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2015 Is The Year to Understand your Practice value and build your plan for the future This year it is important to remember why an appraisal of your practice is right for you. Our detailed appraisal of your practice determines an accurate market value for the purpose of: financial planning, insurance, purchase and sale, divorce, incorporation, retirement planning and more!

PETS AND THE HOMELESS

The cost of an appraisal is 100% tax deductible and our process only requires a few hours of your time in person.

THE LOWDOWN ON VETERINARIAN OFFICE RENTAL RATES

Jon Walton specializes in the sale and appraisal of veterinary practices. Having grown up in the industry, he has a great deal of knowledge about the veterinary practice environment and how the business of a successful practice operates. If you are thinking about buying, selling or having your practice appraised, contact Jon for a free consultation today:

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James Ruddy EDITOR

Karen Henderson MANAGING ASSOCIATE EDITOR

1 | EDITOR’S PAGES Pets And The Homeless, Compassion Fatigue, Feature Interviews, Content Notes And More

11 | PET THERAPY AND DEMENTIA JustoCat® And Dementia Cat Therapy

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KAREN HENDERSON

JAMES RUDDY

3 | BOOK REVIEW Lucky Dog: How Being A Veterinarian Saved My Life by Dr. Sarah Boston REVIEWED BY KAREN HENDERSON

5 | FEATURE INTERVIEW Janice Olynich

13 | FEATURE INTERVIEW Dr. Barry MacEachern

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16 | OFFICE LEASE ADVICE Veterinary Office Rental Rates Continue To Cost Tenants More JEREMY D. BEHAR

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8 | FEATURE INTERVIEW Dr. Megan O’Connell

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18 | FEATURE INTERVIEW Dr. Michelle Lem

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21 | S  ubscription Information, Thoughts And Photos Of The Homeless And Their Pets

Profitable Practice: Veterinarian Edition is printed and distributed 3 times a year by Jamieson-Quinn Holdings Ltd. dba Advertising In Print for ROI Corporation Brokerage. The contents of this publication are protected by copyright and may not be reproduced without the written permission of ROI Corporation Brokerage. Please return undeliverable addresses to: 200 - 896 Cambie Street, Vancouver, BC,V6B 2P6. Tel: 604-681-1811 Fax: 604-681-0456. Publication Mail Agreement No. 41073506. While the publisher has exercised every effort to ensure that the information presented is complete and accurate, it may contain errors, omissions or information that has subsequently become outdated by industry changes or conditions, new laws or regulations, or other circumstances. Neither author nor publisher accepts any liability or responsibility to any person or entity with respect to any loss or damage alleged to have been caused, directly or indirectly, by the information, ideas, opinions or other content in this publication.

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Pets And The Homeless, Compassion Fatigue, Feature Interviews, Content Notes And More by James Ruddy

This issue of Profitable Practice draws attention to two issues of importance to veterinarians. The first is the concept that veterinarians possess an innate quality of compassion in the treatment of pets/animals and their owners. The second issue examines the homeless in Toronto and the remarkable relationship that many homeless people have with their pets. Karen Henderson, our Managing Associate Editor, provides the following view. The plight of the homeless and their pets As I walk my dog Sammy Sosa around the streets of Toronto, I am seeing more and more homeless people who have pets, mostly dogs. Although those who do not own pets may wonder why, the answer to animal lovers is obvious: a pet provides unconditional love and companionship when no other exists. Dogs can also provide some degree of protection or an early warning system should a sleeping homeless person face aggression. A 2008 study of vulnerably housed adults in Toronto, Ottawa, and Vancouver found that 11.5 per cent of participants owned pets; similarly, a 2009 criminalization survey found that of one sample of homeless youth in Toronto, 12.8 per cent owned pets. Unfortunately this city has only one petfriendly homeless shelter, the Bethlehem United Shelter operated by Fred Victor. The shelter is a joint project of Fred Victor, Bethlehem United Church (Apostolic) and the City of Toronto. It is spacious, wheelchair accessible and maintains 60 beds for women, men, transgendered people, couples and dogs or cats; rabbits and fish are also welcome. The shelter provides access to free grooming and lower rates for veterinary care and pet training. There is more than enough food and cat litter available. One might wonder if pets owned by homeless people are properly fed and cared for,

but study after study indicates that the pets come first. Some people gave their pets their own food or used it to supplement their pet’s food requirements; others said they always fed their pet first. Street clinics organized by groups like Ottawa’s Community Veterinary Outreach are important in maintaining the health of pets with homeless, vulnerably housed and/or low-income owners.

Compassion and practice In general, health care professionals are blessed or cursed (as the case may be) with an innate quality of compassion. This character trait leads many people to a life of service providing comfort and care to others.Veterinarians, in particular, seem to have an abundance of the compassionate component. This becomes an obvious and expected conclusion after having interviewed many veterinarians. For veterinarians, the service provided is to both the pet/animal being treated and the owner. The compassion given varies greatly and the skill set needed is complicated. In cases where the veterinarian is dealing with a much-loved family pet, emotions can run very high. In other cases, the finances available may limit the amount of comfort and care that is given. In the case of livestock and production animals, economics is a must consideration. Pain and suffering are always factors. Euthanasia is an option to be considered. Dealing with these scenarios and others requires a delicate touch and a

PROFITABLE PRACTICE

PROFITABLE PRACTICE

EDITOR’S PAGES

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BOOK REVIEW

very high level of understanding the entire situation. There are moral and ethical dilemmas involved in the process. Often veterinarians are conflicted about what to do.

Lucky Dog: How Being a Veterinarian Saved My Life

After years of practice, veterinarians who have to decide what is the best course of action may suffer “burn out” or what is often called compassion fatigue. With this ailment in mind, Profitable Practice interviewed three veterinarians at different stages of their careers who were following very different career paths.

Dr. Barry MacEachern extends his workday to include treatment of wildlife. His work includes euthanasia, which is never pleasant—but is required to prevent unnecessary suffering. He mentors, aids and provides supplies gratis to Cuban veterinarians to do their work. Dr. Michelle Lem provides a unique service for the homeless and their pets called Community Veterinary Outreach. She faces an uphill battle finding necessary funding, adequate supplies and volunteers for the many tasks to be done. She works daily with many of Canada’s less fortunate people and their pets. All three of these veterinarians have an abundance of compassion. All are stressed at times and must decide to deal with the workload, the frustrations and the moral/ethical decisions that have to be made. All will tell you they love their work and have no intention of doing anything else.

More on content • Jeremy D. Behar advises veterinarians that the rental rates for veterinary offices are increasing and suggests ways for veterinarians to be proactive in this regard.

