Should You Invest in Training and Career Development for Your Employees?

Should you invest in employee training and career development while we are still waiting for the economy to turn around?  Despite economic uncertainty, business savvy Practice Owners know that learning matters and is the key to survival, recovery and future growth.  What are the factors that influence a Practice’s need for providing training/career development?

  • Work environment and workflow changes.
  • The need for different types of jobs.
  • Advancements in technology.
  • Limited opportunity for advancement without certain skills.
  • Organizational philosophy and culture.

Aligning training and career development plans with the strategic goals of the organization is a win-win for all concerned.  A career development path provides employees with an ongoing mechanism to enhance their skills and knowledge, which leads to mastering their jobs and enhancing professional development. Creating a career development path increases employee engagement (a critical driver of business success) and has a direct impact on the entire Practice by improving morale, job/career satisfaction, motivation, retention, productivity, and responsiveness in meeting the Practice’s short term, as well as, long term business objectives. All of these factors have a positive impact on the Practice’s bottom line.

Do you know what really motivates today’s employees?  The top three internal motivators that provide deep personal satisfaction are as follows:

  • Autonomy – the amount of control and discretion in how the work is performed (focus is on the outcomes/results, not the process; decision making)
  • Mastery – to become more efficient and effective at performing a task (the opportunity to learn; teach and educate)
  • Purpose –  the desire to support something larger than ourselves (achieving personal goals, your ‘passion’ in life)

How would you rate job satisfaction at your Practice? Do your employees experience enjoyment as a result of performing the work itself?  Would the following top drivers for job satisfaction be available within your organization?

  • Opportunities to apply one’s talents?
  • Opportunities to succeed?
  • Opportunities to learn?

An additional benefit of investing in training and career development reinforces to your employees that the Practice is concerned with their well-being by providing an avenue to reach individual, personal career goals while growing the Practice.

You may have been thinking about this value proposition of investing in training/career development for your employees and your Practice and wondering what major elements need to be addressed. When framing the dimensions of creating training and career development plans, you should follow these guidelines:

  • Review the Practice’s functional organization chart in support of your mission statement and goals.
    • Analyze the needs of the Practice – do you have the right skill sets in the right positions to advance and sustain your business?
    • Do your employees have the requirements to meet the challenges or are there gaps in their skill levels to perform current or future positions?
    • Are you developing high potential (‘A’ players) employees for your bench strength succession planning?
  • Determine the employee development budget.
    • Plan a realistic budget in which you use internal resources, such as cross-training or web based training (lower costs, convenience).
    • Evaluate the need for specialized training and its impact on the bottom line.
    • Don’t forget competency training that does not necessarily involve technical skills.
  • Create a career development plan for the employee with information obtained in active, participatory discussions with the employee in line with the needs of the Practice.
    • Prepare large but attainable goals with established timeframes to meet the goals.
    • Establish the resources that will be needed in order to reach the goals.
    • Consider impact on staffing so that employees have the opportunity to receive the training/education (don’t plan empty actions).
    • Link the goals to the employee’s performance appraisal (essential component of performance reviews is employee development).
    • Consistently encourage employees to achieve and demonstrate established goals (give him/her the opportunity to use the new skill set).
  • Determine the types of tools/resources that could be used for development purposes (be creative).
    • On the job training.
    • Certification training.
    • E-learning/online training, webcasts.
    • CE, Seminars.
    • Cross-training, lunch & learns, knowledge sharing.
    • Mentoring.
    • Job rotation.
    • Internships, externships.
  • Monitor the employee’s performance in order to evaluate and provide feedback on knowledge gain and skill mastery.
    • Supervisors/Managers are accountable for planning/supporting the employee’s need for time off and the use of other avenues to assist the employee in achieving individual goals as well as the Practice’s goals.

Training and career development are strategic drivers for your Practices’ growth. Think about it as a positive, joint venture. The Practice reaps the benefit of an enhanced expertise that was not in place before and which allows the operations to function more efficiently. At the same time, the employee has satisfied an internal motivator.

State-Law Savvy: How to Find and Follow State Employment Laws

Employment laws have been created to protect workers from wrongdoing in the workplace, addressing issues such as the following:

  • minimum wage requirements
  • protection from discrimination
  • workplace safety
  • child labor laws
  • workers’ compensation

These laws have been constructed to protect both the employee and the employer. In the United States, the relationship between employer and employee is known as a “master-servant” situation because the employee is expected to perform specified duties under the auspices of the employer. Labor laws have been created to prevent employers from abusing their power. These laws continue to be created and modified with the changing times.

