COVID-19 Updates

For Texas A&M College of Veterinary Medicine & Biomedical Science’s updates, please see the CVM COVID-19 Updates page.


7/31/20

Texas A&M Small Animal Hospital to change Admission procedure

With the return of students for classes, the Texas A&M Veterinary Medical Teaching Hospital (VMTH) is refining our check-in process.

Small Animal Admissions

Currently, clients are not allowed in the Small Animal Hospital’s main lobby; however, we will ask you to escort your pet to the front when instructed.

Upon arrival, please park in a designated space and call the numbers listed on the sign. A Client Services Representative will assist you with your appointment check-in and provide instructions on when and how to bring your pet to the front of the hospital. It is VERY important to follow any instructions given, as our goal is to keep you and your pet safe.

NOTE:

  • ALL Cats MUST be in a carrier. If you do not have a carrier, please notify the representative when you call-in upon arrival.
  • All Dogs MUST be on a leash or in a carrier. If you do not have one, please notify the representative when you call-in upon arrival.

IMPORTANT: Please be aware that you may receive several phone calls from “Blocked” or “Unknown” numbers, these are likely from our staff, students, or veterinarians.  Please answer these calls.

An extended lobby, with limited sitting, is available for clients who are coming in from out-of-town or for those who are asked to stay onsite while we care for your pet. The extended lobby also has restroom access.

After dropping off your pet, please feel free to return home or run errands. Information about local shopping and dining is available at https://www.experiencebcs.com/. We will notify you when your pet is ready for pick up. All invoices will be handled over the phone at the time of discharge.

Thank you for allowing us to care for your pet while teaching future Aggie Vets!!!


7/18/20

Statement from CVM on Animals and COVID-19

COVID-19 and Animals

SARS CoV-2, the cause of COVID-19, is a novel, or new, virus, and there is much yet to be discovered.

There have been recent news reports of a tiger that contracted the disease from a handler who was an asymptomatic carrier and other reports where experimentally exposed animals have developed clinical signs consistent with coronavirus infection that was then passed on to other animals. These studies were performed on very small numbers, have not gone through the normal review process, and have focused on human-to-animal and animal-to-animal transmission.

However, there have been no studies to date demonstrating that domestic animals and pets can transmit COVID-19 to their owners.

The Texas A&M College of Veterinary Medicine & Biomedical Sciences (CVM) and its Veterinary Medical Teaching Hospital (VMTH) are continuing to monitor research and news regarding the SARS-CoV-2 virus and the COVID-19 outbreak as it relates to companion animals.

Based on the information that is currently available, the CVM and VMTH recommend pet owners continue to follow United States Department of Agriculture (USDA), Centers for Disease Control & Prevention (CDC), and American Veterinary Medical Association (AVMT) guidelines for proper hygiene and social distancing.

What You Need to Know About COVID-19 and Pets

Specifically, the CVM and VMTH recommend referencing this PDF for more information


6/30/20

Texas A&M Small Animal Hospital Scales Back Operations

With the increase in the number of cases of COVID-19 in the state, the Texas A&M College of Veterinary Medicine & Biomedical Sciences’ (CVM) Veterinary Medical Teaching Hospital (VMTH) is taking additional steps as we work to keep clinicians, support personnel, students, clients, and other hospital visitors as healthy and safe as possible.

In doing so, beginning the week of June 29, the Small Animal Hospital will begin scaling back operations by temporarily reducing some of our scheduled appointments for elective cases.

This is one of many steps the VMTH is taking to minimize the possibility of exposure to COVID-19 for anyone who visits the Small or Large Animal Hospitals.

In addition to continuing to encourage faculty, staff, and students to follow Centers for Disease Control & Prevention guidelines for physical distancing, mask-wearing, and personal hygiene, the VMTH has also continued increased cleaning protocols and is working to implement guidelines for monitoring and managing the potential for the spread of COVID-19 in the event hospital faculty and staff test positive for the virus.

Because the VMTH is an essential entity and we understand the importance of providing veterinary care to animals in need during this time of uncertainty, we hope that these safety measures will allow us to continue operations while being responsive to the needs of hospital personnel.

As always, we appreciate your patience and understanding as we navigate the changing circumstances presented by COVID-19.

For more information, please call the Small Animal Hospital at (979) 845-2351.


