Equine veterinarians are increasingly mobile these days, and not only with respect to their practice as a whole, but in their need to move quickly from horse-to-horse with their equipment. But a veterinarian’s time is money, and so whatever the equipment, it needs to be effective, easy-to-use, and portable. And what if the techs could do it instead? This article will reveal Regenerative Laser Therapy (RLT) as a viable option in the clinic, on the go, or at a show.
- Conditions to Benefit
- Categorizing Conditions
- Price Structure: Packages and Bundles
- Empowering Technicians
Conditions to Benefit
RLT’s principal targets, above all else, are tendon and ligament injuries. This technology is one of the only, and probably the most predictably effective modalities for the treatment of these types of injuries. Through hundreds of case studies and now even a double-blinded clinical trial, RLT technology has been shown to shorten the inflammatory response of these injuries, enhance the regenerative phase, and in doing so provide more vascularity and more organized tissue repair in these notoriously difficult lesions.
Beyond just being one of the only tools are the hard stuff, laser can help with musculo-skeletal injuries of the bone and joints. While you have other modalities that potential benefit these, laser will decrease inflammation and pain in a quick and side-effect free way, even on joints that don’t lend themselves to, say, injections.
Wound care is another bread-and-butter target for laser therapy. Whether from fence lacerations or infections, laser therapy will help to epithelialize the edges of the wound while simultaneously promoting a solid bed of granulation, all while oxygenating the tissue and suffocating bacterial infections. Especially in the distal limb, both of these are important to avoid too much proud flesh.
It is important to categorize all the above conditions to get a better feel of the best financial structure of things. A basic breakdown is this: acute, chronic, and pre-performance.
Acute injuries are those sustained in the last ~2 weeks, before any serious scar tissue has formed. These can include wounds, sprains, strains, or even the more serious tendon/ligament tears/lesions, but as mentioned, before any significant amount of scar tissue or fibrosis is present. During this phase of the injury, the best treatment protocol calls for 6-10 treatments, usually every other day.
Chronic refers to the injuries that have progressed far enough to have some notable scar tissue or fibrosis that is visualized ultrasonographically and that is clinically limiting mobility, weight bearing, or range of motion. These often require more treatments, spaced out a little more: 2-3 times per week for up to 20-25 treatments. This may sound daunting, but the idea that scar tissue can be eliminated and collagen fibers re-aligned makes this well worth the wait.
Pre-performance treatments can be 1-3 treatments on areas that are prone to injury or those that have had prior injuries, however minor. Immediately post-performance treatments have also been reported to decrease recovery time. Important to note is that the USEF website denotes RLT technology as safe and legal. That said, FEI bans all lasers (and most other regenerative modalities) 4 days out.
There are lots of creative ways to bill for laser, but here are a couple tried-and-true methods.
1) Time is Money: the longer you have to spend with a patient, the more you charge. So for wounds, which may take only 2-3 minutes of treatment, you can charge around $30. For musculo-skeletal issues in the bone and joint, the treatments are on the order of 7-9 minutes so you can charge upwards of $70-90 per session. For the bigger anatomies and bi-lateral conditions, you can charge a little higher into the $100 realm.
2) Packages. If you know an Acute condition is going to take 6-10 treatments, it is often advantageous to give a discount on a package of 10 treatments. This is appealing to the horse-owner since they are getting a discount. And the advantages to you are a) you get money upfront, b) the horse-owners are committing to and partnering with you, and c) they are more likely to be compliant. By compliant I mean, you know that you need these 6-10 sessions to make a clinical impact. And so since they’ve already paid for these session, they are more likely to come and get those treatments. The same goes for Chronic or Pre-Performance treatments, though for Chronic, you may be more inclined to break it into two sets of 12 treatment packages.
3) Bundles. There is more to the clinical recovery than just laser. If you are an equine clinic, there is boarding. If you are ambulatory, there is the initial farm call and then the visits per treatment. In both cases there may be imaging involved or adjunct therapies. It is often more transparent to the horse-owner to set the entire stage upfront; one price that includes everything it takes to get the horse back to work.
The equine practice is run by veterinarians. Recent surveys put nearly 90% of the workload of a given case on the shoulders of the veterinarian, including radiography, ultrasound, injections, etc. RLT Technology does not require the veterinarians time EVERY time. The first and final set of treatments on any given package should be performed by the veterinarian. At the onset, the locality and prescription is discussed with the horse-owner; at the wrap-up, clinical effect and go-forward maintenance plan is discussed. Between these end-points however, there is virtually no reason why the technician can not carry our these treatments. The interfaces are simple, there is very little risk to the patient, and beyond some initial training, there is no real in-depth need to know about the pathology…just the anatomy to be treated. Also, sedation is not needed to perform the treatments, so no need to monitor vitals or risk of falling.
From a financial standpoint, getting the income level that this modality produces at the cost of a technician is a very efficient model that will lead to significant clinical impact.
Take Home Message
Regenerative Laser Therapy is making its way into mainstream equine medicine. The studies (both anecdotal and controlled) are there and all point to the fact that this is one of the very few modalities that can offer a solution to some of the most irritating pathologies, especially in the distal limb. And clinical impact is only possible if the modality is financially feasible. We hope to have shown you here that whether you are in the clinic, on the go, or at the show, RLT technology has a place in your practice.
To discuss more about the feasibility of Regenerative Laser in your practice, contact our laser specialist today.