Calendar of Events

By: Jon Geller, DVM, DABVP emeritus

Description: This session will cover the challenges of providing effective veterinary care in low resource settings (in a field, parking lot, or under a bridge) to pets of those who are experiencing, or at risk of homelessness. Homelessness is a major unsolved problem in almost every city in America, as well as in rural settings, and those who are experiencing homelessness often their pet provides them their (only) companionship, unconditional acceptance, a sense of purpose in an otherwise purposeless life, as well as protection in a highly dysfunctional environment. Training in emergency medicine is helpful in triaging sick animals and working with limited patient-side diagnostics, with a major reliance on a good history-taking and physical exam skills. In the street setting, some chaos can be expected, especially with the challenges or working with indigent pet owners, around 30-35% of whom are dealing with their own mental health and substance abuse issues. Street Medicine is free medicine, and working without the economic constraints of estimates and high-end treatment plans can be liberating for clinicians.

By the end of the session, attendees will be able to:

1. To provide an overview of pets and homelessness in the US
2. To explore and discuss the complex issues related to pet ownership and access to care for those that are homeless
3. To discuss in detail effective means of providing effective care, both preventive and urgent, in low resource settings

Speaker Info: Dr. Jon Geller is a graduate of Colorado State University College of Veterinary Medicine. After graduating, he practiced as an emergency clinician in Colorado for 20 years and started up 4 emergency clinics. He became Board Certified as Veterinary Practitioner in Canine and Feline Medicine in 2010. In 2015 he founded The Street Dog Coalition, a non-profit charity, which provides free medical care, and other related services, to pets of owners at risk of, or experiencing homelessness in over 50 US cities.

Recently, The Street Dog Coalition went international, setting up a vet clinic in a tent at the Romania-Ukraine border, where teams of veterinarians have been providing free veterinary care to pets of Ukraine refugees. Currently, The Street Dog Coalition is working with Worldwide Vets to send in the first mobile veterinary clinic into Ukraine.

Dr. Geller was named Veterinarian of the Year by the Colorado Veterinary Medical Association for 2019. In the spirit of unbridled learning, he is currently enrolled as an MPH candidate at the University of Minnesota. He recently received the ASPCA Henry Bergh Award for 2022 and just started a new position as an Instructor at The Colorado School of Public Health teaching a class called “Homelessness in America.”

By: Rose Nolen-Walston DVM, DACVIM

Description: Diagnosis is considered the pinnacle of cognitive skill in medicine, being both essential for successful outcome and yet extraordinarily difficult to master. In human medicine, a recent report found that almost everyone who goes to the doctor will experience a misdiagnosis in their lifetime, a key factor in ~50% of litigation against doctors. In this session we’ll talk about the two ways we come to a diagnosis: “thinking fast” (known as system-1 reasoning) is the rapid, intuitive and non-analytical approach to identify common diseases, and used in the majority of cases by experienced clinicians, whereas “thinking slow”, or system-2 reasoning, uses an analytical, hypothesis-driven, problem-based approach to diagnosis and is essential for patients with complex or multisystemic disease. Given the realities of veterinary practice, system-1 reasoning is an essential skill but it comes with a much higher risk of subconscious cognitive biases that make misdiagnosis more likely. We will go over some of the most common examples of cognitive biases, discuss how they apply to veterinary medicine, and identify some simple strategies that can be incorporated in a matter of seconds into every day, high-paced practice. Then we’ll review the fundamentals of the problem-based approach to diagnosis and hone some skills that will improve your ability to pursue a diagnosis in cases where pattern recognition is insufficient.

By the end of the session, attendees will be able to:

1. How does your brain work when you make a diagnosis? Discriminate between system-1 (“”think fast!””) and system-2 (think slow!””) reasoning and identify the benefits and pitfalls of each approach in the context of veterinary diagnosis.
2. Thinking about thinking: use metacognition to understand why our brains can lead us down the wrong path, and being able to recognize when we are at risk of cognitive errors.
3. Why do misdiagnoses happen? Analyze the cognitive biases that result in misdiagnosis and create usable strategies to avoid them. What are the common ways our brains lead us astray? How you can tell when it’s happening, and what are some simple tricks you can use to avoid them.