COMPASSION FATIGUE BURNOUT SYMPTOMS Cognitive Lowered concentration, apathy, rigidity, disorientation, minimization, preoccupation with trauma

Emotional Powerlessness, anxiety, guilt, anger, numbness, fear, helplessness, sadness, depression, depleted, shock, blunted or enhanced affect. Experiencing troubling dreams similar to a patient’s dream. Suddenly and involuntarily recalling a frightening experience while working with a patient or family

Irritable, withdrawn, moody, poor sleep, nightmares, appetite change, hyper-vigilance, isolating

Spiritual Questioning life’s meaning, pervasive hopelessness, loss of purpose, questioning of religious beliefs, loss of faith/ skepticism

Somatic

• Janice Olynich provides interesting insights into the

Sweating, rapid heartbeat, breathing difficulty, aches and pains, dizziness, impaired immune system, headaches, difficulty falling or staying asleep

world of prosthetics and orthotics designed for both animals and humans.

• Karen Henderson examines JustoCat®, therapy treatment for people with dementia, an illness that continues to grow at an alarming rate.

Things to remember Readers are reminded to go to the inside back cover of this magazine for subscriber information. As always Profitable Practice encourages you (the reader) to send your comments and suggestions; if you have a story to tell that would be of interest to veterinary professionals, please contact: [email protected]. If you want to access back issues of the magazine go to profitable-practice.com/magazine/veterinary.

BY DENNIS PORTNOY, M.F.T. For the Dennis Portnoy’s complete article go to: http://www.compassionfatigue.org/pages/healthprogress.pdf Compassion fatigue is caused by empathy. It is the natural consequence of stress resulting from caring for and helping traumatized or suffering people. ~ DENNIS PORTNOY, M.F.T.

James Ruddy James Ruddy is the Editor of Profitable Practice Magazine and can be reached at [email protected].

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Dr. Sarah Boston

Behavioural

•  Dr. Sarah Boston’s book Lucky Dog: How Being

A Veterinarian Saved My Life is reviewed by Karen Henderson.

“What would I do if I were a dog (diagnosed with an illness)? I will never give you a straight answer because there isn’t one. The best I can do is answer this question with more questions.”

A Canadian veterinarian compares her personal journey through health care with the care that her patients (dogs) get and the dogs come out on top! As dog owners we have heard it before and we hear it again in this book: If you have to get cancer, be a dog. Or for that matter, no matter what illness you contract, a dog will most likely receive more prompt, integrated treatment than we humans. In fact, the first words Dr. Boston writes in her book are: “I wish I were a dog.” Dr. Sarah Boston is a veterinary surgical oncologist who at the time she wrote this book was practicing in Ontario. She spent her days locating lumps on animals, and one day she found one on her own right thyroid gland. When she learned it would take two weeks even to be seen for an ultrasound, Boston had her husband, a fellow veterinarian, bring home a portable ultrasound machine so she could scan and view the growth herself. Even without biopsy test results in hand, Boston believed it was likely a carcinoma and she pushed to have it surgically removed. At this point you knew that this was not going to be the standard ‘I’ve got cancer, I need treatment, I get treatment, I may survive’ story.

“Death isn’t always sad, and putting an animal down isn’t always sad either. It’s the why that matters.” … “Sometimes it is hard to tell why a client holds off on treatment until late in the course of the disease. It happens in human patients too. They let things go.” Dr. Sarah Boston

PROFITABLE PRACTICE

Dr. Megan O’Connell is a young veterinarian who expresses her frustration of not being able to provide the necessary care because of inadequate owner finances. In addition, she struggles to pay back her student loans and as a result— wonders briefly if she has made the right career choice.

By Dr. Sarah Boston Reviewed by Karen Henderson

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FEATURE INTERVIEW

Feature Interview: Janice Olynich with Managing Associate Editor

Dr. Boston waited four weeks for pathology test results to confirm that she had thyroid cancer. As a veterinary surgical oncologist at the University of Florida where she now practices, her animal patients typically have these results in four days. Her analysis of comparative wait times: In the human world it’s 5:1, five time units of waiting to one time unit spent with doctor. In the veterinary world it’s more like 1:5. Nor would she ever consider using volunteers to keep patients’ families informed on their surgery day as we do in the human world; her clients would never tolerate it.

Her condemnation of our medical system is clear: “The Canadian health care system can take a serious health concern and drag things out for long enough that it becomes a life-threatening disease.”

Between appointments with her endocrinologist, primary care doctor and head and neck surgeon, the process of getting to her first surgery took 2 1/2 months.

Dr. Boston clearly loves what she does. She writes: “I am full of respect and awe for my patients. They sail through their surgeries with dignity and grace. They make no complaints and have endless forgiveness for the things we do to them. All they ask in return is a bit of hand feeding and some human kindness.” No wonder she wishes she were a dog.

When she moved to the U.S. her health care experience is entirely different as she continues to go for monitoring and follow up. She cannot believe that she will see a doctor the same week she calls for an appointment. She cannot believe that people actually call her back with test results and appointment times.

We should not have to be dogs to get appropriate health care in this country. Bottom Line: If you become ill, understand the critical role of advocacy; ensure you have someone who can speak for you.

Meanwhile her book moves back and forth between Boston’s personal care experiences and that of some of her patients.

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Janice Olynich is the founder of PawsAbility, a Toronto-based custom prosthetic and orthotic service for animals.

Janice, it’s a pleasure to meet you; I think what you do is fascinating. Since you are not a veterinarian, please tell us about your education. I graduated from the University of Western Ontario with a degree in kinesiology, and was then accepted into the Clinical Methods in Orthotics and Prosthetics program at George Brown College. I chose to specialize in prosthetics and after completing a two-year internship in the prosthetic department at the Sunnybrook Health Sciences Centre I wrote and passed my certification exams.

“I remember at the time I was going through this, I had a patient whose owner was very upset that she had to wait a whole day to get a CT scan on her dog,” Boston said. “I remember just thinking: ‘You have no idea.’” In addition to juxtaposing her experiences with human and veterinary medicine, a central theme in Boston’s book is the importance of taking personal responsibility for one’s own health. “Our owners are advocates for their pets,” Boston said. “If you’re ill, either you have to be your own advocate or have someone advocate for you.” She writes: “The mass is out and it seems that it has been completely removed, and the struggle is over. Not the struggle with the disease, but the fight to be heard.”

