May 15, 2020
On March 24, 2020, the U.S. Food and Drug Administration (FDA) suspended temporarily the enforcement of certain regulations governing veterinarian-client-patient relationships (VCPRs), a move that helps veterinarians examine and treat animals using telemedicine, while limiting human interaction and the potential spread of COVID-19. This is welcome news if you’re considering telemedicine for your practice, but you also need to review the specific VCPR requirements that may exist in your state; as well as telemedicine licensing considerations if you’re treating patients across state lines.
After you’ve done that, there are a number of technology options available, including TeleVet, Medici, GuardianVets, AirVet, BabelBark and VetCareShare. Here are a few common features, and the potential benefits they provide:
Remote exams and evaluations
Telemedicine platforms make it easier to offer certain services remotely, such as medical progress exams and follow-up evaluations of existing conditions. For instance, a vet could remotely offer post-operative surgical consults; and evaluations of skin disorders, wound healing, ear infections or bladder infections.
File and screen sharing
The telemedicine platforms offered by these companies include features that have been widely adopted during COVID-19, including image and video sharing, and document transfers. In addition, some allow vets to share lab results or x-rays with a voice recording that explains the results to the animal’s owner. Many of these platforms also help veterinary practices store and maintain medical records, including pictures, data, client/provider communications, and recorded consultations.
Remote monitoring of patients
Some platforms also include around the clock ability to monitor a patient’s well-being. For example, telemedicine platforms have been used to supplement and support veterinary staff by providing a hotline that can triage patients’ medical needs remotely. Further, to ensure continuity of care, some platforms can send veterinary practices the details of the call and outcomes, which can be helpful with after-hours cases and overflow.
Patient monitoring applications
Another benefit of some platforms is a patient monitoring application, which enables the service provider and the client to share health metrics such as weight, diet, nutrition, medication compliance, activity or exercise. This feature expands the data in a veterinary practice’s medical records because clients can make contemporaneous updates, such as a recording of a pet’s food, or notes about prescriptions purchased elsewhere, all of which can help if correlated health issues arise later.
May 15, 2020
Stay at home orders and social distancing may be the current norm, but eventually businesses will re-open and gradually come back to life. In the rush to return to normal, veterinary practices must carefully plot the safest and smoothest path forward. In this article, we address many of the issues veterinary practice owners need to be mindful of as they re-integrate their workforce, including employment rules, guidance for managing the care of household animals that reside with a person with COVID-19, and best practices for implementing curbside service and/or telemedicine.
What kind of medical information can veterinary practice employers ask their employees?
Employers covered by the Americans with Disabilities Act (“ADA”) may ask employees who report feeling ill at work, or who call in sick, questions about their symptoms to determine if they have or may have COVID-19. Currently these symptoms include, for example, fever, chills, cough, shortness of breath, or sore throat. These inquiries are not disability-related and are thus permitted under the ADA. Similarly, an employer can send home an employee who has reported to work with COVID-19 or symptoms associated with it. Further, because the CDC and state/local health authorities have acknowledged community spread of COVID-19, employers may also measure employees' body temperature as an additional measure to protect the practice. However, as with all medical information, employers must maintain all information about employee symptoms and illness as a confidential medical record in compliance with the ADA.
May a veterinary practice employer compel its employees to take a vaccine during a pandemic?
No. An employee may be entitled to an exemption from a mandatory vaccination requirement based on an ADA disability that prevents him from taking the influenza vaccine. This would be a reasonable accommodation barring undue hardship (significant difficulty or expense). Similarly, under Title VII of the Civil Rights Act of 1964, once an employer receives notice that an employee’s sincerely held religious belief, practice, or observance prevents him from taking the influenza vaccine, the employer must provide a reasonable accommodation unless it would pose an undue hardship as defined by Title VII. Although there is no currently known vaccine available for COVID-19, ADA-covered employers should consider simply encouraging employees to get the vaccine rather than requiring them to take it.
May a veterinary practice employer require employees who have been away from the workplace during a pandemic to provide a doctor’s note certifying fitness to return to work?
