AVMA Presidential Candidates Discuss Governance, Future Scope of the Profession, and Advocacy

Posted July 7, 2014

Donald Smith, Cornell University 

On June 18, the website of the American Veterinary Medical Association (JAVMA news) posted an interview with the two candidates for president-elect of the AVMA.1 Drs. Larry G. Dee and Joseph H. Kinnarney are running for the position that will be decided by the House of Delegates (HOD) July 25th preceding the annual convention in Denver.

After reading the responses to the interviewer’s questions, I decided to invite the two candidates to expand on specific subjects that I thought may be of interest to readers of this site. Both candidates agreed and their written responses follow. I am grateful to both individuals for participating in this request for comment, and to AVMA Senior News Editor, Susan C. Kohler, for her support.2

Regarding Length of Terms in Office:
You have a combined 27 years of service in the House of Delegates (HOD). Admittedly that was a different era when service and time commitment were often measured by longevity, but even during those decades some may have felt it excessive to have such a long period of service. How do you explain this when you both advocate for more active engagement from the membership?

Dr. Larry G. Dee:
The short answer to the question is that we represented our associations in an acceptable, appropriate, and perhaps, exemplary fashion that encouraged our reelection to additional terms in the HOD. When I first entered the HOD 20 years ago, the typical delegate had demonstrated years of service to their association, often as president of that association. Longevity of service in the House allowed a better understanding of AVMA process, and allowed the development of relationships between members. These factors must be compared to the value of increasing opportunities for new representation with its implied increase in activity, vigor, and enthusiasm, as well as increased representation of younger members of the Association.

While I was in the House, the FVMA elected the alternate delegate to a four-year term, automatically becoming delegate for an additional four years. In the absence of a superior candidate for the position, I was reelected alternate delegate at the end of my term as delegate. During my tenure in the House, I was able to introduce resolutions that resulted in the current State Advocacy Committee, and the AVMA position on standardization of microchips. In addition, through debate on the House floor, I was able to convince the House to refer to the Animal Welfare Committee a resolution which had been approved by the Executive Board, the HAC, and the reference committee, that, if passed, would have embarrassed the Association and the profession.

My terms in the House were frustrated by my inability to identify Florida veterinarians who would run for the various councils and committees, a frustration that continues. I believe the goal for the HOD should be to have delegates in the House who actively address the challenges of our profession and are willing to act as catalysts for change. I do not believe that longevity, in itself, is completely good or bad, nor do I believe that youth and inexperience, in themselves, should be gatekeepers for service.

Whether the changes in governance structure are approved or not, I believe they have invigorated the House to have a more active role in leading the Association.

Dr. Joseph H. Kinnarney:
I was fortunate to be a young leader in AVMA. At 35, I was elected alternate delegate to AVMA. At 45 I was elected AVMA Vice President and then went back in the HOD as delegate. While I agree it is important to involve younger members in leadership positions, we must also have a governance structure that allows advancement of more seasoned members.

Regarding Women’s Leadership in the AVMA:
In your combined reports, there is only one oblique mention of gender and that is in reference to “the nonpractice obligations of many women veterinarians.3 How would your appointment as president create opportunities for women’s leadership in the profession? More specifically, how would you propose helping to close the leadership gap in the AVMA?

Dr. Dee:
Ask them to serve.Offer expanded leadership training, like the Veterinary Leadership Conference to younger members of the profession. Clearly state that you have expectations that the women and men entering the profession will serve in leadership capacities. Understand the economic challenges of recent graduates and define leadership opportunities in time and economic costs so that they are attainable by this generation.

The Association is continuing to add places on various councils and committees for student representation and could expand this to include other young representatives. We may find that stipends may be required for some positions, such as the Executive Board, because of the costs incurred in time and money when serving in this capacity.

Dr. Kinnarney:
Gender issues in our profession need to be addressed as well as the make-up of our profession. Do we reflect the society we serve? No. Does our leadership reflect the membership? No. AVMA must address both of these issues. During the last 10 years both state association leadership and HOD Makeup has become more balanced. However, at the AVMA Officer and Executive Board level there have not been enough female members. We, as the current leaders must look at those positions and ask why there is this imbalance. Then work to make effective changes. With the current schedule of Board members, it eliminates over 99% of our members from seeking these positions. We must look at how the Board functions and make it doable for more of our members to seek these positions.

Regarding the Future Scope of the Profession:
One of you is quoted in JAVMA, “A hundred years ago, I am sure veterinarians thought the profession was over when cars replaced the horse and mule. Instead, we grew and adapted to the changing needs of the American public.”4 Yes, many thought the profession was in crisis when the remainder of our city colleges closed in the 1920s and the veterinary colleges retreated to the country where we clung to the land grant priority. A few of our leaders adopted public health priorities, but the majority of us learned how to treat cows and pigs and chickens, and a few farm horses. We left behind cities largely devoid of veterinarians interested in caring for the growing small animal population and we left the medical profession without the benefit of as many colleagues interested in comparative medicine.