Pet with orthosis

Karen Henderson Karen Henderson is the Managing Associate Editor of Profitable Practice and can be reached at [email protected]

What professional affiliations do you have? I am a Certified Prosthetist through the Canadian Board for the Certification of Prosthetists and Orthotists. This applies to the human side of the field only, so with respect to working with animals, there are no formal

standards of certification. In general, the people who provide this type of service for animals tend to come from a prosthetic and orthotic background so there is much transfer of knowledge in all aspects of designing, making and fitting devices. It is important to note that because my scope of practice is really the making and fitting of devices, all dogs are assessed, diagnosed and referred to the service through their veterinarian.

Why did you found PawsAbility? I had the opportunity to make a prosthesis for a dog in 2006, and after that experience I was approached to make braces for a number of other dogs. It became apparent that there was a need for this type of custom bracing as an alternate modality of treatment within the field of animal rehabilitation.

Are you the only person in Canada who does this? There are a few companies in Canada that make custom braces for dogs, but most will involve the veterinarian in the casting process and again to fit the device, after it is manufactured at a central location. PawsAbility is unique in its approach to making devices in that all steps of the process are done on site in my

PROFITABLE PRACTICE

The end of the story for Dr. Boston is positive; she is cancer free. But I believe she has learned a painful lesson regarding the Canadian health care system, which I hope Canadian readers will take to heart. That lesson: Push, ask questions, push some more and ask more questions. Demand to know your treatment protocol.

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shop in Toronto. It does require that clients travel to see me, but I feel that this service model is the best for achieving a successful fitting.

three separate visits it will be spread over 2-3 weeks. With some clients who come from out of town I will do two steps in one visit, and as a result that speeds up the process. I will also occasionally do a really quick turnaround for a client who comes in from very far away and stays in town overnight.

How do you stay current with technological developments in human prosthetics so you can bring this knowledge to your canine clients? In addition to my work at PawsAbility, I also work part-time in the prosthetic department at a children’s rehabilitation hospital. While I did work just at PawsAbility for a number of years, I felt it was important to maintain my skills as applied to the care of people and to maintain my connection to the prosthetic and orthotic field. There are aspects of my experience at PawsAbility that I can bring to the human side of things, and vice versa. It is really a privilege to be able to work in both areas, and I think that all of my clients benefit from this arrangement.

has been lovely. It just has been the logistical challenges of being able to work off-site and trying to get the fit right in as few tries as possible! Another challenge that I have run into is with dogs that I am fitting for a prosthesis where there is a long section of limb that needs to be replaced. When it is just a small part of the leg that is missing I can do a short lift on the end of the prosthetic socket (the structure that holds onto the remaining limb). This can be made of cork or other firm material and it is just to make the height of the legs equal. When a dog is missing more of their leg, there is more space to make up to span the distance to the ground. This involves making a foot out of a fiberglass laminate and then attaching it and aligning it to the socket. With prosthetic fitting for humans, these types of

Pet with two support devices

So tell us a little about you… your hobbies, interests?

Do you work alone or with others at PawsAbility? Do you want to grow the company?

Janice Olynich

How do veterinarians/pet owners find out about you? Since all cases have to be referred from a veterinarian, many clients have found PawsAbility through their vet clinic. Some clinics may still not be aware of the service and they have found out about it when a client has brought the information to them. There is information about PawsAbility online, and in the past I have exhibited at conferences for veterinarians and veterinary technicians, as well at events geared to pet owners.

So I would guess you do not have a typical day. My days are generally a mix of casting/making/fitting devices; and returning phone calls and e-mails. I make all of my own devices so a lot of my time is spent in the fabrication process. Many people might not realize that there is 10-12 hours of time put into each device from taking the cast to when the device is dispensed.

How long does it take to have a custom brace made? That depends mostly on my workload, and a bit on where the clients are coming from. In most cases if we are doing 6

As anyone who has a business will know, there is not much spare time in my life, but if I did have time I would spend it painting, sewing or some other crafty endeavor. Luckily, my work has an element of crafting to it, since every device is hand made, so I always have an outlet for creativity. I also have two dogs, a Border Collie and a German Shepherd, and they keep me busy, both at work and at home.

I do work alone at PawsAbility, and while I have thought about growth through hiring I am not sure if or when I will take this step. I enjoy being in control of the process, and I am very efficient working on my own. So far this has allowed me to grow the business to a level that I am comfortable with.

What are some of most common things you see in your work with dogs?

I understand why you need to maintain your expertise with human clients; where do you see yourself in, say, 15 years in your canine practice?

I would say that most of the dogs that I see are in need of orthotic devices and it is less common that I would see a dog in need of prosthesis. The most common type of orthosis would be a stifle brace, which can be used to manage cruciate ligament injuries in dogs that are unable to have a surgical repair. The hock and the carpus are also joints that are commonly braced, because of injury and degenerative conditions that develop over time.

Fifteen years is quite a long time to consider, but I have found that I really enjoy the balance and variety of working both with humans and animals. I would hope that I will still be making and fitting devices that contribute positively to the lives of all the clients that I have an opportunity to see. Bottom Line:This interview proves that both humans and their animal companions suffer from similar structural problems that require bracing, among other solutions. It’s evident that research in one arena can positively influence outcomes in another— one more example of human and animals working together to better the lives of both.

Do you work with animals other than dogs? I have had the opportunity to work with a few cats, a goat, a duck and a pony.

Tell us about a few of your more challenging cases. Fitting the pony has been challenging for a few reasons. She has a brace on one leg and an extension prosthesis on the other, and they are both larger devices than I generally work with at PawsAbility. She lives well outside of the city, and all of the casting/test-fitting/fitting has to be done out there, so if something needs to be adjusted I am limited with how much I can do away from my shop. Luckily, she is an extremely sweet and cooperative pony, so working with her

Pet with prosthetic limb components are manufactured commercially, and have a lot of alignment adjustability built into their design. I have been a bit spoiled by this and so making components from scratch for the dogs always seems like a long, involved process!

Janice Olynich Janice Olynich is the founder of PawsAbility, a Toronto-based custom prosthetic and or thotic ser vice for animals. For more information please visit www.pawsability.ca.

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FEATURE INTERVIEW

Feature Interview: Dr. Megan O’Connell with Editor

though I’d had a lifetime of handling them prior to arriving at University of Wisconsin at Madison. I had shown in 4-H and belonged to a riding club for many years.

If you could change an aspect of your veterinary training and education, what would it be?

You started your career as a large animal veterinarian and now you are employed as a small animal veterinarian. From your perspective to date, what are the major differences between the two?

I would have appreciated more hands-on opportunities in veterinary school. There was a hierarchy of clinicians, residents, interns, and finally fourth-year students at the tail end. It was difficult to practice things that we’d be expected to be competent in after graduation. Also, there were no business related courses to give students background in the financial and managerial aspects of running a veterinary clinic and owning a practice.

