Not All MRI's Are Ceated Equal....

I have been performing MRI's on my patients since I left my residency in the early 1990's. Back then we utilized human facilities when they were closed. The trips to an MRI facility were clandestine events, in the dark of night, entering at the back door or loading dock of the facility. Basically the MRI's that we performed were run by skilled, trained technicians and they were of the same quality as the MRI's that were being produced by the facility for people. All the MRI'sd that I had the experience of performing were of excellent quality. The techs would even joke that they preferred our patients over the humans, because our patients were, in general, much easier to deal with! Then, over time, the human MRI facilities became so busy that they began to run 24/7 and there was no time to squeeze in the veterinary patient during off hours when no human patients would be bothered.

In a way it was a relief to not have to get up at 3 AM to deliver a patient to the MRI facility and manage its anesthesia then to arrive back at work to start my clinic day. But along with all that extra sleep time there came a new problem, where were we going to take the patients that needed an MRI? Slowly, facilities developed that provided MRI and CT to veterinary patients, we began using The Lawson Imaging Institute , www.MBVS.CA. This facility is awesome. It is run by a group of individuals that are devoted to providing the highest quality images and patient care. I can say that I have never had a bad experience or customer complaint about their services except that they are along drive away in Mississauga , Canada. These folks have the very best equipment and they price their studies (including anesthesia and interpretation) at about $ 1,500 US. Many members of this operation are scientists, engineers and physicists. They understand the way that the MRI works and the need for the best quality equipment to achieve the most acurate study. Although I would love to have a MRI within our facility, I have always said that we would only consider it if we could provide a similar service to the one provided by our colleges in Canada and for a similar cost. Otherwise, sending my patients to Mississauga, where they can get the best study for the best price, is the right thing to do.

As time went on otherlocal hospitals got MRI's. These were small mobile units or even less powerful machines that were far inferior to what was provided across the border and they were charging 2-3 times more. Colleagues were impressed by these other hospitals providing a MRI service, but very few were able to appreciate, or they didn't care to address, the differnces in study quality.

A few months ago my partner forwarded an article from the New York times explaining how how MRI machinary can vary and the quality of studies can vary to such an extent that misdiagnosis' can occur. Take a look at this article entitiled 'The Scan That Didn't Scan', http://s.nyt.com/s/NbdAuJZ. I was very pleased to see that someone was trying to eduacate the general public regarding the differences in MRI services. I hope that over time veterinary clients too will become more informed consumers. Just because a tool is in a hospital it does not mean that it is the newest or best quality and sometimes you do not get what you pay for!

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The Changing Face of Family Medicine

It has been a long time in the making, but we have officially kicked off a new phase to our hospital. We call it a family medicine service or a wellness clinic. The focus of VCS Pets First is to provide the routine, day to day, veterinary care that all pets need within a facility that houses an emergency service , a specialty hospital and hopefully, in the future, many other pet orientated services. This gives the client and the pets access to some incredibly skilled individuals, both doctors and staff, as well as access to the hospital 24/7 and all of its advanced equipment.
What is really exciting about developing this service now, are the chages that are occuring within our industry. We are setting the foundations for a service at the same time that our profession is realizing that vaccines are not necessary every year or even every other year. We are starting to see that the annual visit should be a time to focus on wellness, physical examinations, early diagnosis of health issues and, in general, preventative medicine that really, only includes vaccines as a minor aspect of patient care. This is exciting to me because I have always felt that we as a profession had made a fatal error in trying to use vaccines and dispensing drugs as the focal point of general practice and its revenue. Veterinarians are so much more than administrators of shots and drugs and we had been, in my etimation, selling ourselves short.
I recently had an opportunity to attend a lecture about vaccine protocols in veterinary medicine. It was great to hear that our professional organizations like ACVIM, AAHA and even the drug companies are recommending vaccines every 3 years after the 1 year -old cat or dog receives its booster and that after 7 years of age our cats and dogs may only need a rabies vaccine every 3 years. It is quite possible that we will learn over the next few years that we will extend the interval between vaccines even further.
Don't think that that means your pet should visit the veterinarian less often though, its those regular visits and examinations that will keep you pet healthy and make you aware of health issues that you might not have noticed if it were not for t he annual wellness examination with your family veterinarian.

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