Webinar Wednesday Replay: Mark Cushing

 

 

Hello, everyone. Welcome to another Webinar Wednesday brought to you by GeniusVets. I'm your host, David Hall, and today I'm thrilled to be welcoming another incredible guest to the show, Mark Cushing. Mark is the founding partner of the Animal Policy Group, a longtime political strategist, government regulatory advisor, corporate executive, and a former litigator.

Since 2004, Mark's been specializing in animal health, animal welfare, veterinarians, and veterinary educational issues and accreditation. Mark is a frequent speaker at veterinary medicine and animal policy related conferences, and an author with a new book titled, Pet Nation: The Love Affair That Changed America. The book tells the inside story of the forces behind how our pets became treasured members of the family. Mark, thank you so much for joining us here today.

 

Mark, one of the first things I always like to ask people, you're so accomplished, you have so much going on, really in a lot of different capacities. How do you get it all done? Do you have any real personal tips to how you approach your day? Any typical strategies, organizational tips, tools or things that you do to help keep yourself on track in moving all of these different things forward?

 

I do. If you'd asked me 10 years ago, I wouldn't have even thought it was an important question. You just get up and go. But, yes, I do. I get up really early, whether I want to or not, I just tend to wake up early. I get up about 5:00, 5:15 in the morning. A lot of my clients are on the East Coast and I'm in Pacific time, so it gives me a chance to not let them get too far ahead of me on the day. That was my original thought. But, what I found is that I get a lot of work done between about 5:30 and noon. I really go hard. I think - you're up, you're alert. I work out in the morning.

My workouts are funny. Because I used to travel every week. Obviously, with COVID, you don't go anywhere. But my joke was every hotel room had a floor. I built my exercise routine around a crazy number of push-ups, and then I've added to that a crazy number of squats which I hate. I don't like anything about squats.

I do 500 push-ups, five sets of 100 every day and then I do six sets of 50 squats, 300.

It's crazy. But it's really flexible, and it's cardio its core. As you get older, you just don't want to look it. I figured... I never had an excuse like, the gym's too far away or I don't have my car with me or something because I'm on a floor at all times in life. I'm standing on something that could be a surface. The other thing I do is, and I'm really religious about this is, if I have to get something done, I do it right then. I don't let hang. All day I'm thinking, oh, I forgot to do, or I've got to... I just, if I got something that I promised somebody or I set some type of schedule, I just get to it. Then I take a break, and I do something during the day.

My workday is probably 12, 14 hours in length, but it's not 1214 hours of continuous activity by any means. I'm not Superman. But that tends to work for me. I've got a nice glass of water here after 20 years of people telling me to drink more water. I'm doing it, I drink the water, and then I now... I love good red wines. Earlier in life, I liked cheap red wines but I like better wines now than I used to. I treat myself in the evening.

It's a nice early start, couple of glasses of good Cabernet or Oregon Pinot to wrap up the day and get to bed early. That's it.

 

What time do you get to bed be able to get up at 5:00 AM and do 500 push-ups?

Probably 10:00 or 11:00. I think I sleep six, seven hours a night. I wish I slept eight. I've never really done that and it seems to work.

 

With all the strategic consulting, the government policy work that you've been doing for so many years, it's obvious that it's given you some incredibly unique perspective into vet care in America, into pet care, and the veterinary industry specifically. You just held the Virtual Care Summit, and that's a fascinating topic for us to talk about. You're doing incredible work with the Animal Policy Group, and I'd love to raise awareness and give our audience some insights and some perspective into that work. But first and foremost, congratulations on the new book.Yeah, it's fun. It was a lot of ideas I've developed over the last 10, 15 years. But the idea for this book came from my agent. I was approached by her and the publishers wanted someone to tell the story from the inside with perspective, not just as a reporter, because I'm not a reporter, on what happened with pets? How did we go from where we were in the US to where we are now?

If you think of it, it's more like I'm up about 1000 feet. I'm not giving people tips on how to raise their cocker spaniel or how to take care of their Maine Coon cat, it's about 1000 feet above the ground looking at how the whole culture of pets transformed American society. Not just our relationship with pets, but the impact on society and where we brought pets to.

