Dr Ryan Leong Has Seen Both Sides Of The Table

Ryan loves to share his veterinary career on Instagram -let’s fill in the gaps on Ryan’s journey to becoming a surgical specialist, which includes standing on the other side of the VetPrac workshop table for the first time at the VetPrac Practical Skills Bootcamp Workshop in November 2018.

Ryan graduated from the University of Sydney in 2012. He did a 12-month surgical internship at Melbourne Veterinary Specialist Centre with Dr. Simon Kudnig and Dr. Peter Laverty right after graduation. After that, he spent two years in general practice in Alice Springs and Adelaide. In 2016, he completed another 12-month surgical internship in Animal Referral Hospital Canberra with Dr. Jacob Michelsen, Dr. Bruce Smith and Dr. Sarah Webb. The following year, he stayed on and commenced a three-year surgical residency and also obtained his Membership in Small Animal Surgery with the Australian and New Zealand College of Veterinary Scientists.

Ryan has been through Tibial Tuberosity Advancement, Abdominal Ultrasound and External Skeletal Fixator VetPrac workshops in the past as a participant. He can’t wait for the upcoming Practical Skills Bootcamp Workshop in Wagga Wagga. In Ryan’s words, “to be able to stand on the other side of the table to contribute to the continuing education of our fellow veterinary colleagues is a privilege I am grateful to be given”.

Ryan likes VetPrac workshops for the variety of types of courses offered. “From different species to different disciplines, there’s a workshop for everyone to choose from. The low tutor to participant ratio means that all participants get more attention during the practical classes. The food is a highlight at VetPrac courses, not to mention the massages as well!”

His surgical residency has given him the opportunity to be exposed to a wide range of orthopaedic and soft tissue surgery. Abdominal surgeries that are commonly performed at his practice include GDV, splenectomy, gastrointestinal tract surgeries, abdominal visceral biopsies, cystotomies, adrenalectomies and portosystemic shunt attenuations. One of his most memorable surgeries is a Staffy that he had to operate on late at night for a mesenteric torsion. It was not a surgery without its fair share of intraoperative complications but he’s glad to report that a good clinical outcome was achieved.

To share in Ryan’s passion for surgery and education, not to mention the food and massages, register for the Practical Veterinary Skills Bootcamp workshop on November 8-10, 2018 at Wagga Wagga. For more information, check out the brochure.

Written by Alison Caiafa

We’ve Found The Perfect Recipe For VetPrac Bootcamp Educators!

We mixed many years of veterinary clinical experience, with a love of adventure and travel, and a willingness to give it a go and enjoy the experience along the way regardless of the result.

The products of such a recipe… Dr Peter Young and Dr Geraldine Gorman.

Let’s find out more about these 2 characters that will no doubt make Practical Skills Bootcamp 2018 a great learning experience for all participants.

Peter Young photoDr Peter Young graduated with honours from Sydney University in 1981 and spent 7 years in mixed practice in Victoria and NSW, before moving to Albury, NSW in 1988 where he developed his interest in small animal surgery. He gained his memberships of the ANZCVS in small animal surgery in 1990 and spent the next 20 years predominantly seeing surgical cases in private practice. In 2010 he commenced work at Charles Sturt University; he was a lecturer in Small Animal Surgery, Referral surgeon at the Veterinary Teaching Hospital and from 2012-2015 Superintendent of the Veterinary Teaching Hospital. At CSU he also supervised the research projects of 3 honours students and was involved in research supervised by Prof Glenn Edwards covering some aspects of arterial stenting, bone healing and the urinary tract.

In December 2015 Peter left his full-time position at CSU to allow more time to pursue his many exciting hobbies, including karate and trekking at altitude.

Peter started training for karate at a relatively late age, and now is a 3rd Dan. In 1997 he competed with 1750 other martial arts competitors at the Karate world championships in Okinawa, which many consider to be the birthplace of karate.

Peter has a love hate relationship with cold temperatures and high altitudes! He’s experienced the highs (quite literally!) and lows of his exciting pursuits.