There are several things I miss about large animal medicine. Travelling around the countryside was lovely because of the beautiful scenery, and I also miss the fact that between each call you got a little drive time (I see a new patient every 20 minutes at my current job!). However, in comparison to small animal medicine, large animal is far more dangerous. There is more exposure to the weather and the elements, and the job also requires being “on-call”. During my large animal career I routinely worked 50-60 daytime hours and in addition I was on-call a couple of weeknights and every other weekend for any and all emergencies. This meant leaving the house at 2 a.m. in the dead of winter, working holidays and answering countless panicked phone calls. While on-call, I had to stay within a certain radius of the clinic, abstain from alcohol, watch my phone obsessively and never lose cell service—and whatever I was doing I had to be able to leave at a moment’s notice (watching a movie at a theatre, dinner with friends, painting my toenails… all were out of the question).

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Dr. Megan O’Connell

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Editor’s Notes: Dr. Megan O’Connell is a young veterinarian who intended to become a large animal veterinarian but soon switched to small animal veterinary medicine. She loves what she does and speaks candidly of her experiences as a young veterinarian and her concerns about choosing a career in veterinary medicine. The interview reveals a caring, thoughtful and very personable veterinarian—she was formally trained in the United States and has insights that should be of interest to Canadian veterinarians of all ages and at all stages of their careers.

What or who was your initial motivation and influence to become a veterinarian? I never really wanted to do anything else. My career path somewhat came down to a process of elimination, where I had always gotten good grades and knew I wanted to work with animals… there are several jobs such as kennel owner, groomer, etc. that require little to no schooling and I definitely wanted a college education. When I was in high school, my family did rescue a neglected and abused dog (because I was at the veterinary clinic at the right time job-shadowing). This solidified my decision because I really enjoyed nursing him back to health although it was a lot of work. Harley passed away at 14 years old a few months ago; he was a loving companion that gave us everything we ever gave him ten times over!

Describe your training with horses as a large animal veterinarian. My “formal” training with horses in veterinary school was only a tiny part of learning to safely handle and restrain them. I learned how to ride at a summer camp at age 9 and I got my first horse when I was 11. I felt as

In contrast, I have a much-improved quality of life as a small animal vet. My clients bring their pets to me in a climatecontrolled environment, and due to an emergency clinic nearby that is open 24-7, I don’t have ANY on-call shifts. This is not possible as a small animal vet in a rural area without an emergency clinic, but for me it was a huge perk of switching to small animal and moving to Appleton.

What do you like best about what you do now as a veterinarian? I like helping animals, and therefore helping their owners.

As a young veterinarian embarking on your new career, what has surprised you the most? Working within a prohibitively tight budget is hard, because I want to do more and I have the power to do more, but many people either cannot or will not pay for my skills and services. In veterinary school and afterwards in equine practice, a certain economic status was required to be able to walk in the door of such a veterinary clinic. In a general small animal practice, each client values their pet differently—and therefore must be carefully approached when it comes to diagnostics and treatment options.

What gives you satisfaction both professionally and personally? •  Professionally: finding a diagnosis, solving a problem,

expanding my skillset, communicating effectively and having good relationships with my co-workers and clients.

•  Personally: time spent with family and friends, learning, being active and being in the great outdoors.

Where do you see yourself in five years time? Short answer: I have no idea! I’m getting married this summer, so I suppose happily married in five years is a start! I could live possibly in the same town, possibly elsewhere; there is very little holding me in Appleton, Wisconsin. I will probably not be a practice owner; at this point I have little to no interest in that. I have no idea on whether to have children or not… I feel like I should start thinking about these things! I would love to be making some progress on my student loan debt and hopefully become financially secure.

Do you have pets of your own? If so, please elaborate. My fiancé came with two Boston Terriers; otherwise I had no dogs of my own. Tilly is 11 and Stella is 7, both former puppy mill-breeding females who lived in wire cages and had litter after litter. They are both rather scarred from their start in life and I would consider them “special needs” dogs. I picked up a very ill kitten at a farm after asking permission from the four children who lived there (their response was that they had 20 other cats and this one had always been sick so I could make him better!). Clyde is 8 months old now and pure trouble! He adds a lot to our household and I consider him more “mine” whereas the dogs are loyal and loving to my fiancé and more or less tolerate my presence. I also have one remaining horse that is showing his age at 24 years old. My grandparents take care of Shilo for me so he lives 2½ hours away in my hometown. He is mostly retired and is ridden approximately once a year because he is lame on 3 out of 4 limbs. His personality is that of a 1000-pound Golden Retriever, he wants to be with you and be loved and I have been so fortunate to have him.

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PET THERAPY AND DEMENTIA

JustoCat And Dementia Cat Therapy ®

What is your favourite animal to treat? I have no favourite between horses, dogs, and cats. They are all wonderful (and sometimes terrible) in their own ways. I have some favourite patients of all species!

What three words describe you best?

by Karen Henderson

1. Compassionate 2. Driven 3. Patient

Dr. O’Connell’s horse, Shilo to go around. A recent study found a 12.5 per cent surplus of veterinarians for the number of jobs available. I am very fortunate to have a job, but feel completely hopeless of ever paying my student loan debt.

I say “no worries” a lot. I picked it up from an Australian resident in veterinary school. It’s interesting I say that often because I worry all the time!

Dr. O’Connell’s pets

Final Question: Do you have any regrets with regard to choosing a career in veterinary medicine? Yes, I have major regrets. I don’t think I’d go back and do it again. Financially it was a huge mistake. I am in debt 2.3 times what I make in a year for student loans alone, and any financial expert will say you should not be in debt more than what you make in a year. I am drowning in student loans with really high interest rates. No one tells you how difficult it will be, or how to handle your money. We had one lecture regarding finances one week prior to graduation. Veterinary schools raise tuition and increase class sizes constantly in an attempt to make more money, leading to a flood of veterinarians who need work and there’s not enough 10

Euthanizing pets is a very loving act at times, but it also can be very painful thing to do at times. Throw in there the occasional euthanasia where there is a question in my mind if the pet could be saved (either through additional testing and treatment, a surgery, or perhaps training and behavioural modification) and it gets quite difficult mentally. After crying with an owner about losing their family’s beloved pet I have to immediately walk into another room and address another concern or vaccinate a new puppy, with a smile on my face. Veterinarians sadly have a high rate of suicide, drug and alcohol problems, and other mental health issues. I do yoga, exercise and spend time doing things I love in an attempt to recharge. Bottom Line:This interview reveals some of the concerns many young veterinarians face with regard to repayment of student loans and having to deal with the economic realities of treating animals and pets alike.

