Dr. Lane: I'd like to see as many general practitioners as possible come back into the universities. The universities have pretty much
said no we don't want GP's teaching our kids, but I learned a lot from some of the old timers out in the trenches. They helped
with my education along with the specialists. We do need more specialists; in fact, I think there's a maldistribution of specialists.
Our veterinary schools were born on an agrarian idea that the legislature would fund them because of the food and fiber portion
of our profession. Now we've moved totally away from food and fiber focus at our schools. The state legislatures are asking
why we are funding programs for dogs and cats. The veterinary schools are strangled for money. We've got to find the Betty
White of this world to come in and help us fund these programs better. I doubt if all this money will come from the state
as far funding a continuing expansion of specialists in companion animal medicine.
Dr. David Lane
Dr. Walther: I have just a brief comment on a challenge that's going to come as a result of these tremendous changes occurring and that
is the medical/legal issue of when to refer. And I think I would like to see the guidelines come from the profession rather
than from the legal ramifications of our not doing it. This is something that's going to have to be taught in the schools;
it's going to have to be an education for practitioners and the public on when is the proper time.
Dr. Block: When I was prepping for this talk, I came across a JAVMA paper from the early '90s that surveyed practice owners on some
of the surgical skills that they felt graduating seniors should be able to perform and they included in the top five were
fracture repair, PU surgery, cruciate surgery and an FHO. That was 15 to 16 years ago. These days, I don't think you could
get a student to not refer one of these cases based on the training he or she receives in veterinary school. I'm the beneficiary
of an excellent veterinary education, but does it make sense that we have our students spend 50 percent of their surgery block
watching intrathoracic surgery and 14 hemilaminectomies knowing that when they see the down dog in practice they're going
to try cutting it themselves?
Ms. Richard: From the perspective of human medicine, certainly residency training programs have been around for years, but one of the
reasons they're so well funded is because they do receive public funding through Medicare reimbursement.
Kerry M. Richard, JD
There is no parallel system in veterinary medicine. So if a specialty clinic trains a resident, the only way they make money
off that resident is by charging for their services to private payers which means they're doing more work than they are learning
in many instances.
It's not necessarily an effective model. Within the academic institutions, they're finding difficult opportunities to train
without funding residents. To push for specialization through greater residency programs may not work for veterinary medicine
at least until a funding source comes out. I know we're going to get into this idea of third-party payers later which may
in fact end up being that source of funding as it is on the human side in many cases.