Using digital radiographs is a good way to show clients why you’ve come to a certain diagnosis. Recent studies indicate millennials prefer to have information shared with them versus being told what to do. Since this generation of pet owners outspends others on pet care, it only makes sense to accommodate this preference, particularly when it comes to digital imaging. Incorporating a CT scanner or other imaging modality can help practitioners to more fully explain their diagnosis and treatment plan. After all, isn’t a picture worth a thousand words? Digital imaging for orthopedics Given the way online retailers have disrupted pharmacy sales, the industry is experiencing a shift toward diagnostics and treatment versus medication in terms of a practice’s income. One of the main areas of veterinary medicine benefiting from digital imaging is orthopedics. As some clients have a hard time interpreting why their pet is in pain, there’s nothing like being able to show them a clear fracture line or significant degenerative joint disease, especially in a 3-D reconstructed form such as CT. When you can demonstrate to a pet owner a completely worn or remodeled femoral head or a clear fracture in a weight-bearing metacarpal bone, the result is better understanding of the diagnosis, and as a result, better compliance. Dentistry applications Studies show 80 percent of all dental disease is below the gum, which means it’s not visible simply by looking at it. Digital images shared with clients following dental procedures and surgeries can be an important way to assuage cognitive dissonance in pet owners, otherwise known as buyer’s remorse. Clients can see the reason for the extraction, for example, and know where their dollars were spent. Shane Whitaker, DVM, of Highway 58 Animal Hospital in Chattanooga, Tenn., counts among his diagnostic tools a CT scanner that generates a complete digital 3-D reconstruction. He says he uses it on every dental patient the clinic sees. “We CT the full head, teeth, nasal cavity, ears, and get it all in one 18-second scan. [Just one image] generates a tremendous amount of income for us because we routinely find things in the ears, we find tumors and infections in the nose, we’re getting biopsies and cultures, we find things in the teeth that we previously could not see using dental radiography alone, and it also generates other surgeries.” When considering adding a CT scanner to your practice, keep in mind you must have enough space to accommodate the machine. In most cases, it is harder to find the square footage than it is to see a return on your investment. Incorporating this technology also provides quicker gains if you already have an active surgery department, as most of the ROI is in the procedures generated after the scan. By placing a probe on the pet’s chest, clients can see the heart pumping and visualize the veterinarian’s diagnosis. The cost of leasing a CT scanner can range depending on the supplier. However, let’s consider a lease totaling $3,000 per month over say, 84 months. By increasing the dental prophy charge by $50 to $100, a practice owner can compensate for the lease cost by doing approximately nine to 15 dental procedures per week. Resources are also available to train doctors to perform surgeries and treatments that are commonly generated by CT, such as total ear canal ablations/ventral bulla osteotomies (TECA/VBOs), myelograms, hemilaminectomies, sinus biopsies, myringotomies, and arthroscopic surgeries. All these procedures can boost your ROI, helping to offset the cost of leasing the scanner. Better discovery with faster recovery Due to the fact it is minimally invasive, laparoscopic exploratory surgery is becoming more and more popular, allowing clinicians to visualize the abdomen without the intense recovery of an open procedure. With it, a surgeon can make a 1-cm incision to insert a camera to visualize all the major organs (e.g. the spleen, liver, kidneys) and determine whether there are any neoplastic or necrotic lesions. He or she can record the images to show to the pet owner (if they are not too squeamish). It is a lot easier for a dog to recover from a 1-cm midline incision than one extending from the umbilicus to the xiphoid. This technology can be particularly helpful for clients facing end-of-life decisions for their pets. It allows clinicians to provide more information to owners on their pet’s illness and to properly stage different cancers. This eliminates the need to discuss or consider intraoperative euthanasia, and increases quality of life for both the client and patient. Seeing is believing Practices performing echocardiograms with ultrasound are reporting better understanding among clients regarding their pet’s health. Placing a probe on the pet’s chest allows clients to see the heart pumping and visualize the veterinarian’s diagnosis (i.e. a valve that is functioning improperly). Clients respond really well to seeing the problem, rather than just hearing the words describing what is happening and what treatment will correct it. Noah Arnold, DVM, of Dr. Noah’s Ark in Milwaukee, Wis., often brings clients over to his digital X-ray table to show them exactly what he’s seeing. “I’m really impressed with digital radiology. You can manipulate images, zoom in, and change the exposure. It’s one of the big selling points when people come to see me.” He continues, “Most folks are used to clinics built in the 1960s and ’70s. There are things I have here other clinics that have been around for years can’t offer, and clients notice. It’s a point of pride to say, ‘Why don’t you follow me into the treatment area, and we’ll take a look at this together on the big monitor in the X-ray suite?’ It is a good way to teach, but there also is a wow factor.” Understanding what’s what It’s important to help clients get their bearings when showing them any digital image. We look at these all the time, but it’s important to help clients orient themselves. Point out normal anatomy and structures they will be able to identify such as bones, the heart, or the kidneys. Walk them through it: “This left sinus is normal, but on the right side, it’s full of soft tissue. This is why your dog has a bloody nose and why we need to get a biopsy,” for example. No doubt, digital imaging can help better communicate health issues and treatment plans to pet owners. And when it comes to patients getting the care they need, shouldn’t you use every tool at your disposal? Veterinary medicine is changing at a rapid pace, and there is increased focus on procedures, treatments, and diagnostics that provide a hospital with stability and profitability. In the last five years, advancements in digital modalities are making it more affordable and easier to implement these technological tools than ever before. Today, most hospitals performing two dental prophylaxis treatments per day can afford a CT scanner on their dental business alone. Imagine where the next five years will take us. Christopher Weaver is Patterson Veterinary’s national imaging specialist, helping practices around the country install and learn to use their equipment. His experience as head of computed tomography, senior surgical technician, and head of teleradiology and technology informs his work today. Weaver can be reached via email christopher.weaver@pattersonvet.com.