Dr. Megan O’Connell Dr. Megan O’Connell is a graduate of the University of Wisconsin at Madison who has worked both as a large animal and small animal veterinarian in her young career. Dr. O’Connell can be reached through the editor of this magazine.

JustoCat® Justo is Latin for therapy. Dementia is exploding around the world; in fact, it is now being considered an epidemic. According to the Alzheimer’s Society of Canada we have 747,000 people with some sort of dementia (cognitive impairment) and are diagnosing a new case every five minutes. By 2031 there will be 1.4 million sufferers, and we will be seeing a new case every two minutes. At this point, there is no known cause or cure for diseases such as Alzheimer’s, the most common form of dementia. The research being conducted all over the world is becoming more frantic each year, but with few useful outcomes. In fact, 2014 has been judged the worst year for pharmaceutical research outcomes. The available drugs have been in existence for years, and although they may help lessen symptoms, nothing can stop the disease progression. Meanwhile both professional and family caregivers must cope with dementia in any other ways possible, and what they are finding is that non-pharmaceutical interventions (which should be used first) can have some startling effects on managing the difficult behaviours so characteristic of dementia—isolation, wandering, crying out, combativeness, apathy, paranoia—to name a few. Other therapies include traditional treatments such as behavioural therapy, reality orientation and validation therapy, art/music therapy, cognitive therapy, aromatherapy, bright light therapy and multisensory therapies. A new entrant into the dementia therapy world is JustoCat®, a robot developed by academics in Sweden—

a washable toy that purrs and meows like any normal cat, but offers comfort, pleasure and peace of mind to people suffering with dementia. JustoCat® has been developed and manufactured by Robyn Robotics AB, Sweden. The technology is the result of a partnership between health care researchers at Mälardalen University in Sweden and robotics experts at the Robotdalen Company. At the moment, JustoCat® can be ordered from Denmark, the Netherlands, Germany and Finland. The inventors insist she is much more like a medical device and so comes with a rather steep price tag of about £1000. JustoCat® is about the same size and weight as a normal cat, and comes in grey and white. It runs on a battery that can last several days, but should be charged every night to ensure it does not run out while being used as therapy. One of the developers, Professor Asplund said: “The care-givers used JustoCat® as a tool for relaxation, to calm down the patient with dementia and as a distraction to help deal with agitation that might disturb other patients. The cat encourages and stimulates communication, she allows the patients to recall memories of their own cats and distracts repetitive behaviour…JustoCat® can provide peace, be soothing and be a tool for increased interaction and communication. It is a complement in the care of people with dementia and in the care of people with intellectual disabilities. Tests and research demonstrates positive results from the users, as well as patients and caregivers (see sidebar). The goal of JustoCat® is to enrich the daily lives of people with dementia. It can provide increased psychological, physical and social well-being. The cat also provides some respite to nurses and carers because dementia sufferers who take to her are generally calmer and easy to communicate

PROFITABLE PRACTICE

What is your favourite expression/ saying/quotation/mantra/book?

Another reason I regret my job choice is that it is emotionally draining. Many clients expect me to work for free, rather than realizing I am an employee at a small business that does need to stay afloat. People get belligerent regarding money, and berate vets for “not caring” when that’s all we do. Clients who decline all of my suggestions due to cost and then get upset when the pet does not improve are frustrating to deal with as well. I even had a client demand her money back when her diabetic cat died, as if we could guarantee a positive outcome and should reimburse her when it did not work out.

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FEATURE INTERVIEW with. This is not a toy.You can buy a toy much cheaper, but it will not have the same effect. It is classified as a class one medical device and therefore a doctor can prescribe it. It is hygienic, a toy is not.” If JustoCat® is as effective as the

Karen Henderson Karen Henderson is the Managing Associate Editor of Profitable Practice and can be reached at [email protected]

Feature Interview: Dr. Barry MacEachern With Editor

JustoCat® Experiences

researchers hope, it may end up being prescribed by doctors. Pet therapy has been used in many other circumstances as we have described in this publication—to help the blind and disabled, but this robot is certainly a new take on the practice. As a former dementia caregiver, I would have been delighted to give it a try—anything to ease my father’s agitation—but I suspect JustoCat® may not have comforted my father since he was not an animal lover. I will never know.

“Animals are such agreeable friends—they ask no questions, they pass no criticisms.” ~ George Eliot

Ulf and Eric had a very nice father-son relation. Ulf really cared for his father Eric, who was living with late-stage dementia at the special housing. Ulf ’s story is that his father, who in some way had lost his ability to speak (a common dementia symptom), got his speaking ability back due to JustoCat®. Ulf told us that his father was very fond of JustoCat® and took care of it. The cat was always with him, either beside him in the bed, in his lap or lying on his walker. Ulf said: “Aside from the fact that the cat had a meaning to my father and was important for him to care for, it gave us something to talk about. We could talk about the cat (Eric named it Knäppen (Snap), due to the breathing sound). To talk about the meals or the weather was so limited and meaningless. I experienced that JustoCat® gave my dad a meaning to the days, an increased quality of life in his last days. When dad died I sat on his left side of the bed holding his hand, on the other side was JustoCat®…” Eric and Ulf

Sources

Source: justocat.com

Karen’s note: When my father lived in a long term care facility near my home in Toronto, I would always take my dog Oreo with me to visit. It took us forever to work our way through the lobby to the elevator and up to see Dad, as so many of the wheelchair-bound and ambulatory residents would stop us and want to talk about their dogs and past lives, or all they could remember of these lives. These precious moments were often the only time I saw these poor souls come alive and light up—all because of a dog and her unconditional affection and patience.

www.robynrobotics.se justocat.com www.dailymail.co.uk/health/article-2968620/Could-dementia-patients-helped-ROBOTIC-cats-Devices-purr-meowprovide-comfort-ease-loneliness.html 12

Dr. Barry MacEachern Part of Profitable Practice’s mandate is to feature veterinarians who give back to their profession. Dr. Barry MacEachern reveals how he does this regularly in the following interview. As a Hope for Wildlife TV personality, he is amazed that the TV show is now in its seventh year of production. He relates later in this interview how the TV show was initially unscripted and somewhat haphazard in its early filming. Hope for Wildlife is now a polished production and has done much to educate the general public about the challenges that wildlife face in today’s world. It also has brought attention to the work that wildlife veterinarians like Dr. MacEachern do daily.