I love the fact that cats and dogs didn't ask for it. It's not like they got organized as a union and said, "Hey, we want these five things." But, it just flipped, and they went from accessories to kings and queens of the roost. We just let them in. From living outside in the doghouse to right on our beds, right?

That phrase, he's in the doghouse, you don't hear that anymore. If you heard it now, it would be like a compliment, "Oh, good for him. He's sleeping on a fleece blanket and eating as good a food as exists." It was a fun book to write. It touches on the economics, the politics, the society, the culture of pets, both the battles... There are a lot of bumps along the way. It hasn't been just a red carpet welcoming pets into the economy, into the space that we live in, and a lot of fun issues we could get into if you'd like.

 

Some of the stuff I know you talk about is like, dogs versus cats…

Yeah, a couple of things are interesting. It is purely by accident, and I've tried to determine if there was any rationale for it. But, we have almost the same number of pet cats as pet dogs in America. I don't know why that is. I'm always struck by that number. Roughly about 90 million of each. They appeal to different parts of people. You'll hear folks described as I'm a dog guy, or she's a cat person, or she's a cat woman. The truth is, more and more people have both. We have two cats and a dog, but they're distinctly different species.

They are to me as different as a bird and a snake. They just behave differently. The old adage is dogs have owners and cats have staff. I think there's some truth to that. I've got a cat right over here. I don't know if you can see here there.

She appears to be exhausted, and she's only tired because all she's done is sleep. She hasn't done any work today. Her encounter with me this morning was some contempt for the food I fed her, it wasn't what she wanted today. She looked at me like, "I don't know why I keep you on my staff. Once again, you disappoint me, and I'm going to go into a different room, and please don't follow me." Whereas a dog is like, what do you want to do? What can we play with right now? Let's go. You tell me.

But, more seriously, we spend a lot more money on dogs than cats. That gap is narrowing, I don't think out of guilt on the part of cat owners but more just discovery of cat owners that cats need things as much as dogs do. But we spend more on health care for dogs. They go to the veterinarian more often. That's easily explained, right? Try to go under a bed, pull a cat out, put her in a crate, listen to her wailing. However you're going to get to the vet, that's not much fun. Some people think it's so stressful on a cat, they're better off not getting care. I don't think that myself.

I think with telemedicine, for example, the greatest beneficiaries are going to be cats, not dogs. You're going to see a lot of people say, "Okay, now this works for me. I don't have to go through all that stress." Particularly older cat owners, that maybe they live in an urban apartment, Bethesda, Maryland, who wants to go through all that, go down seven floors, getting in a bus. I can't even finish the sentence, you're not going to do it. Telemedicine, one of the reasons I make the case for it all the time is, there's a whole class of pet owners that love their pet as much as anybody, but it just doesn't work for them to get to a clinic. So, why wouldn't we want to take it to them? It's just very exciting.

The other thing that's interesting about cats is, they came to the US in the late 18th century, in the first part of the 19th century on ships from Europe with a single job, they were sanitary workers; catch, kill and eat mice and rats. That's it. Just do that. They got here, they populated the cities of the East Coast, and the Midwest doing the same thing. They continued as sanitary workers. Then public health departments sprung up and technology changed. That wasn't going to be how we got rid of rodents, so to speak, and they got fired from their job.

Besides getting fired, they were mass euthanized. We euthanized cats by the millions. They became like rodents. Suddenly, cats were everywhere, and people thought, we got to get rid of these things. But to now, there are more pet cases slightly than pet dogs. How's that even possible? How do you go from that status to this status?

There are a couple of good reasons that a good friend, Joyce Briggs, has shared with me worth thinking about. One is that kitty litter was developed. Suddenly, you can have your cat in the house and not every day spend 20 minutes finding out where she peed or what thing was destroyed. Then flea and tick control. You had cats able to be inside the house, in some cases go back and forth and not create problems.

I think cats are this great comeback story. Dogs, they always seemed to be more pets, but they are mainly the elite. You go back 5000, 10,000 years, you'll see carvings with dogs and some of the cats, but they're usually with elites; kings, queens, Pharaohs, emperors, and so forth. Even through World War II, and after that, they were around, but they were mainly outside. Some people were as close as they are now, but most, it wasn't that way.