He has trekked in Nepal on 3 occasions. In 2006 his second trek in Nepal was organized to celebrate his son’s 21st Birthday; that expedition successfully reached beyond base camp. Conditions were not as favourable on his 3rd trek in 2013. He was almost blown off the mountain at 4500m on the way to Mera Peak and had to retreat to lower ground.

Peter has also spent some time in the India Himalayas; this trip in 2008 involved 2 weeks volunteering for Vets Beyond Borders performing desexing on local dogs.

He was really excited to be a volunteer vet at the iconic Iditarod Dog sled Race in Alaska March 2018, and had successfully progressed through the pre-race training, but alas, succumbed to cold induced asthma 2 days into the race. He had never suffered from asthma before!

Peter is a classic example of someone who doesn’t stress when things don’t go to plan; he just gets on with it.

Dr Geraldine Gorman hails from Dublin, Ireland, and graduated with a Master of Veterinary medicine from University College Dublin in 1984. Geraldine gained her Membership of Australian and NZ College of Veterinary Scientists in small animal dentistry and oral surgery in 2010, and now spends much of her time seeing veterinary dental cases. She worked in NZ for 17 years, then moved to Australia in 2017 and now works at James Street Veterinary Hospital in Beenleigh, an outer southern suburb of Brisbane. Geraldine Gorman 1

Geraldine cannot remember ever wanting to be anything other than a vet but originally it was going to be a horse vet as she’s a horse fanatic, played polocrosse, and loved competitive trail riding. However, she found that she was incompatible with most horse owners and Geraldine ended up in small animal practice. The dentistry interest evolved from her feeling of being completely useless at dentistry due to lack of education and skills at university. This led her on a quest to master her weakness and she soon became addicted to the work that previously terrified her. In Geraldine’s words: “Know your enemy and it becomes your friend”!

She believes general practitioners would benefit from learning about dental radiographs – “once mastered they change everything”. Other advice for general practitioner vets who’d like to improve their skills in dentistry includes having patience and allowing enough time for the dental procedure ahead, having a good knowledge of the underlying anatomy as well as the pathophysiology of the condition that you are treating, and learning to do good extractions using the correct tools.

To be sure to be sure, Geraldine loves Ireland – it’s where her family is; all 8 of her siblings and her parents are still alive so she goes back as often as she can. But, in Geraldine’s words “the weather in Ireland is bad, very bad actually and it’s easier to be outdoors, active and healthy in the NZ or Australian climate”.

Geraldine has 4 grown up children. NZ is where her children spent most of their early years and one of them is still living there. The family moved to NZ originally in 1994 after a 3 year stay in Zimbabwe. At first they came “just to have a look” and gradually fell in love with the weather, lifestyle and people of NZ. They tried moving back to Ireland at one stage but missed their Kiwi life too much; their children voted to return to the land of the long white cloud. Her children then grew up and moved (mainly to Australia!) so Geraldine and her husband followed in 2017 to make themselves more accessible to visit, and to challenge themselves in their jobs.

Since moving to SE Queensland she’s taken up mountain biking as an alternative to horse riding which is too difficult in suburbia. Days off see her out on her bike or hiking. She’s just spent a week hiking 80 km on Fraser Island with her husband and son. For longer breaks she likes to travel to somewhere that she can hike and experience the wilderness. Her last trip was to Utah, USA where she back-packed in Capitol Reef for 5 days and did a mountain bike tour for another week. She loves road trips; she’s just bought a camper trailer to see a bit more of Australia. Just for something else to add to her adventure and fun packed life, her latest pursuit is rock and roll dancing. She’d promised herself to learn it for years and has finally got around to taking lessons and loves it.

So, from Ireland to New Zealand to Australia, from horse riding to mountain bike riding, hiking and road trips, and now rock and roll dancing, Geraldine lives life and work to the full and is still finding new fun things to do in her spare time.