Speaker Info: Rose Nolen-Walston grew up on a farm in England with plans to become a professional dressage rider but a complete lack of talent for the sport led her to veterinary medicine, where she eventually graduated from UGA in 2001 with her DVM. She went on to do an internship and residency in large animal internal medicine at Tufts before joining the faculty at the University of Pennsylvania’s School of Veterinary Medicine in 2006. In 2014 Dr Nolen-Walston won University of Pennsylvania’s Lindback Award for Distinguished Teaching and is past president of the Veterinary Comparative Respiratory Society. She is currently pursuing a non-traditional residency in clinical pathology at Tufts while continuing her Penn faculty appointment and is loving every second of learning more about the small animal side of medicine too!

Join us in a safe space where you can talk, share, brainstorm and commiserate over various clinical topics with fellow VECCS members!

Topic: The Case for Quality Improvement in Vet Med

Moderator: Dr. Meredith Daly

Description: Medical errors occur frequently in veterinary medicine. It’s impossible to know precisely how often because adverse event reporting is uncommon, reporting methodologies aren’t standardized, and patient safety and quality improvement programs are fairly new in veterinary medicine. To prevent medical errors, we have to understand why they occur and invest in systems to prevent them. Most importantly, we must all begin by acknowledging that medical errors are a result of faulty systems, not flawed people. None of us become veterinarians to harm patients, and although these errors may not be our fault—they are our responsibility. To abide by our first principle more fully to “first, do no harm,” we must work together, learn from each other, and galvanize the need for quality improvement programs in veterinary medicine.

By: Rose Nolen-Walston DVM, DACVIM

Description: It’s incredibly hard being a veterinarian, and practicing clinical medicine is one of the highest pressure, high stakes environments out there. Even the most competent, confident veterinarian has days where it feels like nothing is coming together for them. But it turns out that there are functional limitations to how much the brain can do: we’ll discuss cognitive load theory and the myth of multi-tasking, and why feel like our brains fail us sometimes. Then we’ll cover extrinsic and intrinsic cognitive load and go over evidence-based strategies to allow your brain to work at full capacity. Even with that, though, everyone has days where imposter syndrome sneaks up on us (and some of us wish we had even the occasional day where it didn’t!). We’ll delve into why imposter syndrome occurs and how to address it, with a quick tour of the Dunning-Kruger effect. And finally, we’ll discuss the second victim effect, which is the emotional trauma that healthcare providers experience when they make a medical error, and how these factors lead to burnout and compassion fatigue. These problems are endemic, and we’ll finish with how to recognize them, why they occur, and most importantly, how we can find strategies to protect ourselves from them.

By the end of the session, attendees will be able to:

1. Why it feels like our brains can’t keep up: how cognitive load theory affects your ability to process high-volume information in a high stress environment, and how to leverage the theory to become a more efficient, effective clinician and teacher.
2. Why it feels like our brains can’t keep up: using “deliberate practice theory” as a roadmap to improving expertise, even after years in practice.
3. Why it feels like we’re not smart enough: examining the interplay of the Dunning-Kruger effect (a cognitive bias in which people wrongly overestimate their knowledge or ability in a specific area) and imposter syndrome (an internal experience of believing that you are not as competent as others perceive you are) is so prevalent in our field, and how we can grow past it.
4. Why do we feel burned out: how burned out are you, is there a way to measure it? We’ll describe the consequences of burn-out, and what works and what doesn’t, to mitigate burnout and compassion fatigue in clinical medicine.

Speaker Info: Rose Nolen-Walston grew up on a farm in England with plans to become a professional dressage rider but a complete lack of talent for the sport led her to veterinary medicine, where she eventually graduated from UGA in 2001 with her DVM. She went on to do an internship and residency in large animal internal medicine at Tufts before joining the faculty at the University of Pennsylvania’s School of Veterinary Medicine in 2006. In 2014 Dr Nolen-Walston won University of Pennsylvania’s Lindback Award for Distinguished Teaching and is past president of the Veterinary Comparative Respiratory Society. She is currently pursuing a non-traditional residency in clinical pathology at Tufts while continuing her Penn faculty appointment and is loving every second of learning more about the small animal side of medicine too!