Now, they're out the front door and they're everywhere in America. Dogs are the public face of the pet nation, and it's an interesting thing to watch.

 

I know you talk about also in the book, going from this no pets allowed anywhere. You go to restaurants, whatever to now, it's just pet friendly everywhere. That changed.

That's a battleground still. First of all, obviously, you respect the rights of 30% or so of Americans that don't have pets. But by the way, that 30% aren't all people who don't like pets. Some used to have a pet, circumstances change, they may have a pet again. Some maybe had a bad experience, a dog bite as a child that is an emotional memory they can't get rid of. But in truth, the note... I talk about, we can foresee when no pets allowed is going to shrink to public restaurants, kitchens, and just very specific areas with public health risk. But you're going to see pet owners push for access, apartment stores, you name it, planes and trains. Already, of course, hotels. In fact, hotels are maybe the most phenomenal switch. No pets allowed to, the entire floor is reserved for non-pet owners. In other words, most of the floors are for pets, but we will have a floor for those of you that haven't caught on that pets are cool.

Kimpton Hotels are like that, they have a pet officer who manages their pet policies. It's not, I don't think, driven by the goodness of their heart, it's just good business. People want to travel with their pets.

 

What are the next steps after the book? Will you still be advocating for animals

It's been a natural evolution of what I do, where I'm very interested in the connection between pets and society. Not just the human-animal bond engagement, one to one, but the impact of pets and the culture and economy of pets. If the book's successful, I think it'll have a lot of opportunities to speak and to write a lot more on that topic. I think there's a lot more interest. David, you'd be intrigued by this, probably a third to a half of my media interviews are with business media, that want to know about, my God, we understand that this is the best economic sector going right now. Companies and investors are figuring that out, finally.

I have thought about what the second version of this might be, I won't spoil the party by talking about it, but it'd be an extension of where we could go with pets. That may be something I address. But it's fun for now. I think it's raising the awareness, particularly for political folks, and the people that make policies that used to think of pets as cute and fun, and they always would show you their dog or cat on their iPhone but laugh when you wanted them to take the topic seriously.

As recently as 10 years ago, I can remember lobbying congressmen and they would proudly show me, "Here's my... isn't this Yorkie cute? I just love this girl so much." Then you talk about the human-animal bond and what it does for people in communities and there'd be a dole look on their face like, she's my pet and she's fun, but it's not more than that.

What the book's about, it's all more than that. It's a lot more than just private enjoyment of a pet, which is worthwhile, of course, on its own, but there's a lot more going on. I think we'll have a lot more discussion about it because of the book.

 

Moving on to COVID—veterinarians were considered essential workers. But, that wasn't the case actually out of the gate. As soon as all the laws came down, and I know that AAHA, I know the AVMA, and potentially yourself and others as well, that there was a lot of lobbying that went on to point out that veterinary needs to be considered essential. That saved additional millions of jobs, and livelihoods and all sorts of stuff, so let's talk about the Animal Policy Group.

Well, I have a team of eight and we work all 50 states. State vet med boards, state legislatures, Governor's offices, pharmacy boards, for a number of the bigger players in the industry. When COVID hit, which for everybody was about the second week of March when it went from something over there in Italy and obviously China, where I'd been in the middle of December. My wife and I were in China teaching at a university. Not in Wuhan, but I worried for a few weeks if I part of the problem.

But about the second week of December, I remember wondering, things are going to change, and maybe slow down. Like everybody, you weren't sure how it affected your business. It was almost like on a switch, my team shifted into full time, 12 hours a day, talking to 50 states at various different levels on PPE issues. On the essential versus non-essential issues, on telemedicine issues, on do you have only essential surgery permitted? Those issues. You always had to have a rationale besides the self-serving economic interests of a profession. There's no duty to keep veterinarians employed to make money, you can't make that case.

Also, we work with PetSmart. We were involved as intensively on grooming issues. Because a lot of states that made the good decision on veterinary, treated grooming like it was just some exotic luxury for wealthy pet owners, and it had nothing to do with the well being of the pets, the well being of the home, and so forth.

