1 Aug 2023
Balancing the needs of all stakeholders is a crucial judgement to make before deciding to invest in new diagnostic equipment. It can be all too easy to waste a lot money on equipment that clinicians won’t use and clients won’t pay for, as Nacho Mérida Isla explains…
Nacho Mérida Isla
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Image © iStock.com / ShadeON
A frequent question I am asked by my clients is whether they should (or should not) invest in a particular piece of equipment.
Like a child in a sweet shop, the plethora of new devices on offer can feel overwhelmingly tempting. Then we may start to fantasise about how we will be able to do more things and attract new clients, with the obvious outcome being increased profits, of course. Or maybe not?
When I visit practices in the UK, I find both ends of the equipment spectrum. At one end are clinics with a cornucopia of the latest and most advanced equipment that is completely underused. At the other end, clinics are equally bountifully equipped, but with largely broken, obsolete or inappropriate equipment (trying to maximise profit by extending the sensible lifespan of the item).
Both scenarios are equally damaging. The former frustrates the management team, as investment does not get recuperated and jeopardises future purchases. The latter frustrates staff attempting to achieve gold-standard work with substandard equipment.
Before deciding on the next purchase, every practice owner/manager needs to consider what type of service they provide. Veterinary care (using the human model) can be divided into four different levels of care:
The difference between the levels of care is not only concerned with the type of conditions or patients seen, but also critically about the expectations of the owner and, above all, the skills the team has. Current business models in which specialisation of the services offered requires the cheapest available workforce has radicalised the difference between practices.
Most people would agree that for a casual worker performing Friday night takeaway deliveries, a Formula 1 car is probably not the most appropriate vehicle. Also, putting that driver in that car would not automatically give them the driving skills of Lewis Hamilton.
It is similarly foolhardy to hand a new graduate the most expensive, premium-quality ultrasound machine on the market and expect them to operate it optimally and interpret the images as capably as an imaging diplomate. Unfortunately, these differences are not portrayed properly by the practices.
For example, if you advertise your practice as having a CT machine, the owners will come with expectations of the standards and expertise they will receive. If the skills of your vets or presentation of the practice are not consistent with this, the expectations of the clients will inevitably not be met.
Generating false expectations is the shortest route to a complaint. So, set your stall out with purpose and clarity to the client, and you will meet their expectations.
Every time we consider purchasing a new piece of equipment, consider how/who it will benefit in the veterinary team, and the clients alike. Also, consider if this equipment is transferable. For example, you may have a vet who is capable and keen with endoscopy, but consider what will happen to the endoscope if this vet moves on to pastures new. Would the demand for this procedure persist? Would another vet at the practice be enthusiastic about taking over the role? Or would the equipment retire to the back of the cupboard?
Might it be more sensible to spend extra money on a better specification ultrasound or invest in a fast and reliable electrocautery system for elective surgeries, for example?
No one-size-fits-all answer exists, and as with much in veterinary medicine, the best answer is “it depends”. However, some questions we can ask ourselves about our own practices to help make these more educated choices.
Acquired skill is also required to operate and interpret the endoscope, so it may be necessary to invest in a course to train the vets.
A multiparametric monitor can be used outside of the confinements of the surgical theatre. It is a relatable machine (owners have seen it in many movies), so use it at every opportunity you have. It will not only be a good advert for your commitment to new technologies, but it will make the amortisation period shorter.
In the same way, the team needs to be trained to use it in an adequate manner, and the customer will need to be educated on the pros and cons for their pet.
Equipment is an expense as well as an investment, so deciding on purchases should always come with a marketing plan. Previous articles (such as www.vettimes.co.uk/?p=72138) have explained how to calculate amortisation and the cost of equipment. In reality, the question is “what is more valuable?” Is it a piece of equipment that is used daily at a low sale price or one that gets used infrequently at a price with a large margin and high added value?
Evidence-based medicine and specialised centres have shown us some of the benefits of using newer diagnostic and treatment techniques, but we need to assess how best to adopt and adapt this to primary or secondary practices. For any investment to be successful, it needs to be adopted by the customers who will end up paying for it.
Consider if your practice would benefit from an ultra-specialised piece of equipment to use in very specific cases or would it be better to invest in equipment that would reduce the cost of everyday procedures? Also, will your customers understand how a practice full of high ticket equipment will translate to increased costs of veterinary care and are they happy with the cost:benefit balance?
In the opinion of the author, practices should revisit their KPIs and find the source of their income and which services are sold more commonly. The focus should be on equipment that improves the performance.
This investment might not only be in veterinary equipment, but it might also apply to customer experience enhancement devices. A shift in the veterinary industry is necessary to become a real customer-orientated service provider. A good coffee machine in reception might do more for your bottom line than a diagnostic tool. Changing the focus from critically ill patients that require saviours to maintaining healthy pets and happy owners is a simple, yet skilful, art.
As a summary, equipment is needed to move forwards at a veterinary practice. The exercise to carry out prior to purchase is almost the same whether it is a newer version of an already existing item or a completely new piece of kit.
Investments in equipment can give an edge against the competition, but only when you understand the competition are other service providers, not only veterinary practices, looking to cash into disposable income. Pursue diagnostic excellence, but do not allow the pursuit of diagnostic excellence to lead you into a building full of underused, expensive machines in the hands of underqualified users.
