Estimate of the annual economic impact of treatment of cranial cruciate ligament injury in dogs in the United States.

OBJECTIVE: To estimate the economic impact to veterinary clients for the medical and surgical treatment of rupture of the cranial cruciate ligament (RCCL) in dogs for the year 2003. DESIGN: Economic impact survey. SAMPLE POPULATION: 501 diplomates of the American College of Veterinary Surgeons (ACVS) indicating that their area of surgical emphasis was small animal orthopedic surgery or small animal general and orthopedic surgery and 4,000 veterinarians indicating to the AVMA that their professional area was small animal practice exclusive or mixed animal practice (at least 80% small animal). PROCEDURE: Veterinarians were surveyed concerning the cost for medical and surgical treatment of RCCL for 2003. The economic impact was calculated by multiplying the number of RCCL surgeries performed by the mean cost of surgery. This was added to the number of RCCL cases managed medically multiplied by the mean cost of medical management. This estimate for survey responders was extrapolated to the total number of veterinarians in the study population for the ACVS or AVMA. RESULTS: Estimates for the total cost of surgery were $171,730,134.72 and $1,020,167,907 for veterinarians in the ACVS and AVMA populations, respectively. The cost of medical management was $2,885,687.86 and $126,558,155.16 for veterinarians in the ACVS and AVMA populations, respectively. After combining the ACVS and AVMA populations, we estimated that owners spent $1.32 billion for the treatment of RCCL in the United States in 2003. CONCLUSIONS AND CLINICAL RELEVANCE: RCCL is a prevalent, costly injury. Results may motivate veterinary and consumer agencies to prioritize funding for a better understanding of the injury.

Retention of surgery specialists in academia: a critical agenda.

Recruitment and retention of specialists to academia appears to be a growing problem in university teaching hospitals. Members of the American College of Veterinary Surgeons (ACVS) believe that the movement of surgery specialists to practice may have an impact on the training of veterinary students and surgery residents. To address these concerns, 1,071 ACVS diplomates and 60 department heads and hospital directors from all veterinary schools in North America were surveyed to determine whether a problem exists, the extent of the problem, and potential reasons for migration of specialists to practice. Responses were obtained from 620 ACVS diplomates (58 per cent) and 38 department heads and hospital directors (63%) from 28 different universities. The responses confirmed a net movement of surgery specialists from academia to practice. Eighty seven percent of department heads and hospital directors believed there was a shortage of small animal surgery specialists in academia; this information was supported by the fact that 47% responded that they had open positions and 68% had difficulty filling positions in the last five years. The demand was slightly less for large animal surgery specialists, and 42 per cent of respondents indicated that they had open positions. Financial considerations were the most common reason for surgery specialists to move from academia to private practice. Seventy-six percent of responding ACVS diplomates in private practice had a total compensation package valued at greater than $125,000 per year, whereas 77.8% of diplomates in academia had total compensation valued at $125,000 or less. Most universities offer starting salaries (not including benefits) for recently certified surgery specialists ranging from $70,000 to $90,000. Reasons for moving from academia to practice besides financial considerations included undesirable location of university hospitals; lack of interest in research; and a belief that university administration was not supportive of surgery specialists. Many academic surgery specialists were frustrated by the requirement for productivity in research, teaching, and service for promotion in tenure-track positions.

The economics of surgical laser technology in veterinary practice.

A decision to invest in and develop laser technology should only be made after a thorough investigation and comparison of the available types, vendors, available features, and purchasing options. A sound marketing program must then be used for introducing laser technology to the staff, clients, and colleagues. Without adhering to such a program, a practice will [figure: see text] not experience the necessary profitability following the purchase of a laser. Staff enthusiasm and support will dwindle, and ultimately the laser investment will be viewed unfavorably. When marketed properly, however, the investment in a surgical laser will provide outstanding profitability. The return on investment can be provided by using the support staff for client education, by offering laser technology for routine elective procedures and complex procedures, and by adhering strictly to a fee schedule. Add that to the truly remarkable results obtained using laser surgical techniques, a practice will be greatly enhanced.

A survey of surgical draping practices in small-animal practice in the UK.

Veterinary practices in the United Kingdom were surveyed to compare their surgical draping practices with Royal College of Veterinary Surgeons (RCVS) accreditation tier and other surgery-related factors. Using descriptive statistics and logistic or ordinal regression analysis (where appropriate), the relationships between draping material and accreditation tier and other surgery-related factors were assessed. Procedures were categorised as short or long. Two hundred and sixty-nine surveys were completed. Reusable drapes were used in 66 per cent of practices. Antibiotics were administered routinely in 38 per cent of short and 93 per cent of long procedures. Practices accredited as a Veterinary Hospital (VH) were 6.3-7.2 (short and long surgeries, respectively) times more likely to use disposable drapes, when compared with non-accredited practices. Use of dedicated surgical attire, draping the whole animal/table, and routine antibiotic usage were also positively correlated with disposable drape usage. Fifty-one per cent of practices rated infection rate as most important when choosing drape material. 'Best practice' techniques are associated with lower importance given to infection rate, and higher importance given to financial cost, when choosing drape material. Disposable drape use correlates with RCVS accreditation and with other aspects of surgical technique. Importance ratings awarded correlate with best practice procedures. Clinical relevance 'Best practice' draping procedures, that are not governed by RCVS accreditation scheme, are also more frequently performed in accredited VHs.