4/19/20

parking sign reads Please remain in your vehicle & call 979-845-3232 or 979-458-2590 Parking Space #1 To pick up medications call 979-845-9118 • Texas A&M University Veterinary Medical Teaching Hospital logo

The Texas A&M College of Veterinary Medicine and Biomedical Science’s (CVM) Veterinary Medical Teaching Hospital (VMTH) is continuing our efforts to provide essential veterinary medical services in a way that is safe for our clients, faculty, and staff.

Small Animal Admissions

Curbside admission and discharge processes will continue at the Small Animal Hospital; however, during the admissions process, we will ask that clients enter the normal Small Animal Hospital Parking Lot (Lot 38), off of Raymond-Stotzer Parkway.

After turning into Lot 38, clients can park in any of the numbered spaces and should call the telephone number listed on the sign to get their pet checked in and begin the admissions process.

parking sign reads Food Animal Parking Space #F1 Please Remain In Your Vehicle & Call 979-845-3541 to Begin the Screening Process • Texas A&M University Veterinary Medical Teaching Hospital logoLarge Animal Admissions

Curbside admission and discharge processes will also continue at the Large Animal Hospital. Clients will continue to use the traditional route to the Large Animal Hospital (from Raymond-Stotzer Parkway, turn onto Veterinary Way and then right at the stop sign, following the road around to and through the gates).

Once in Lot 45 (the normal Large Animal Hospital client parking), clients can park in numbered spaces designated for equine and food animal patients (please see the map below). Clients should then call the telephone number listed on the sign to begin the admissions process.

While these admissions processes are different than how we normally function, our commitment to providing excellence and compassion remains the same.

We urge everyone to stay safe and heed all public health recommendations for successfully navigating through the COVID-19 pandemic.

map illustrating updated procedure for Small Animal and Large Animal Admissions at the Texas A&M Veterinary Medical Hospital


04/09/20

As the Texas A&M College of Veterinary Medicine & Biomedical Sciences’ (CVM) Veterinary Medical Teaching Hospital (VMTH) continues in its mission to care for urgent and emergent cases during the COVID-19 pandemic, we wanted to provide another update on new procedures and resources available for our valued clients, referring veterinarians (rDVMs), and friends.

Temporary Small Animal Hospital Entrance set up during COVID-19 VMTH operations

Emergency & Critical Care Service
As part of the VMTH’s efforts to focus on urgent and emergent cases, we have made changes that allow hospital clinicians and support staff to provide the best care possible for our patients. As part of this, the VMTH has closed the Emergency & Critical Care (ECC) Service during daytime hours Monday through Friday.

Patients are now being routed directly to a specialty service for evaluation and treatment instead of first being received by ECC Service, which traditionally evaluates and directs the patient to the appropriate specialty service.

This allows the hospital to streamline care for urgent and emergent cases, while also allowing our Critical Care area to focus on in-house patients that require longer-term care.

To help facilitate this process, we are asking clients and rDVMs to call ahead to one of the numbers below and speak with a staff member about the patient so that when the patient arrives, he/she can be routed to the appropriate specialty area.

Large Animal Hospital: 979.845.3541 | Small Animal Hospital: 979.845.2351

Female veterinarian in exam room with a kitten discussing a case via web conferencing with a female VMTH clinician

Telemedicine Expansion
Because COVID-19 has necessitated the postponement or cancellation of many elective appointments, our VirtualVet program has now expanded to include many services within the Large Animal Hospital (LAH).

Telemedicine visits can be used for rDVM case consultations, to review radiographs/other imaging modalities, and to develop diagnostic or treatment plans through our secure and user-friendly online platform.

Details on the VirtualVet program, including how to connect, instructions for account creation, clinic codes, and other support information, is available online. rDVMs may also contact one of the VirtualVet team members at 979.845.3541 (ask for Ryan Kirk, Emily Adamson, or Dr. Lori Teller), by email at VirtualVets@cvm.tamu.edu, or by visiting https://vetmed.tamu.edu/virtualvet/.

The VirtualVet program is also continuing to offer online visits to some of our clients with both large and small animals for a nominal fee.

Reducing COVID-19 Transmission
The CVM and VMTH are continuing to monitor research and news regarding the SARS-CoV-2 virus and the COVID-19 outbreak as it relates to companion animals.