Yes. Such inquiries are permitted under the ADA either because they would not be disability-related or, if the pandemic influenza were truly severe, they would be justified under the ADA standards for disability-related inquiries of employees. As a practical matter, however, doctors and other health care professionals may be too busy during and immediately after a pandemic outbreak to provide fitness-for-duty documentation. Therefore, new approaches may be necessary, such as reliance on local clinics to provide a form, a stamp, or an e-mail to certify that an individual does not have the pandemic virus.
What guidance exists for veterinary practices that manage the care of household animals that reside with a person with COVID-19?
In addition to other prevention measures, people with COVID-19 should be advised to limit interaction with household animals. Specifically, while a person infected with COVID-19 is symptomatic, they should maintain separation from household animals as they would with other household members, and avoid direct contact with pets, including petting, snuggling, being kissed or licked, sleeping in the same location, and sharing food. If possible, a household member should be designated to care for pets in the home and should follow standard handwashing practices before and after interacting with the household animal. If a person with COVID-19 must care for pets, they should ensure they wash their hands before and after caring for pets. If an owner is sick with COVID-19, a family member or friend from outside the household may bring the animal to a veterinary hospital or clinic. Telemedicine may also be appropriate to provide consultation with a veterinarian if the owner is a COVID-19 case and is unable to find an alternative caretaker to bring the pet to the hospital.
Veterinarians and their staff should review and adhere to their biosafety and biosecurity protocols for infectious diseases to ensure the safety of their patients. Further, they should familiarize themselves with the concepts in NASPHV Compendium of Veterinary Standard Precautions for Zoonotic Disease Prevention in Veterinary Personnel. This document outlines routine infection prevention practices designed to minimize transmission of zoonotic pathogens from animals to veterinary personnel. These infection prevention and control guidelines should be consistently implemented in veterinary practices and hospitals, regardless of ongoing outbreaks of infectious diseases, but are especially important during an outbreak of an emerging infectious disease such as COVID-19. Further, a state public health veterinarian should be contacted by animal health professionals or veterinarians that have discovered a household animal with a new, concerning illness that has had close contact or resides with a person with COVID-19.
How should veterinary practice managers change their protocols to continue providing excellent service while keeping people and animals as safe as possible?
Social distancing has proven to be an effective way to mitigate the spread of COVID-19. Therefore, many veterinary practices and hospitals have changed their workflow completely to offer curbside service. If your practice has not implemented telemedicine or curbside services yet, this may be the best way to ease back into life after COVID-19. Many practices made the decision early on to stop elective procedures and ancillary services (e.g. grooming, boarding) and currently are providing only outpatient services and emergency surgeries. With a few exceptions, namely euthanasia appointments, clients are being asked to remain in their cars and are not permitted in the building.
March 12, 2020
A Management Services Organization Adds a Layer of Structural Complexity to a Veterinary Practice but Offers Non-Veterinarians and Even Family Members the Opportunity to Reap the Financial Rewards
Veterinarians, investors and executives who want to form a management services organization (MSO) often do so without fully exploring the reasons. One revolutionary change in the veterinary industry over the last decade was heightened interest in MSOs, which resulted in a lot of newer market entrants, including, but not limited to, private equity.
October 6, 2019
Avoiding Malpractice Liability: A Guideline for Veterinary Practices
October 5, 2019
Surviving the Corporatization of Veterinary Medicine as an Independent Practice
While the veterinary industry remains comparatively fragmented to other parts of health care, the area has seen substantial consolidation over the last five years. The consolidation has largely been led by Mars, Inc., who are considered by many to be the lone strategic buyer in the industry. But, as more private equity firms begin to explore sales of their investments in veterinary hospital groups, new strategic buyers attempting to capture economies of scale could emerge. In this coming shift, how can a veterinary practice owner continue to grow their practice, or, if the time is right, obtain the best value for their practice?