We worked intensively through May, and by then, most of that work was done. But that's a lot of what we do for our clients. I know the other groups you mentioned, were active in it too, but it was hand to hand combat, to some extent.

It proved the thesis of my book, which I wasn't planning on. Obviously, I didn't foresee it a year and a half ago, anything called COVID. What was that, that the fundamentals of the pet economy and the transformation of our culture to adopting pets and embracing pets were complete. It was complete before COVID. Such that when COVID hit, you couldn't really look seriously at pets and treat them as nonessential. I won't say the state, but I had a conversation with the governor's chief of staff who was pushing back hard on the essential services issue.

I said, "Well, let me just be blunt about this. When you have let's say 1000 pets die on your watch in the homes of your voters. How's that feel?" He went, "Ouch." That when I said, "That's real. That's what happens if you treat veterinary as non-essential, and they don't get medical care. They have the same organs as people have, and pets in trouble need the care." I said, "That to me is a pretty easy call, right?”

I'm not going to take credit that that state made the decision that phone call, but I know that he hung up the phone and talked to some people and said, "Wait, wait, wait, let's rethink this whole veterinary thing. It's a little more complicated than we'd like to think." It's not like saying kids can't ride their bikes out in the street, they can survive without getting their bike out the garage for two months, just by analogy. That's not what this is. This is an essential, living, breathing thing that's part of a family now.

The good news is, most governors and most politicians already knew that which proves our point that we had really changed the status. If this had happened in 1960, maybe 10 states would have said, "Yeah, if your pets dying, that your vet can come to your house. That we don't need any... " Anyway, it was interesting.

 

On a broader scope that is not related to COVID. I'd love for you to tell us more about the Animal Policy Group. Starting just at the most basic, what's the mission and policy, or mission purpose of the organization?

Well, I'm a lawyer by training and by practice, but we're not a law firm. I'm not hired to be a lawyer for a company. But I use my law degree, obviously, all the time. I was a trial lawyer for many years. The first thing we built it on was advocacy. Advocacy in three areas, and this is still a foundation of it. One, pets and veterinary are regulated at the state level. They're not regulated at the federal level. Occasionally, there's a bill in Congress, yes, but the truth is, the action is in the states and each of the states, separate legislature, separate Department of Health, separate Veterinary Medical Board, separate State Board of Pharmacy.

There began to be more and more issues from 2005 when it got started, to 2010 in the states. We monitor every state, every day, 24/7, and we analyze and report every day, what's going on of any interest or impact on pets, on animal welfare, on veterinary.

 

How does that monitoring work?

It's a software program and we've customized it, and I have a tremendous team that does this. Scott Young…

 

Are they listening to conversations that are happening in places worth monitoring?

No, it's focused on proposed policy, proposed legislation, potential action by a veterinary medical board.

There's a monitoring and reporting because if you don't know what's going on, you can't do anything about it, right? But that's tied to the advocacy, which is my part. California is about to do something. Maybe it's a good idea, let's help them. Maybe it's a bad idea, let's stop them. I began with the MARS practices, and then I had success. So, a lot of additional companies retained us to do the same thing. That's one side of the policy.

The second side of policy, which has been the last five years and really, it's the majority of my time these days, David, is industry policy, telemedicine, vet nurses, issues that are common to the industry where not everybody agrees, not every state VMA's on the right side of the issue and so forth. I began to create Coalitions on behalf of client groups who wanted to see the needle move, particularly in telemedicine back in 2016.

There's that side of it, and then the third piece, which began with a phone call to help Ross University get accredited, it's an offshore school, but it's 95% American students who come practice in the US and they needed to be American accredited, and they were facing a real challenge. A good friend, the founder of Banfield suggested to him they give me a call. I've never done that and that was in 2009 and had success. Then the National University of Mexico got turned down and they hired me and I got that undone. Then Lincoln Memorial heard about me and said, "Can you do that? Can you get us accredited?”

