). Does the relief veterinarian get paid hourly to make phone calls at the end of a shift, or does payment cease at the end of the final appointment? All these questions can be resolved in advance with a well-crafted relief contract.

Relief veterinarians play a vital role in clinic scheduling. They enable owners to take personal time, and they soften the blow when an associate is on family leave or exits the hospital unexpectedly. No clinic owner wants to sour a relationship with a good, reliable relief veterinarian. But in the absence of a clear contract, the relief doctor/clinic owner relationship can suffer as unanticipated disagreements arise.

Sometimes hourly per diem veterinarians linger long after office appointments end, making more and longer phone calls on the clock than the practice owner feels are necessary. Occasionally the owner or medical director can attempt to micromanage cases being handled by the fill-in veterinarian. I have seen instances where a practice and per diem doctors clash over dress (too casual?), footwear (slip and fall/Occupational Safety and Health Administration violation risk?), and even inappropriate lunch hour sunbathing between morning and afternoon appointments. Relief contracts can address any such issues from the outset of the worker-owner relationship.

The IRS is interested in your contract—or lack thereof

The IRS loves employees—independent contractors, not so much. In fact, the agency considers everybody not an owner to be an employee until proved otherwise. If a relief veterinarian wants to carry out services as an independent contractor, it means an obligation to demonstrate that they are not an employee under law. With a solid written relief services contract that fully describes the business relationship, this obligation is much easier to satisfy.

The contract terms help clarify reasons relief veterinarians may appropriately consider themselves nonemployees. The IRS prefers individuals to be considered employees because the agency tends to get its withholding money from each paycheck right away, before the worker ever gets paid. The same goes for the worker’s required Federal Insurance Contributions Act (FICA) and Medicare contributions.

Independent contractors, on the other hand, generally receive payment for services in lump sums without any immediate withholding. Rather, they are charged with meeting several tax compliance obligations, including making estimated tax payments. The federal government doesn’t like having to risk chasing down independent contractors who sometimes spend funds owed to Treasury or Social Security Administration.

Therefore, if a relief veterinarian pursues a gig career without strictly adhering to the characteristics of an independent contractor, the federal government may and can impose financial penalties against him and any clinic that inappropriately failed to withhold and remit taxes, FICA contributions, and Medicare payments from the relief veterinarian’s earnings.

However, clarifying language can be included in a relief contract to reinforce the notion that the occasional worker is indeed an independent contractor. This includes clear statements explaining how the job was obtained, whether the worker is paid commission (aka production), whether services are provided on the same schedule each week, and whether the worker provides their own instruments and equipment. (For more detailed information about the characteristics of an “independent contractor,” refer to 

 per www.irs.gov/pub/irs-pdf/fss8.pdf to provide guidance.)

The existence of a written agreement between a per diem or shift veterinarian and a clinic is persuasive if IRS seeks details of the relief client/contractor relationship.

Naturally, state tax authorities are interested in the “contractor or employee” nature of a relief veterinarian in states that have an income tax. But even states like Florida and Texas, which do not have income tax, want to know who in the work relationship is tasked with providing regulatory compliance over the worker/owner arrangement.

If you are an employee, your boss is charged with making sure you are covered by a workers’ compensation policy. In the absence of a relief contract, that issue may be neglected, with the owner later discovering that failure to cover the per diem doctor constituted a violation of the law.

The same problem exists regarding statutory unemployment insurance filing and remittance laws. And don’t forget about legally required disability insurance payments.

Written relief contracts are good insurance

The general rule I recommend that relief veterinarians follow is this: If you are doing a limited amount of relief work, request that your employer pay you according to a written contract, but as an employee, not an independent contractor. The contract will cover the items that could otherwise result in a disagreement, but the W-2 worker status will keep everyone paying and reporting to the federal, state, and municipal governments as they should.

I suggest that for veterinarians making gig work a primary occupation, a contract also be used, but that it additionally include as much detail as possible to support the argument that independent contractor status—if sought—is firmly supported in writing and with formality.

Christopher J. Allen, DVM, JD, is the president of Associates in Veterinary Law, PC, which provides legal and consulting services exclusively to veterinarians. He can be reached at info@veterinarylaw.com. Allen serves on the dvm360® Editorial Advisory Board.

One veterinarian shares the ins and outs of relief work, plus what to look for in your contract agreement.

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Fetch dvm360 kicks off 2021 with new virtual conference