2023: The Biggest Stories of the Year

The Stories of 2023:
Business x Vet Med

The VCPR

The veterinarian-client-patient relationship (VCPR) made headlines multiple times this year and with good reason. Since the VCPR must be established before treating a patient, it stands to reason that the rise of telemedicine is raising questions with respect to what constitutes a VCPR. The rules were written before the rise of internet enabled appointments, and every country/jurisdiction seems to be handling the issue slightly differently.

At its core, the question is whether establishing a VCPR requires an in-person visit, or if a telemedicine appointment sufficient. Proponents will say that the ability to assess and prescribe medications will allow more patients to be seen in less time, and provide greater access to veterinary care - especially to those in remote areas. Those against it says that the quality of care will suffer if vets aren’t able to physically asses their patients. As we’re still sorting out the aftermath of a pandemic that pushed us all more online, it makes sense that in 2023, the VCPR made headlines a few times.

First, regulators in the UK relaxed the rules by allowing veterinarians to prescribe medications in some instances without a physical exam. However, the new rules do come with caveats, including that a physical examination is required "in all but exceptional circumstances" when prescribing antibiotics and other antimicrobial drugs since overuse contributes to drug resistance.

In September, the AVMA advocated for the VCPR to be established in person and firmly opposes a VCPR being established virtually because it “creates serious risks for patient health and safety.”

However, just weeks later in October, California passed Bill 1399 which allow Californians to schedule a virtual visit with a veterinarian beginning January 1, 2024. For us, the key word there is a veterinarian, because the bill specifies a VCPR could be established remotely, even if it’s not the animals primary veterinarian. The new rules are set to go into effect next week.

The issue of how the VCPR rules are applied, and how it affects our day-to-day isn’t going anywhere. In fact, we think this will continue to be a top story for years to come. Has it affected your practice yet? Reply to this email and let us know.

Walmart, Amazon, and Chewy - oh my!

The last 10 years have been dominated by the consolidation trend in the profession. And while this is unlikely to stop completely, the current economic environment has slowed down the rate of acquisitions.

Perhaps that is why this year saw some of the biggest names in business set their sights on the pet care market. Could be the beginning of a new trend in the business of veterinary clinic ownership? We wouldn’t be surprised. After all, the global pet industry expected to grow to $500 billion by 2030 and the biggest companies are best suited to get a slice of that pie.

In September, Walmart announced that they will be opening their first physical veterinary clinic just outside of Atlanta. This will complement the more established parts of Walmart’s pet business: their private label dog food, pet medications at Walmart pharmacies, and telehealth appointments to Walmart+ subscribers. With approximately 5,000 locations in North America and the bankroll to expand into any field they want, 2023 is likely to just be the beginning of Walmart’s quick expansion into the veterinary care market.

Next came Amazon, who is reportedly considering entering the veterinary telehealth market to compete with Walmart. Whereas Walmart’s competitive advantage comes in the form of a vast network of brick and mortar locations that can support rapid expansion of vet clinics, Amazon would be looking to undercut their telehealth business by leveraging their vast network of existing subscribers.

And finally just last week, Chewy announced that they will be opening their first vet clinic, in their latest endeavour to be the ultimate one-stop shop for all pet owners. The first practice will open in Florida early next year, and they plan to continue expanding throughout 2024. The clinics will offer routine appointments, urgent care, and surgery.

With America’s largest retailers now entering the space, these stories are likely to have massive implications on the profession in 2024 and beyond. Imagine a veterinary practice in all 5,000 Walmart locations in North America... then we would definitely need more vets.

Check out past editions of Weekend Rounds for more on these topics:

• Big Changes To Telemedicine in the UK on January 22

• Walmart Enters the Pet Care Market on September 24

• Amazon, the VCPR, and the FTC on October 29

• Free Telehealth 30,000 Feet Up on December 17

The Stories of 2023:
Animals x Vet Med

The Canine Respiratory Infection

Our most read story this year was on the canine respiratory infection affecting parts of the United States. Unfortunately, we will leave 2023 without knowing exactly what is going on, but here is the breakdown in case you missed it:

• Dogs across North America are presenting to their veterinarians with respiratory compromise

• The number of cases has spurned the media to call it an “outbreak”

• Infectious disease experts aren’t so sure, calling it part of the normal fluctuation in case numbers

• No on knows if this is a new infectious agent or something commonly associated with CIRDC

• Case numbers are trending downwards as of this month

Attack of the orcas!

