BluePearl Veterinary Partners

Kevin Winkler

In early 1996, I was a third-year surgery resident at the University of Illinois. We had an MRI that looked home built and was in pieces more than it worked. Our second-year resident was begging and borrowing equipment to start an arthroscopy service. Laparoscopy was not even a thought at the time. Now, 24 years later, some individual general practices offer laparoscopic and arthroscopic alternatives to traditional surgery. For those old enough, my first computer had a 286 chip with a whopping 25 megabytes of onboard memory with a five and a quarter inch floppy disc drive. Fifteen years later, the first CT machine I used in private practice had the same computer. Technology has made dramatic inroads into our field of veterinary medicine since that time.

On the business side, the rapid corporatization of the veterinary field has brought in the financial capital necessary to invest in electronic medical record systems and cloud storage. Also, business analytics is more available and much more in-depth. Pet insurance now allows direct payment to the veterinary professional and immediate precertifications in some situations. The benefit of third-party reimbursement for the pet is immeasurable, yet used by a tiny percentage of clientele. I do dread following one portion of the human medical model. We have recently added a part-time position to handle insurance issues. We can argue over how much better computers have made our lives, but there is no question they have improved productivity in the workplace. Social media and its ability to rate anything has changed everyone’s approach to business. Attention to NPS scores and other drivers in the marketing world can improve the bottom line. On the downside, that same technology has brought about the faceless ability to commit cyberbullying, which has contributed to the high suicide rate in our profession.

Technology is evolving so rapidly that it can be difficult to keep pace. The availability of advanced imaging with CT and MRI is such an improvement over the days of iodinated contrast studies we routinely performed. But it hardly stops there. The public expects that the same care options that are available to them, are also available for their four-legged children. I am always amazed at the number of MD’s who are shocked that we offer CT and MRI imaging on-site. Unfortunately, the demand for increasing levels of care also comes with the expectation of personalized care while the price is expected to remain at the 1990’s levels.

“The public expects that the same care options that are available to them, are also available for their four-legged children”

Our field is much more than the old model of general daytime practices with after-hours on-call duty or an overnight ER clinic in the more urban areas. We have morphed into a field of advanced specialty and 24-hour care for our pets. Human hospitals have the size to justify on-site, 24- hour availability of clinical pathologists. With the global web, there are now companies that offer the same 24-hour cytology availability in the veterinary market. The cytology samples are digitized in-house with diagnostic interpretations returned in less than an hour at any time of day. Online consultations are readily available in cardiology, critical care, and internal medicine.

On the human side, the use of artificial intelligence (AI) technology has been heavily debated. Concerns about overdiagnosis and missed diagnoses have slowed the development and use of these tools. The rules in veterinary medicine are usually not as restrictive. Online radiology consultations for veterinarians in general practice are now available using the same AI technology. This allows the return of results in as little as 10 minutes. While some in specialty fields see this as a risk, the concepts and use in practice are inevitable.

Diabetic monitoring of cats is problematic because of the stress incurred in the hospital. Now, human systems designed to monitor subcutaneous glucose levels have transformed our ability to manage diabetes accurately. Two weeks of monitoring can be performed using an online web application and the cat does not need to leave their house. In surgery, 3-D printing is now readily available for surgical planning purposes. As human-robotic surgery moves to 2nd and 3rd generation units, the first-gen units will move into veterinary medicine. Assuming they are successful, veterinary specific units will ultimately be developed. Where does it stop? If you can answer that, then you can also tell me where human medicine will be in 30 years. While I did not recognize the full range of future opportunities as a student, some can, and they are the future drivers of our field.

While I do not know if I will see Star Trek level medical technology in my lifetime, I am sure my children will. I do retain one worry. Too many students want to leap to technology for the next diagnostic test at the expense of a thorough physical examination. The loss of that skill is the loss of one of the most basic blocks of medicine. That skill erosion will not be in our best interest. On a final note, yes, we have significantly upgraded the old CT!