While there have been no studies to date demonstrating that domestic animals and pets can transmit COVID-19 to their owners, VMTH veterinarians continue to encourage basic precautions such as frequent and thorough hand-washing and limiting “face-to-face contact” interactions with your pet.

Because a pet’s body, like any other frequently touched surface, may carry the virus if touched by infected individuals, the CVM has created the above video resource that discusses how to appropriately decontaminate a pet that may have been exposed to the virus.

Thank You
The VMTH is dedicated to providing the best possible care to all of our patients during this unprecedented time.

As always, we thank you for the kindness and patience we have witnessed as we have worked to adapt to the changing circumstances and ask that you continue to monitor our website—vethospital.tamu.edu—for updates on the hospital’s COVID-19 response and for additional updates on hospital services.


04/08/20

Statement from CVM on Animals and COVID-19

COVID-19 and Animals

SARS CoV-2, the cause of COVID-19, is a novel, or new, virus, and there is much yet to be discovered.

There have been recent news reports of a tiger that contracted the disease from a handler who was an asymptomatic carrier and other reports where experimentally exposed animals have developed clinical signs consistent with coronavirus infection that was then passed on to other animals. These studies were performed on very small numbers, have not gone through the normal review process, and have focused on human-to-animal and animal-to-animal transmission.

However, there have been no studies to date demonstrating that domestic animals and pets can transmit COVID-19 to their owners.

The Texas A&M College of Veterinary Medicine & Biomedical Sciences (CVM) and its Veterinary Medical Teaching Hospital (VMTH) are continuing to monitor research and news regarding the SARS-CoV-2 virus and the COVID-19 outbreak as it relates to companion animals.

Based on the information that is currently available, the CVM and VMTH recommend pet owners continue to follow United States Department of Agriculture (USDA), Centers for Disease Control & Prevention (CDC), and American Veterinary Medical Association (AVMT) guidelines for proper hygiene and social distancing.

Specifically, the CVM and VMTH recommend:

  • Pet owners should continue taking basic precautions such as frequent and thorough hand-washing and limit “face-to-face contact” interactions with your pet.
  • Owners who are not sick do not need to isolate from pets, nor is there any recommendation to discontinue routine activities such as walking or playing with your pets if you are well.
  • If you have tested positive or are presumptively positive for COVID-19, separate yourself not only from other people but also from your animals. This may include having someone who is healthy feed your pets and not allowing your pets to sleep with you.
  • If an animal has to be removed from a household with someone who is ill, the pet should be bathed or their coat should be wiped to prevent transmission of the virus from the animal’s fur.

The COVID-19-Positive Household

If you or a family member have been diagnosed with COVID-19 and your pet becomes ill and shows signs of upper respiratory disease, we encourage you to contact your veterinarian. They may elect to test your pet for COVID-19. Testing requires approval from public health and animal health authorities and is only recommended for those animals exhibiting respiratory signs and that come from a household with someone who has been diagnosed presumptive or positive for COVID-19.

We want to repeat that there have been no studies to date demonstrating that domestic animals and pets can transmit COVID-19 to their owners. CVM veterinarians will continue to monitor news and scientific journals regarding COVID-19 transmission for animals and humans and with time and as new information becomes available, the CVM will continue to update its recommendations on COVID-19.

For more information about COVID-19 and pets, please see the USDA question-and-answer page at https://www.aphis.usda.gov/aphis/newsroom/news/sa_by_date/sa-2020/ny-zoo-covid-19.

You may also visit the Texas Animal Health Commission’s (TAHC) webpage on companion animal coronavirus testing at https://www.tahc.texas.gov/covid19/TAHCVeterinaryGuidance_COVID_CompanionAnimalTesting.pdf.


03/20/20

March 20 VMTH Town Hall Notes

The following are notes from the Q&A session during the Texas A&M Veterinary Medical Teaching Hospital’s (VMTH) ZOOM Town Hall on Friday, March 20, 2020, at 9:00 a.m. CDT.

Q: Should we have veterinary technology students coming into the building from Houston, and are we screening them?

A: We have currently taken the stance to not screen employees, but are continuously encouraging people to follow healthcare advice and stay home if they have any symptoms.

Q: How far out can we cancel non-urgent appointments?

A: Elective non-essential cases: Can wait a week or two, but can’t be canceled long-term. We’re currently looking at how to open up the schedule to things that can’t wait long-term.