We think that both Peter and Geraldine have the perfect personality to teach surgery and dentistry respectively at Practical Skills Bootcamp! Come and discover more about Peter and Geraldine at the VetPrac Bootcamp Workshop at CSU on November 8-10, 2018. As well as learning new surgical and dental skills, you might also get to hear about some of their exciting adventure travel experiences!

Dr Peter Young can be contacted on pyoung@csu.edu.au or 0417255886

Dr Geraldine Gorman can be contacted on gg4vet@hotmail.com (preferred option) or 0435830299.

Website:  petdentalvetcom.com

Written by Alison Caiafa

Making A Difference In The Front-line… Meet Dr Vickie Saye

She loves a challenge, especially when it involves using high tech machinery and dealing with critical care patients! But she also loves explaining things, especially when she can use her artistic skills!

Sound unique? Meet the one and only Dr Vickie Saye, Clinical Director, Veterinarian at ARH Canberra – Emergency.

Let’s get to know Vickie a little more.

What inspired you to become a veterinarian and then go onto specialise in emergency and critical care?

The usual ‘I love animals’, fortunately I also liked being a vet!  Drawn to ECC for the types and difficulty of cases.

What is still your biggest challenge with being an emergency medicine clinician?

Dealing with GPs that have a poor appreciation of the work we do, and the high-level skill set that is entailed.

What is it about emergency and critical care that you enjoy the most?

I enjoy the challenge of ECC cases and feeling like you’re making a big difference in the frontline. Also getting to use a lot of the high-tech gadgets like ventilators.  Finally, I enjoy decision making under pressure where it matters if you get it wrong.

Are you working on any projects at the moment?

Am moving to Hong Kong next year so trying to figure out where my career will go there. Potentially into biomedical engineering as there is little capacity for me to specialise over there.  Will also investigate a lecturing position at HK university in veterinary medicine.

What do you enjoy about teaching?

Listening to a question, being able to explain the answer simply and clearly, and watching for nonverbal cues that they understand. I really love to explain things, especially if it involves drawing something!

How do you spend your days off?

Reading about GP practice at the moment! Otherwise looking after my elderly dog and my puppy who has hip dysplasia.  Some gaming and hopefully some archery when the weather warms up.

Why not come to Wagga Wagga and meet Dr Vicki Saye at the Practical Skills Bootcamp, November 8-10, 2018. You might even get her to draw something by way of an explanation! But you can be sure that all your questions will be answered in a very clear, simple, practical way. Register today HERE. For more information, check out the brochure.

Contact information: vickie@hallvet.com.au

Written by Alison Caiafa

Passionate About Critical Care Medicine.. Meet Dr Ellie Leister

Meet the girl from the country who has a passion for critical care medicine and adventure, heads the Pet Intensive Care unit at Veterinary Specialist Services in Brisbane, and educates for VetPrac at the Practical Veterinary Skills Bootcamp, Dr Ellie Leister.

What inspired you to become a veterinarian and then go onto specialise in emergency and critical care?

From a very young age I knew I wanted to work with animals, I grew up in rural NSW on a beef cattle property, rode horses all through my childhood, and was surrounded by dogs, cats, guinea pigs, ferrets and wildlife.  I did work experience with Rob Churchill at Crookwell Veterinary Clinic in year 10 of high school and knew that I had found my career. Fortunately, I managed to get through my HSC and gain entry into the University of Sydney Veterinary Science Degree. As a new graduate I was very lucky to have a wonderful start to my career working at The Valley Vet Hospital in Wingham, NSW. From there I ventured overseas to England and worked in the Channel Islands, Norfolk and Wales before settling in Bristol for a few years and turning to the dark side and embracing emergency work. I returned to Australia in 2011 with an itch for something more and stepped into the role of the intensive care veterinarian at Veterinary Specialist Services and Animal Emergency Services in July 2012.  This opportunity opened many more doors and I started a residency in Veterinary Emergency and Critical Care in 2015.  Being able to understand the how and why of critical care medicine is what really makes me tick and I hope to keep pushing the boundaries of knowledge and research in the veterinary field for many years to come.

