New equine vets: The tools you need to start off on the right hoof
Kyle Palmer, CVT
Long-time dvm360 magazine and Firstline contributor Kyle Palmer, CVT, is hospital manager for VCA Salem in Salem, Oregon, as well as a practice management consultant for a number of other hospitals.
You have the veterinary degree. Now you need the equipment so your business can break into a gallop. Heres some guidance on what you should buy now and what can wait until later.
(callipso88 - stock.adobe.com)Four years of undergrad school: check.
Four years of veterinary school: check.
One year (in some states) of internship under supervision: check.
For equine practitioners beginning a solo career or starting their own business as part of a group, an important question must be tackled next: What equipment do I need right now, and what can I put off buying until later? The short answer is, it depends. If you want the long answer, keep reading.
Unless you're planning to operate a 100 percent haul-in practice, you'll need to put some thought into your ride. Having a vehicle with four-wheel drive seems important in almost any geographical area, but those who expect to traverse significant distances in the course of practice should also consider fuel efficiency. Overlooking the cost of gasoline as part of your operating budget can be an expensive mistake.
While some practitioners would argue that the type of vehicle plays a crucial role in the client's perception of value and the veterinarian's qualifications, having a vehicle that meets your needs and contributes to organizational efficiency should be the focus. In other words, it may not be as important to roll up in a fancy pickup when a well-stocked minivan could make your life easier on a daily basis. A strong argument in favor of a pickup truck and prefabricated “vet box” is the ability to have your own water available. However, there are other ways to get access to water, and I know practitioners who've simply used their clients' water their entire careers.
The verdict: Immediate need. But don't saddle yourself with unmanageable debt or ongoing gas and maintenance issues that will drain your resources for many years to come.
Despite incredible advancement in technologies over the past 10 years, the most important component of any veterinary appointment remains the comprehensive physical exam and history. For equine work, the statistical frequency of lameness points to having a top-notch set of hoof tools at the ready when you drive out for your first day. Hoof testers, a good hoof knife, a hoof searcher and a hoof groover will ensure that the abscess is easily diagnosed, located and drained. And while you may not be a farrier, having some basic farrier tools will also come in handy, because your diagnosis may depend on removing a shoe or trimming a section of split or broken hoof.
It's hard to imagine any recent veterinary school graduate not having one already, but a high-quality stethoscope is essential. Given the nature of equine work, it's not a bad idea to buy two. Nothing makes a new practitioner look inept faster than not having one on hand. Even experienced veterinarians will admit they've left theirs behind on a call more than once, not noticing the absence until the next stop.
Small instruments such as a needle driver, thumb forceps, hemostat, surgical scissors and scalpel are vital components of minor field surgery and should be with you at all times. And because general practice seems to include the opportunity to castrate horses on at least a periodic basis, you can stock your vehicle with a dependable emasculator without breaking the bank.
Restraint is a touchy subject based on your philosophy, but carrying a couple of twitches (see previous comments about leaving something on a call) and stud chains can make your life easier on occasion. Assuming that the client has these things and knows when and how they should be used can edge you closer to danger in certain situations.
Since performing an eye or ear exam without an ophthalmoscope or otoscope is nearly impossible, invest in one of each (or a dual-use product). While some may tell you that you'd know in advance if such equipment was needed, I don't recommend relying on your clients' understanding of all of their horses' needs.
The verdict: The whole list above is an immediate need.
Diagnostic imaging machines
Because of cost considerations, this is an area that may inspire some debate. Digital radiography is available in computerized radiography (CR) and direct radiography (DR) formats, and only one of these is appropriate for a completely ambulatory practitioner.
DR units allow you to produce an image onsite in real time, which is highly valuable in terms of getting an immediate diagnosis and impressing clients. CR units require the use of cassettes (which aren't cheap) and a fixed-location piece of equipment that computerizes the images. That equipment can't be taken on the road and would presumably be best suited for a practice with a brick-and-mortar location or a mixed-animal practice. The downside of CR is often a fixed and limited number of cassettes and always a delayed diagnosis as they have to be processed later. Price considerations mean you need to think about how radiography will fit into your practice from day one.
Join a team?
One concept worth exploring is that of multiple mobile practitioners using the services of a centrally located veterinarian with a practice focused on radiography. Instead of having 20 solo practitioners each carrying around $50,000 worth of equipment that is used only occasionally, everyone would refer their clients to the same veterinarian for digital radiography.
Ultrasonography is also expensive and only occasionally used, but if you're planning on charging hard into the area of reproduction, then by all means, you'll need an ultrasound on hand every day. If you're not planning on doing any reproductive work (and many new practitioners can be squeamish about it), take a good look at waiting on this one. For rural practitioners, the concept above of a centralized practitioner focused on imaging could help here too.
The verdict: Weigh the costs. Consider starting your practice with neither of these pieces of equipment or just a basic radiography unit until you have a better handle on how often you'll use it and what options exist in your area for taking care of these patients in other ways.
This depends on your practice. Proper motorized dental equipment, including handpieces and burs, can present significant costs. If this isn't a service you plan to initially offer, depending on where you live, you may be able to refer patients to another veterinarian in the area who focuses exclusively on dentistry. A good compromise would be to carry some inexpensive hand floating tools in case you come across something minor that requires immediate intervention while waiting for another veterinarian to see the horse.
The verdict: Depends on you. If you plan to do a lot of dentistry, invest in dental equipment. If you're not sure, hold off and see how your practice develops.
Some veterinarians actively use shockwave and cold-laser therapy on patients with both acute and chronic lameness. Many practitioners still question the scientific measurement of the success of these treatments, and both present an unnecessary initial expense to a practitioner worried about cash flow and debt.
The verdict: Unless you sleep on a mattress stuffed with cash, hold off.
Starting a new practice comes with a great deal of unknowns: How busy will you be? What services do you want to provide? What services will your clients demand you provide? What services can you refer to another veterinarian without losing clients? As a new practitioner, you can expect to have a certain amount of practice-related stress in your life, so there's no good reason to add the fear of financial insolvency to the list. Plan smart, buy smart and practice smart, and you'll be sure to be around for years.
Kyle Palmer, CVT, is a frequent contributor to dvm360.com and dvm360 magazine, a Firstline Editorial Advisory Board member, and practice manager at Silver Creek Animal Clinic in Silverton, Oregon. Send your questions or comments to email@example.com.