Private Equity has been a persistent investor in the veterinary industry because of the lack of strategic buyers, the attractive private pay revenue stream, and the largely recession proof market for veterinary services. Over the past 5 years the industry has seen two stages. First, the Ares purchase of National Veterinary Associates for 13x EBITDA in mid-2014 until the Morgan Stanley investment in Pathway Partners. The second stage began with Mars Inc.’s purchase of VCA at a multiple of 18x EBITDA in late 2017 is continuing today. The current climate of large valuations are seen when larger groups can capture economies of scale, roughly at 20 clinics. However, the purchase price for smaller groups and add-on investments has also crept up to about 8x-10x EBIDTA from 6x.
Currently, the expectation is that the private equity firms will remain active in the space for another 6-8 years at which point the market is expected to have become more consolidated. This shift will occur as investments reach the end of their timeline and begin to sell to established corporate groups like Mars or new strategic buyer entrants.
A practice owner in this environment can find it stressful to grow their business with the economic pressure that can come from corporate groups or feel anxious that they are not getting the best possible price for the business they have worked so hard to build.
First, remember that what makes a veterinary practice successful has not changed in the current environment. Veterinary practice owners should continue to do what some large corporations cannot: practice better medicine and offer better and more personalized client services! But in order to continue to grow and be attractive to clients and potential buyers, practice owners should learn from the corporate model and focus on the business side of revenue and improving efficiencies.
A few areas that practice owners can learn from the big corporations are:
Corporations spend a lot of time marketing and it really matters. Spend time developing a marketing plan and thinking about strategic partners in the community.
Team and Client Education
Corporations do a great job and invest a lot of effort into making sure their teams are on the same page. Practice owners should develop training manuals for their employees on a variety of topics. Furthermore, corporations often have resources online to educate clients on major issues.
Talent Acquisition and Retention
Big corporations have the advantage when it comes from providing benefits to new and existing hires. Practice owners should educate themselves on benefit offerings and make the investment in the wellbeing of their associates and staff.
Lastly, practice owners shouldn’t shy away from investing in the physical appearance of the practice. While corporations might be able to invest more money into renovations, smaller investments into the facilities of the practice can pay large dividends down the road.
In the climate of corporate competition, remember to focus on what made your practice successful in the first place. The independent veterinary practice will continue to survive, but the corporate structure is here to stay.
For more information, please contact Peter Tanella at 973.243.7915 or firstname.lastname@example.org.
October 4, 2019
Maximizing your “Paw”-Fits: Structuring Your Veterinary Practice the Right Way
Choosing the right business structure for a veterinary practice is a vital decision that can have significant consequences for the future of your practice. If a veterinarian selects the wrong structure, it can cost their business a significant amount of money. Choosing a correct business structure for a veterinary practice is a fundamental decision that will impact your business daily and should be guided by an attorney. The main factors to consider when structuring your business are: (1) the financial issues and tax consequences; (2) limited liability; and (3) flexibility versus formality. Selecting a business structure is one of the most important decisions you will make for your practice. In selecting the right entity, substantial tax, legal, and accounting expertise is recommended. It is advantageous to start your business on a good foot, and while it may look daunting to hire expert consultants at the beginning of your endeavor, it is a valuable investment for your future success. The proper structure of your veterinary practice will allow you to reap all the possible benefits and increase your chances at a successful practice. However, it is recommended for veterinarians to stay active in the process in order to ensure that the expert’s proposals reflect the needs and goals of your practice.
Tax benefits are a primary driver when choosing a proper legal structure for a veterinary practice. Two key aspects include: taxation on income/profits and taxation on the sale/transformation of a practice.
Limited liability is another significant consideration when deciding between business entities. The majority of independent veterinary practitioners around the country have traditionally operated as a partnership or sole proprietorship. However, there is a growing trend towards incorporating a practice and/or forming LLC’s as a vehicle for running the business because the structures various benefits. This business structure combines features of a corporation and has elements of a partnership and/or sole proprietorship. Limited liability companies can be tactical from a tax standpoint. Single member LLCs can be taxed either as a ‘C’ Corp or sole proprietorship. Multi-member LLC’s can elect to be taxed as either a ‘C’ Corp or partnership. However, this can be dependent on the state, as not every state allows for veterinarians to form an LLC (for example, California). There are many benefits for the LLC Sub ‘S’ structure. These types of entities are treated the same as any other corporation under state law. Although under federal law, ‘S’ corps do not receive federal tax.
