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Echocardiography Can Retool A Practice

The addition of echocardiography to a practice can make a huge difference.

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The down economy has led many veterinarians to place continuing education and equipment purchases on hold, but business experts say companies should use the time to their advantage and retool. Adding a modality such as echocardiography is one way to attract “A” clients and make use of any extra time you or your technicians may have.

Echocardiography debuted in the veterinary industry by means of specialty practice, but now general practitioners are increasingly getting involved and even investing in training technicians to perform echocardiography. From 65 to 70 percent of U.S. veterinary practices have some form of ultrasound equipment and find that clients are willing to spring for the exam fees.

“Providing echocardiography exams as an inhouse offering shows that you want to continue to improve the standard of care you give to patients,” says Clint Roth, DVM, regional sales director of Sound Technologies Inc. of Carlsbad, Calif.

“Echocardiography is one of the few technologies that gives you dynamic information about the strength and level of function of the heart. It is integral in the diagnosis of canine and feline heart conditions, and at least 70 percent of clients will OK this type of procedure.”

While decreases in veterinary revenue haven’t been as dramatic as in other industries, general practitioners have reported fewer client visits but higher individual sales. The clients more willing to approve a higher level of care in fair times are continuing even now.

Evaluating the client base will help a practitioner determine whether the equipment and training investment will work.

Echocardiography earned its position as a viable tool for diagnosing cardiovascular diseases long ago, and it remains the first choice in general practice diagnosis, research and clinical trials.

“Echocardiography tells the structure and function of the heart,” says Ashley B. Saunders, DVM, Dipl. ACVIM (cardiology), assistant professor of cardiology in the Department of Small Animal Medicine at Texas A&M University.

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“That is something an X-ray can’t compare to. But when diagnosing certain heart diseases like congestive heart failure, an X-ray is still the gold standard since it shows the lungs. We use transesophageal echocardiography, which places an endoscope in the patient’s esophagus to get a close look at the heart’s valves and chambers without interference from the ribs or lungs. This is the kind of advanced procedure a general practitioner would want to pass onto a specialist.”

Dr. Saunders says general practitioners providing echocardiography as an inhouse service is an excellent idea considering that the U.S. has only about 250 veterinary cardiologists.

“A client may not have the ability to travel far to a specialist,” Saunders says, “so adding echocardiography to your list of services will make your practice cutting-edge and save the client money. As long as veterinarians know when a case is out of their range of expertise to hand it over to a cardiologist, it would be a great service.”

The challenge, according to experts, is finding time to learn to use the equipment effectively. Even if business has slowed, it hasn’t come to a screeching halt and vets have a personal life.

“The average veterinarian needs to perform 75 to 100 cardiac exams before feeling comfortable with his or her skills,” Sound Technologies’ Dr. Roth says.

Many manufacturers offer seminars and courses for veterinarians and technicians. Though technician echocardiography training has increased in recent years, veterinarians are still predominantly learning to perform both the exam and diagnostic evaluation.

“The quality of the image and depth of the information found during a cardiac exam varies,” Roth says. “It all depends on the quality of equipment you use and the skill of the person giving the exam.”

June A. Boon, an echocardiographer at Colorado State University’s James L. Voss Teaching Hospital, says echocardiography skills require dedication and a commitment to perfection.

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“ACVIM diplomates typically get the very difficult to diagnose cases, while general practitioners tend to purchase equipment that can be used for several ultrasound capabilities and may not see enough specific cases to diagnose the less common heart abnormalities,” Boon says. “I’ve been performing echocardiograms for 30 years and it’s really a rare technician that can perform efficient echocardiography exams.”

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