Q: Can you please elaborate on how we are addressing the mental health of employees on the hospital floor?

A: We’re thinking about it and communicating with other veterinary hospitals on their plans, and you should see something coming out in the next few days with more information about resources to promote mental health in this situation.

Dr. Wes Bissett volunteered to serve as the conduit for assistance that the VET team can provide.

MD Live is offering no fee for call-in, for any medical issue and likely for counseling support. Sandra Church will send out more information. (See additional 03/20/20 update beneath this one.)

Q: I work in VTPB administration, but is there anywhere that I can volunteer in Small or Large Animal?

A: The best place to direct that request too for right now would be Sheila Carter and Dr. Wes Bissett, and they can help determine how your expertise can be best utilized.

Q: What is the plan to scale down the way we are working now? This is a problem likely to be with us for 6 months or so…what’s going to happen with the new student year in May?

A: Local and wider spread of the virus, animal health needs, staffing, PPE availability; daily conversations are taking place at the moment. We are doing our best to address the unknown contexts.

We’re in the process of making plans for different contingencies. At the moment, it’s too early to say what the situation is going to look like come May. We will roll out information about the contingency plans as they become available.

Q: Will there be any support for parents with children if schools in the area close until August?

We’re having these conversations currently, and we’re trying to reassign people to accommodate as best we can, and avoid people needing to take leave to care for their children.

Q: I’m currently seeing alerts that they are calling for veterinary medicine hospitals to volunteer their ventilators for human use. As cases increase that may change where they may ask to report them. Is there any concern in the near future that human hospitals will use our resources, or perhaps use our facilities?

A: This is an evolving situation, and we’re trying to be cognizant about the use of PPE and shortages in the human health sector. We’ve been in contact with emergency medicine leaders and student health to determine where needs may be.

Dr. Wes Bissett: Could it happen? Yes, it’s happened before and it was very successful. But every effort is being made to ensure that leaders in these areas are aware, and we are providing them with the information to help make the best decision possible.

Q: Do we have VMIS running in our homes?

A: VMIS is available through the remote desktop system. There’s a webpage with the link to set everything up to be able to access resources. (See the REMOTE ACCESS page at the CVM website.)

Q: With our increase in cleaning is there any concern with our cleaning products, such as Rescue, being available?

A: Right now, we have enough and aren’t short on anything; most of our allotment will reset in April, so hopefully they will be able to honor the promised order for April. We believe we should be okay.

Our purchasing group and pharmacy are looking for additional cleaning supplies locally each day to get items if they are needed.

SSC Custodial also has a high level of confidence that they have enough product in stock to maintain paper towels, hand sanitizer, etc.

Q: If there’s a shelter-in-place order from the governor like in California, do we know what that will mean for the hospital?

A: It depends on if veterinary services are deemed essential. If they are deemed essential, we will remain open, and people will still be able to travel here. Right now, the understanding is that veterinary medicine would be deemed an essential business. In the stimulus package being considered by the U.S. Senate, there’s a stipulation that veterinary medicine would be considered essential as well. If that’s passed, we would remain open.

Q: If Texas A&M decides to ask students to leave the dorms, what will happen to our student worker positions? How long will we be able to maintain our student workers?

A: We will employ student workers as much as possible, with the understanding that if they live on campus and dorms close, they would not be able to stay and work. However, we are working on opening student worker positions for some of our 4VM students who would like to stay and work. We will maintain student workers unless Texas A&M tells us we’re unable to.

Q: Has there been any discussion about relaxing the requirement for in-person examination for the establishment of a telehealth VCPR?

A: Dr. Lori Teller: State board issued a statement earlier this week that you should still establish a VCPR with a hands-on physical exam. After that point, use your best judgment.

Q: What happens if we get a positive COVID-19 test in one of the hospitals or a positive test with a family member that lives with an employee? Is there a mechanism in place yet?

A: The health department would come in and do contact tracing, and employees that were deemed to have close contact with that person would be moved into self-isolation. More guidance on workflow pattern logistics should be coming within the next 24 hours.

We do recognize that this is stressful for everyone involved, but the purpose of processes that we’re implementing is that when someone tests positive, we can limit who they have been in close contact with rather than having to close down the whole hospital.