Suddenly, I built an accreditation practice, the most recent is the University of Arizona, which opened that school three days ago, here in Tucson. I live outside Scottsdale. That's led to even work outside the veterinary field. Suddenly, it was just policy everywhere, and it was education and public awareness. It was advocacy, it was debate, stopping things, promoting things, it's been a real mixture. I have a team, obviously, that are really skilled, that back me up and work with me. That's what the Animal Policy Group is.

The truth is, I couldn't come up with a creative name. A client said to me, "I've been writing a check to your law firm in Portland," where I lived at the time, "And we're not in Oregon and you really aren't our lawyer. Have you thought about creating a brand?" I thought, "Actually, that's a good idea. I hadn't thought about that.”

I thought well... I literally couldn't come up with anything more clever than Animal Policy Group, and it's the best business decision I've ever made, because now when you Google Animal Policy, we pop up, and that's really what we do. It's been a lot of fun. I've been surprised and obviously pleased with the success we've had.

I thought about Pet Policy, but I do work in the food animal field, not as much, so I just pick animals? Why not, and it worked.

 

A lot of the issues that you've been very successfully able to tackle have been client-directed. "Hey, this is an issue that we're having, can you help us with this?" Therefore, you dive in and help that. But I also am hearing that you're doing a lot of work that you are doing because you think that these issues are important. You personally want to see them move forward. What are the issues that you see as a priority for your organization to tackle right now?

I'll preface the answer, and I'll give you that list. Everything I do, if you know me, everything I do is client-focused. I don't pursue issues that I think are going to hurt my clients. I'm not apologetic about introducing myself as a hired gun, because that's what a litigator is, and I come out of that background. I get hired to promote my client's interests. But, as I had success, this was about seven, eight years ago, halfway through the journey that we're on right now, I realized, I established myself, I had somewhat of a name, and a reputation, not to the extent I do now, and I was in a position to promote things and get out in front of issues.

I've told people who've asked me, "What do you really do for a living?" I said, "I get hired to change things. I get hired to promote change." Because the veterinary profession and animal health profession, like many professions have resisted change, but it's even deeper than that. I've used the phrase that it's never believed that the future is going to value veterinary care and it's never really believed that the culture values veterinary care as much as they do. They don't expect good things to happen. They don't expect success to continue.

There's an inherent conservativism that this isn't going to last, and we don't really matter as much as we could or should matter. I've pushed that. My first debate, which I'm still engaged in is... This goes back seven, eight years when you began to see in big conventions, topics like overpopulation to vets. There were meetings and the rooms were packed. I can remember a room in St. Louis at the AVMA in 2011, I think it was, and that was the topic and everybody was basically on the side. I stood up and said, "Timeout. We don't have a surplus of vets, we have a shortage. You have an actual shortage of veterinarians. Let me tell you why we have a shortage.”

I went through the demographics of that, and I said, "It's going to get worse every single year, but let me pose this question to you. You're going to go to the public, and tell them that your idea of the future is to shrink this profession? That sounds a lot to me like a shrinking supply, which sounds a whole lot like raising prices and costs. I can't believe you're seriously considering that message. It's, A, not true and B, it's self-destructive.”

I got laughed at and hooted at. I had a lot of people say to me, "You couldn't be more wrong." I just said, "Let's just see, let's just stay at it." We had a debate in 2014, in Denver at the AVMA, and I'll just say it went really well. I went like I was prepared for trial, and I had a lot of data, and I believe in data. I just laid out the numbers and said, "You'd have to work hard to screw up pet healthcare in America." That was in 2014. Well, now it's 2020. You know what the number one problem for every veterinary practice in America? It cannot find a veterinarian. They can't find them. You go anywhere; rural, suburban, cities, east, north, west, south doesn't matter

I wasn't like a guru that knew the future. I got more comfortable and telemedicine was one of my next issues. Well, both of those issues are still challenging. We don't have enough vet schools, we're not producing enough veterinarians. I've gotten very interested in the vet tech side. Vet techs on average leave the profession after four years. We don't pay them enough. We don't make it a sustainable career. You get a buck an hour better job somewhere else, as much as you love animals, you really can't afford not to. We haven't created the ladder of steps for a vet tech like we have in nursing.