When did you first know you wanted to be a veterinarian? It’s all I ever wanted to do. I grew up on a small hobby farm. I don’t remember wanting to be anything else.

What or who influenced your decision to do so? I think growing up in the country surrounded by wildlife and farm animals and all the dogs and cats around the farm was a huge influence. My mother encouraged me to follow my dream of working with and helping animals.

Describe a typical day for you. My day always starts with a stop at Tim Hortons for a XL Coffee—two milk—two sweeteners… then I am at the clinic by 8 a.m. I see appointments and perform surgery from 8 a.m. until 8 p.m. Monday to Friday on small animal patients. It’s usually a mix of vaccine appointments, wellness exams, sick animals, routine sterilization surgeries, more advanced surgery such as foreign body removal, and dental cleanings.

PROFITABLE PRACTICE

A dementia sufferer and her JustoCat®

When we had the very first prototype ready, I took it to the special housing for dementia patients we had cooperated with in the development process. I was a bit disappointed by the look and functions of the prototype, and the professional caregivers also had their doubts. However, we took the robot cat and went to a caring unit. Therese, the occupational therapist, asked an old lady, drinking coffee in the living room if she would like to meet a robotic cat? “Yes…”, the lady answered. Therese started the robot cat and handed it to the lady. Directly she accepted the cat and held it like a baby to her chest and looked into the cat’s eyes. She really acknowledged the cat and started to talk to the cat, and told the cat about the nine cats she had owned in her former life. As a nurse and nursing researcher it was important for me to not fool the woman or act like she did not know what she was doing, so I introduced myself, and respectfully told her: “You know this is not a real cat, it is a robotic cat .”With emphasis she answered me: “I know! But, you know, this cat does not need to be feed nor use the litter tray!”

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made great friends in Cuba who are veterinarians and animal lovers/advocates. I usually go to Cuba twice yearly and take veterinary supplies for the veterinarians and have been able to help out with spay/neuter campaigns on street animals during my visits. Currently, I am hosting one of the veterinarians at my house—he has come up to Canada for one month to see how animal care is done in Canada— hoping to bring back some ideas for the Cuban team.

What are you passionate about? Helping people and animals—I know it sounds corny but that’s really what gives me a high!

What gives you satisfaction— professionally and personally? Professionally – Same as just mentioned. I just enjoy being able to help others and feel satisfied when I am able to help owners and their fur babies… and also when I am able to help wildlife… even when it may be euthanized I know I am ending the animal’s suffering. Personally – I really don’t have much of a personal life at the moment. Everything I do focuses on my career.

Favourite food or restaurant Sushi.

Favourite hobby/pastime. Currently no time for hobbies but look forward to the time in the future I can get involved with horses again.

Dr. MacEachern with four friends Wildlife exams get squeezed into the mix. Any free time I have during the day is taken up looking at wildlife patients. If I don’t have time during the day, then I will stay late after work to complete the wildlife cases. Last Friday we were here in the clinic until 10 p.m. cleaning up wounds on a bobcat under anesthetic. I really don’t think there is a typical day for me… when doing wildlife mixed with regular practice you never know how your day will unfold. You just have to be ready and willing to make adjustments to your day.

You are a very well known TV personality. Can you tell us a little about how your show came about? We are currently taping our 7th season and honestly I am still unsure of the exact details of how the show got started. The first time they taped for the show I was told by the producers of Hope for Wildlife that it was a documentary they will be filming—no mention of a weekly show—lol. Hope was scared that I would run in the opposite direction if I knew it was going to be an ongoing thing. Then the TV cameras just started showing up more and more taping my wildlife work. We were probably half way through the first year of filming before I realized where this was all heading. So I guess you could say I just got thrown into the show—there really was no planning and no desire on my part to be on TV. Now that we have been at it for so long I look back and am thankful 14

They can be dangerous! Dogs and cats can also be dangerous but with wildlife they are very unpredictable. Extra precautions need to be taken for safety. Also there is the danger of disease transmission and therefore precautions need to be taken when handling cats/dogs in the same environment as wildlife. I find it difficult at times to find the information I need to help me with wildlife cases— not as much resource material about wildlife diseases. There is also more euthanasia in wildlife than I do in dog/cat patients. Any wild animal that cannot be fixed and returned to the wild is euthanized. Some days 50 per cent of the wildlife I look at are euthanized—this can really take its toll on one’s spirit and staff morale.

Tell us a little about the give back initiative you do in Cuba and the relationship you have with some Cuban veterinarians. I help out with a Canadian charity that does work in Cuba—APAC—All for Progress in Animal Care. I have

Three words that friends would use to describe you A. Kind B. Funny C. Dedicated

Two things on your bucket list.

for the show—it’s been a fun experience. I have gotten to visit rehabs all over Canada, USA, Europe and Costa Rica.

You spend a lot of time treating wildlife. While this is very admirable—what are some of the pitfalls of treating wildlife that people may not know?

Dr. MacEachern with hawk

1. Show a horse at World Quarter Horse show in Halter. 2. Visit Australia

More About APAC We are a group of volunteers united by a common goal of helping companion and stray dogs and cats through sterilization, education and adoption programs. We are a 100 per cent volunteer organization and our activities are funded by donations from our members and friends. We work under the patronage of CCVC - Matanzas (Cuban Scientific Veterinary Council - Matanzas Filial), a chapter of the Non-Government Organization reporting to the Cuban Ministry of Agriculture, and with CONBAC (Comision Nacional de Bienestar Animal de Cuba). Together we organize spay/neuter campaigns in local towns, and educate people about the benefits of sterilization of pets. We introduce TNR and Cat Cafe programs to Varadero resorts who have a problem with cats.

Favourite quote/expression. “May I strive to be the man my dogs think that I am.” ~ author unknown.

Any regrets? I wish I had started my own practice earlier in my life. I had always worked for others. It’s been seven months being my own boss. Bottom Line:This interview features a well-known veterinarian who has a special interest in treating wildlife and gives back to his profession in an unique way.

Dr. Barr y MacEachern Dr. Barry MacEachern owns the Burnside Veterinary Hospital in Dar tmouth, Nova Scotia and is featured on the TV program Hope for Wildlife (now in its seventh season). He can be reached at 902.407.9663 or at [email protected].

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OFFICE LEASE ADVICE

Veterinary Office Rental Rates Continue To Cost Tenants More by Jeremy D. Behar

Upon the lease expiry date, an increasing number of veterinary tenants are accepting whatever terms the landlord proposes so as not to disrupt their practice. This can mean they agree to unreasonably high rental rates and expensive hidden terms, or face eviction, relocating the practice they worked so hard to build, costing upwards of $150,000 in moving expenses. For many, agreeing to the landlord’s terms is the only choice they can make in order to stay in business.