Dr. Wes Bissett: Remember that you are responsible for your health and the health of those you work with, so please look at it that way, and keep that in mind in your daily activities outside of work as well. Start thinking as a service unit about social distance, and think about where you go as a unit outside of work. Take simple steps to limit your exposure, and try to maintain consistency across the service.

Q: Can you further elaborate on plans for house officers? How is the hospital planning to support house officers if we are rearranged to other services and how will this affect our residency/internship requirements?

There is a working group on the Small Animal side looking at case capacity, residency program requirements, and service needs. We hope to share more information about that by Monday at the latest.

Q: Do we know where it’s possible to get tested for COVID-19 in town (since some of us may be self-isolating at this point for allergies)?

There is a local concierge doctor, and the way the process works us that you have a phone screening to determine symptoms and if they deem that testing is needed, they will send someone to your house to have you tested, if you are denied testing by a hospital. MD Live may also have options for this.

Q: I know this question is floating around among staff members. If we are working half days, are we allowed to use sick time to cover the other part of the day? If schools are closed can parents utilize sick time?

A: We’re trying to give alternate work options whenever we can, and main campus is wanting to be flexible and work with everyone as much as they can. Work with your supervisor and contact Sandra Church in HR about developing and “Alternate Work Location” plan.

Q: Do we feel that having to spread our technicians and student workers to other services to accommodate shortages is increasing all of our risks if someone does test positive, as they asked about above? What kind of steps to we have in place to help this? This would be more for asymptomatic people rather than people who feel sick and come to work anyways.

A: We’re doing our best to think about that and working to modify workflow in areas that are high traffic. We’re working to develop a more strategic plan about the workflow process when people are moving across sections. One conversation is that staff will wear PPE if they cross service areas to lend support.

Q: Could we consider letting fourth-year veterinary students volunteer instead of taking veterinary technology students we don’t know?

We prefer to hire them as student workers, and we’re looking to determine what the staffing needs are, rather than having more people come in than we need, or in areas where they’re not needed.

Dr. Karen Cornell: For various reasons, we cannot have them volunteer. Happy to share the logistics but essentially the answer is no.

Q: If this stretches into the summer, are there different plans for the intake of owners/pets? As it starts to heat up, it may become difficult for staff to continue to be based outdoors for long periods of time.

A: We’ll be using some of the VET inventory (like air-conditioned tents) as it heats up to make that process work better and to protect staff and animals

Q: Do we need to plan for incoming interns and residents?

A: There are a lot of unknowns between now and July. Small Animal has been having preliminary conversations about this and trying to determine how we will move forward as we learn more about travel, exam availability, etc.

Dr. Karen Cornell:
State board exam for graduating students: We will shuttle students in on the dates that they would normally take the state board, and we will bring students in groups of nine to complete their exams in a proctored setting while maintaining social distance.

Spring NAVLE date: Currently in flux right now and many of their testing centers are closing. The NAVLE window is currently pushed back and NAVLE has been reaching out to students to reschedule for free for the fall. The vast majority of our students have passed the NAVLE, but not all have sat the exam yet.

Q: Can we pair up techs so that physical duties that require close contact is with the same person to limit cross-contamination?

A: We will continue to look at these kinds of solutions and you’ll see more guidance and potentially more changes coming. We would like to slow the pace of change, but we’re trying to focus on keeping everyone safe.

Comment from Heather Moberly: The Medical Sciences Library is virtual. However, many veterinary resources are only in print. We can transfer our print to multimedia materials temporarily to the VMTH. We can scan print to PDF. We can pursue increasing online access to materials. We are available to assist virtually with lit search, etc. Just ask!


03/20/20

MD LIVE Inc. Telehealth Services at No Cost to A&M Care Members

Get access to care 24 hours a day, seven days a week by online video, mobile app or phone.

Texas A&M System Chancellor John Sharp has temporarily reduced the copay for MD LIVE Inc Telehealth services to $0 beginning 3/19/2020, in an effort to facilitate access to medical care for all A&M Care members. MDLive Virtual Visits is a feature through the BCBS A&M Care Health Plans that lets you visit independently contracted MDLIVE board-certified doctors when you may need care or have medical questions. Plus, they may even write and send prescriptions to a nearby pharmacy (when appropriate).