Two good examples of employment laws created to balance the master-servant relationship include the following:

  • Fair Labor Standards Act (FLSA)
  • Age Discrimination in Employment Act

They aren’t the only laws providing this balance, but are good examples of the kinds of laws created to help ensure that employers cannot discriminate against their employees or otherwise abuse their position. The goal is not to create laws that simply favor the employee over the employers, but to create a more balanced and equal relationship. For example, employers are protected in that if they don’t believe a person is capable of doing a particular job, they are not required to hire the person. They also do not have  to keep someone indefinitely who isn’t performing to a reasonably-established standard.

There are federal laws addressing each of these topics, and states also make their own laws, as well. States cannot create laws that contradict existing federal laws, and if no relevant state law exists, then the corresponding federal rule applies.

Next, we will address state laws in two different but equally important ways:

  • how to discover what the laws are in your state
  • how to best follow those state-specific laws

Finding State-Specific Employment Law Information

You can find answers to questions about employment law, in general, through the United States Department of Labor. There are also links to state-specific law information. Ways to contact this federal agency include:

U.S. Department of Labor
AGENCY NAME
OFFICE NUMBER

200 Constitution Ave NW
Washington, DC 20210

The U.S. Department of Labor may direct you to an agency in your own state to get the state-specific answers you need, so you will often find answers more quickly by going directly to your State Labor Office; you can find a comprehensive contact list here: https://www.dol.gov/whd/contacts/state_of.htm

Another way to find this information is to talk to an attorney well versed in your state’s employment laws. This is often the best way to understand how a particular law applies to your specific situation.

Following State-Specific Employment Laws

Step one to following any law, of course, is to thoroughly understand that law and its implications. You will also need to investigate how your specific situation fits into applicable laws.

Here’s just one example of an employment law that differs from state to state: final paycheck laws. Because the FLSA does not address this issue at all, you need to look to state laws to find out how and when you must issue a final paycheck to an employee leaving your practice. Does it matter, for example, whether the employee was fired or if he or she quit? Sometimes, yes. Sometimes, no. It depends upon the law in your state.

Regarding finally paychecks, four states currently have varying laws on this topic: Alabama, Florida, Georgia and Mississippi. In Missouri, no law exists about when you must give a final paycheck to an employee who quits, but a fired one must receive it immediately. In Ohio, no state law dictates when a fired employee gets his or her last paycheck, but one who quits must receive it by the first day of the month for wages earned in the first half of the prior month, or on the fifteenth of the month if wages were earned in the second half of the previous month.

So, by examining just one state employment law in six different states, it’s easy to see the wide variety inherent in today’s laws. When someone leaves your practice, how vacation time payout is handled is also subject to varying state laws. Some states have no laws whatsoever on the subject. Others say accrued vacation time must be paid out, while others state that it must be paid out if the employee agrees to certain conditions—and, for example, in Maryland, employers can create a written policy that states they don’t pay out for accrued vacation at all. If employees are notified of this policy when first hired, this policy can stand.

Here’s an example of one type of employment law that is covered by federal law, in which a state is allowed to offer more to employees, but not less: minimum wage laws. You can find information about each state’s laws at the U.S. Department of Labor’s site (https://www.dol.gov/whd/minwage/america.htm) via a color-coded map that indicates how that state’s laws compare to the federal standard. Hover your mouse over your state to see the current rate for you and click on your state to find more detailed information about applicable laws.

For example, in 2018, the federal wage law is $7.25. Click on Nevada in the map described above, and you can see that they have established a two-tiered system. If an employer doesn’t offer health insurance benefits, the minimum wage is $8.25, with premium pay required on days that exceed eight hours or weeks that exceed 40. However, if the employer does offer health insurance benefits and the employee accepts them, then the minimum wage is the same as the federal rate of $7.25.

Meanwhile in Missouri, they have established a minimum wage rate of $7.85, with no daily premium pay requirements, and premium pay is only required if an employee works more than 40 hours per week. Employees who work for a retail or service business with gross annual sales of less than half a million dollars per year, though, are not required to receive more than the federal minimum wage rate. And, if an employee works in a “seasonal amusement or recreation” business, premium pay is not required until “after 52 hours.”

