Veterinarians are superb multitaskers. We juggle many responsibilities throughout the day; answering phone calls and emails, working up cases, managing client expectations and staff concerns, finishing administrative paper work and dealing with the myriad of other problems that tend to arise.
When I talk to other practitioners about why, in a busy practice with multiple associates and a strong medical focus, ultrasound has not been added, I typically hear the same three concerns:
- Some feel that there is not enough time in the day to learn a new technology.
- The practice won’t be able to pay off the machine.
- Clients will find the cost too expensive.
I actually believe the exact opposite on all three of the above reasons.
No Time To Learn New Technology
Yes, learning a new skill takes time and an open mind. However, I can tell you from firsthand experience that these machines have become incredibly user–friendly since I was in veterinary school 20 years ago. Companies with ultrasound technology understand the time constraints most small animal practicing veterinarians are under and want to guide you on how to apply the machine instantly, as such, most offer online or on–site support to help integrate the machine into your practice.
Additionally, having credentialed veterinary technicians learn to use this tool helps elevate these staff members and makes them feel a more integral part of the team, while saving valuable veterinary time.
Example: One of the fastest ways to start implementing ultrasound into daily practice is the utilization of ultrasound for cystocentesis. This is an introductory skill that can be quickly taught to all veterinarians and credentialed veterinary technicians in a short time period. Not only is this a great revenue stream for a profit center, it is most importantly better medicine. A quick, cursory scan of a canine or feline bladder with a standard probe can diagnose bladder stones, polypoid cystitis, a thickened bladder wall and even suspect bladder tumors (and a very valid reason to NOT obtain urine by cystocentesis.)
This additional knowledge helps reach a diagnosis faster and potentially drives the need for additional diagnostics. It is also a great addition to any breed–specific screening programs, e.g. screening breeds that are high risk bladder stone formers or Westies with a higher risk of transitional cell carcinoma.
Not Able to Pay off Machine
While cystocentesis will slowly help pay off the investment of an ultrasound machine, it is a large capital investment for all practices and, in today’s uncertain financial climate, this debt can create worry and anxiety. However, there are a number of companies offering this technology, and this means they have competition for your dollar and will get creative to make you their client.
Talk to these companies about leasing programs, payment options and other ways they can help you make sure this investment makes financial sense for your practice. This discussion should also include the type of medical workups being performed at the practice, the space available for the machine(s) and the current knowledge base at the practice. This will help define and tailor the best “starting” machine, what probes are needed, what training is essential and necessary for implementation of additional uses of the ultrasound machine and allow for budgeting and predicting of cost and eventual payment of the machine.
Cost to Clients
We must also keep in mind that we, as veterinarians, are not the only part of the veterinary–client–patient relationship that must see value in this machine. It is imperative to educate clients on the benefits (and limitations) of an ultrasound, the non-invasive nature, the speed of diagnosis and the wealth of knowledge derived from full ultrasound studies. To be successful, we need to remember a few important tenets of the veterinary industry today.
The new generation of pet parents (the millennials) have some specific character traits. As a group, they tend to come to exams with more questions, a desire for more details and previous online research they’ve done prior to the appointment. They want information quickly and in an easily accessible format. In addition, they tend to be more cost conscious with the same expectations for excellent medical care and successful outcomes. However, they also want the best medical care possible for their pets.
Once you see all of the different ways you can use ultrasound on an everyday basis to provide better medical care, you will easily be able to explain to clients (especially millennials) that you can keep the cost relatively low while still providing superior and rapid diagnostics and medical care.
A perfect example of how to use this technology for best medicine with financial value is the use of ultrasound for the F.A.S.T exam—otherwise known as the Focused Assessment with Sonography for Trauma. The ultrasound probe is placed on four different quadrants of the abdomen (or thorax) and is used as a rapid screening test for free blood or urine in the abdomen (usually secondary to a ruptured splenic tumor or urinary bladder) or free blood around the heart (pericardial effusion). This also can be taught to many members of the veterinary team.
This timely screening test is one of the most helpful, but unfortunately one of the most underutilized tests in veterinary medicine today. It is noninvasive, can be performed quickly as the patient enters the hospital (median study time was 6 minutes), requires only a very small and portable machine and requires only minimal sonography skills.
The JAVMA 2004 veterinary F.A.S.T study also found that one third of the patients in the study that had trauma secondary to contact with a motor vehicle also had a hemoabdomen. This is a much higher incidence than previous studies and that speaks to the specificity of the test. This test also has a high sensitivity, meaning that it is very accurate if NO free fluid is found during the F.A.S.T exam. The outcome being that the veterinarian will look outside of the abdomen to other parts of the animal when suspecting internal bleeding.
Ultrasound can be a very efficient and cost effective addition to any practice. It screens and diagnoses medical and surgical conditions from a non invasive perspective AND generates revenue. While there is a learning curve with any new technology, it truly will elevate both medicine and financial growth within any small animal practice. +