We now live in a world where animals are considered to be an important contributor to human health, even one of the factors that could help slow the escalating cost of medical care. How do you think the AVMA could have a role in helping the veterinary profession develop a 21st century partnership with human medicine, one that we began to have a century ago when some of our veterinary colleges were aligned with major medical schools like Harvard, New York University, Columbia, and George Washington University? On the topic of pet health care, do you also think we have the capacity to expand the role of the academic veterinary community in the major urban areas of the country?

Dr. Dee:
These multiple issues are challenging. I think the primary gatekeeper in the One Health Initiative is the human medical profession. We must through advocacy and legislation expand our roles in this arena. Much of this challenge is economically driven. To expand our role in One Health I would consider supporting and expanding the National Academies of Practice in Veterinary Medicine by increasing the number of nominated individuals and giving financial and staff support to their initiatives. Expanding the financial support of veterinarians working in basic science and public health would be an initial step in improving our standing in the eyes of the human medical community.

“Expanding the role of the academic veterinary community in the major urban areas” is unclear. If you mean having “the capacity to open university administered or owned clinical facilities in urban areas,” while we may have the capacity, it would be opposed by most AVMA members in private practice. It would be seen as a non-profit competing against tax-paying small business. I believe there are an adequate number of specialty practices in urban areas to serve the needs of the public. One could consider these specialty practices as representing “the academic veterinary community.”

Dr. Kinnarney:
The AVMA president has not only been the spokesperson for the association, but also to our members and other veterinary associations. It is the time for our president to go to the public and profess the value of a veterinarian not only in terms of clinical practice, but public health, food safety, research, bio-security and human animal bond. The association must be considered the premier expert in these areas.

Regarding Advocacy for the Profession:
You both talk about communication and advocacy. If you had 30 minutes one-on-one with each of three prominent people (of any profession or position) to discuss one issue of the veterinary profession, who would they be and what issue would you address with each person?

Dr. Dee:
• President Obama: Veterinary medicine in biological terrorism events
• Head of FEMA: Veterinary resources and natural disasters
• Head of Parks and Wildlife Service: Feral horses

Dr. Kinnarney:
• Arne Duncan, Secretary of Education: How to address the debt to income problem facing veterinary medicine.
• Dr. Margaret Chan, Director Of WHO: The importance of Veterinary Medicine in protecting the health of the world.
• Warren Buffet: How to get the economics of the profession back on track.

On behalf of all of the readers of www.veritasdvmblog.com, I extend my sincere thanks and appreciation to both Dr. Dee and Dr. Kinnarney.

Dr. Smith invites comments at dfs6@cornell.edu

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1 ] Nolen, R. Scott (interviews). ““AVMA presidential candidates, in their own words. Dee, Kinnarney lay out their visions for the profession and AVMA,” Journal of the American Veterinary Medical Association. July 1, 2014. 245(1):16-19.
2 Kahler, Susan C. (AVMA Senior News Editor), email to Donald F. Smith (Cornell University), July 1, 2014.
3 Nolen, “AVMA presidential candidates, in their own words.”
4 Ibid.

A Veterinary Student Interviews Practicing Veterinarians to Help Prepare for Her Career

Guest Author: Elizabeth Newsom-Stewart

Note: The original and complete version of this story 

will be posted on March 19 at www.veritasDVMblog.com

Editor’s Note: Elizabeth Newsom-Stewart is a second-year DVM student at Cornell University who recently interviewed a veterinarian to fulfill her assignment in a class I teach, Veterinary Medicine: The Versatile Profession. I chose her paper to reprint here because it speaks cogently to the important issue of whether or not new graduates need to do an internship to feel qualified to enter veterinary practice.  Because of Elizabeth’s desire to become involved in the leadership of the profession through organized veterinary medicine, she interviewed another veterinarian who has provided leadership at the regional and state levels in New York.

Donald F. Smith

There are two aspects of the veterinary profession that are important to me: being an excellent clinician who practices high quality medicine and surgery, and being a leader in organized veterinary medicine. Those issues were best addressed by veterinarians in two different stages of their careers; therefore, I interviewed two different women. First, I interviewed Dr. Angela Silva (Indriolo), a 2011 Cornell graduate, and we discussed issues relating to transitioning from the role of a veterinary student into that of a practicing veterinarian. I also interviewed Dr. Linda Tintle, a 1981 Cornell graduate, regarding leadership in organized veterinary medicine.

 

Elizabeth Newsom-Stewart, Cornell DVM Class of 2016

Photo Taken during Rural Area Veterinary Services Rotation

(Photo provided by Ms. Newsom-Stewart)

I chose to interview Dr. Silva because, as a relatively recent graduate, I felt that she would have a helpful perspective on how to develop oneself into the best veterinarian possible, especially during the crucial first few years post graduation. Dr. Silva spent two years as a small animal general practitioner at Bond Animal Hospital, a busy general practice in White Plains. She has now transitioned to a practice that is closer to her home. Dr. Silva is a certified veterinary acupuncturist, is certified in stem-cell therapy, and has completed a course at Colorado State University in client communication, called the FRANK program.  Dr. Silva now lives with her husband and two standard poodles in Somers, New York. As I did an externship with her in the past, I know that she is an excellent veterinarian who also maintains a healthy work-life balance, and I therefore felt that she was a perfect person to interview.