Be proactive, not reactive While the competition is very real, proactive veterinarians don’t have to worry about fighting for their space. Though the idea of a gladiator-like showdown may be appealing to some, the reality is that a sensible and proactive approach to lease renewals can save a veterinarian from unreasonable renewal terms.

Tenant Lease Cycle Expiry Date

More thoughts from Jeremy D. Behar “Landlords have started using the recent market demand for commercial real estate and influx of startup practices to ask for higher rental rates from renewing animal health tenants.”

“While the competition is very real, proactive veterinarians don’t have to worry about fighting for their space. By planning for their lease renewal negotiation ahead of time, veterinarians will find themselves in a seat of power to act in their own interest.”

8 months

PROFITABLE PRACTICE

12 months left

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In 2015 the North American economy continues to strengthen, directly translating into lower vacancy rates for commercial properties and leading to higher rental rates and more opportunistic landlords.

Demand for veterinary office vacancies continues to grow Where we previously saw a flatline in occupancy rates across the country, the improving global economy, despite plummeting oil prices, has dictated an increase in demand for commercial real estate, and an influx of startup and expanding practices. As premium commercial real estate continues to be a hot commodity, rental rates are on the rise and startup animal health professionals, despite higher debt levels than ever before, are prepared to pay.

What does this mean for existing animal health tenants? Landlords have become more tight-fisted to make up for past years of modest rental increases. Knowing that the market is turning a corner, landlords are using

market demand to ask for higher rental rates and are reducing the amount of incentives for existing tenants. They know that if their tenant does not agree to their terms, there are others waiting in the wings that will.

24 months

“Beginning the lease renewal process 18-24 months before the office lease expiry date, a veterinarian can position themselves for a stronger, smarter and more favourable lease negotiation, with optimal time to bring their landlord to the table.”

Number of months to Tenant Lease Expiration

The landlord advantage

Prepare for office lease negotiations early

Landlords understand how difficult and expensive it is to relocate an animal health practice; therefore, they are sending out fewer notices to tenants with the goal of keeping upcoming office lease expiry dates in the dark.

By being conscious of the Tenant Lease Cycle (see illustration), and beginning the renewal process 18-24 months before the office lease expiry date, a veterinarian can position themselves for a stronger, smarter and more favorable lease negotiation, giving themselves optimal time to bring their landlord to the table, assess their goals, and create a negotiation strategy. By planning ahead, veterinary tenants will find themselves in a seat of power to act in their own interest. They can meet their landlord on equal footing, allowing both parties ample time to present their terms and negotiate a suitable veterinary office lease arrangement that will provide security and longterm practice protection. Bottom Line:This article advises veterinarians that the rental rates for veterinary offices are increasing and suggests ways for veterinarians to be proactive in this regard.

Jeremy D. Behar Jeremy D. Behar is the President and CEO of Cirrus Consulting Group. With over 100 years of combined experience, Cirrus Consulting Group is the pre-eminent leader in office lease negotiations and commercial real estate in Nor th America. Since founding Cirrus Consulting Group in 1994, Jeremy has expanded the company from its sole focus on office lease negotiation services to a broad line, world-class health care consulting organization. For a complimentary consultation, contact a Cirrus team member by calling 1.800.459.3413 or emailing [email protected].

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FEATURE INTERVIEW

Do you have a routine where you visit certain sites in a given area each month?

Feature Interview: Michelle Lem

It depends on the community. In Ottawa every other month or so we will run the clinic at three locations—the Ottawa Mission which is downtown, Ottawa Salus which is in the west and also at the Dalhousie Community Centre.

with Managing Associate Editor

We also have locations in Hamilton, Kitchener and in Toronto at The Yonge Street Mission on Gerrard. All these clinics in the province operate independently and simultaneously.

How are you funded? We have small amounts of funding. Incredibly generous volunteers staff the clinics and the vast majority of supplies we use are kindly donated by industries. We do receive programspecific funding from foundations so we can develop our One Health Engagement Program.

What is the One Health Engagement Program?

PROFITABLE PRACTICE

Dr. Michelle Lem

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Michelle is the founder of a unique Ontario community service called Community Veterinary Outreach, which reaches out to and supports the homeless and their pets in Ontario. We reached Michelle in Ottawa, ON.

Michelle, thank you for taking time out of your very busy life to speak with us. Let’s start with your educational background. I have a Bachelor of Science, followed by a DVM degree and a Masters of Science in Population Medicine.

Before we begin talking about your outreach program, can you give us a brief summary of your career? While completing my undergrad degree, I worked in a lab at the University of Guelph. After I finished there, I went to work for several months as a visiting scientist and technician at the International Livestock Research Institute, an animal disease laboratory in Kenya. While there I decided I wanted to pursue veterinary medicine,

and I graduated from the OVC program in 2001. Shortly after graduating, my husband, who is also a veterinarian and I went to New Zealand where we practiced for six months in a mixed animal practice. We returned to Ottawa in 2003 where I started a mobile animal practice, which evolved into the present community outreach program at Ottawa mission. In 2004 I started teaching at Algonquin College, where I still teach intermittently.

How does the service work? It’s a mobile clinic but not like the American ones that people can walk onto. We set up inside a social service location—a shelter or a community centre for example—with the supplies that are required. We can’t perform surgeries, anesthesia or other diagnostic testing with the unit; we treat common issues and of course we practice preventive medicine. Animals are examined, vaccinated, treated for internal and external parasites, implanted with a microchip and owners receive education and advice on nutrition, dental care, behaviour, and the benefits of sterilization. Last year, we examined, treated, and vaccinated almost 700 animals, and have experienced an ever-increasing rise in demand for these services.

This is the interaction between humans, pets and their environment, which could be the street, an isolated rural environment or a First Nations reserve. What we do that is a little bit different from other veterinary outreach programs is, that while we of course practice veterinary care, it is through this care that we can engage the people, the pet owners and in their environment and offer and/or connect them with social services or primary healthcare they may need. In Toronto, for example, we put on a flu clinic in conjunction with the animal outreach clinic. We are doing a project with the Canadian Mental Health Association, Ottawa Public Health and Ottawa Community Housing to look at pets as motivators for smoking cessation within an Ottawa community housing building. In Toronto where we have done most of our piloting we have had nurses, and Toronto Public Health participate—we have also had an oral hygienist who delivered free dental health checkups. We always work with social services or public health organizations. Through our program we get to see people who have never been involved with public health; they will reach out for help for their pets but not for themselves. So by providing the veterinary care they need, homeless pet owners are willing to engage with the system. The process means they must connect with a health care worker of some type to be referred to one of the veterinary clinics. We have agency partners who will screen and make the referrals for us; while doing so they also learn the housing situation of the client, what social supports they may have in place and offer help in these areas, even though in the end the client may not qualify for the veterinary care component.

