November 18, 2010
Canine Health Institute closing its doors
Veterinary center for pain, rehab, imaging, neurosurgery was unique
By: Edie Lau
For The VIN News Service
A posh 6,000-square-foot veterinary center devoted to dogs needing pain treatment, physical therapy, neurosurgery and imaging services is closing this month, not quite two years after it opened.
The Canine Health Institute in Houston was doomed by tough economic conditions and other unfortunate events, according to its leaders.
“It’s a pity, because it’s such a beautiful facility, and the employees were absolutely great,” said owner Dr. Jeffrey Kozak, MD, a spinal surgeon who opened the facility in 2009. “It’s a vision that I think was right. ... It just wasn’t at the right place and the right time.”
Kozak believes the economic recession was the institute’s biggest hindrance but identified other factors, including an apparent unwillingness of area veterinarians to support the venture by referring cases.
“We tried very hard to market (to) and educate the Houston veterinarians, but after 15 months, it was pretty apparent that the veterinary community was still hesitant to approach rehabilitation or diagnostic imaging in a way that would make the business model sustainable,” he said. “The amount of volume generated in a town of 4 million (people) was just very disappointing.”
Kozak took some of the blame, as well. “I’m sure the fact that I was not a veterinarian played a role... If I had been a veterinarian, I think I would have been more conservative,” he said, noting that the level of medical services for which pet owners are willing or able to pay isn’t likely to match human medicine, which is funded predominantly by insurance.
“We were overconfident and trying to do everything we could to live the vision,” Kozak said.
In an interview with the VIN News Service in early 2009, Kozak and his wife at the time, Vickey Kozak, described themselves as lifelong animal lovers who wished to save and improve dogs’ lives by providing access to medical services that are standard for people.
Vickey Kozak imagined a center for rehabilitation therapy that could help geriatric dogs that might otherwise be euthanized. Jeffrey Kozak championed the pain-management component because his experience as a spinal surgeon told him that controlling pain is an important part of healing.
To Kozak’s thinking, comprehensively addressing pain required state-of-the-art imaging equipment, in part to aid in diagnoses and in part to guide treatments that involve injecting medication directly into inflamed joints and nerves.
The institute occupied 6,000 square feet in an upscale strip shopping center and involved an investment in the millions. “It was leased at a time when the real estate market was at a high, and we opened up right after the economic downturn (hit),” said Dr. Stephen Pittenger, DVM, medical director of the institute. “Despite all of that, we were still making it work.”
But Kozak said the business struggled from the start. “It was never close to paying the overhead,” he said. “We never had a single month that came anywhere close.”
In the fall of 2009, Kozak said, he had to decide whether to close the practice or do something to try to generate more business. He opted to expand, adding neurology and neurosurgery services and regenerative medicine. The latter involved establishing an in-house stem cell laboratory to support experimental treatments in which stem cells derived from patients’ adipose tissue were injected into arthritic joints or injured tendons.
The changes initially brought an encouraging uptick in business but demand proved erratic, in keeping with the stuttering economy, Kozak said.
Events in the personal lives of the institute’s players had an effect, as well.
The Kozaks divorced, and the center’s single full-time neurosurgeon, Dr. Dan Hicks, decided to relocate to his home state to be closer to family.
“It was like a double whammy,” said Pittenger, who perceived that the Kozaks’ breakup sapped the owner’s will to continue the business.
Kozak said the divorce did not precipitate his decision to close. “The business was failing long before the marriage was an issue,” he said.
In any case, Kozak decided to try to sell the center. Pittenger said the practice was growing and that the veterinarians could have taken over without any further financial backing, but the neurosurgery component was critical. Unfortunately, he said, the team was unable to find a replacement for Hicks.
“Finding a (veterinary) neurologist is like finding a needle in a haystack,” Pittenger said. “There’s not enough out there. We had a line on one, and I think he would have moved, but his wife didn’t want to move.”
(According to the American College of Veterinary Internal Medicine, board-certified neurologists practicing in the United States, Canada and Europe number 195.)
The institute was left with one part-time neurologist who was unable to assume full-time duties due to family obligations. Pittenger said the neurology and neurosurgery practice was essential to the center because it provided the patient flow needed to support the expensive imaging equipment.
Pittenger was not immediately able to recount how many patients were treated at the institute, but he said the center performed about 350 scans, mostly MRIs.
Kozak said he talked with veterinarians elsewhere in the country who expressed interest in taking over, but nothing panned out.
Pittenger said the equipment will be sold to try to defray some of the financial loss. He noted that human hospitals may be interested in the MRI and CT scanners.
Dr. James Rieman, a small-animal practitioner in Houston who referred eight to 10 patients to the center, lamented its closure. “It was a great idea and really filled a need here,” he said.
Dr. Robert Stein, a veterinary pain specialist with expertise in rehabilitation therapy and acupuncture located near Buffalo, N.Y., said in an interview by e-mail that he was “deeply saddened” by the development.
“The Canine Health Institute represented an ideal approach to comprehensive pain and functional management,” said Stein, who is immediate past president of the International Veterinary Academy of Pain Management.
To interpret the center’s closure as a failure of the concept, Stein said, “wouldn't be fair; there are too many factors influencing (its) current tenuous state.”
He noted that the needs of a majority of dogs and cats requiring treatment for pain and functional management can be met by smaller scale pain-management and rehabilitative services, but that the services must be provided in collaborative efforts.
“The patient is not well served by acupuncture, rehabilitative, and allopathic pain services functioning as disconnected islands,” he said. “There needs to be a team-oriented dynamic that leverages the best qualities of each discipline based on the unique needs of a given patient.”
Although rueful about the institute’s end, Pittenger, who owns a separate practice, said he is confident the remaining veterinarians and staff will find other jobs. He takes satisfaction in knowing the team demonstrated that a specialty veterinary rehabilitation, pain medicine, imaging and neurosurgery center was doable.
“It was a lot of fun,” he said. “It certainly was a unique concept.”
VIN News Service commentaries are opinion pieces presenting insights, personal experiences and/or perspectives on topical issues by members of the veterinary community. To submit a commentary for consideration, email firstname.lastname@example.org.
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