Because I am questioning whether or not to do an internship, I asked Dr. Silva her opinion. She feels that an internship is an appropriate choice if a student does not feel confident enough to practice upon graduation, but she insists that one can become an equally excellent clinician without one.  She explained that, for a new veterinarian who really cares about their patients, the first year of practice is “like an internship, with a much higher salary.”  By this she meant that a new graduate will need to spend hours every night speaking with specialists and diagnostic laboratories; and doing research in order to provide the best patient care.

The negatives of doing an internship also include that they may not be as relevant to what a general practitioner may encounter. For example, she explained that one of her friends finished an internship “being able to easily formulate a ten-drug treatment plan for kidney failure, but unable to do a cat spay in under an hour.”  Interns may also gain little experience in the practicalities of general medicine, such as client financial constraints, client communication, and moving in a “step-by-step manner” that moves with the client’s needs instead of in opposition to them.

Very notable to me was her statement that, “You graduate knowing how to practice good medicine, but not how to work with your clients [towards a common goal].”  She explained that client communication is one of the most critical aspects of practice, but is not effectively taught or learned until after graduation. A helpful tip that she gave me was to pursue additional training, such as the FRANK program that her employer, Dr. Aspros, sent her to Colorado State University to obtain.

 

On a similar note, Dr. Silva also emphasized the importance of mentorship—finding a practice owner who is aware of the challenges faced by new graduates, and who is willing to mentor as needed. Although it seems obvious, many new veterinarians also do not seem to realize how important it is that they find an employer who practices high quality medicine and surgery, because a new graduate will be following most of their practice policies and recommendations for several years. We also discussed issues such as the importance of continuing education, being proactive about honing skills, maintaining a work-life balance, and working well with technicians, staff, and practice owners.

Although interviewing Dr. Silva was extremely helpful for me, I still had questions with another aspect of veterinary medicine; that is, becoming a leader in the veterinary profession as a whole. To that end, I decided to interview Dr. Linda Tintle, founder and owner of a small animal general practice in Wurtsboro, New York.  Dr. Tintle is very active in the Hudson Valley Veterinary Medical Society, the New York State Veterinary Medical Society (NYSVMS), and is a past member of the Dean’s Advisory Council at Cornell. She is president of the Orange County Animal Emergency Service, and is active in the Shar-pei community, having been involved in research of breed specific disorders and the Chinese Shar-pei Club of America.

My many questions for Dr. Tintle may seem very basic, but I truly did not know the answer.  For example, what does being involved in “organized veterinary medicine” actually mean?  What, practically, does one do on a daily basis?  What is the purpose of the state society?  What about the regional society?  How does one get involved?

Dr. Tintle was patient and knowledgeable. She described how the regional society is mainly involved in local issues, including continuing education and the addressing of ethical complaints or issues between veterinary colleagues.  At a state level, she told me how the state society is essentially a liaison between veterinarians and the New York State government, which establishes laws, policies, and regulations that influence the way veterinarians are permitted to practice.  For example, issues regarding the legitimacy of equine dentists, a bill making debarking illegal under any circumstances, and restrictions on having compounded doses in a clinic have a very real effect on veterinarians, and the state society works to make the impact of these laws as minimally detrimental (and hopefully as beneficial) as possible.

The NYSVMS also tries to assist its members in other ways, such as providing health insurance, educating its members on legal matters such as those described above, as well as more managerial issues like hours and employee restrictions. They provide continuing education opportunities through biannual conferences in conjunction with Cornell, and also have run a veterinary accreditation program to help clinics meet the New York State practice standards and abide by all the legislation that applies to them.

Because it is very important to me to be involved in organized medicine, I asked Dr. Tintle how one can go about that as a new graduate. She said that many regional associations are eager to find new people to serve. She explained that there are so few veterinarians interested in being involved that many members remain in the same position for several years out of necessity.

Additionally, she told me of a great program offered by the NYSVMS that is aimed at developing the leadership abilities of new graduates. It is run by the Committee for Leadership Advancement, and essentially helps new graduates transition into leadership roles. The program can also help with other issues facing new graduates. If I practice here in New York, I will absolutely take advantage of that opportunity; if I go elsewhere, I will know what to look for in whatever state I work.

I found both of these interviews to be very helpful, and an excellent opportunity to answer questions that will help me build my career in the future. Mentorship is so important in becoming a great clinician, and in being productive member of the profession as a whole. I will absolutely remember the advice that both women gave me, and put it into action as I move out of the student role into the role of a practicing clinician and member of the national veterinary community.

By Elizabeth Newsom-Stewart, DVM student, Class of 2016, Cornell University