The path back to practice
Ensign says coming back to the profession was an easy decision. The hard part was knowing how hard he'd have to study. And
study he did, plowing ahead to regain his status as a licensed veterinarian and get back to doing what he'd been trained for.
Once the Nevada State Board of Veterinary Medical Examiners renewed his veterinary license, Ensign volunteered at Heaven Can
Wait Animal Society, a nonprofit organization that includes a spay-neuter clinic. There he could get far more surgical experience
than in private practice. One Sunday a month, he joined about half a dozen volunteer veterinarians who performed up to 400
spays or neuters in the organization's feral cat clinic.
"I really enjoyed that," Ensign says. "It's a great place and the volume of surgery you get is really good. The tissue handling
is good for your hands. I did hundreds of surgeries there, and in a short period of time. It would have taken a long time
in regular practice to get that much work in."
Surgery was one skill Ensign was particularly interested in sharpening. "Surgery is my favorite part of practice," he says.
"When I got out of veterinary school, I thought about doing a surgery residency, but at the time it didn't make financial
sense. You went for another three or four years of training and you made less than if you owned a practice. Today specialists
do really well, but back then there weren't the big specialty practices."
Changes in the profession
Since returning to veterinary practice, Ensign's eyes have been opened to all the changes that have taken place in veterinary
medicine since 1994. Those changes are evident at West Flamingo Animal Hospital, which now features a wider range of services,
from a certified veterinary acupuncturist, a staff surgeon, an oncologist, dental radiography, ultrasound and echocardiography
to a canine blood bank. Christopher Yach, DVM, who joined Ensign in the practice in 1990 and bought it from him when he went
to Washington in 1994, also enlarged the facility while growing the staff to 47 during those two decades.
Underlying many of the the changes in the profession since he left for Washington, Ensign says, is increased specialization.
"You refer a lot more than you used to," he says. "It's nice when you have a difficult neurology case to be able to pick up
the phone and talk to a neurologist. Sometimes you ship the patient over there, sometimes they help you with the treatment,
sometimes you send them over just for a CT scan. Having more options available is one of the great advances today."
Ensign also sees the enhanced role of the veterinary technician as a significant change in veterinary medicine since the 1990s.
He says he hired the first licensed technician in Las Vegas when he owned West Flamingo Animal Hospital—the first veterinary
hospital in Las Vegas staffed 24 hours a day, he says. Finding one licensed technician was hard in those days, he says, but
today the city has two schools graduating veterinary technicians.
"Technicians do a lot more today," he says. "You get to do more of what doctors are trained to do. Technicians, or veterinary
nurses, get to do more what they're trained to do. And we both enjoy our jobs more because of that."
However, better-leveraged staff skills doesn't necessarily mean Ensign treats more patients in a day. He's found in the past
six months that he's actually seeing fewer patients "but working them up more." When he practiced in the 1980s and 1990s,
he says, vaccines played a much greater role in small animal practice, along with declaws and spays and neuters.
Another difference now, he says, is an increased emphasis on pain management. In the 1980s awareness of pain management in
animals was growing but veterinarians didn't "pay nearly as much attention to it." In an orthopedic case, for instance, where
the veterinarian wanted to immobilize the leg for a period of time, "we thought, 'If it hurts, they won't use the leg,'" Ensign
says. "Obviously you give them pain medication today."