For certain veterinary practices, it can be advantageous to be the only owner and in complete control of the practice. There would be no requirement for seeking approval and or consent of any partners, members, or officers. With a sole proprietorship, there are also minimum to no reporting requirements. Sole proprietorships do not need to file an annual report with the state or federal government. However, under a sole proprietorship, a veterinarian will be held personally liable for all general debts and liabilities of the practice. Moreover, in a partnership, each partner is jointly and severally liable for the debts and obligations of the business. In comparison to sole proprietorships and partnerships, the significant advantage of a corporation or LLC is that the owners of the business (the shareholders/and or members) enjoy the benefits of limited liability.
There is one big exception; however, in that a veterinarian is always liable for his/her own professional negligence and negligence of other employees. Insurance is the only avenue to mitigate this kind of liability, and it a necessity in veterinary practices.
Benefits of Flexibility and Adhering to Formalities
Certain entities also provide more flexibility and can be less of a burden than others. Veterinarians often ignore these formalities, which can be a serious mistake. In certain instances, courts have looked past the liability shield and have held owners personally liable for failing to observe the formalities of separating their personal affairs from their veterinary practice.
July 1, 2019
In early January, Governor Phil Murphy and Democratic leaders of the Legislature struck a deal that would raise the minimum wage to $15.00 per hour in New Jersey. On Monday, February 4, Governor Murphy followed through on his campaign promise, signing the legislation that will increase the state’s minimum wage over the next few years. This deal places New Jersey among the most progressive states in the nation, joining California, New York, and Massachusetts, in phasing into a $15 hourly wage.
While the wage increases are seen to be beneficial for employees, numerous small to medium-sized businesses are apprehensive about the reforms and impact on company revenues. The good news is that the impending changes provide an opportunity for New Jersey employers to audit their pay practices and ensure that they are in compliance with all wage and hour laws. Below summarizes the potential impact of the new ordinance and provides some tips for adjusting to the wage increases:
I. Increases will continue through 2024
The new minimum wage ordinance will not occur immediately. Rather, the deal sets forth a gradual increase until it reaches $15 dollars per hour in January 1, 2024. The current minimum wage in New Jersey is $8.85 per hour. The following chart details the scheduled increases in the state’s minimum wage.
The minimum wage would then increase on January 1 by $1 each year from 2022 to 2024 until topping out at $15 per hour. The new minimum wage will apply to most workers in the state, although there are a few so called carve-outs. The deal calls for most wage earners to receive a minimum of $15 an hour by 2024, but includes a slower schedule for workers at seasonal businesses, small businesses with five or fewer employees, and farmworkers. Farm workers, for example, will see their minimum wage climb to just $12.50 an hour over five years. Seasonal workers and small businesses with five people or fewer would see their minimum wages reach $15 an hour by 2026.
II. The Business Impact
Although raising the minimum wage is generally seen as beneficial for employees, there can be certain costs for businesses operating in the state. Specifically, small businesses in New Jersey could feel the brunt of the minimum wage increases. Opponents believe that the announcement reflects another potential hit to small businesses who are already absorbing cumulative costs in other forms of new mandates by the Murphy administration. Nearly 70 percent of respondents to the latest NJBIA business-outlook survey said their businesses would be impacted in some way if the state were to enact legislation mandating a $15 minimum wage. To offset such a requirement, they said some businesses — though not a majority of them — would reduce staff and working hours, and enact price increases or turn to automation.
Overall, it is estimated that over 1 million New Jersey workers will be impacted by the minimum wage changes, according to the governor and lawmakers. As a result, employers and businesses should weigh the impact of a higher minimum wage on profitability, hiring, and overall finances.
III. Staying Compliant
Now more than ever, states, counties, and cities, who do not see movement at the federal level, are implementing specific minimum wage laws in their jurisdictions. As a result, employers must ensure that they comply with federal, state, and local minimum wage laws. While the federal minimum wage ($7.25 per hour) isn’t changing next year, the state of New Jersey and many other states will have new minimum wage rates throughout 2019.