You manage a team of 16 at the Pet Intensive Care unit at Veterinary Specialist Services in Brisbane. What’s the biggest challenge of this management role?

Managing the PICU doesn’t really feel like a challenge.  To me it is a journey that I’m on with the ICU team. We now have a leadership team for the PICU, and are working together to continue to improve the PICU.  Being able to staff a 24/7 hospital is difficult as shift work is tough on staff in the long run. I don’t think there will ever be a perfect solution; we are constantly trying to formulate rosters that are compatible with a reasonable lifestyle.

In your opinion, what makes a great workplace?

In my opinion it is hands down the team of people you work with; everyone contributes in their own way to a great work place.  I truly love going to work.  Every day is different, you never know what is going to come in through those ICU doors.  We have an amazing group of vets, nurses, kennel hands and client care teams.  They are kind and compassionate and we stand by our core values.

What advice would you give new graduates?

Live life! Get some experience. Work in a good mixed practice (or small animal if large/mixed animal practice isn’t even on your radar) and learn how to deal with situations out of your comfort zone when all you have is your work car, some drugs and equipment in the back! Choose your first job carefully and make sure you have a supportive group of vets and nurses around you; use them for a second opinion and allow them to watch you grow.

What’s your most memorable case in your veterinary career so far?

There are multiple… A couple that jump to mind are little Cleo and TJ.

Cleo was a 2-year-old French bulldog owned by a lovely vet.  She had 1A tick paralysis, aspirated a large amount of vomit and deteriorated acutely. She developed severe aspiration pneumonia requiring 10 days of mechanical ventilation, became septic and developed acute respiratory distress syndrome. Just when we thought we had her out of danger she re-presented with respiratory distress and multiple tracheal strictures at the sight of her tracheostomy and thoracic inlet.  We sought advice from a human paediatric specialist and a veterinary specialist from UC Davis.  We balloon dilated her trachea multiple times before placing an intra luminal stent under fluoroscopy with the Veterinary Specialist Services team.  Unfortunately, she then strictured through the stent and we placed a covered stent within the original stent.  Sadly, a few months later she strictured proximally to the stents and the decision was made to say goodbye.

TJ is another French bulldog case. He was bottle fed and aspirated a large amount of milk at 10 days of age. He ended up in the ICU on IVFT, antibiotics and oxygen supplementation.  He deteriorated and suffered a cardiopulmonary arrest.  In the absence of resuscitation orders, we automatically started CPR.  The ICU nurse intubated him with a 14-gauge catheter, he was given adrenaline and atropine and we achieved return of circulation within one round of CPR.  I called the owner to advise him of the acute deterioration and that he should come down to make decisions, thinking that we would be euthanising TJ.  When the owner arrived, he asked me if there was anything we could do.  I looked up at the large critical care ventilator then back down at the 300gm puppy and said, “I guess we can try and ventilate him”.  I had never put anything that small on a ventilator.  With the 24/7 nursing care of the ICU team TJ lived and made it home to a very caring family.

How do you spend your days off?

True days off are spent with friends doing anything adventurous. Other days off are spent catching up on life, study, gym and watching the world go by with my little sphynx cats!

You can meet Dr Ellie Leister and share her passion for critical care medicine at the VetPrac Practical Skills Bootcamp workshop on November 8-10, 2018 at CSU. To find out more information, check out the brochure. If you’re interested in attending head to this page here!

Ellie can be contacted at eleister@peticu.com.au or 0439606810; the Pet ICU website is coming shortly.

Written by Alison Caiafa

Faced With Demanding, Kooky or Different Clients?

Dear Colleagues,

So many of us take calls from clients who become “John’s clients” or “Cathy’s clients” or “Nicole’s clients”. These are people who are sometimes demanding or kooky or different… And so many of us get frustrated with our work colleagues for a million different reasons and find ourselves worrying if we gave the right advice or made the right decision for our patients. And even if you feel you’re doing all the right things you might get complaints about stuff internally from staff or from clients.

