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AVMA Board chair discusses recent Association initiatives
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Dr. Brown
Dr. Gary Brown, 2018-19 AVMA Board of Directors chair

In the months since Dr. Gary Brown's election as chair of the AVMA Board of Directors last July in Denver, the Association has consolidated its Trusts, restructured the American Veterinary Medical Foundation, and adopted a plan for increasing membership dues. In short: The AVMA Board has been busy.

Dr. Brown talks about these and other developments, including telemedicine, veterinary technician utilization, and access to care, in the following interview with JAVMA News.

Q. In your estimation, what are the more notable actions taken by the Board during your tenure as chair?

A. This year's Board actions reflect previous years' planning as well as those taken in response to current and anticipated needs. It has been my honor to chair our Board at a time of such positive change.

Aligning the efforts of AVMA Life and AVMA PLIT under a new umbrella trust is as significant as the establishment of Life and PLIT some 60 years ago. It helps ensure that the diverse products and services provided to AVMA members by the Trusts are integrated within the AVMA's overall strategic plan. The restructuring will now allow for expanded offerings beyond insurance and, over time, a seamless member experience.

We have often heard from members about their desire for the AVMA to again sponsor group health insurance plans. As a result of recent federal regulatory changes, planning is well underway to again sponsor health plans, and—absent disruption from an ongoing national legal challenge to all association health plans—the AVMA will again offer plans in a few states very soon, with the anticipation that the number of states will grow as the state regulatory environments allow.

Similarly, integration of the AVMF more closely with the AVMA assures a common strategic future for both.

More than 400 volunteers contributed to the deliberations of our councils, committees, panels, working groups, and task forces, many of which sent substantive recommendations to the Board for action. These ranged from the adoption of principles and definitions important to effective antimicrobial stewardship to the development of a program to support workplace well-being in veterinary practices.

Other key topics the Board has addressed include policies and resources on opioids and prescription drug monitoring programs, guidance on the depopulation of animals in response to disease and destructive human-caused or natural events, and veterinary licensing in waters of the U.S. exclusive economic zone (the area of coastal water and seabed where the federal government has jurisdiction over natural resources). One of the most impactful AVMA policies is our Model Veterinary Practice Act. Efforts to update it have drawn from the expertise of volunteers across the profession through a working group convened under the guidance of the Council on Veterinary Service. While the update remains a work in progress, including consideration of valuable suggestions submitted recently by the House of Delegates, we believe we are very close to achieving consensus.

Creation of the new budget, a collaborative effort led by our treasurer, Dr. Arnold Goldman, required careful scrutiny of AVMA operations to assess programs for member value and to ensure efficiency. While that careful evaluation found opportunities for streamlining certain areas, it also revealed the need for a modest increase in dues to ensure that the AVMA can continue to deliver quality products and services, education, professional resources, and advocacy for its members. The expected outcome of that increase will be a financially strong AVMA that has the means necessary to address current and future member needs.

The AVMA has worked hard this year to nurture its relationships with other organizations to ensure a climate of support for all veterinarians and all members of the veterinary team. The AVMA's administrative support for the National Association of Veterinary Technicians in America, Women's Veterinary Leadership Development Initiative, and Veterinary Medical Association Executives is an important part of that effort. When these organizations succeed, their members succeed, and that success trickles down into the business of veterinary medicine—whether that business is an independent or corporate practice, allied industry, or government.

Q. What are you hoping to see with the new AVMA website?

A. The Board is steadfast in its commitment to the new, as demonstrated by its appropriation of substantial financial and staff resources. We know this is a very high member priority, and I believe our members will be excited by the result. Objectives include ease of use and search, with fewer clicks to reach the desired page, and I expect to see a contemporary and friendly homepage, with current items of interest for members and the public. I look forward to a much-improved governance portal, an aspect of important to the House of Delegates, Board, councils, and committees.

Overall, I expect a site that members will find easy to use and one that educates the public, advocates for the profession, communicates the vast library of information we offer, and is useful to veterinarians.