That's a big issue for me right now, virtual care is. Yes, we got people talking about it four years ago, but there weren't enough people doing anything about it, and we watched human medicine for hell, 25 years as if we couldn't do the same thing. I steal a lot of good ideas for veterinary from human medicine, because it has so much more money and so much more research, and it pushed the envelope. It's pretty easy to just reach over and say, well, that would work here. Why wouldn't that work for pets and their doctors?

That's a major issue for me right now. There's more coming, but I think those are some... I'm also involved, you probably want to ask about this, on the question of do we have an adequate supply of dogs in the US? My answer is, "No, we don't." You want to see a problem lurking, it will be when we really, really confront the shortage of dogs and they become a luxury item, which we just can't let that happen. Well, that's not going to happen on its own. It's not going to be changed on its own. Those are just a few of the things that I'm thinking about when I'm doing squats or push-ups.

 

The topic of finding and attracting doctors and staff is something that we very actively address and work on here at GeniusVets with every one of our clients. The executive director of the SCVMA Dr. Peter Weinstein spoke to us about this during his webinar, and said he’s coaching practices on is simply being able to have better business practices and the logistics of running a practice. What are your thoughts?

Let me comment on that, and I agree with Peter and I've been very involved in an ongoing project to address that systemically, not just practice to practice. The origin of that is really interesting. It reveals a lot about the psyche, if you will, of veterinarians that were trained in the '70s and '80s, and '90s. There was a fear factor, if I let my vet tech do more, I'm not going to be as important, I'm not going to be valuable. Oh my God, I'm going to lose money, and that's fair. Every business owner needs to think about making money and keeping the lights on.

You stop and go, "Wait a second. The stats that got my attention was back in 2006, was that pediatricians saw an average of 42 patients a day and veterinarians saw an average of 12. You stop and go, "Wait a second?" There's only one reason for that, the efficient use of non-doctor staff. Most of us in our annual physical are happy to spend time with the nurse who will talk to you as a human, knows a whole lot about healthcare, give you good advice. You see your doctor for five to 10 minutes, that's fine. The veterinary model was just the opposite. But it was driven by a fear factor, David, it wasn't driven by a shortage of skilled workers.

In 2018, at the Banfield Industry Summit, it was devoted entirely to vet techs and their underutilization and their unhappiness. The average practice used credentialed vet techs; RVTs, LVTs, CVTs. Credential meaning to your degree and pass the national board exam used them at 40% of their trained board-certified skill level. Which would be like telling Clayton Kershaw, you've got to throw with the opposite arm, 60% of your pitches. I don't think so. I don't think that's going to work for me. This is what I do, so let me do it with this hand.

It's a struggle, and there's a generational issue with telemedicine and there's a generational issue with vet techs, and I'm a baby boomer, okay? So, I'm talking about my generation. I'm not pointing the finger at somebody older than me and saying, "You're the problem." But there is there's a big thought that you give up something if you use telemedicine, you give up something if you give vet techs too much money. I've worked on the veterinary nursing issue and I've had veterinarians say to me, "Mark, if we change their title to veterinary nurse, am I going to have to pay them more?" My answer is always, "I hope so. Not because the law will require it, but why wouldn't you? Are you having a retention problem?" "Yeah. God, it drives me crazy." "You think it might have something to do with making $32,000 a year?" How's that work?

It's just understanding that doctors have figured out, if you leverage that talent, Peter, Weinstein's good model, then you can do the high value things. Telemedicine is a great example, most of the calls can be handled by vet techs, and frankly, that pet owner would be happier talking to a vet tech, who's probably more engaging and more comfortable talking about things, while the doctor is doing what she wants to do. But I'm telling you something, it's a challenge with the profession to not be threatened, and that goes back to the fear factor that we can't sustain success, that we're not as valuable.

Millennials that come along and Gen Zs, and they've basically just planted a flag that says these things. Number one, we you want pet health care at the same level of human health care. Number two, I will pay for my dog and cat's care, at the same level I pay for myself, okay? I want the same amount of expertise. I want it anytime I ask for it, and I'll pay. I don't expect to have free consultations. Get right there, that's what we want.

