James Herriot to “one-medicine”

Challenges for private companion animal vets (and incidentally also welfare groups)

Ray Butcher ICAWC, RIGA 2011

Reflects my own experiences – largely UK based

Old enough to remember the “old days”

Unique position – have been a high profile vet “politician” / involved in welfare charities / a private practitioner all at the same time

A personal view

Evolution of companion animal vet practice in UK and worldwide

Changing situation in welfare charities

Parallel evolution but prejudices perhaps rooted in the past (esp at local level)

Stress the need for collaboration

Pointers for the future

Plan

Vet History (UK): James Herriot image

Thames flood 1953

Intensive agriculture

Vet History: 1950’s – food for all!

Development of companion animal practice

Vet nurse training Changing client

demands and expectations

1970’s +

1980’sNot all work!

Massive investment in terms of money and facilities

Change in attitudes of vets and staff – women, work/life balance

Employment and Health and Safety legislation

Competition Facing the reality that

practice is a business

Current time (1)

Emphasis on positive health care and prevention rather than treating disease

In UK – much of this done by nurses

Current time (2)

Trend to specialisation◦ Species◦ Disciplines

Current time (3)

Evolution of Nursing Profession

Working with other animal health professionals – physios, behaviourists etc.

Still barriers in some countries

Current time (4)

Continued change in client expectations (not related to costs only)

Reduced standing of “professions”

Economic crisis > impact on own business as well as clients

Current time (5)

Not to illicit sympathy! Stress practice is a

business This is what we do to

feed our families Making a profit is

desirable – indeed essential!!

Difficult decisions What is best for

welfare?

Why tell you this?

Private registered Hospital

50 staff Image important as a

“service provider”

WVC in 2011

Image – Vientienne, Laos

Image / adding value

Internet Meetings networking

Aspirations in developing countries

Accidents and disease Positive animal health Family health Community Health

Change in approach

“One medicine”

Changes in charities

Well-meaning but lacking overall plan

Dealing with crises but doing nothing to change anything long term

Care about animals more than people

Often felt abandoned by society

Charities – stereotype of “old style”

Thought they could solve the problem themselves

Unwilling to work with others

Own welfare standards in own facilities often substandard

Charities – stereotype of “old style”

Many examples Become professional >

successful as businesses Staff make up - range of

professionals -not necessarily “animal people”

Alliances > cooperation > bigger political clout

Educational programmes essential component

Evolution – “new” style

Re-homing – not just numbers but matching the right dog to the family

CNR – community involvement, stressing aftercare

Every intervention is an education opportunity

Quality of service

Welfare spectrum: suffering and well-being

Also important Caring but

professional “Playing the system”

Image

Internet Meetings networking

Aspirations in developing countries

1985 – 2011:Reality check:Business plans

Re-focusing aims and objectivesProfessionalism

VET Practice

LocalCharities

1950 - 1985:Identifying new challenges

Economic pressures Rapidly changing societal needs

Aims and objectives much in common Challenges much in common Much greater cooperation at international /

national level May still be “in-built prejudices (esp at local

level)◦ Vets - “Only interested in money”, “Do not care

about animals” ◦ Charities - un-realistic expectations, “mad”, Poor

standards of welfare

Vets and charities:

Common Ground

Promotion of humanity – concern for all living things (including people)

Professional Recognise the importance of considering

and working with other stakeholders (including locals)

“One medicine” philosophy

Basic assumptions

EU and companion animals

Important concept – control of whole population not “strays”

Consider “free roaming” not stray

Image – “stray” > unwanted/expendable

Dog population control

Free Roaming

Owned dogsLost

Owned dogsabandoned

Community Dogs

FeralDogs

Owned dogswandering

TOTAL DOG POPULATION

Confined / Controlled Free Roaming

Dogs in breeding / commercial supply chain

Owned Dogs

Owned dogsLost

Owned dogsabandoned

Community Dogs

Feral Dogs

Abandonment

Re-homing

Education???