In Arizona, the minimum wage is $10.50 per hour. In Oregon, it is $10.75, with premium pay after 40 hours – and, if someone works in “nonfarm canneries, driers, or packing plants and in mills, factories or manufacturing establishments (excluding sawmills, planning mills, shingle mills, and logging camps)”, premium pay is required after ten hours in a day.

Not all examples apply to veterinary practices, of course, and the point of these examples is to show how widely state laws can vary. So, it’s wise to fully use the resources available to you through government offices and websites and, when needed, through advice of employment attorneys. Laws can change, so make sure that your practice is state-savvy for this year’s laws.

Following State Laws: Vital for Practice Success

Because employment laws are created to help maintain a healthy balance between employer and employee, carefully following them helps you to create and/or maintain a healthy work environment for everyone in the practice. Conversely, by not following these laws, you’ll open your practice up to a significant risk for lawsuits.

 

Compensation Best Practices in 2018

It would be so simple if practice owners could open a fortune cookie for each one of their employees and find the method by which to fairly compensate them.  While there are commonly accepted methods of compensation, their implementation in veterinary practices varies because different entrepreneurs have different business goals.  Also, “fairness” is a relative term that introduces variability into an equation that might otherwise be consistent from practice to practice.  This article describes the factors that practice owners should consider when determining compensation for veterinarians and paraprofessional staff.

Benchmarks

Below is a table that provides a snapshot of current key indicators available for small animal companion practices.  It is not meant to be all-inclusive, but rather to provide some guidelines that enable managers to take the practice’s compensation pulse. They can then determine if the practice is on track for the next year or needs to perform some diagnostics to prevent a fiscal derailment.

Name of Key Indicator Key Indicator Comments Where Found
Total revenue per doctor Less than $450K       10.1%

450K-500K               4.5%

500K-550K               10.1%

550K-600K               14.6%

600K-650K               15.8%

650K-700K               9.0%

700K-750K               5.6%

750K-800K               5.6%

800K-850K               10.1%

850K-900K               3.4%

More than 900K       11.2%

Medical hours only The Well-Managed Practice Benchmarks Study (2017)
Percentage of gross income for paraprofessional staff compensation 22.5% (wages only)

0.6% (retirement)

1.4% (payroll taxes)

24.5% (total cost)

 

  The Well-Managed Practice Benchmarks Study (2017)
Percentage of gross income for veterinary compensation 21% (blended rate) Wages The Well-Managed Practice Benchmarks Study (2017)
Name of Key Indicator Key Indicator Comments Where Found
Average starting salary for a veterinary associate $66,800

 

With < 1 year of experience (excludes benefits) The Well-Managed Practice Benchmarks Study (2017)
Average student debt $166,714

 

The average of 2017 veterinary school graduates with loan debt DVM360 – Where DVMs fit in the U.S. Student Debt Crisis
Average amount of employee’s healthcare cost paid by a Well-Managed Practice 67%   The Well-Managed Practice Benchmarks Study (2017)
Associate compensation ranges (%) for private practices

 

Blended rate: 16-22%

Split rate: 22-26% for services, 4-8% for products

  The Well-Managed Practice Benchmarks Study (2017)
Starting compensation ranges for (hourly rate):

Hospital Administrator

 

Practice Manager

 

Receptionist

 

Credentialed Technician

 

Veterinary Assistant

 

Median        75th Percentile

 

$29.65              $35.10

 

$21.65              $22.80

 

$12.00              $13.00

 

$15.00              $16.00

 

$11.50              $12.50

Median and 75th Percentile ranges as benchmark The Well-Managed Practice Benchmarks Study (2017)
On average, full-time support staff to doctor ratio

 

4.2 All staff members The Well-Managed Practice Benchmarks Study (2017)
On average, veterinary technician/assistant to doctor ratio 1.9 Includes credentialed technicians, non-credentialed technicians, and veterinary assistants only The Well-Managed Practice Benchmarks Study (2017)
Name of Key Indicator Key Indicator Comments Where Found
Average profit margin 9.9%   NCVEI Update – New Insights in Practice Growth- Karen Felsted presented at NAVC 2011
Debunking The Myths Of Base Salary And Production Percentages Why pro sal can work for your practice Each of the debunked myths gives practical tips to follow to include the links for dvm360.com (ProSal) and PayScale.com Veterinary Economics March 2010 – Squashing Pro Sal Myths
Percentage of practices using compensation method for associates Fixed Salary – 21.4%

