Practitioner's Guide

The Veterinary Medical Teaching Hospital [VMTH] is the largest single component of the College of Veterinary Medicine. The VMTH consists of a Large Animal Hospital, a Small Animal Hospital, a dedicated Zoological and Wildlife Medicine facility, an array of high tech equipment and a 100-member faculty of specialists and sub-specialists in a wide range of veterinary specialty disciplines. The VMTH Administrative Office provides overall leadership and support, directly administering the Hospital pharmacy, the medical records unit, computer services, the laundry and sterilization unit, and central receiving and storage. Under the leadership of the Hospital Director, the Administrative Office is responsible for financial and budgetary management including purchasing, accounts payable and client billing; staff recruitment, hiring, personnel management and staff enhancement programs; client relations and professional liability matters; public relations, community involvement and liaisons with veterinarians in private practice.

• to teach the clinical science and practice of veterinary medicine, surgery and health care.
• to provide high-quality patient care in a referral center linked with other institutions and private practices in a network capable of delivering primary, secondary and tertiary levels of practice. Tertiary care units are unique and represent the most advanced care available. They are linked closely to and are dependent upon research areas of emphasis, and who benefit from close working relationships with other colleges and institutions. Availability of tertiary level services is limited by "the state of the art" and available funding but is expected to increase through networking and use of shared programs.
• to serve as a laboratory and resource for interdepartmental and interdisciplinary study of naturally-occurring animal disease and animal health management.

A central pharmacy with satellites in the Large Animal Hospital and Small Animal Hospital provides prescription drugs, supplies and services for use on Hospital patients. Federal regulations prohibit pharmacy sales outside the Hospital and specifically prohibit filling or refilling prescriptions for anyone other than hospital staff. We regret that we cannot provide prescription service for veterinarians who do not hold VMTH appointments.

The practice includes referral patients and primary care patients. Limited local field service and community practice units provide primary patient care for a caseload large enough to support teaching programs.

Referral patients provide opportunities for referring veterinarians and attending faculty members to share in the investigation and management of naturally-occurring diseases and challenging cases, while students benefit from exposure to a wide variety of learning experiences. After each referral case is completed, clients are instructed to contact their referring veterinarian for follow-up care and treatment of future ailments that might develop. If they wish to return to the Veterinary Teaching Hospital, another referral by their veterinarian is encouraged.

To minimize the inconvenience of long waiting periods and assure the availability of proper personnel, patients are seen by appointment only. The veterinarian or the owner may schedule appointments. Clinical faculty members work in hospital service groups that provide patient care and teaching. Please be aware that a large portion of our faculty members' time is committed to classroom teaching, research, administrative service and other scholarly activities and it may not always be possible to make a specific appointment with a specific faculty member. Our receptionists are available during normal business hours, Monday - Friday, 8:00 a.m. - 5:00 p.m., to schedule appointments.

It is essential that you call us before sending an emergency referral so we can arrange for appropriate support personnel.

The College of Veterinary Medicine receives state-appropriated funds for faculty salaries and teaching plus major equipment purchases. However, the major portion of the Veterinary Medical Teaching Hospital operating budget including expenses for labor, support personnel, drugs, feed, laboratory services and operational expenses are generated from fees for client services.

In general, VMTH fees for patient care are similar to those of private hospitals. Average total charges per case are generally higher as a result of more extensive diagnostic workups and treatment required for referred and difficult cases. Occasionally a limited portion of a fee is funded from a budgeted teaching allowance or research fund and is granted only in those cases that are unique and offer exceptional teaching or investigative value. Payment in full by cash, check, Visa, MasterCard, Discover, or American Express is due upon termination of the office call or release of the patient from the Hospital. The clinic business office manager will be happy to discuss payment options. A deposit of approximately 50 percent is required at the time of admission for all hospitalized patients; cost estimates are available on all cases. Preliminary invoices, financial estimates and client communications are continually updated by the attending faculty member and staff.

Arrange a specific appointment for the referral by telephone or direct contact. Should the referring practitioner wish to discuss the medical aspects of a particular case prior to arranging a referral appointment, he or she may do so by contacting a faculty member or house officer on duty who is assigned to the service to which the case is to be referred. Emergency referral appointments may be made by contacting the faculty member on emergency duty or the faculty member to whom the case is being referred. Telephone access to individual faculty members is limited by classroom and laboratory teaching, Hospital receiving duty, student rounds, research, committee meetings and patient care. However, phone calls will be returned as soon as possible.

Provide an appropriate case history and summary of all previous tests, surgeries, radiographs and medications. Although the receiving and referring veterinarian may have discussed a referral prior to the animal being seen at the Veterinary Medical Teaching Hospital, it is in the best interests of the patient, client and the Hospital to provide this information.

Discuss VMTH policies outlined in this guide with the client and inform him or her of appropriate referral protocol. The Hospital publishes various client information pieces you may find helpful from time to time. Contact the VMTH Administration Office at (979) 845-9100 for copies or answers to questions you or your clients may have.