These new minimum wage ordinances can increase compliance risks for employers, requiring new workplace postings and changes to existing workplace policies. Therefore, employers need to be cognizant of the legal liabilities they could face if company wage and hour policies are not in compliance prior to the increase. Compliance is essential; employers in violation of payroll regulations can face penalties, including steep fines and civil litigation. When dealing with questions about minimum wage and overtime statutes, it is recommended that all employers consult with experienced counsel.
IV. Preparing for the Changes: Adjusting Pay Structures
In states that have significantly increased their minimum wages, the financial impacts often occur immediately and can be burdensome for small business owners. Employers should find ways to manage the effect on increase of pay structures. For example, if the minimum wage increases and jobs that currently pay $10 an hour are not entry-level positions – but a next level up – there could be a compression issues. Thus, employers should adjust their payment structures and account for them to be shifted up. The best way for making this wage shift can depend on the specific company and its compensation structure. Employers do not have to adjust all levels, but it is important to consider adjusting lower-paid jobs from a certain hourly rate on down.
V. Employees Earning More than the Minimum Wage
When the minimum wage increases, some employers wonder if they should also provide a raise to employees already earning equal to or more than the new rate. For example, if the minimum wage increases from $9 per hour to $10 per hour, should an employee already earning $10 per hour also get a raise? While the employer is under no obligation to provide a raise, some employees may be expecting one. In this scenario, the employer should consider the potential impact on labor costs, employee morale, internal equity (how employees are paid when compared with other employees within your company based on skills and experience), and the typical merit increase schedule.
As a result of Governor Murphy’s new deal, New Jersey’s minimum wage will continue to increase, starting July 1, 2019. With the patchwork of federal, state, and local minimum wage laws becoming more complicated, employers and organizations will need to pay more attention to the these issues and payment structures. Paying small business employees fairly begins with gaining a good understanding of the minimum wage laws. In doing so, employers need to remain compliant and cognizant to changes at the federal, state, and municipal level. Advanced legal planning will help employers – both public and private sector – to comply with the new minimum wage thresholds.
Enlisting the help of outside legal counsel can assure compliance with the complex patchwork of different minimum wage laws. Mandelbaum Salsburg P.C. is a full-service law firm focusing on providing exceptional legal counsel to its clients. Our labor and employment attorneys are uniquely qualified to assist you and your business in achieving full compliance with New Jersey labor laws. Please feel free to contact us if there are any issues that we can assist you with.
Mandelbaum Salsburg P.C. provides legal alerts to inform readers regarding trending legal issues and developments in the law. This communication does not create, offer, or reduce to writing the existence of an attorney-client relationship. This communication is not legal advice and may not apply to the specific facts of any particular matter.
 New Jersey Becomes 4th State to Increase Minimum Wage to $15, CBS News (February 5, 2019), https://www.cbsnews.com/news/new-jersey-gov-phil-murphy-minimum-wage-increase-today-2019-02-04/.
 Nick Corasaniti, In New Jersey, the Minimum Wage is Set to Rise to $15 an Hour, new york times (Jan. 17, 2019), https://www.nytimes.com/2019/01/17/nyregion/nj-minimum-wage.html.
 Mike Catalini, New Jersey Governor, Lawmakers Make $15 Minimum Wage Deal, nbc philadelphia (Jan. 18, 2019), https://www.nbcphiladelphia.com/news/local/New-Jersey-Governor-Lawmakers-Minimum-Wage-Deal-504542452.html.
 Murphy, Dems Reach Minimum Wage Deal, nj herald (Jan. 18, 2019), https://www.njherald.com/20190118/murphy-dems-reach-minimum-wage-deal.
 NJBIA’s 60th Annual Business Outlook Survey, New Jersey Business & Industry Association, https://www.njbia.org/wp-content/uploads/2016/05/NJBIA-2019-Business-Outlook-Survey-Handout-V5.pdf.