Experiencing these things or feeling this way doesn’t mean we dislike any of these people or that we disrespect them. It doesn’t mean we don’t know how to do our job either. It’s a signalment of misunderstanding that comes from never having learned about ethics, values and communication in a detailed manner. It does NOT mean you are unethical, or have bad judgment, communication or ethical standards. It means there are differences, which might not be able to be shared or considered due to time constraints, the workplace environment or the relationship you have with the person and situation that is difficult. Or perhaps you have never considered the differences that make your clinical encounters difficult?

These are the things which fuel conversations on social media networks. These are the issues which commonly land us in front of the registration boards and lead to sleepless nights. Sure there are others too… but these difficult clinical encounters are the most common. And the easiest to rectify.

If you can make it to Rose Bay, Sydney on October 15-17th for the Navigating Difficult Clinical Encounters Seminar, you will revise the evidence and understanding behind:

How values influence decision making
Skills in setting expectations
The best way to stage diagnostics
Client, employee and clinic perspectives
Communication styles
Considerations in euthanasia
Handling complaints
The “What would you do?” question

You will develop skills in:

To understand the client’s mindset and its influence on carers
to build rapport, confidence and trust with client.
To recover from a bad start
Facts about trash talking
The ethics of decision making
About the complex nature of animal welfare vs client confidentially vs employment loyalty
How to navigate cost vs welfare consideration
The benefits of repetition
How guilt affects communication
Evidence about effective communication strategies
How to navigate difficult clinical encounters effectively

The idea that gaining these skills through evidence-based information, provided to you by specialists in their fields could dramatically improve your life might seem unfathomable. But I have been sitting with these women and listening to them discuss the elements of the workshop for almost a year. They are exciting, passionate and so incredibly helpful it will blow your mind.

Navigating Difficult Clinical Encounters is open to everyone and will really reduce headaches we all get from difficult clinical encounters.The point of the program is to help us make better clinical decisions. There is good evidence that our moral judgement, our communication techniques and our well being influences our clinical decision making even more than our scientific training in veterinary science. And that there is significant influence by all people involved in the care of a pet.

This training program addresses this, not by just telling us what we should be doing, but by teaching us HOW to do it better.

We all want to go to work happy and come home happy. The best way to do this is when we are able to express and practice our values when caring for a pet. But when we can’t because we are not the only ones involved in the decisions of care for the animals we treat, then we need good skills to protect our patients, ourselves and our colleagues from pain.

Sincerely,

Ilana Mendels

When I Sold My Vet Business to Corporate

The personal experience of a dedicated veterinary practice owner

By Anonymous

So you’ve toiled away for 20 years and built the practice to be busy, and at times, a chaotic business. You’ve purchased rental properties with the income and financially supported your family (if your partner has stuck around and raised the kids by themselves). You’ve tried to sneak away for short holidays with the family (especially when the kids were little),  but every second year the vet that you thought was good enough to finally able to leave for a day or two alone to run the clinic, has left again. And the job advert has only resulted in two applicants, neither of which are ideal, so it’s back to you and the part-time vet.

Your partner is always talking about you slowing down and now your long time nurse is having a family and leaving. And the two vets you have previously spoken to aren’t at all interested in buying into the business. Reason given: “why would I want to work as hard as you?”.

So, you’re a bit down. But you “are what you do”. You’re a good vet, maybe not a specialist, but you have great clients, many of which you regard as friends, and the team is great. And you like what you do every day – speying cats is relaxing!

You start to think about selling the business, but there doesn’t seem to be anyone to sell it to.  And you don’t want to be like the GPs who just walk away because they can’t sell their practice. But all the other professionals (dentists and some Drs) are selling to corporates or merging.

And so it begins!

Initially, the purchase offer looks amazing – I mean no-one would pay that for the practice other than a corporate. And they’ll give you access to technology, other human resources support, potential bonuses, time off, nice salary, and you only have to stay for two years and get the final 30% of the sale price if you maintain the profit level, which is a given especially considering their buying power and economics of scale, right?