Owned dogswandering

LOST

Returned

Culture

Direct physical injury to humans, their pets or livestock, and wildlife.

Indirect injury as a result of road traffic accidents

Reservoir of disease to humans and their pets

Pollution from faeces, urine etc

General nuisance - noise

Problems associated with Free Roaming dogs

Loss of human and animal life

Fear of the disease Cost / availability of

vaccination Cost / availability of

post exposure therapy (PET)

Added pressure in Rabies endemic areas

ICAM Framework

Dog population control

Developing and implementing a population management strategy

Initial data collection and identification of major stakeholders

Interpretation of the data and identification of local priorities

Consideration of potential components of strategy

Agreement of overall plan, setting aims and objectives and delegation of tasks

Implementation, monitoring and evaluation

Multiple stakeholders

Animals

Vets

AnimalHealthMinistry

Human HealthMinistry

Municipality

NGOsGeneralPublic

Educators

Humane “stray” dog Control:Why should local vet practitioners care?

“….. I promise above all that I will pursue the work of my profession with uprightness of conduct and that my constant endeavour will be to ensure the welfare of the animals committed to my care”.

Veterinary Declaration

Ensuring animal welfare is a key element of our role

Have we risen to the challenge?

Vets as the “animal advocate”

IntensiveAgriculture

Moral obligation EU – Treaty of

Amsterdam > Legal obligation

“Sentient Beings”

Sentient beings:Implications for stray control strategies

Can we argue that this is an area that will help to build the business?

Vet Practice as a business

“Free -roaming” : Source of disease and injury to “pets” in our care

Rabies: Incidence

55,000 human deaths in Africa and Asia every year – especially children

100 deaths in children every day

May include owned animals that are allowed to wander

Clients or potential clients

Free roaming dogs

Can we be selective?

Important concept from “James Herriot” era.

“Caring” Image

Direct involvement Linked to compulsory

vaccination Linked to neutering

Opportunities for practitioners:Registration

May be compulsory visit to vet

Marketing opportunity

Opportunities for practitioners:zoonosis control

Pet dogs potentially most productive

Requires vet involvement

Cost implications Needs compromise?

Opportunities for practitioners:Sterilisation

Responsible Pet Ownership

Opportunity to market clinic

Opportunities for practitioners:Education and marketing

Moral obligation – care of living things and promoting humanity

Professional obligation – “animal advocate” Professional obligation to community – have

expertise to improve public health

Summary:Why should vet practitioners care?

Professional obligation to clients – have expertise to protect health of pets

Enhanced image as “carer” will impact on view of community to clinic

Potential opportunity to market clinic with increase workload and client base

Summary:Why should vet practitioners care?

Goodwill Image Community

responsibility Potential increase in

client base Developing surgical

skills? Financial gain?

Benefits for vets to have working relationship with charities

More satisfied owner Healthier dog Better educated

owner > better potential to take up vet services

Benefits to vet practice if re-homing centre is good quality

Benefits to vet practice in having better educated public

Compromise / symbiosis

Vets and welfare charities have joint role as part of “community health care team”

The Future?

The need to change the way people behave Educated public better for animal welfare

and better for vets so “win / win”

Education

Rabies / zoonoses Bites

Family / Community Health

68

Feedback from the field

Owners - “My dog doesn’t bite” Sponsors &Vets – not keen on negative

image

69

Field Injury prevention

Problem of communicating a “FEAR message”

Witte K. 1996; Cho & Witte, 2005; Gore & Bracken, 2005

Spreading the message

Improved welfare involves educating people to change their attitudes and behaviour

Can only be successful if multiple stakeholders in the community work to an agreed strategy

Each stakeholder group will have their own agenda

Maybe historical “baggage” – concentrate on points of common interest / agreement

May need compromises Must be perceived advantages to get “buy-in”

Summary

Multiple stakeholders

Animals

Vets

AnimalHealthMinistry

Human HealthMinistry

Municipality

NGOsGeneralPublic

Educators

But have fun on the way!