Base + Percent of Production – 56.4%

Percent of Production – 18%

Hourly – 3.8%

  The Well-Managed Practice Benchmarks Study (2017)
Total compensation worksheet   How you calculate your pay ranges affect your bottom line DVM360 Dec. 2011 – ProSal Total Compensation Worksheet
Crediting doctor’s production   What should be credited to the doctor and what should be credited to the practice DVM360 Nov. 2013– Crediting Doctor’s Production Worksheet

DVM360 July 2005 – Giving Away a Fortune

2010 Veterinary Economics State of the Industry Study   Quantifies compensation methods, how satisfied the owners are, how happy the associates are DVM360 August 2010 – Veterinary compensation conundrum

  

Veterinary Compensation

Many periodicals and books discuss the factors one should consider in establishing a compensation policy for veterinarians. Of particular importance is the question of whether compensation should consist of a fixed salary, a percentage of the revenue generated by the veterinarian and collected by the practice (i.e., commission-based), or a combination of the two. If a commission-based component is present, it is also important to consider how the revenue figure will be calculated. Will it be limited to revenues generated from professional services, or will it include revenues generated from items like over-the-counter medications and foods?    Percentages can also vary in relation to the magnitude of the revenue number that is generated.  Implementing compensation systems in practice requires attention to the details of production calculation and timing of payment. The key to remember is there is NO one size fits all when determining the appropriate compensation for veterinary and non-veterinary staff.  There are numerous factors that go into assessing the actual method used for compensation, which often requires the assistance of an advisor.

National starting salary information is generally published annually in the Journal of the AVMA. (See: Employment, starting salaries, and educational indebtedness of year-2013 graduates of US veterinary medical colleges, October 1, 2013, Vol. 243, No. 7, Pages 983-987; Employment of male and female graduates of US veterinary medical colleges,  JAVMA October 1, 2011, Vol. 239, No. 7, Pages 953-957.) See also the latest biennial edition of the American Animal Hospital Association’s Compensation and Benefits-An In-Depth Look and the AVMA’s Economic Report on Veterinarians and Veterinary Practices (Wise, J., Center for Information Management, AVMA, Shaumberg, IL (Tel: 847-925-8070). Two periodicals, Veterinary Economics and Veterinary Hospital Management Association Newsletter, also regularly publish helpful articles. In addition, Wutchiett Tumblin and Veterinary Economics published Benchmarks 2013 Well Managed Practices.

Paraprofessional Compensation

 Paraprofessionals are often compensated on an hourly basis and the industry has yet to develop widely adopted performance-based compensation models. Paraprofessionals generally report low job satisfaction and high turnover rates. In the 2016 NAVTA Demographic Survey, 38% of veterinary technicians left the practice due to insufficient pay, 20% due to lack of respect from an employer, 20% from burnout and 14% because of the lack of benefits. Full time technicians reported a salary between $15-20 per hour, while part-time technicians reported $14-16 per hour. After taxes, even the well-paid veterinary technicians are only slightly above what is considered the poverty line for a family of four in the United States ($24,300).

According to the United States Bureau of Labor Statistics, the median pay for veterinary technicians was $16.06 per hour in 2017. By comparison, a JAVMA published study on Jan. 1, 2016 of certified veterinary technician specialists reported that the weighted mean pay rate in 2013 was $23.50 per hour.

In AAHA’s 2016 Compensation & Benefits survey, average veterinary employee turnover was 21%.  In Veterinary Economics 2010 Benchmarks survey of Well Managed Practices, turnover was 26% for receptionists, 21% for assistants, and 44% for ward attendants. To compare with the national workforce, Compdata’s Annual Compensation Survey showed that national average turnover was 18.7% in 2008 and 15.9% in 2010.  The chart above can be helpful to calculate a practice’s turnover expenses. Turnover is a pervasive and expensive problem that can be mitigated by learning how to properly motivate employees.