So after some extremely stressful weeks providing every detail to the potential purchaser and stressful times while they do stocktakes and put in place new computers and software, the day finally comes for the takeover. But you are so fed up you are seriously thinking of pulling the pin on it, however you are so far down the track that you go ahead.

The money (70%) goes into your account, which you then you give to the investment company to invest in whatever manner they think is ok. Your life is changed. You are free, relaxed and have so much time off you don’t know what to do with it. Your family will be miraculously pleased to see you and you will be booking holidays to all sorts of places – wrong! Nothing has changed!

vet business

You didn’t really think how this would change your life other than the lump sum and now it seems to be more stress and less income. And there still aren’t any more vets around so time off is still difficult.

You aren’t more relaxed. You have to email a corporate office to question simple things like stock ordering or marketing decisions and plans. NO-one in support offices will answer their phone.

Some might say that you obviously aren’t adjusting to not being in control. But that’s not it, it’s because you are still left to manage the day to day business and every aspect of being a vet. The main devastating problem is:  your project isn’t yours anymore.

Small business owners, and especially vets that have worked in their own business for a reasonable length of time, are motivated busy people that are generally “active relaxers” as well. Slowing down is sometimes MORE stressful. Those employment HR issues, managing the team, stressful cases where you don’t know what’s wrong with the patient , paying bills, or keeping costs down are actually stimulating albeit stressful. Take some of that away and you are bored, stressed and frustrated!

So you go on CPD course and maybe study. But then you have to apply via the corporate and will probably be bonded for another 1-2 years.

Before you sell a veterinary practice consider the following points: 

1. DON’T just think that you want to sell the business to be free.
DO think about what you want to achieve.

Maybe you could achieve the same financial reward by working in your business for another 5 years, and at that point it would be ok to walk away or try and sell it outright for less. That’s pretty much what the purchase price the corporate paid you was worked out on – multiplier of 5. And in 5 years your might be more organised to walk away as you have a plan or project to go to. Maybe locums, maybe property of some sort, maybe travel then locums.

2. DO have a plan!

Think of what you would do if you had 6 months off right now, and then what you would do after that, including financial considerations. Aren’t you too young to stop working altogether? Do you really want to do locums or work in another practice? Could you cope with that?

3. DO REMEMBER that the sale includes a RESTRAINT of TRADE.

Research this carefully. When does it start, and for how long, and for what area/s. You can’t just start again after the two years that they bond you to the business for. You will have to move if you want to start again.

NEXT, consider the final pay out:

What were you thinking?

This was supposed to be an uplifting experience for the business and yourself. You finally get the final payout sorted out and then you have to decide what you want to do. Remembering you have a restraint of trade, and a family, and yourself to support for quite a few more years.

Do you stay on? Do you hire locums? Do you apply for industry jobs?

The decision making is huge!

The financial reward in no way compensates for the emotional and life turmoil the sale of your business can create. And the financial reward is a one hit wonder – you’ve got a lot of years to go. 

You actually get a huge positive reward from being a vet every day and the human contact with your team and your clients. Taking this away may not be a solution to the chronic tiredness you may feel at times or the chronic apparent stresses. (Joining a well-being program might be a good idea) There may be more alternatives than “ditching”. Somehow, achieving the impossible and finding a good locum for two weeks (no matter what the cost) may be all you need on a regular basis.

If you are 50-60 and thinking of selling, I hope this helps in some way to stimulate some discussion and thought. It’s not all bad – sure you get to realise in financial terms your input in creating a successful business but what next?

If you’re looking to retire from your business, or perhaps you’re looking to become your own boss, VetPrac are hosting a seminar with Practice Sales Search on how to sell your practice and how to purchase a practice. If you’re thinking of making any changes, it’s highly recommended you attend so that you have the right information and support to make the right moves. These practical information days explain the red tape, planning, and considerations you will want to know before you jump into an expensive and legally binding contract. For more information head HERE.