When David Weule, DVM, decided to add endoscopy to his small-animal practice, he knew just what he wanted most from the technology. His wish was as clear as the ears on his patients’ heads. Leveraging a consistent, specialized need among patients—in this case otoscopy—is a good way to get started with the technology of endoscopy, say those who make and sell the equipment as well as the practitioners who use it. “I knew it was the next level of diagnostics, and I knew it could give patients and clients the next edge up on better medicine,” says Dr. Weule, owner-operator of Rainbow Veterinary Hospital in Burbank, Calif. “There isn’t a day that goes by when we aren’t using the scope on ears. That’s the thing we do the most, and we’ve gotten really good at it.” Video otoscopy is far from the only use found by Weule (pronounced Wiley) since he added endoscopy equipment two years ago. He has followed another recommendation of experienced users: Plan for the future and prepare to expand your opportunities. After considering his options, Dr. Weule opted for a system from Karl Storz Veterinary Endoscopy in Goleta, Calif., in part because it allowed him to get rigid and flexible scopes he can use with one tower and light system as well as other interchangeable components. That compatibility can save money in the long run for practitioners who are able to add new capabilities without having to buy new self-contained units. Starter Kit A practitioner might begin with rigid endoscopy because it’s the less expensive option and the easier to learn. But without expandability in the original system, adding flexible endoscopy “not only means a substantial new investment (for a new tower), but you also have to be concerned about storage,” says Matt Willis, West Coast account manager for Karl Storz. Weule focused less on the cost and more on the opportunity when he added endoscopy to his hospital, which he says “just might be the busiest one-doctor practice in the nation.” “I looked around a bit, did my homework and said, ‘This is an investment.’ I don’t mind investing money, as long as it makes me some.” Capable of using the same video processor and light source with rigid scopes and fiberscopes, Weule’s equipment accommodates everything from rhinoscopy and bronchoscopy to liver biopsies and examinations and procedures of the gastrointestinal tract. In fact, he spent $25,000 to $30,000 to put scope set-ups and video monitors in every exam room, and each procedure is videotaped and archived. The Big Payoff Ultimately, in Weule’s practice, all roads seem to lead to the ears. “Scoping ears has paid for all of my scope equipment and other material,” he says. “I think in our first year, we did more than $250,000 on ears alone.” For a video otoscopic procedure these days, Weule gets $500 versus $50 to $100 previously, he says. “And I have people breaking down my door for us to clean ears, because they know we do it right.” For Irvin Herling, DVM, the most satisfaction comes from laparoscopic procedures. “I love the detail with which you can see the structures and the organs,” says Dr. Herling, of Doc Side Veterinary Medical Center in Baltimore. “When you’re looking on a monitor, a tiny blood vessel looks like a huge rope.” Digital imagery of procedures helps clients appreciate the service and the value of veterinary care, Dr. Herling adds. Weule says video technology makes a huge difference on issues of compliance. Invest Time in Education The two doctors and others in the industry caution practitioners against thinking they can buy the equipment, train for a few hours, and start enjoying immediate and sustained success with endoscopy. “One of the most important things I recommend to anyone getting into endoscopy is to find a hands-on workshop,” says Christopher Chamness, DVM, director of international marketing for Karl Storz. Weule started by taking a four-day endoscopy course at the University of Guelph’s Ontario Veterinary College. “I knew I wanted more than just a pedantic course that would explain what a scope is,” he says. “I had the scope in my hands, working on multiple cases. I worked for hours, so much so that when I went home, my hands hurt. But out of that experience, I had enough confidence to go home and work with the scope.” Weule expects to continue leveraging his training and experience as he works to expand the scope of his minimally invasive capabilities. “This technology has made a tremendous difference in the lives of my patients and my clients,” he says, “and it continues to make just as big a difference in my life in medicine.” <HOME>