How do people find out where you are going to be and when? It’s through the caseworkers at the agencies whom we have notified that we will be coming and are accepting referrals. These agencies in turn communicate with the homeless through drop in centres, needle exchanges etc. Sometimes people do have phones or addresses and they can be contacted that way.

Is there a typical client? No, not really. What I can say is that they are vulnerably housed and they love their pet more than anything indicated by research we have done using scales of attachment.

I know from reading about you that volunteers are critical to your growth and success; how do qualified veterinarians fit into the picture? We are set up so that we have volunteer Regional Directors/ veterinarians in different areas; they are the ones who operate the clinics with volunteer help. It used to be me all the time, but as we grew we connected with other like-minded people who were willing to lead these clinics. Our Regional Directors include Dr. Susan Kilborn in Ottawa, Dr. Shane Bateman in the Golden Triangle, and Dr. Mark Kinghorn in Toronto.

How do you find all these volunteers? It really hasn’t been that difficult; word of mouth is very powerful! We have had whole clinics come out and volunteer as a group. For most veterinarians, the experience reminds them of why they became a veterinarian in the first place. Something magical happens when you take money out of the equation. We have practice owners, retired veterinarians and students; they all love the experience. We have people who have been volunteering with us for 12 years.

So who keeps track of all these clinics and all these volunteers… are you at the top? I like to think of myself at the bottom of the pyramid; we are a servant leadership based organization (see Servant Leadership Approach sidebar); we are grass roots, community driven. We go where we are invited. We provide the mobile unit and supplies and they provide the people. I will mentor a community to get it going, to see if it’s going to be sustainable. We do ask them to look for funding opportunities within their community to cover what we cannot. We are launching a pilot operation in Guelph in the spring and hope to expand in Toronto.

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“The servant-leader is servant first. It begins with the natural feeling that one wants to serve, to serve first. Then conscious choice brings one to aspire to lead. The difference manifests itself in the care taken by the servant – first to make sure that other people’s needs are being served. The best test, and difficult to administer is: Do those served grow as persons; do they, while being served, become healthier, wiser, freer, more autonomous, more likely themselves to become servants? And what effect on the least privileged in society; will they benefit, or at least not be further deprived?” ROBERT GREENLEAF

SUBSCRIPTION INFORMATION, THOUGHTS AND PHOTOS OF THE HOMELESS AND THEIR PETS

It sounds like you lead a chaotic life; what do you do to ease the pressure? I don’t have much time for anything. I have two kids, three cats and a dog so you can guess where I spend the little free time I do have.

Do you get contacted by other veterinarians saying they want to get involved? Yes, but every circumstance is different. It can be any stakeholder in the community who has the time and interest in being the leader and making the necessary stakeholder connections.

Thoughts and Photos of the Homeless “We think sometimes that poverty is only being hungry, naked and homeless. The poverty of being unwanted, unloved and uncared for is the greatest poverty. We must start in our own homes to remedy this kind of poverty.” MOTHER TERESA

Bottom Line: As any other professional, veterinarians can follow a windy path before ending up finding their real passion—in this case working with the homeless and their pets to better the lives of both.

Michelle Lem

I went to Mini-Med here in Toronto at Uof T some years ago; you have Mini-Vet. How does that work? We provide the public with insight into the field of veterinary medicine, promote community outreach by the veterinary community through education on animal health and the human-animal relationship, increase awareness of veterinary medicine as a profession, and raise funds for Community Veterinary Outreach work. Our lecture series provides the opportunity to hear our community’s leading veterinary practitioners discuss and present the “inside” of the veterinary profession. We have run the course every year in Ottawa and in Hamilton we have run it for two years, and we are starting to look at Toronto. It’s both a fundraiser and a community engagement piece for us.

How do the master classes work? These are four-hour lectures on one topic for a small group who want more in-depth information and more interaction.

What are the major challenges you face; I assume funding must be at the top of the list? Yes, of course funding is always an issue, but specifically it’s capacity building funding.

I have to ask; how do you earn a living through all this?

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Well, it was part time for many years but then when I went back to get my Masters and did research on pet ownership by the homeless, it was looking like this was becoming more and more my life’s work. Recently I was nominated and elected an Ashoka Fellow; they support social enterprise (see sidebar). Since citizens have to make a living and social innovation does not pay very well, they have to find ways so people could commit to their idea full time to see where it could go. So for the past year I have been generously supported by a living stipend from Ashoka.

Homeless person with pet and counsellor

Michelle Lem is a 2001 graduate of the Ontario Veterinary College, and the founder and director of Community Veterinary Outreach. Michelle is also an active member of the Canadian Veterinary Medical Association, a member of the Animal Welfare Committee and a trained member of the Canadian Veterinary Reserve. Michelle was elected as an Ashoka Fellow in 2013. You can reach her through vetoutreach.org.

“Seven out of 10 Americans are one paycheck away from being homeless.” PRAS MICHEL

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What Is Ashoka Ashoka is named after a person who was extraordinarily creative, both in social welfare and economic development. He was very tolerant, very global minded—a good symbol of what social entrepreneurs do. Ashoka is the global association of the world’s leading social entrepreneurs—individuals with system-changing solutions for the world’s most urgent social problems who are redefining the global citizen sector by creating a system of collaborative entrepreneurship. Connecting the work of individual social entrepreneurs to business, academic and public sector partners, Ashoka creates a network effect driving the sector forward and developing new solutions to global problems. To date, Ashoka has elected over 3000 social entrepreneurs as Ashoka Fellows, in 72 countries in five continents. Canada has elected 48 Fellows since 2002. By working with our network, we have identified the key principles of transformation. We are working with business entrepreneurs, corporations, government agencies and universities to create a new reality. Ashoka envisions a world where Everyone can be a Changemaker™: a world that responds quickly and effectively to social challenges, and where each individual has the freedom, confidence and societal support to address any social problem and drive change. Ashoka strives to shape a global, entrepreneurial, competitive citizen sector: one that allows social entrepreneurs to thrive and enables the world’s citizens to think and act as Changemakers. Source: Canada.ashoka.org

Homeless person with cat

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“We have come dangerously close to accepting the homeless situation as a problem that we just can’t solve.”

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The Servant Leadership Approach

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