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InFocus

Increasing the use of laser therapy – 2

Stephen Barabas of VBS Direct concludes his article on the science, clinical aspects and practical management of incorporating low level light therapy (LLLT) into veterinary practice.

ON starting a new laser service within your practice it is essential to market it properly to your customers. Today’s social media forums are an ideal and inexpensive route to highlight the laser therapy to your customer base and get clients involved who have had successful treatments of their pets to endorse it.

Most practices are surprised how quickly clients learn about the new laser service offered for their pets’ health and are keen to pay for a course to see if it will help their pet’s long-standing osteoarthritic or lick granuloma disorder.

Waiting room advertising on televisions, posters and client leaflets will provide instant information to clients but also will generate new referrals. Most good laser companies will provide a package of marketing literature, videos, photos and case studies to have within the practice and website to help start promoting laser therapy.

Other key factors to increasing client awareness and adoption of the new laser service is having it as an option on all the operation and dental forms, plus have a booklet of case studies and client testimonials present in the waiting room and posted on the website. This helps clients appreciate the benefits and results, plus keeps vets and nurses working in unison together on ensuring new cases are provided due to the success stories generated.

The involvement of the client during laser sessions not only helps in recording improvements over the course of treatments, but helps in getting clients promoting the laser therapy amongst the animal-owning community and differentiates you from other local veterinary practices.

Charging

Most laser therapy courses involve an initial six sessions for chronic conditions and post-surgical rehabilitation over a 2-3 week period, with fewer sessions required for acute or superficial injuries. Dental and simple skin injuries may only have two sessions a couple of days apart.

For chronic allergic skin or osteoarthritic conditions, each animal is assessed at the end of the first treatment course and an exact protocol plan is devised for the client and pet to ensure long-term management with or without other therapies.

Most practices charging solely for the time and laser therapy given by a veterinary nurse or physiotherapist will be £20-£35 per 10 minute session, with sometimes a discount for booking batches of treatments. If multiple joints are requiring laser therapy, an extended fee charge may be applied due to the extra time required.

When used post-surgically for wound healing or as part of the dental operation, a smaller fee is added to the cost of the surgery and post-operative check-up lasering session.

Returns

Veterinary practices sometimes purchase equipment on impulse rather than based on sound financial planning or on assessment of skill sets within the practice. For example, would your practice and clients be better served having a specialist trained ultrasonographer visiting weekly, rather than purchase a top-range machine?

Although good quality, powerful lasers are not cheap, based on the daily use across pain management, wounds, soft tissue injuries and post-surgery rehabilitation cases, no piece of veterinary equipment can fit so easily into medical and surgical routines; owner compliance is good and it is generally operated and run by physiotherapists or nurses working in conjunction with veterinary supervision, so the return on investment is rapid and considerable.

Class IV laser therapy not only provides new options for therapeutic treatment of patients as a sole therapy or in conjunction with other treatments, but they can significantly increase footfall and interactions with clients. The involvement in laser sessions by pet owners is a rewarding experience for all and helps significantly in self-marketing this new piece of cutting-edge technology for the practice.

Numerous finance companies are also available to give expert advice on the best tax-efficient options available for purchasing a laser machine. A close examination of the figures from a UK one-and-a-half-vet practice using a Class IV laser shows that just one treatment per day would make profit for the practice, in fact with only 10% compliance of cases seen per week they would pay for the machine in less than a year. Most practices treat 4-15 sessions, daily, with chronic osteoarthritic cases each having up to 12 sessions over the year. It is easy to see how the numbers get quite large when based on real practice figures.

Installation and training

Good laser equipment companies will invest time and energy in setting up and installing the laser within the practice.

It is essential that training of all staff using the machine occurs to ensure proper and safe laser use within the practice. Education on the science, uses and hazards of using laser therapy within the veterinary practice is necessary to comply with legal aspects on health and safety (Health and Safety, 2010) and the appropriate protective eyewear is worn. Laser safety rules should be set up in each practice based on staff users, laser rooms, contingency plans and protection measures; these may be reviewed by RCVS inspectors or H&S local authority officers post initial training.

Due to the sophistication of technology utilised, a clear service plan should be available with each machine and additional support available should any breakages occur when using the machine, plus an ability to update software as new protocols are discovered to improve existing treatment protocols.

In this internet age, provision of video clips, client testimonials and educational pieces should be provided for the practice website to assist in educating the clients on the merits of laser therapy and safety: these would include practice posters and client literature.

At the end of the training all staff should be clear how they are going to market the laser therapy to their customers and what cases they will initially start using the machine on, with a standard pricing system, so it is clear and transparent for all the staff and clients to understand.

On-going support and help should be available to the practice from the laser company and educational training should be periodically offered due to the rapid changes in science, protocols and understandings of laser therapy.

Conclusion

In the last decade, the knowledge and scientific understanding for laser therapy has grown exponentially. Initially scientists pioneered this movement with very general hypotheses and virtually unguided effective dosage knowledge. Modern therapeutic lasers have a solid foundation on the underlying mechanisms and identifying the optimal treatment parameters.

Continued research and development of this modality is important but recent improvements in the quality and user-friendly modern therapeutic lasers has meant that laser therapy is now accessible for use in medical and veterinary practices within the UK. In ensuring your staff and clients’ pets have a positive response from laser therapy, make sure you invest time and energy in choosing the right laser equipment for your practice. It will be time well spent.

References

  • Baltzer, W. et al (2011) Preoperative LLLT in dogs undergoing tibial plateau levelling osteotomy: double-blinded, placebo controlled clinical trial (awaiting publication). Cardona, M. (2013) Treatment of immune-mediated neutrophilic vasculitis in a Shar Pei with Low level laser therapy. SEVC 2013.
  • Carvalho, R. L. (2010) Effects of Low-Level Laser therapy on pain and scar formation after inguinal herniation surgery: A randomized controlled single-blind study. Photomedicine and Laser Surgery 28 (3) 417-422. Chow, R. T. et al (2009) Efficacy of LLLT in the management of neck pain: a systematic review and meta-analysis of randomised placebo or active treatment controlled trials. The Lancet 374: 1,897-1,908.
  • Chung, H. et al (2012) The nuts and bolts of Low level laser light therapy. Ann Biomed Eng 40 (2): 516-533. Enwemeka, C. S. et al (2004) The efficacy of Low power lasers in tissue repair and pain control: a meta-analysis study. Photomedicine and Laser Surgery 22 (4): 323-329.
  • Health and Safety (2010) The Control of Artificial Optical Radiation at Work Regulations 2010, No. 1140.
  • Khadra, M. et al (2005) Effects of laser therapy on attachment, proliferation and differentiation of human osteoblastic like cells attached on titanium implant materials. Biomaterials 26: 3,503-3,509
  • Manteifel, V. M. and Karu T. I. (2005) Structure of mitochondria and activity of their respiratory chain in successive generation of yeast cells exposed to He-Ne laser light. Biology Bulletin 32 (6): 556-566
  • Minatel, D. G. (2009) Phototherapy promotes healing of chronic diabetic leg ulcers that failed to respond to other therapies. Lasers in Surgery and Medicine 41: 433-441.
  • Oliveira, F. S. et al (2009) Effects of LLLT (830nm) with different therapy regimes on the process of tissue repair in partial lesion calcaneous tendon. Lasers in Surgery and Medicine 41: 271-276.
  • Stephens, B., Baltzer, W. and Harrington, P. (2011) Internal dosimetry: combining simulation with phantom and ex vivo measurements. NAALT Congress 2011.

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