“Do you offer acupuncture?” “Could chiropractic treatments help my dog?” More veterinarians are hearing questions like this, thanks to the growing number of clients who want to explore alternative options for their pets. So it makes good sense to think about adding some of these therapies to your own practice.
But how do you go about finding Complementary and Alternative Veterinary Medicine professionals? What should you look for when deciding who to work with? For this article, we drew on the expertise of three integrative veterinarians who work with CAVM specialists – Dr. Richard Palmquist, DVM, Dr. Pedro Luis Rivera, DVM, FACFN, and Dr. Mark D. Newkirk, VMD.
IVC: What qualities do you look for in a CAVM specialist?
RP: Ideally, we are looking for a balance between four things:
1. Competency — do they know their materials? In areas like acupuncture, herbs, chiropractic and classical homeopathy, veterinary certification groups train and certify professionals. If the veterinarian is certified, that indicates at least basic competency. Many doctors are well trained but have not sought out formal certification. In some cases there are no recognized certifications, so we need to consider other issues when evaluating a practice’s potential usefulness.
2. Communication skills — integrative and CAVM veterinary professionals are intimately involved with interpersonal relationships, and are generally ethical and truth-centered in their associations. These qualities are essential when working in patient-centered approaches. Finding and conveying information in a way the consumer can understand and use is critical. A lion’s share of the work in integrative medicine involves communication, so if you can’t communicate effectively with a professional, that person may not be the right one.
3. Reputation — when a professional is successful in treating large numbers of cases for long periods, they probably have competency and communication skills. What’s more, they usually know how to interact with many circumstances and have proven the test of time. The community usually knows these people and values their presence.
4. Compatibility — integrative veterinary care is an intimate relationship between animal, steward and professional. All three parts of the relationship must work together, and not everyone gets along with differing personality traits. Call or visit the specialist’s office and see directly how people interact and how they treat others. Competent people know that individuals are important and they strive to find other’s needs and fulfil them. They are liked and successful, and are usually happy, too. PLR: Education, certification, number of years’ experience, and a valid professional license is what I look for in a CAVM practitioner. In any service we seek out, it is our responsibility to be sure the people we are entrusting our patients to have the proper education in the modality we are looking for. It is up to us to ask: “Where did you get your training, and most importantly, did you successfully complete it?” Many unethical practitioners are advertising that they went to a reputable program, and in actuality did attend one module or class, but never completed the program. We need to be aware of the various programs out there, and the state laws referring to who can actually perform the modality, and be sure the practitioner we are interested in is within those parameters. A weekend seminar does not make anyone qualified or competent to work with our patients. MDN: Look for many of the same qualities that you’d look for in any veterinarian — table side manner, communication skills, reputation, knowledge level, expertise of office staff. Don’t be afraid to ask questions.
IVC: How do you find these professionals?
RP: You can find holistic veterinarians in your area by checking membership lists from groups like the AHVMA. Realize that such lists are not endorsements, and only list the information provided by the member hospital.
• To find out about a clinic’s reputation, simply ask around town.
• Go to groomers, holistic health food or animal supply stores, and ask where people go for holistic care.
• Seek people at dog parks, specialty breed clubs, and animal adoptions.
• Internet sites may be useful but realize they can be easily influenced both positively and negatively. Take what you read on the Internet with a grain of salt and do more investigation than simply looking the clinic up on your favorite rating site. Some sites allow businesses to buy memberships and change their site postings, while others don’t solicit business payments. Know the site before you take the information there too seriously.
• Many integrative doctors have blogs or web sites. Visit them, read their materials and see whether they are compatible with your expectations and desires. PLR: There are many wonderful and reputable organizations available to help us find the right professional for our treatment choices. Many veterinarians, although they may not practice CAVM, are fully aware of those in the community who do. If this is not an option, most people rely on “word of mouth”.
This is a good first step, but we must then go to the next step:
1. Where did the person get his/her training?
2. Did s/he successfully complete it?
3. Does s/he have the proper licensure/certification required in your state?
4. How long have s/he been practicing their chosen modality? A number of organizations can help assure the competency of licensed practitioners in various CAVM modalities.