You may want to have a virtual visit:

  • Instead of going to the ER or urgent care for non-emergency visits
  • If your doctor is booked
  • While at home, work or on-the-go

This alternative provides safe and convenient care for 50+ non-emergency medical & behavioral health conditions 24/7/365, including the common cold and flu, ear problems, headaches, nausea and more.

To use MDLive, have your BCBSTX member ID card ready, and:

  • go to http://mdlive.com/bcbstx and activate your account,
  • download the MDLive app on your phone, or
  • call customer service at 1-888-680-8646.

If you have questions call 1-888-680-8646 to speak with an MD LIVE Inc. Telehealth Services representative.


03/20/20

See the CVM’s latest press release about the VMTH’s COVID-19 response.
Texas A&M Veterinary Medical Teaching Hospital Implements Changes to Protect Staff, Clients


03/15/20

Dear clients and friends of the VMTH:

We wanted to communicate the steps that the Texas A&M College of Veterinary Medicine & Biomedical Sciences’ (CVM) Veterinary Medical Teaching Hospital (VMTH) has taken to ensure the safety of our community and patients in light of the COVID-19 pandemic.

  • Currently, we are only receiving urgent and emergent cases to direct resources to those animals most in need of medical care.
  • The VMTH has dramatically enhanced disinfection within the hospital to include surfaces that are commonly touched, including in exam rooms, clinical areas, and lobby spaces.
  • Staff, clinicians, and students have been instructed to follow CDC guidelines on good hygiene to prevent the spread of infection.
  • The VMTH is reducing the number of staff, faculty, and students on-premises to limit exposure

For clients, we are also taking additional measures beginning Monday, March 16:

  • We are screening clients for clinical signs compatible with COVID-19, so that we can appropriately handle animals and take contact precautions.
  • We are now using a car-side admissions and discharge process:
    • Clients will drive with their pets to an alternate location, in the Large Animal Hospital parking lot, be checked in car-side, and have a history taken via cell phone (instructions will be provided at admissions).
    • Animals will be greeted car-side by our staff and brought to our hospital for diagnosis and treatment.
    • Clients will have limited access to our facilities but may stay on-site in their cars. We encourage all clients to depart the hospital and wait for a message regarding when their animal will be ready for discharge.
  • Clients needing prescription refills for their pets should call the VMTH Pharmacy at (979) 845-9118 or log into the VMTH Client Portal at https://vet.tamu.edu/client.
  • In addition, clients who are unsure whether their animal’s condition is urgent or emergent are encouraged to call the Small Animal Hospital at (979) 845-2351 or the Large Animal Hospital at (979) 845-3541 for pre-screening.
  • We anticipate increased wait times for our clients and we greatly appreciate the patience of all as we work to deliver the very best care in the safest way possible.

As always, our goal is to continue to provide outstanding patient and client care, while providing our students with a positive learning experience.

Please continue to monitor the VMTH website—at vethospital.tamu.edu—for updates on the hospital’s COVID-19 response and for additional updates on rescheduling appointments. 

Thank you for your patience and kindness during this challenging time.


03/13/20

In order to provide the highest level of care for our patients and clients, the Texas A&M Veterinary Medical Teaching Hospital is asking a few questions of our clients prior to all scheduled appointments.

If you or a family member is displaying flu-like symptoms (including a new or worsening cough and/or fever in the past 14 days) or have traveled to countries with sustained community transmission of COVID-19 in the past 14 days, we ask that you reschedule your appointment.

If rescheduling is not possible because your animal has urgent or emergent healthcare needs, please notify the Small Animal Hospital at 979-845-2351 and the Large Animal Hospital at 979-845-3541 before arrival so that we may take appropriate measures to assure your safety and the safety of others.

In addition, when visiting the Veterinary Medical Teaching Hospital, we encourage you to follow CDC guidelines for personal health and hygiene:

  • Wash your hands with soap and water prior to coming to the hospital;
  • Use provided hand sanitizer upon arriving at the hospital;
  • Avoid touching your eyes, nose, and mouth;
  • Cover your mouth and nose if you cough or sneeze, using a tissue or your inner elbow (not your hands); and
  • When possible maintain a safe social distance (6 feet) between yourself and others and abstain from shaking hands.

We greatly appreciate your help in working to ensure the safety of our visitors, faculty, staff, and students at the Texas A&M College of Veterinary Medicine & Biomedical Sciences, as well as other clients and patients.