AAHA president to focus on practice efficiency, pain management guidelines

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Dr. R. Michael Thomas
Dr. R. Michael Thomas

Dr. R. Michael Thomas envisions small animal veterinarians thinking seriously about the merits of practice consolidation by the time his term as president of the AAHA ends next year.

Veterinarians are among the most inefficient providers of medical service in the world, Dr. Thomas said, and "many, many" companion animal hospitals should consider mergers or buyouts as ways of improving veterinary income and quality of patient care.

Dr. Thomas was installed as the new president of the AAHA this March during the association's 68th annual meeting, in San Antonio. He plans on using this platform to promote a national dialogue on practitioner efficiency and to start the process of drafting guidelines for managing pain in animals.

Growing up on a small farm in Indiana, Dr. Thomas realized he wanted to dedicate his life to veterinary medicine. "Farming operations triggered my interest in veterinary medicine, and I wanted to be a food animal practitioner," he said. "My dream was to drive around the road with my arm out the window, saving the lives of cows that were having trouble [delivering] calves."

His family later moved to Miami. Dr. Thomas attended the University of Florida and went on to Auburn University College of Veterinary Medicine, where he developed a love for small animal medicine and surgery. There he got involved with the student chapter of the AAHA, and was impressed with its commitment to excellence in small animal care.

By the time he received his DVM degree with honors in 1968, Dr. Thomas had decided he would work only at AAHA-accredited hospitals. He practiced first in Chicago, then in North Carolina and Florida before returning to Indiana, where he founded Noah's Hospitals. The company now encompasses seven AAHA-accredited hospitals with a staff of nearly 20 veterinarians.

Management responsibilities require most of Dr. Thomas' attention now, but he still finds time for surgeries, especially of the orthopedic nature.

Dr. Thomas first became part of the association's leadership in 1992 when he was asked to be part of the standards committee. He has served in several other capacities, including treasurer and vice president. Distance education and the MarketLink, which offers discounted veterinary drugs and supplies to AAHA members, were two areas Dr. Thomas helped implement. In addition to the AAHA, he was president of the Central Indiana VMA.

Recent veterinary graduates face challenges similar to those of Dr. Thomas' day, only magnified. "I thought I was very poor going through veterinary school, but at least I didn't have to borrow [the amount of] money that the students are borrowing today," he said. "So when I got out of school, I didn't have all that student debt hanging over my shoulders."

Much of the profession's economic problems can be attributed to veterinary students not learning basic business skills, which makes the difference between a struggling and a successful practice, according to Dr. Thomas. This has led to an inefficient delivery system consisting of too many poorly equipped and badly managed hospitals operating nowhere near capacity.

The result is a highly skilled, highly educated profession in which the average income is below that of physical therapists. "Is that right after an average of eight years of college for most veterinarians? That doesn't make sense," he said.

Practice mergers and buyouts are one remedy for the current problem. "In my opinion, many, many hospitals in this country need to think about merging with their neighbor or purchasing a hospital from a veterinarian who wants to retire so that we can become more efficient, we can better utilize our facilities, and maybe we can build nice new ones with state-of-the-art equipment," he said.

As such, during his 2001-2002 term, Dr. Thomas will promote a national dialogue on veterinary efficiency.

Under his direction, the AAHA will also begin working with experts in anesthesiology on developing standards for pre- and postoperative pain management. Not too long ago, veterinary schools were teaching students that animals didn't perceive pain the same way humans do, and that pain could aid an animal's recovery. Recent pharmacologic developments and a growing awareness of the human-animal bond, however, are creating a climate in which animal pain should be alleviated, Dr. Thomas said.

"[Pain management] is an emerging science and an emerging body of knowledge that we didn't have before," he said. "It's good for pets, it's good for hospital owners, but most importantly, it's the right thing to do."