Brave new practice: Two doctors develop new clinic model

Brave new practice: Two doctors develop new clinic model

Colleagues join forces in effort to help stop economic euthanasias.
Oct 01, 2009

Dr. Dennis Elmer was finishing up his day as a relief veterinarian. He called his wife, Catherine, a licensed veterinary technician at another hospital, to discuss dinner plans. But the evening meal would have to wait. Catherine wasn't sure when she'd get off work—the team at her hospital had been trying to treat a urethral obstruction in a male cat for 45 minutes without success.

Pioneers: Drs. Dennis Elmer (left) and Eric Larsen co-founded the Advanced Veterinary Care Group in Canton, Mich., to provide pet owners with alternatives to economic euthanasia. Here, the two doctors are performing a triple tibial osteotomy on a dog.
Dr. Elmer told his wife that it seemed like the cat needed a perineal urethrostomy. She agreed, but none of the doctors at her hospital performed the procedure, and the owners couldn't afford to go to a specialist. Dr. Elmer told his wife that if the clients would be willing to drive across town and pay the fee at the practice where he was providing relief services, he'd do the surgery. Forty-five minutes later the cat was at his hospital, the procedure was performed, and another life was saved. Later that night, Dr. Elmer asked himself, "How many times a day does this happen?"

Meet the team: Advanced Veterinary Care Group eliminates extra overhead by keeping the in-clinic staff to a minimum. From left to right are Dr. Eric Larsen; Kristen Waddell, LVT; Nicole DeFelice, LVT; Catherine Elmer, LVT; and Dr. Dennis Elmer with Titus and Lutius.
That question led Dr. Elmer to set up a meeting with his friend and former colleague Dr. Eric Larsen. Together the two doctors discussed the possibility of starting a referral center exclusively focused on diagnostics, treatments, and surgeries. They would staff the center with general practitioners and enable local clinics to offer more extensive services while keeping costs affordable for pet owners. Advanced Veterinary Care Group (AVCG) opened its doors last October in Canton, Mich., with the goal of extending the capabilities of general practices in the metro Detroit area.

Rehabilitation: Nicole DeFelice, LVT, works with Bowser, who underwent femoral head ostectomy surgery, on strength training and weight shifting.
AVCG has all the diagnostic tools a doctor could hope for and then some. Capabilities and specialized equipment include digital radiography, digital video endoscopy, digital ultrasound with color flow Doppler, electrocardiography, laser surgery, an underwater treadmill, and an MRI system made specifically for veterinary medicine. The procedures the doctors perform range from splenectomies to triple tibial osteotomies to treat canine cruciate ligament insufficiency.

What makes these veterinarians accessible to others in the area is that their fees align with general practice rather than specialty practice. "If a dog presents to a doctor and needs to see a neurologist, by all means that doctor should refer to a neurologist," Dr. Larsen says. "But if the client can't afford the MRI costs associated with seeing a specialist and is trying to decide whether to euthanize her pet because of a loss of rear leg function, that's where we come in."

Dr. Elmer agrees. The group's goal is to provide struggling pet owners with another option before they opt for economic euthanasia. AVCG does this by offering an extended level of general-practice care that other doctors can't, whether because they lack the ultrasound unit to image a gallbladder or the skill to fix a fractured femur with an interlocking nail.