The current economy’s negative effects on equine veterinary medicine is not news, nor is the fact that veterinarians across the board have explored numerous ways of responding to it—in the effort, of course, to survive.
Unfortunately, there are no magic answers or silver bullets, but vets are also not without options: With a little forethought, pragmatism, creativity and a willingness to perform hard work, a number of equine veterinary practices continue to thrive during a period that is, at the very least, challenging. And one way that has proven successful for some is through the adoption of a specialty.
First things first, however: While finances may be a driving force in making this decision, they shouldn’t be the only reason vets go into a specialty. Robert P. Magnus, a DVM who specializes in practice management, sports medicine and lameness (among other things) at Wisconsin Equine Clinic & Hospital in Oconomowoc, Wisconsin, emphasizes that the initial question every veterinarian should ask is: Am I really passionate about this specialty?
“If you are going from general practice into a specialty area, it should be something you really enjoy because then, most likely, you will be very good at it,” he says. “For example, if you are a general practitioner, and now you are going to go into dentistry, are you prepared to do dentistry 90 percent of the time, and will that make you happy?”
That’s not to say that economics don’t come into play: “The second part is to look at your market area,” Magnus says. Will you operate as a one-person practice, or will you offer your services to other practices in the area? Will the new specialty target horses exclusively, or will you open it up to other animals as well? And finally: Are there enough cases in your community to enable you to make a living?
“The first thing I would begin with is a piece of paper so you can start examining the pros and cons,” Magnus says. “Then, try to develop a plan on how you can be successful.” He also suggests contacting someone else in the industry—obviously, an individual whose viewpoint you respect—to gain his or her insight.
“Oftentimes, when people want to go into specialty areas because it’s something that they really enjoy doing, their hearts get in the way of good, sound business decisions. The goal is to have your heart and your business decisions aligned so that you are successful in what you do.”
For Jay Merriam, DVM, of Massachusetts Equine Clinic in Uxbridge, Massachusetts, economics dictated the need to stop specializing in one area (surgery on racetrack horses) in favor of being part of a general practice made up of five vets in total, for which he specializes in both surgery and lameness cases.
“The racing industry around us virtually disappeared, and my caseload went way down simply because there were no more racehorses,” he recounts. “We began to do a lot of reproductive work, and that disappeared because of economics.” His interest and practice in show horse lameness helped to build his caseload at the Uxbridge practice.
In order to build his qualifications in the area of sports medicine, Merriam regularly participates in continuing education courses, such as those focused on lameness, acupuncture and stem cell therapy.
“There are many avenues for graduate veterinarians who are faced with changing economies to begin to specialize,” he says. The biggest challenge is properly assessing the need for specialty services in any given geographical territory.
Some specialized equine veterinarians have responded to the issue of geography by becoming truly ambulatory. There are a number of practitioners of equine dentistry, for example, who travel across the country to perform their services. This isn’t a feasible option for everyone, however; in most cases, vets are forced to work within their own communities.
Equine Sports Medicine & Surgery, a practice based in Weatherford, Texas, was established by three racetrack vets—Drs. Martin Ivey, Steve Hurlbert and Mike Fox—in 2001. As the practice grew, so did its specialty offerings; in addition to offering ambulatory services, the practice provides services related to surgery, hyperbaric medicine, internal medicine, sports medicine, lameness, dentistry, chiropractic care and reproduction. Kirk Eddleman, MHA and CEO, has been with the practice since 2005. He explains that the addition of each specialty required a significant investment and considerable due diligence. If, for example, you have decided to be an equine acupuncturist and the course costs $5,000 plus travel and expenses, how long will it take to pay the practice back for the up-front investment of obtaining this education?
“All of the various specialties can be approached in this way: You can look at a time frame and a dollar amount, and then decide whether or not it makes sense,” Merriam says.
One aspect of adopting a specialization is advertising it, a task that has become increasingly easier and more cost-effective thanks to social networks such as Facebook and Twitter, Merriam points out. “These networks are important in equine practice; equine clients tend to be connected through groups that focus on their own specialization,” he says. “For example, all of the Morgan people hang out together online, as do all of the Quarter Horse people. Getting the word out isn’t hard at all anymore.”
Merriam notes that one of the side effects of both the Internet—which gives horse owners access to reams of educational materials—as well as a tough economy is that clients have become increasingly discerning. “Clients are well-educated, and they tend to gravitate toward people who have serious credentials,” he says. This trend, he believes, will continue to intensify, prompting equine practices to position themselves as specialized experts.
“The key is to analyze what you want to do, and then approach it as a business—not just a random interest.”
Hitting a Homer
Magnus maintains that the key to success is being passionate about the work itself, while at the same time remaining pragmatic enough to make wise business decisions.
“I’ve always lived by the philosophy that if there is something [at which] you are exceptional … and that you enjoy, you will be successful; and this is irrespective of what’s going on in the economy,” he says.
He adds that start-up costs for many specialties have come down, largely due to the decreasing cost of technology. “If there are enough patients in the area and you are really good at what you do, and you approach the market with integrity and honesty, I think it will be a home run and you will be successful. The caveat is that you have to like working hard, but beyond that, it’s all common sense.”
The Cost of Being Special
Specializing can pay, but at a price. Before investing in the education, equipment and—in the case of hospitals that are exploring the addition of a specialist—it’s a good idea to conduct a break-even analysis.
The easiest costs to project are fixed: equipment, supplies, renovations and eventually, staff. What’s tricky is estimating how large a caseload the new specialty will produce. Kirk Eddleman, MHA and CEO at Equine Sports Medicine & Surgery in Weatherford, Texas, advises that veterinarians begin by assessing how many patients the practice has dealt with historically, and then poll existing clients and, in many cases, surrounding practices.
“We have done informal surveys: If we were to offer this service, would you use us?” he illustrates. “We will also call another practice in the area and say: If we had a surgeon on staff, would you be willing to send us referrals?” He notes that if you have a solid reputation, the response is affirmative; however, you can’t count on how much business they will throw your way. “They may tell us that they will send us everyone, but in reality, they may not,” he explains.
While pursuing a new endeavor always involves risk, Eddleman prefers a conservative approach to break-even analyses. “There are a lot of variables to consider, and it’s not something that you go into lightly,” he says. “The numbers have to be justified.”
Then, if your practice is considering the addition of a new specialist, it’s a matter of finding someone who fits in with your organization’s culture. “Usually, you can find someone who will work hard, but sometimes, it’s difficult to find people who mesh and who will grow your client base,” he explains. “Will they get along well with your staff? Will they get along with your clients?”
Should New Grads Specialize Right Away?
With student debt being what it is, the temptation for new graduates to specialize immediately is understandable. But Kirk Eddleman, MHA and CEO at Equine Sports Medicine & Surgery in Weatherford, Texas, warns that new vets should get out the calculator before committing themselves to specializing the minute they receive their diplomas.
“My concern is that they already have a lot of debt, and they need to start paying it off,” Eddleman explains. To become a specialist, one must complete a residency, which usually contributes to student debt.
There are private practice residencies available—Equine Sports Medicine & Surgery has one in place—and the salaries residents are offered can be better than what residents are paid in universities. “That may be what we will see more of in the future,” Eddleman speculates. “That way, they can pay off a bit of debt instead of going into it further.”
For now, however, the majority of residencies are available in university-based teaching hospitals.
“If they are thinking about being a specialist, they have to consider the debt,” Eddleman underlines. “They also have to consider that they will be spending X number of additional years without making money to pay toward that debt, and with the potential of going deeper into it."