A mind map is a diagram used to represent words, ideas, tasks, or other items linked to and arranged around a central key word or idea. Mind maps are used to generate, visualize, structure, and classify ideas, and as an aid in study, organization, problem solving, decision making, and writing.
The elements of a given mind map are arranged intuitively according to the importance of the concepts, and are classified into groupings, branches, or areas, with the goal of representing semantic or other connections between portions of information. British popular psychology author Tony Buzan claims to have invented modern mind mapping. Mind mapping is a very powerful “brain friendly” method for communicating large amounts of information in a more natural way than our traditional methods. The HealthMap is a communication tool designed around the concepts of mind mapping.
Safari Wellness Healthmaps
Safari Wellness HealthMaps are extremely effective mind maps that enable multiple subjects to be viewed on a single sheet of paper. The Safari Wellness HealthMaps enable a complete discussion about the care issues concerned with pet health wellness. Wellness involves four major categories:
|Examinations and Immunizations||
||Longevity and Quality of Life||
These four categories are further explained using topics and graphics that depict the message to the client. A HealthMap is used to tell a story about the health issues and the veterinarian's recommendations for these health issues. The Safari Wellness HealthMap is used as a visual script for the health care team member to use to guide the pet owner to develop a complete wellness protocol for their pet. These wellness HealthMaps are being used by many veterinary practices in the USA. They are printed in bulk and then manually customized for each pet prior to the pets scheduled visit to the practice. Today these HealthMaps are made with the VetPlan Software and the utilization of them has proven to be hugely effective at fostering wellness in veterinary practices in the UK, Australia, and Japan as well as the USA.
VetPlan Wellness HealthMap
VetPlan creates a Wellness MindMap we call a HealthMap of the Wellness recommendations that your practice makes for each of your client’s pets. Wellness is a relatively new focus for our profession. Whereas “Illness” is the domain of the doctor, wellness is the domain of the client. This is because many of the wellness items are optional and therefore the responsibility of the client. It is the responsibility of the clinic to educate the client about the availability and need for these wellness recommendations and is the responsibility of the client to decide to take these recommendations or not. This highlights a difference between “recommendations” and “requirements”. “Wellness Requirements” are what we as a profession are used to offering our clients as a minimal set of care necessary to have their pet protected from likely disease. If a client doed not takes these “Wellness Requirements” we almost consider the pet poorly cared for or consider the client a poor pet owner with minimal attachment to the pet. “Wellness Recommendations” are necessary just for the opposite client, the client with the strong relationship with their pet; the client who wants to do everything to prevent illness or to assure that the client is doing everything they can for their loved one. These clients are called “Bond-Centered” clients and desire more than the typical “Wellness Requirements” made by of most in our profession. The bond-centered client wants to know about all the services our profession to offer for their pet and they want to be the ones who make the final decision about these services designed to promote wellness. For your practice to receive the most benefit from the HealthMap, you must consider changing your current Wellness Requirements to include Wellness Recommendations as well. These recommendations give the client the choice about the level of care they provide to their pet. Through this customization process, rationales are given to explain the “bond-centered” point of view to encourage you to adopt this new realization of the needs of our clients.
The “bond-centered” client wants to know about diagnostic tests that can show the absence of disease. Most traditional veterinarians run diagnostic tests sparingly or only when “indicated”. This means we as veterinarians are “programmed” to run diagnostic tests only when we are likely to find an abnormality. Many disease processes however are genetically preprogrammed to occur in dogs and cats and early identification of the presence of an abnormal process or trend can lead to early management intervention. Generally these processes represent a continuum of disease that the pet’s biological system adjusts to without any outward signs. Intervention may be as easy as a change in diet or just monitoring of the trend. The new generation of clients sees the world differently. They want to have normal results they want to run tests on apparently normal pets for the assurance that they are taking good care of their loved ones. Testing recommendations should be customized for the species, breed and risk factors. The genetic predispositions for disease syndromes that can be preemptively tested for, prior to the onset of disease are listed in the VetPlan Breeds Form which is used to add the breed specific diagnostic test recommendations to the HealthMap. The biggest overall change with regard to these new “bond-centered” recommendations is the age and frequency that the recommendations are made. We recommend blood screens and urine screens every six months. Remember these are recommendations not requirements and the client is given the choice to make an educated decision about what tests and when to perform them on their pet. You never want a client to ask you why they did not know about a test or risk factor after their pet has the disease.