 David Levinsky, Murphy, Legislative Leaders Reach Deal on $15 Minimum Wage, (Jan. 17, 2019) https://www.burlingtoncountytimes.com/news/20190117/murphy-legislative-leaders-reach-deal-on-15-minimum-wage.
June 30, 2019
Pot for Spot?: Legal Issues Surrounding the Treatment of Veterinary Patients with Cannabis
California has become the first state to give veterinarians the legal protection to discuss medicinal cannabis as a form of animal treatment, but the question is should other states follow suit? Under federal law cannabis is strictly illegal and is considered a schedule 1 controlled substance; which makes many veterinarians afraid to discuss cannabis use with pet owners due to the guidelines of their professional licenses. Federal law is extremely different from the various state laws which may allow medicinal/recreational use of cannabis. However, state issued laws regarding the consumption of cannabis in humans do not apply to use in animals. CBD infused products have swept the market, due to the increase in the legalization of medical and recreational marijuana throughout the United States. These factors have led many pet owners to question whether it is safe to treat their pets’ ailments with medicinal cannabis, but in 49 states they are not allowed to discuss this proposition with their veterinarian. The reluctancy from veterinarians to discuss cannabis treatment for their patients has led patients to take their animals’ treatment into their own hands, with many pet owners conducting online research and treating their animals with unregulated products that contain cannabinoids. According to a 2018 study conducted by Colorado State University’s veterinary medicine researchers, almost eighty percent of 1,068 dog owners who participated in the survey admitted to buying cannabis infused products for their pets.
The internet is flooded with CBD infused animal treats and miracle stories about how CBD saved animals lives. However, it is hard to decipher fact from falsity in an area that has been notoriously under researched and viewed as illegal. Albeit; because of the rise of the legality of cannabis use in humans, there has been a recent rise in studies concerning animals and cannabis; these studies have shown evidence that cannabis can be beneficial for cats and dogs who suffer from diseases such as epilepsy, anxiety and arthritis, without the typical side effects of prescription medication. The FDA has the authority to regulate all products which claim to have therapeutic properties; the agency focuses on the safety and efficacy of the products. Since there has not been many studies on the effect of cannabis in animals, there has only been one product that is derived from cannabis that have been approved by the FDA in a extralabel manner by veterinarians, while following the guidelines of the Animal Medicinal Drug Use Clarification Act.
In addition to the legal ramifications, and licensing concerns, there have been a substantial amount of veterinary cases of Cannabis toxicosis in pets, which usually stems from animals consuming edibles intended for human consumption. To bolster this ailment, most of the edibles are made with other products which are toxic to animals such as chocolate, raisins and xylitol; which lower the chances of the animal making a full recovery. There have been several deaths reported due to cannabis toxicosis in animals and have led many pet owners and veterinarians to be suspicious of using cannabis to treat ailments in animals.
For more information contact Peter H. Tanella at email@example.com.
Attorney: Peter Tanella
June 29, 2019
Independent Contractor or Employee: What’s the Difference?
It's a vexing question for practice owners: How do you classify a potential new veterinarian who is joining your practice? Is the veterinarian an independent contractor or an employee?
The misclassification of an employee as an independent contractor can result in serious financial ramifications, including taxes, fines, and penalties from both state and federal agencies.
What is an independent contractor?
Generally, veterinarians are independent contractors if they have control over the number of patients they see and their work schedule. They are not independent contractors if they perform services that can be controlled by the practice.
Practices often classify veterinarians as independent contractors to avoid having to comply with state and federal withholding requirements and payroll taxes. The practice simply issues 1099s to the veterinarian at the end of each year, and the veterinarians are responsible for reporting their income, which is subject to self-employment tax.
What is an employee?
If the practice has control over the veterinarians' patient load and schedule, they are employees of the practice. Employees are supervised by the practice and may be entitled to certain benefits and protections under state and federal laws. For instance, the practice is responsible for withholding a portion of employees' earnings for tax purposes.
4 classification factors
Independent contractors have complete autonomy over their work lives, whereas employees must answer to and abide by their employers. State and federal agencies consider four primary factors when determining if a veterinarian is an employee or an independent contractor.