How lucky can a profession be that that's the dynamic you're in? But I say it in the book, and chapter seven is devoted to pet healthcare, is that pet healthcare is racing to catch up to what millennials want it to look like. The practices that figure that out, are doing great. Part of that challenge, to finish that point is specialists.

When I grew up, the only specialists were at vet schools. The concept of an oncologist, a radiologist, an orthopedic surgeon, and that space was just not anything real to people. That's all changed. You have big practices like Red Bank, like Blue Pearls with 50, 60 doctors. Guess what? They have a huge shortage. They cannot find enough docs, nor can GPs, but that's an acute problem there, because people want it. A long time ago, we would have thought, no one is going to pay for that. Your dog is going to live 11 years. If he or she gets cancer at year nine, it's just, it didn't work out. That's not how it is anymore. What can we do about that? Let's go fix it.

 

How are you fighting the resistance from veterinarians that aren't on board with Telehealth?

We call it virtual care because it's more than just telemedicine, but I don't mind using either phrase, which we gave the association a different name. We're already at 3200 members after three months, which will put us in the top, I think 10 or 15 veterinary associations. So, there's a lot of interest. We've got a long way to go.

COVID's had a lot to do with that. For four years, people have thought about it, tried it here and there. Some have gone all in, but most haven't, and COVID changed that. Is there still a core group that are skeptical? Sure. The point I make, or association makes is, you don't have to use it if you don't want to. Nobody's proposing that there's a law that everybody has to use it. It is simply, if you're comfortable as a veterinarian, with your training in getting started with the client through Zoom, like we're doing here, that's your judgment, and why get in front of that?

Then there are the myths about it. There are the myths that it's all substandard. It's not below standard. You do what you can, you don't do surgery over the phone, you don't do that, but there's things you can do. We had a great response to our summit, we had six hours of programming, and we really aimed every session, David at getting not specialists, but getting practitioners comfortable with how you might use it. There's tons of resources now. There's no excuse for not learning about it and trying it, because the tools are there, and you don't have to shut your practice down, you don't have to turn all your staff into technology geeks. You could outsource, there's many ways that you can deliver a telemedicine experience, and you can make money on it. That's the biggest skepticism people had is, I don't want to just give advice over the phone. Well, I'm a lawyer, we always charge. It's insulting to say to a veterinarian, I wouldn't pay for your advice. I'm talking to you because you know something.

 

Don’t you think veterinarians almost need a flow chart of how virtual care will work to get on board?

That’s a great point and a great question. We devoted one session specifically to that topic of what are the things that naturally work in a telemedicine digital context, and what are the things that don't? Don't worry about those. Then, what are the different ways you can do more than you may be doing right now that are easy to do, what are things that a vet tech can do very, very well? We spend a lot of time just on basic blocking and tackling that…

 

Do we have that as a PDF or a presentation?

Yeah. You can still register for the summit, which is free, by the way. Go to vvca.org. You can register, anybody can right now. All the content is up for 90 days. So, another 75 days, so yes. Then we have what we call a 10 Myth busters, wonderful videos that BI did on the myths about telemedicine. I'd encourage you because you can watch 20 minutes and then come back in two days and watch another 20 minutes. I interviewed two experts in Ontario, which, if it were a state... It's where Toronto is, if it were a state, it would be the fifth largest state in the country with 15 million people. Very sophisticated.

They have completely legalized VCPR and telemedicine, period. They've had it for three years. Zero, and I mean zero, literally as of the day of filming, no complaints registered with the state board, or the provincial board about any injury or harm to an animal due to a telemedicine experience.

 

Where are we right now with the VCPR state by state in the US? How many are on board? How many aren't? What do you think is going to be changing soon?

Well, VVCA is going to have something to do with that. I'll say number one, we're not nearly where we need to be. Of the 50 states plus the District of Columbia, the 51 jurisdictions, three don't have a VCPR in their statute. So, you could do it anyway. But the rest don't allow or don't think they allow for VCPR to be created through telemedicine, and we're working on that. States are going to begin to experiment with different ways to stage it to get people comfortable, and that's what you need to do.