Routine Blood Screen
The healthy pet should be receiving a physical examination every six months because pets age faster, mask their symptoms and cannot talk. Physical examinations cannot determine the internal organ function of a pet until the disease is advanced in most cases. Therefore a part of the twice yearly examination should be blood and urine tests to help determine the internal organ function that cannot be determined based on a physical examination alone.
Urine tests are recommended at all ages as complimentary to the physical examination for the urinary, reproductive and excretory systems. Therefore urine tests should be recommended with the same frequency as physical examinations. In human medicine a urinalysis is considered part of a physical examination. In other words a physical examination has not been completed until a urine sample has been evaluated. We are therefore compelled to follow this example. Urinalysis gives a broad range of information about the metabolic health of several organ systems and is complimentary to the ERD test which is specific for the determination of early kidney disease. This means that a urinalysis is not a replacement for an ERD and an ERD is not a replacement for a urinalysis. Both must be recommended. Our current recommendations are for both tests to be performed once a year until the pet is five years of age and then twice a year thereafter.
Early Renal Disease Testing
The ERD test is an Early Renal Disease test developed by Heska. ERD testing is determining the level of microalbuminuria. Microalbuminuria is an indication of damage to the glomerulus in the kidney which is recognized as an early change associated with kidney disease. This test is much more sensitive than any other blood or urine test to determine kidney disease. Most other tests do not detect kidney disease until 75% of the kidney function is depleted rendering therapeutic management more difficult. Many kidney diseases are genetically preprogrammed to occur in dogs and cats and early identification of the presence of an abnormal microalbuminuria can lead to early management intervention. The ERD test is not only highly sensitive it is also highly specific and can determine kidney disease even in the presence of inflammation of the urinary tract. For more information about the sensitivity of ERD tests.
Intestinal parasites pose a threat to our client’s pets as well as to our clients through fecal contamination of the home environment and the potential for visceral larval migrans or local cutaneous migrans of aberrant larva originating from the household pets. This issue has been addressed by the (CAPC) Companion Animal Parasite Council and the Centers for Disease Control(CDC) who has created guidelines for veterinarians with regard to how frequently a pet should be dewormed. These guidelines instruct veterinarians to administer worming medications to puppies and kittens regardless of the fecal results followed by strategic worming of adult pets on a routine schedule. This is the rational for administration of heartworm prevention on a yearly basis regardless of the location because of its efficacy against intestinal parasites. The heartworm prevention is supplemented by frequent (every other week) worming in young animals as well as periodic (every six month) administration of antihelmintic medications to adult pets. This supplemental administration is recommended because once monthly heartworm prevention administration is not frequent enough to break the life cycle of roundworm or hookworm infestations.
VetPlan Physical Examination
The Physical Exam is the most valuable part of any pet visit to the hospital and historically the “wellness examination” has been downplayed as a necessary part of the yearly immunization process. As a profession we need to eliminate the term “Yearly” from our vocabulary and we should start changing for the examination and eliminate the “office visit” charge. The value of the examination provided by VetPlan greatly eclipses the value of an “office visit”. We should recommend an examination to be performed twice a year and require that an examination be performed every 12 months. Animals with chronic disease such as thyroid disease, chronic skin disease and so on should be examined every four months or three times a year and ill pets with chronic disease such as marginal kidney function or diabetes should be examined every three months or four times a year. Pets cannot talk, they mask their illness, and they have a shorter life and therefore need more frequent care than humans. The choice of the frequency should be made by the client with the only requirement as once a year full exam. This exam, by the way, need not be done at the same time as the immunizations.