Remember when orcas were attacking boats? Yeah, June was a pretty wild month. As far as we can tell, no one knows why it happened but at the time three solid theories were floated: an Orca uprising, a fad, and a learned behavior. We like the Orca uprising theory, and hope that they were trying to squash capitalism by sabotaging boats. Who doesn’t like an underdog? Plus, imagine the Netflix movie.

Extending the Canine Lifespan

Loyal, the startup focused on giving big dogs that small dog energy lifespan, achieved a first with the a partial approval for LOY-001, the first drug to target lifespan extension in any species. The drug works by reducing IGF-1, which is responsible for regulating growth and metabolism, but it also accelerates aging and increases the risk of cancer and other diseases.

By lowering IGF-1 levels, LOY-001 could potentially improve the health and longevity of dogs of any breed or size. LOY-001 has received a partial approval from the FDA, after a testing process that took more than four years. The drug is still undergoing further trials and evaluation, and it is not yet available for commercial use. However, it could soon offer a new option for you and your clients to enhance the quality and quantity of life of their beloved companions.

Check out past editions of Weekend Rounds for more on these topics:

• Attack of the orcas! on June 18

• The Canine Respiratory Infection Dominating Headlines on November 26

• Extending the Canine Lifespan on December 10

The Stories of 2023:
Technology x Vet Med

Did ChatGPT diagnose a dog?

If there was one piece of technology that 2023 will be known for, it’s artificial intelligence - and specifically, large language models like ChatGPT. It seemed like every week there were new news stories looking at the capabilities of GPT3.5 and then GPT-4, the models underneath OpenAI’s fastest growing app of all time. And the world of ChatGPT collided with veterinary medicine when a user went viral on the platform formerly known as Twitter, by sharing ChatGPT’s diagnosis of his dog. Here is what went down:

• Sassy (the dog) was diagnosed with a tick-borne disease (Babesia), and despite a serious anemia, the initial treatment prescribed seemed to be working

• After a few days, Cooper (the owner) noticed that Sassy's gums were very pale. He took her back in for more tests which revealed even more severe anemia

• Sassy's vet was not sure what it could be, so they suggested a wait and see approach, but in the meantime Cooper turned to ChatGPT for help

• ChatGPT did a pretty darn good job.

No veterinarians lost their job to ChatGPT and aren’t likely to any time soon. But this was one of the first viral moments for AI chat which will have a growing and outsized impact on the profession in years to come. Technology enthusiasts and veterinary companies are pushing at the seams to see what AI can do, because it appears to be an incredible catalyst to speed up and improve human performance, but not replace it. So if you haven’t already, now would be the time to learn about AI because while AI won’t take your job, it’s possible that someone who knows how to use AI may. A great place to start is the AVMA Axon lecture by Dr. Eli Cohen, free for AVMA members.

AI can help us talk to animals now?

In July, we covered AI applications that enhance our understanding of animal acoustics - a new field of research that uses AI to decode the sounds of animals and plants, revealing their complex “languages” and behaviors. Understanding animal communication can help scientists monitor and protect endangered species from the effects of climate change and human activities. AI has helped discover that flowers can sense bees, orcas have different dialects, dolphins have names, and elephants have a warning signal for honeybees.

At the same time, Zoetis announced a new app that uses AI to analyze skin samples and swabs faster and more accurately than human vets, and generates a report with images for the client.

Things are getting very interesting…

Dog vision went viral on Tik Tok

A Tik Tok filter was all the rage in June when users could switch the colors of the video to see what their dog sees by showing only blues and yellows. No word on when the cat filter is coming, and our guess is because it is technically challenging to create a filter for ‘not giving a crap’. What we do know for sure… the Obi Veterinary Education logo is not dog friendly.

Check out past editions of Weekend Rounds for more on these topics:

• Did ChatGPT Diagnose a Dog? on March 26

• Dog vision goes viral on June 4

• Can AI help us talk to animals? on July 9