Is it possible to practice good medicine AND make money? I believe the two are not exclusive to each other.
Currently I am an instructor of Clinical Pathology for vet techs and pre-vet students. I have noticed an alarming trend in veterinary medicine practice recently. More and more vet clinics seem to be relying solely on reference labs for even the simplest lab tests.
Frankly I don’t understand it.
In-House vs. References Labs: What’s the Difference?
Back in 2005 I hosted a seminar concerning fecal centrifugation for Novartis. Fecal centrifugation is touted as the most sought after method for accuracy in ‘hunting’ for endoparasites, and Novartis wanted to demonstrate the ease with which it could be done in-house. Most vet clinics had seemed to think that the process was too expensive, needed too much tech time and was considered messy. Also, since there is a reference lab centrally located, it was just easier to send samples out.
It was proved during the brief lecture that a second-hand centrifuge would be easily paid for in a relatively short amount of time and that the overall benefits for the client, patient and the financial gain of the clinic were worth the initial outlay of the machine. After our wet lab demonstration, we were gratified to hear that many veterinarians were convinced.
But did it change their behavior? Unfortunately, having a centrally located reference lab, proved too tempting and veterinarians began using them for all laboratory tests.
There was a time when vet clinics only sent out specialty tests to reference labs. Now, everything from CBCs to fecals are routinely sent. In-house testing is becoming almost unheard of in the veterinary field. I find this a sad, disturbing trend on several levels:
–First, and foremost, practicing the best level of medicine should be the ultimate goal of every doctor.
–The ability to process lab tests in-house, especially for sick or at-risk patients will go a long way to alleviate a worried client.
–Having professionally trained personnel as team members also indicates to the clients that the clinic is serious about providing the best care for their pets.
–To accomplish this, it only makes sense to have at least the minimum of lab equipment to do simple tests such as fecals, urinalysis, CBCs, chemistry, cytology, and ear swabs–all of which a trained technician can do. Lab equipment can be leased or purchased outright depending on the size of the clinic.
–These tests not only provide the veterinary with quick health information on the patient, but they are all money makers for the clinic.
Higher Care, Economic Value
There was a time when it was true to say that we in the veterinary field provided better medical treatment to our patients than human doctors could provide to their human patients. There was a time when the vet could have the blood drawn, have the tests processed in-house by the trained vet techs, have radiographs done and looked at while the client waited.
In human medicine it can take days to get lab results. Is this a precedent we want to follow? First and foremost, it not in the best interest of the patient, client or the trained personnel and tells me that the level of quality medical care has lapsed.
It also doesn’t make sense on an economic level either. An important part of the overall educational experience for vets in training should be a course in economic management of a clinic as well as the value of maintaining trained personnel to handle simple in-house lab testing.
Going back to my original example, fecal centrifugation can be easily performed within 20 minutes. It may seem unlikely, but I have researched this carefully-a centrifuge dedicated to fecal samples can be purchased on line second-hand for well under $500.00. The cost of doing one fecal is about fifty cents, which includes materials needed for processing. By running as few at 20 fecal exams at $25.00 each, the cost of the machine is paid for and the client has a result in a few minutes rather than the next day!
Why wait 24-48 hours for a simple test when it can be done in-house within the time it takes for an average office visit? How much more impressive to the client would it be to have a test done while they speak with the vet and to have a result in hand before they even walk to the front desk to pay the bill?
The client is impressed and, the clinic has the satisfaction of knowing they’ve provided the best medical care to the patient—all the while benefiting financially. It’s a win!
The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the DrAndyRoark.com editorial team.
ABOUT THE AUTHOR
Jane CL Kelly CVT has worked in the field of Veterinary medicine for many years. Her passion early on was clinical pathology. Upon graduation as a CVT she worked nearly 10 years in the stat lab at Tufts [Cummings] Vet School of Medicine. For the past 15 years Jane has worked as an instructor of clinical pathology at Becker College teaching vet techs and pre-vet students.