The first factor is who supervises the veterinarian. There are four questions to be answered:
This factor concerns a veterinarian’s schedule and hours:
3. Benefits and insurance
This category focuses on insurance, healthcare coverage, and more:
4. Payment and expenses
The following five questions can sometimes be contentious, so it's best to spell them out clearly:
If an agency, such as a state department of labor or the U.S. Internal Revenue Service, audits a practice and finds that the practice has misclassified a veterinarian as an independent contractor, the consequences of a misclassification can be severe. The agency will likely seek payment of unpaid employment, disability, and Social Security taxes, along with additional interest and penalties. This could potentially cost the practice millions of dollars.
In addition, the misclassified veterinarian may be retroactively entitled to insurance coverage and other benefits that should have been offered by the practice if the veterinarian had been properly classified as an employee. If the veterinarian is deemed to be a nonexempt employee and worked more than 40 hours in any given week, the practice will also be responsible for back payment of overtime.
What can a practice do to protect itself?
The only fail-safe way to survive an audit is to classify veterinarian and staff in compliance with the criteria established by federal and state laws. Although this list is not exhaustive or foolproof, it is a start for identifying the best practices for maintaining classification as independent contractors:
“Compliance with a well-crafted independent contractor agreement is the best defense in a reclassification audit.”
Compliance with a well-crafted independent contractor agreement is the best defense in a reclassification audit.
June 28, 2019
When Two-Legged Epidemics Reach Our Four- Legged Friends: Veterinarians and the Opioid Crisis
It is common knowledge that an opioid epidemic has been sweeping the nation, but many veterinarians do not realize that they have a responsibility to help curve the abuse of pain medication in their practice. Opioids are extremely powerful pain-relieving medications, that are commonly prescribed to treat intense pain. However, these drugs are also extremely addicting, and can cause overdoses in humans and in pets; but the pets are not the problem. Recently a study was conducted by the Colorado School of Public Health, which concluded that a large amount of the veterinarians who were surveyed were concerned that their clients have intentionally hurt their pets in the hope of receiving a prescription for pain killers. Out of the surveyed population, almost forty five percent of the veterinarians knew a pet owner or employee who was abusing opioids. In addition, the University of Pennsylvania Veterinary medicine school analyzed the number of opioids dispensed at their veterinary school for ten years, and concluded that prescriptions rose forty-one percent annually, when the number of new patients only rose thirteen percent.
There have been many incidents of animal abuse by a pet owner in the hopes of obtaining prescription medication. For example, a woman in Kentucky was arrested after she admitted to cutting her dog with a razor blade with the intention of obtaining and consuming pain medication through her veterinarian. The most commonly targeted pain killer that is carried in most veterinary practices is tramadol, because it is highly addictive and is typically prescribed to both humans and animals. Other commonly abused drugs by pet owners include Xanax and Valium, whose prescriptions are extremely difficult to obtain through a physician. These methods are a way for drug addicts to obtain drugs under the radar, so it is imperative for veterinarians to be observant and meaningfully participate in the effort to end the opioid epidemic.
A combination of incidents has pushed the Food and Drug Administration to offer new resources for veterinarians who stock and prescribe opioids. The resource outlines six steps that veterinarians can take to help combat opioid abuse in their practice. It is recommended that veterinarians have an emergency plan outlined if they are ever in a situation in which they suspect opioid diversion, or clients harming their animals in attempt to gain access to pain killers; local police departments are the best people to help advise veterinarians on a plan of action if they ever encounter these dangerous situations. The FDA released a list of tip-off’s that can help veterinarians determine if a client is abusing opioid medication: suspect injuries in new clients, pet owners asking for a specific drug by name, asking for refills because medication was lost or stolen, and having a general demanding attitude about their request. However, it is not only pet owners that veterinarians need to worry about, it is also necessary for them to monitor the behavior of their employees who have access to the drugs. There are many warning signs that a staff member is abusing pain medication such as: lack of focus, frequently missing work, mood swings and anxiety. In addition, it is important for veterinary practice owners to have checks and balances regarding their ordering, storage, administration and dispersion of opioids for the health of their employees and for their own legal protection. This outbreak has made many states create control measuring laws for prescribing opioids. For example, Maine enacted a Prescription Monitoring Program, which must be checked before prescribing opioids and benzodiazepines to animals. The program requires the veterinarian to state the reasoning for the prescription and the physical condition of the animal; logging it into a statewide database, which helps to limit repeat abusers. In addition, the state of New Jersey signed the most restrictive law, limiting a five-day supply of initial opioid prescriptions, and require veterinarians to share the data with fourteen other states to help combat abuse. Many groups are currently pushing for other states to adopt New Jerseys restrictive laws in order to help combat the opioid crisis that is now affecting us all.