Managing Social Media Behavior at Your Veterinary Practice

Originally Published by Today’s Veterinary Business, December 2018

Use of the internet, particularly social media, can be a double-edged sword, especially in the workplace. On the plus side, it can be a wonderful vehicle for marketing your practice and otherwise connecting with clients and potential clients. On the darker side, what happens when an employee posts content that can have a negative impact on the practice? Should you respond? If so, how should you respond? If a post is offensive, do you have the option of disciplining, even firing, that employee?

Because people in general are so openly sharing thoughts and opinions on social media, it’s not surprising that many experts believe that terminations based on employees posting inappropriate content will continue to increase. Handling this type of issue at your practice can be challenging for your human resource team, given that this is a fairly new type of problem to tackle – but, finding the right approach is crucial, given that just one post has the potential to blow up into a public relations and human resource disaster.

So, how do you respond to, say, a sexist-sounding post on an employee’s page? Although you don’t want to over-react or react emotionally in the moment, and you don’t want to micro-manage your employees, here’s the crux of the situation, distilled into just one sentence. How much potential damage could a particular post have on your practice’s reputation?

What’s important is that you respond fairly, not allowing one person who, say, has a knack of being humorous in his or her posts more leeway for the same type of material that another employee posts in a more serious manner. And, if you choose not to respond, be aware that you’re still really responding – giving the message that you either are fine with the posts or you aren’t concerned with the messaging. And, although a non-response is sometimes the right choice, in today’s business environment, your practice could also be harmed by this more passive approach.

What You Can – and Cannot – Do

At a minimum, you should create a policy about your employees’ use of social media while at work. Be clear about what an employee can and cannot do, and then consistently adhere to that policy. You have the option of banning social media use entirely while on the job. If, of course, someone’s job includes posting for the practice, you’ll have to clearly delineate what is and isn’t permissible during work hours.

However, you cannot ban employees from talking about work-related issues online when they aren’t at work, and they are legally permitted to discuss topics with one another on social media that fall within protected concerted guidelines. Employees can, for example, discuss their dissatisfaction about management style at the practice, how much they’re getting paid and so forth on Facebook or Twitter, as just two examples.

Employees are not protected and can be fired, though, when they discuss these issues online with someone outside of the practice, as this no longer falls into the category of co-worker dialogue about the workplace. They can also be terminated for sharing information that is deemed confidential, including but not limited to trade secrets.

Employees aren’t protected when talking about a workplace topic that isn’t related to employment terms. If someone calls a manager “lazy,” that communication may ultimately be protected. If the employee posts, though, that the manager is “fat,” then that may open the employee up for termination. Or if an employee posts that “my veterinary office is full of ugly people,” this is leaving the realm of employment-related discussions.

It can be difficult to discern when a post crosses the line, so your practice may need help with an attorney experienced in this type of law to determine legalities of particular posts. Note that laws can differ by state so, if your company has practices in more than one of them, you may not be able to make blanket social media policies. Employee protection is especially strong in California, Colorado, Louisiana, New York and North Dakota. Also, be aware that employee protection about social media postings applies to unionized as well as non-unionized employees.

Hate Speech and Protected Classes

You can fire employees who engage in hate speech. Sometimes a post clearly contains hate speech, while at other times, it is borderline. Hate speech is defined as communication that has no purpose or meaning other than expressing a feeling of hatred for a particular group, perhaps focused on race, ethnicity or gender, sexual orientation, national origin, religion and so forth.

When Creating a Social Media Policy for Your Practice

Your policy should contain clear guidelines about what is and isn’t permitted while at work, and also explicitly state that trade secrets and the like must remain confidential. The policy should ask employees to not use social media to post defamatory material that could create a hostile work environment. It is also reasonable to ask them to preface any social media remarks made about the practice online with a disclaimer that you don’t represent your employer’s point of view. It makes good sense to be proactive, too, and run your social media policy past your practice’s attorney.

As a creative solution, some companies are providing social media breaks for their employees throughout the day, perhaps 15 minutes in length, a couple of times per day. This can give everyone a chance to relax and refresh their minds. The goal isn’t to completely restrict your employees from ever using social media (which isn’t do-able, anyhow) but to encourage moderate use in appropriate ways. If you want to use this strategy, outline specifics in your social media policy.

Sharing Your Social Media Policy with Employees

How you share the news about your social media policy can go a long way in determining how well it is received. For example, you could pick a day to get some pizzas for your employees, and use that as an occasion to have a discussion on your social media policy. Explain why having the policy is so important in today’s times, and educate them on the problems that can arise when this form of communication isn’t appropriately used.