This is just a partial list:
• American Holistic Veterinary Medical Association (AHVMA)
• College of Animal Chiropractors (CoAC)
• International Veterinary Acupuncture Society (IVAS)
• American Association of Veterinary Acupuncture (AAVA)
• Veterinary Botanical Medical Association (VBMA)
• American Veterinary Chiropractic Association (AVCA)
• International Veterinary Chiropractic Association (IVCA)
• American Association of Rehabilitation Veterinarians (AARV)
MDN: You can find these specialists the same way you’d find other veterinarians. Use the AHVMA website, word of mouth, Yellow Pages and the Internet.
IVC: How do you price these services?
RP: Holistic and integrative services are like any other form of business, and careful consideration is required in pricing each. It is critical that a veterinarian consider the time and space needed for these services, and incorporate these issues into pricing. I suggest getting together with a competent practice manager with experience in such care, and allow him to do his job. Re-evaluate your progress at regular intervals and adjust fees as needed.
As you begin, you may want to price these services at a lower rate until you gain confidence and see positive outcomes. Then you can raise prices to reflect the appropriate exchange rate the service is worth. PLR: Unfortunately, as in most businesses, there are no set prices in veterinary medicine and everyone has to charge what they think their services are worth. It is ultimately up to clients to decide what they can afford to spend on their animals. The owner must understand that for someone to become a competent CAVM practitioner, it entails years of training and national certification testing, not to mention the Continuing Education courses that must be attended to stay up to date with the most current scientific and clinical information. These are some of the factors that go into pricing. MDN: We charge a basic exam fee, based on time. For the first visit, patients usually require two to three times as long as regular patients, thus our holistic exam fee is at least twice our regular fee. Then we add services. So chiropractic treatment would be an extra charge, same as an x-ray would. Each service is then charged separately — acupuncture, NAET, etc. Remedies , herbs, etc. are billed separately as well. Typically, several items are going home with the patient, versus 25 antibiotic pills or 30 prednisone tablets.
“Many integrative doctors have blogs or web sites. Visit them, read their materials and see whether they are compatible with your expectations and desires.” – Rick Palmquist, DVM “The owner must understand that for someone to become a competent CAVM practitioner, it entails years of training and national certification testing, not to mention the Continuing Education courses that must be attended to stay up to date with the most current scientific and clinical information.” — Pedro Luis Rivera, DVM
Dr. Richard Palmquist, DVM, graduated from Colorado State University in 1983. He is chief of integrative health services at Centinela Animal Hospital in Inglewood, California, past president and research chair of the AHVMA, and an international speaker in integrative veterinary medicine. Dr. Palmquist is a consultant for the Veterinary Information Network (VIN) and co-director of the AHVMA Foundation. He has published two books, one for conventional veterinarians and a second for clients discussing how integrative thinking works.
Dr. Pedro Luis Rivera, DVM, FACFN, received his Doctor of Veterinary Medicine degree from Purdue University, School of Veterinary Medicine in 1986 and is a Fellow of the American College of Functional Neurology. He is certified with the College of Animal Chiropractors and the American Veterinary Chiropractic Association. He is still active with the Chiropractic Neurology Program and Masters Degree program at the Carrick Institute. Dr. Rivera is co-owner of The Healing Oasis Veterinary Hospital as well as co-founder and primary instructor at The Healing Oasis Veterinary Wellness Center, a nationally accredited educational institution (ACCET) under the US Dept. of Education, offering state approved programs through the Wisconsin Educational Approval Board (WEAB).
Dr. Mark D. Newkirk, VMD, practices in the New Jersey area. At age 14, he started at Margate Animal Hospital cleaning cages and mopping floors. Now he owns the place, and recently changed the name to Newkirk Family Veterinarians. He practiced conventional medicine for 15 years, then ventured into alternative medicine after realizing “there must be another way” to treat chronically ill patients. Dr. Newkirk’s practice is now 50% alternative medicine. He also has a practice where rehabilitation and physical therapy are his talents.