For more information please contact Peter H. Tanella at firstname.lastname@example.org.
June 26, 2019
The Veterinary Divorce: The Considerations When Leaving a Veterinary Practice
While departing from a veterinary practice may seem like a trivial task, it can often be a complex decision and process. When dealing with a “veterinary divorce”, both parties should engage in careful considerations to protect both the clients and the veterinarians. This article will provide a brief overview of the best practices to consider for a veterinarian leaving his/her veterinary practice – from both the perspective of the veterinary practice group and the individual veterinarian(s).
First, the veterinarian and surviving practice should review their existing contracts in the event that a veterinarian leaves. The two most important agreements to consider is the employment agreement and a shareholder buy-sell agreement (if one exists). These two contracts can have a significant degree of importance if the departing veterinarian wants to continue their practice.
The Employment Agreement
Veterinary practices commonly require their employees to sign an employment agreement when they begin working for the veterinary practice. When dealing with the termination of a relationship, both the employee and employer should understand the details of their employment contract.
When changes in veterinarians causes an economic divorce, a buy-sell agreement can provide a fair resolution. A buy-sell agreement is a contract between business owners that determines what occurs to business ownership upon a triggering event, such as death, disability, bankruptcy, or disputes among shareholders. A buy-sell agreement essentially is an agreement for exiting a practice, and veterinary Buy-sell agreements frequently require a mandatory buy-back of shares.
Thus, if a buy-sell agreement exists, it should be reviewed for any buy-back provisions. The buy-sell agreement would provide a share price, either by an accounting formula or arbitration process. The agreement may also cover the following events:
Additionally, as mentioned above, the parties should beware of any non-competition or non-solicitation clauses in a buy-sell agreement.
Compensation after Termination
When a veterinarian leaves a practice, the practice may provide compensation after the termination date. First, there could be a salary owed to the date of termination plus accrued vacation time. Second, there may be compensation owed for the veterinarian’s share in accounts receivable or collection of a pro-rated share of year end-bonuses.
Exit and Severance Agreement
When an employer decides to terminate its relationship with an employee, it can be advantageous for both sides to enter into an agreement defining their rights and obligations. This agreement is often called a severance agreement. A severance agreement acts as a contract for the employee; however, there is no law requiring employers to offer severance packages. There are two major parts of a severance agreement: the agreement and the release. The agreement outlines what the veterinarian would get in return for their release, and details what the severance package consists of. The release, in essence, is a statement that releases the company from any liabilities associated with the employees exit.
Exit and severance agreements are useful for both parties because they can prevent misunderstandings that can lead to litigation. The agreements may contain provisions against future competition (“non-compete” clauses) and confidentiality provisions relating to the agreement itself. For veterinarians, severance agreements often contain the content of notice by the departing veterinarian and can discuss the duties of retaining client records. Lastly, these agreements act a useful tool for employers because they can release liability. The exit and severance agreement can control and/or negate the veterinarian’s right to pursue claims for prior acts of discrimination, harassment, equal pay, or wrongful termination.
When the relationship of veterinarians and/or veterinary practices comes to an end, it is advisable that these considerations be addressed. If not resolved by negotiation, these types of disputes can result in protracted and expensive litigation. An experienced counsel can help the parties reach an acceptable division, which can be a victory for all of the parties involved.For more information, please contact Peter Tanella at 973.243.7915 or email@example.com.