As you share the role that social media and its messaging plays in your practice’s culture and values, using a helpful approach is more likely to be successful than leaving the impression that you don’t trust your employees and plan to monitor their every message. And sometimes, by simply educating employees on privacy setting options in social media, you can help to prevent an unpleasant situation.

Share examples of appropriate/acceptable posts and ones that cross the line, and be open to questions, concerns and employee feedback. Getting employees to buy into your policy is a big step forward.

Monitoring Social Media

In general, avoid monitoring a specific employee’s social media accounts to watch for inappropriate comments. If you’re aware of a controversial comment, let that employee know how you plan to investigate and then review the situation with him or her. Then do exactly that.

When you follow up with the employee, get his or her side of the story. In some cases, the comment is so inflammatory that termination may be the only response. Other times, what the employee has to say may provide context that allows for lesser forms of discipline. Remember to be consistent and to follow up appropriately with everyone involved at the practice. As needed, update your social media policy and share it with all of your employees.

To view article on Today’s Veterinary Business, click here.

 

Key Factors to Consider in Appraisals and Assessing Practice Value

Written By:David McCormick, MS  Simmons Mid-Atlantic & Great Lakes
Stephanie McGinness, DVM Candidate, 2012

What are the key factors you should consider when assessing practice value?  Profitability and appraisals are both important parts of the process and the following is a list of guidelines and topics to help guide your future research.

 

Practice Value:

  • Profits drive the value of a practice. They are the return on owning the practice and it is the return that is being purchased.  The greater the return, the greater the value. Practices have appraised for anywhere from 110% to 15% of gross revenue.
  • “Profits” are what you would get if you owned the practice only – meaning you don’t work there and you don’t own the real estate (i.e., fair market compensation for your veterinary work, fair market rent and clean financials).
  • If a practice is financially healthy, it will have profitability in the range of 14-18% of revenues.
  • If a practice is financially healthy (14-18% profitability) then it will probably have a value that will end up being between 55% to 80% of revenue.
  • Asking what a practice will go for is like asking what the cost of surgery is; it is such a broad range that it’s tough to be accurate. The recent average of a practice sold by Simmons has a value of roughly 72%, however, they’ve been sold in a range from 30% to 95% and there’s even one on the market now at 110% that will close this month (June 2011).
  • The average practice these days has a profitability in the 8-11% range and thus is likely has a value that will end up being between 30% and 50% of gross revenues (if that).
  • Practice values in general have been decreasing. There’s greater pressure on profitability: increased support staff costs, increasing benefit costs, higher-end pharmaceuticals that can’t be marked up as much, etc.
  • The economy has also impacted values. If the practice was managing for revenues instead of profitability then typically the revenues *and* the profitability took a hit. Profits go down – so does the practice value.

Assessing Profitability & Practice Appraisals

  • It is best to have your practice appraised every 3-5 years for management and planning purposes. If the value is low, the profits were low.  If the profits are low it has to be a revenue and/or expense issue and we can help identify the problem(s).  Fixing the profitability improves the practice’s cash flow, increases the practice profitability and its financial health, and increases the overall practice value.
  • An appraisal is an opinion of value – and anyone can give you “an opinion”. These are big decisions.  If you want a good opinion you need to know where it’s coming from and select a qualified veterinary appraiser.
  • To assess a potential appraiser, request veterinary references and inquire about their experience level (particularly in the veterinary industry), accreditation and credentials (i.e. ASA, CBA, CVA, AVA, AIBA) with the understanding that they don’t guarantee competency, and compare their report to those prepared for you by previous appraisers to assess their report writing competence.
  • Any decision on value should be defendable and is based on the appraiser’s judgment, the financial analysis, and the conditions in the market for that area (assuming here that the goal is fair market value).
  • Free resources for estimating your practice profitability are available on the NCVEI.org website. Find the Profitability Estimator under the Benchmarking tools.  It was developed by the Veterinary Valuation Resource Council (VVRC) and is free.  It helps you go from the practice tax return to an estimate of your true practice profitability.  This is a similar practice to what we do in the No Lo Workshops hosted by VVRC at the major conferences.
  • If you’d like more in depth information, please visit the VetPartners website at www.avpmca.org