Provide liaison between the attending faculty member and client when requested and in the best interest of the patient.

Provide follow-up reports whenever possible to the attending faculty member. Continued communication between the practitioner and the faculty member after a patient has been released from the Hospital can provide valuable information for the patient, client, referring veterinarian, faculty member and students. After release from the Hospital, the attending faculty member and his/her service staff have a responsibility to the referring practitioner and client to be available for consultation concerning future developments.

Patients formerly cared for by private practitioners are occasionally brought to the VMTH without referral. This can result in serious miscommunication and may complicate patient care. In such instances we will be guided by The Principles of Veterinary Medical Ethics published by the AVMA Judicial Council.

Honor the appointment time and allow sufficient office visit time for examination and communication with the client. Diagnostic and treatment plans, possible prognosis and an estimate of anticipated fees will be discussed with the client.

Contact the referring veterinarian and inform him or her of the client's arrival and patient's admittance to the Veterinary Medical Teaching Hospital. This will be done by FAX or written notice mailed on the day the patient is admitted. Please tell the referral secretary if you prefer to receive information by FAX.

Contact the referring veterinarian and inform him or her of the patient's discharge. This will be done by telephone, written notice or FAX on the day of discharge or as soon as possible thereafter. The report may be incomplete but is intended to improve communication and reduce chances for misunderstanding.

Instruct the client upon dismissal to return the patient to the referring veterinarian for follow-up and all other services required. There will be times when it may be necessary for the client to return to the Veterinary Medical Teaching Hospital for future evaluation. This will be done when it is deemed in the best interest of the patient or if requested by the referring veterinarian.

Make a final and complete report to the referring veterinarian as soon as possible after final disposition of the case.

The attending clinicians in the Veterinary Medical Teaching Hospital are veterinarians on the faculty of Texas A&M University with expertise in a variety of specialized fields. Areas of specialty include animal behavior, anesthesiology, cardiology, clinical pharmacology, critical care, dentistry, dermatology, feline medicine, ophthalmology, gastroenterology, oncology, internal medicine, neurology, orthopedic surgery neurosurgery, soft tissue surgery, theriogenology and medical imaging including radiology, ultrasonography, and nuclear medicine.

Faculty members direct the care of each patient. They order the examinations, tests, treatments and feeding programs that are carried out by the students and trained technicians. All surgical procedures and special diagnostic tests are performed by, or under immediate and direct supervision of, faculty members serving as attending clinicians. The faculty members' primary responsibilities are teaching, patient care and research. In addition, faculty members perform other administrative and organizational duties as assigned by the University.

All students who assist faculty members with patient care and treatment are in the last year of their formal training and will shortly complete all requirements to be eligible for the Doctor of Veterinary Medicine degree. Their clinical work is performed under direct supervision of the professional staff. Students are involved in each case to some extent, as the entire hospital is a teaching classroom and laboratory. When specifically permitted by the attending faculty member, a student is allowed to discuss diagnostic testing, prognosis or treatment with the client or the referring veterinarian. Since the student follows the direction of a faculty member, please do not interpret a student's reluctance to discuss details as an unwillingness to be helpful.

Hospital patients are comfortably housed in compartments or stalls suited to their size and special needs. For the more seriously ill, intensive care units with patient monitoring equipment and 24-hour supervision are available in the Large Animal and Small Animal Hospitals. High-quality special care is labor intensive and is not funded from basic teaching budgets. Therefore added financial support for special care must be derived entirely from client fees or extramural funds.

Diagnostic capabilities of attending faculty members are extended by Hospital support laboratories and service areas providing nuclear scanning, fiberoptic endoscopy, arthroscopy, ultrasonography, contrast radiography, electro-diagnostics, computerized axial tomography (CAT) scanning and automated clinical laboratory equipment.

Surgery facilities range from hydraulic tables for efficient handling of large animals to an operating microscope for the most delicate procedures. Radiation therapy, chemotherapy, cryotherapy and YAG laser treatment for ophthalmic disorders supplement traditional treatments.

The College has made continuing contributions to animal and human health, disease prevention, diagnosis and treatment through research. Research efforts are recognized as essential to the advancement of veterinary medicine. The College and the hospital staff offer a unique pool of qualified researchers committed to the advancement of veterinary clinical science.

Private gifts and endowments are increasingly important resources, particularly for projects concerning companion and exotic animal health that receive low priority ratings by other funding sources. Practitioners serve a very special role as advocates of the College and play an important part in introducing potential donors to Development Office personnel. Contributions in support of research, equipment or scholarships may be designated for large animal, small animal, exotic animal, avian, aquatic or other areas of emphasis. Income tax and estate tax reductions are additional benefits derived from participation in this funding program. More information may be obtained by contacting Dr. O.J. Woytek, College of Veterinary Medicine Director of Development, at (979) 845-5051.