You mainly need practitioners using it with their existing clients at such a scale that they turn to the state and go, "Wait a second, this works. How much longer do we have to do this?" That's what happened in human medicine. Everybody fought it at first. Now, one state fights it, and 49 say, "Of course, you can." It's really tied to, you have somebody in an apartment, in a city. You have somebody 60 miles away in a farm in Eastern Kentucky, they're not driving to a vet. So, why not make it comfortable, convenient? There's actually no good argument for not.

 

Are you positioning your organization as the one who's doing a lot to collect that data from existing practices or clients?

The association, Veterinary Virtual Care Association, that'll be one of our four big missions, and we're going to be all over it, we already are. My group, Animal Policy Group, I've written almost as much as anybody on the issue, advocated, gone in front of state med boards, debated people at conferences. We're going to be all over it.

I think it'll take time. But success breeds followers, and it's going to be success practitioners have that pulls their friends in, their colleagues, the women they went to vet school with who try it, and suddenly it's like, why aren't we going to do this? That's where this is going to go. It won't be a downhill ski race. We're not going to just fly down the hill in one year and have 50 states on board. But you'll begin to see states look at and go, this makes sense. I'm optimistic it'll take some time, still.

 

If someone wants to buy your book, where should they go?

You can go any of the usual, Amazon, Barnes & Noble. Online you can get audio, digital, hardcover. You can pre order it, but yes, it's available, easy to get.

 

One of the things that we do here at Webinar Wednesday to wrap up each week to let our audience get to know you better is a game called “Would you Rather?” There's a book about 3000 Would you Rather questions that are just random and a bit weird. Would you rather be a long distance runner or a sprinter?

Sprinter. I was one, and my favorite dogs, a Corgi and a Papillon are short, fast, smart and funny. I'm five foot eight, and I used to sprint, not enough to do it professionally, but I'd rather sprint. Get it over with, right?

 

Would you rather never see another sunset or sunrise?

I'd rather never see a sunrise. What I do in the morning is indoors. I typically work and work out. In the evening, that nice glass of red wine in my hand, sunset doesn't hurt. In Arizona, you gets some sunsets.

 

Would you rather play team sports or an individual event?

A team sport. When you win, it's more fun. Celebrate with your teammates, and you can leverage skills that you don't have, and none of us have all the skills you need.

 

Would probably be a good listener or a good negotiator?

My friends and my colleagues would say, you're lying if I didn't pick negotiator. I negotiate for a living. My mom said, rest her soul, I was negotiating by the time I was three. Listening is important, but I negotiate for a living? I think I'd have to choose that. You’ve got to listen. You’ve got to listen but you got to... Negotiating is an art and I have a simple model. It's called, easy not hard. Make it easy to say yes, or hard to say no. The key is to know when you're in one situation, not the other. If you're in a hard to say no situation, don't think it's going to be easy to say yes. You've got to really build the case that makes it hard to say no. Most of the more important things I've done in my life and trying lawsuits and getting schools accredited and so forth, they fall on the hard to say no category.

 

Last sign off here, what are the places people can connect with you, follow you? What should they be doing? Who should they be following? Give your shoutouts.

Okay, Pet Nation, you can get the book anywhere you want. If you really want to understand what's going on, I think that book, it's a good read. It's 280 pages, so it'll take some time, but I think you'll like it. AnimalPolicyGroup.org is our grouping. You can learn a good bit about us. MarkLCushing.com is my author site. You have to have a site if you're an author, I'm told. Then I'm going to begin to do a lot more podcasts, and that's one way to find out.

I write quite a bit for Today’s Veterinary Business. You can check me out there. Other than that, when we have conferences again, I’m not hard to find. Hopefully, we'll meet up again sometime in our lifetime.

Everybody, thank you so much for tuning in. This is David Hall of GeniusVets. Remember, every single veterinary practice in the country has a full page profile currently live at geniusvets.com, your practice too. If you haven't seen it yet, go to GeniusVets.com/start, there's a video on there that explains it. You can check out your profile. It's yours for free. It doesn't cost you anything. So, claim your profile. Mark, thank you so much, and everybody, until next week, tune in to Webinar Wednesday.