Q. What are your thoughts on the American Association of Veterinary State Boards restructuring the requirement for a veterinarian-client-patient relationship as it relates to telemedicine?

A. The AVMA, Association of American Veterinary Medical Colleges, and AAVSB are jointly and actively supporting opportunities to enhance veterinary practice through the adoption of telehealth and telemedicine technologies. At the same time, ensuring that the legal definitions of the VCPR that exist in federal law, state veterinary medical practice acts, and state veterinary board regulations are robust, consistent, unambiguous to practitioners, and in the best interest of patients and clients is critical to the efficacious and safe practice of veterinary medicine. Technological advancements have altered and in some respects enhanced how veterinarians conduct examinations of their patients.

However, until technology becomes capable of delivering the equivalent of hands-on or eyes-on observations and until it can adequately capture what are often nuanced interactions with clients, I believe an in-person examination or—in the case of groups of animals—an in-person visit to the facility should continue to be required for establishment of a VCPR. In the meantime ... we are monitoring technological advancements and learnings from real-world implementations of telemedicine and telehealth very carefully to make sure that AVMA policy stays up to date with innovations and the experience of veterinarians and their clients.

Q. Can you talk about the AVMA's new focus on improving access to veterinary care?

A. The thought that some animals are lacking appropriate veterinary care creates angst for all compassionate veterinarians. Barriers to service can take a variety of forms, including insufficient economic resources, impaired access to veterinary practices, and language and cultural differences. The AVMA has long focused on improving access to veterinary care. Discussions during a recent Veterinary Information Forum kicked off the AVMA Access to Veterinary Care Initiative. As part of that initiative, the AVMA has convened a working group of stakeholders who are sharing information about how existing programs, practices, and tools are overcoming these barriers to securing veterinary care. That information will be distilled into practice models to assist veterinarians in working effectively and collaboratively within their communities. It should help them actively evaluate opportunities to increase access to veterinary care by applying learnings that might best be adapted to their unique situations. As this initiative evolves, its scope is designed to respond to needs across different sectors of veterinary medicine and to provide resources for individual veterinarians, traditional practices, and nonprofit organizations. When it comes to increasing the availability of care in underserved areas, it's important to remember that related shortages exist in more than 180 rural communities across the country.

The AVMA's ongoing advocacy for the Veterinary Medicine Loan Repayment Program has facilitated some loan repayment for veterinarians in exchange for serving at least three years in federally designated shortage areas. And when cost is the determining factor that prevents animals from receiving needed care, veterinarians can help their clients through the AVMF's Veterinary Care Charitable Fund.

Finally, the 2017-18 edition of the AVMA Pet Ownership & Demographics Sourcebook, which became available a few months ago, analyzed pet ownership and pet care trends and identified opportunities for enhancing and expanding veterinary services.

Q. Can you comment on the working group being formed on veterinary technician utilization? What could come from that?

A. During the January AVMA House of Delegates session, the House requested the Board convene a task force to study how to improve veterinary technician utilization. In response, I have asked the AVMA/NAVTA Leadership Committee and the Committee on Veterinary Technician Education and Activities to collaborate and submit a recommendation for consideration at the April Board meeting. I directed them to propose the charge of the new task force, identify its representative members, and propose its budget.

This initiative holds great promise, not only to promote overall practice economics, but also to improve the well-being, financial success, and work-life integration of veterinarians and veterinary technicians alike. The veterinary workplace is commonly referred to as family. Families help one another, and the AVMA wants all its families to succeed.

The responsibilities of the AVMA Board of Directors' chairmanship are challenging, ever-changing, and require a unique blend of problem-solving, mentorship, and growth. I've been blessed with a supportive Board and an amazing AVMA staff. I strive daily to earn their confidence and to honor the Association we all humbly serve.

Related JAVMA content:

House of Delegates approves dues increase (March 1, 2019)

Health insurance plans could soon return as AVMA member benefit (March 1, 2019)

AVMF board restructures, aligns with AVMA (March 1, 2019)

Brown, Carlson win AVMA Board elections (Sept. 1, 2018)