VET TRUCK CONFIDENTIAL: Navigating the First Years of Equine Veterinary Practice Ownership

Another episode of Vet Truck Confidential with Doctors Kelly Zeytoonian, Misty Gray and Stacey Cordivano. These experienced equine veterinarians share their insights on essential equipment, financial planning, and smart investments when starting a practice, providing a practical roadmap for new and aspiring practice owners.

• Starting a practice requires careful consideration of essential equipment versus nice-to-have items
• Dental equipment provides excellent ROI with minimal maintenance requirements
• Digital radiography immediately legitimizes a new practice, especially in competitive markets
• Smaller investments like professional emails, websites, and software can significantly enhance client perception
• Alternative ultrasound options can replace larger units for many applications
• Gastroscopes often struggle to justify their investment unless you're in a specialty or racetrack practice
• Financing options include manufacturer payment plans, distributor delayed billing programs, and personal loans
• Total startup costs for a well-equipped mobile practice with modest salary: approximately $250k over three years
• Collaboration with other veterinarians through equipment sharing can reduce initial investment needs
• Professional software like G Suite and Canva offer cost-effective ways to appear established and organized

If you're considering practice ownership and have questions, reach out to us directly or suggest topics for future episodes. We're happy to dive deeper into specific areas in upcoming installments.

***Article to check out: Seeding the Field to Grow Future Owners by Dr. Ciera Guardia on page 257

---> AI made this summary, but it's a pretty good one! Thanks again for listening and we hope you are doing well. If you need anything at all, find out contact info at https://www.decadeonevet.com/about. Talk to you soon! -SC-

Chapters

• 0:08 Introducing the Whole Veterinarian Podcast
• 1:10 Starting a Practice: Common Questions
• 3:01 Money Mistakes and Equipment Regrets
• 7:32 Best Practice Investments: Big and Small
• 19:26 Financing Your Veterinary Practice
• 29:40 Action Plan for New Practice Owners

Transcript

Stacey Cordivano: 0:08

Welcome to the Whole Veterinarian Podcast. My name is Dr Stacey Cordivano and I hope that this is a place where we can all learn to be happier, healthier, wealthier and more grateful for the lives that we've created. In this series, Vet Truck Confidential, I am joined by Dr Misty Gray and Dr Kelly Zeytoonian, and we have a more casual discussion on topics that are relatable to us as equine veterinarians. We hope you enjoy them and, as always, we'd love your feedback. If you want to hear something new or different, please get in touch and send us advice or suggestions, as always. Thank you for your time and for listening, and we hope you enjoy today's episode. Hi, ladies, how are you doing? Hey there, Hi, doing great Good to see you. I'm glad we get to chat. We haven't chatted in a little bit.

Kelly Zeytoonian: 1:02

I know it's been a busy, busy everything.

Stacey Cordivano: 1:06

Busy spring. What are we chatting about today? What's on the list?

Kelly Zeytoonian: 1:10

So we are going to be talking about top purchases to consider when starting a practice. You know, kind of give people an idea of what you absolutely should have as you're getting up and running. And the reason for that is we've really been seeing a common theme of questions from people not only in our decade one cohort, but also inquiries to my consulting business, along with some social media posts in some of our like private groups that we're all members of, and the general theme is essentially people asking how they can start up a practice, what's absolutely needed to get started, how much it's going to cost them. You know, how are they going to get paid for. And you know, we were obviously all super thankful to have each other's encouragement and bounce ideas off of each other when we were getting things up and running. And now, through the support of our decade one partners Care Credit, merck, animal Health and Hilltop Bio we are going to bring some helpful tips your way.

Misty Gray: 2:13

Right, so let's talk about what we think you absolutely need to get a practice up and running. Also, just for a second, let me hear how long ago did each of you start your practice? It gives people an idea of where we are on the spectrum of ownership.

Stacey Cordivano: 2:30

I started in the dark ages, which was 2010.

Kelly Zeytoonian: 2:34

I started three years later, in 2013.

Misty Gray: 2:39

Yep and I'm the newest and I started in 2020.

Stacey Cordivano: 2:42

And things have definitely changed right, but there's going to be some similarities and hopefully you can learn from some of our mistakes and what we've learned along the way. So, speaking of mistakes, what is something that you spent money on that you should not have, at least immediately?

Misty Gray: 3:01

Well, a big thing in our early decade one programming is logo design. We talk about that a lot and a lot of people had some success with some various like crowdsourcing kind of logo design. So I tried that and it cost money and I ended up it may have been a function of me too like I felt bad, continuing to ask for more edits or like to tell these strangers on the internet that I didn't like the direction they were going in, but it did cost money and it is not the logo that I ended up using, so that was kind of a waste. Stacey actually helped me design my logo on Canva and that was free. It's much more to my. I love my logo. I love it. It's exactly what I had in mind, so thanks.

Stacey Cordivano: 3:55

Stacey, I asked this because I felt like I made a huge mistake when I was getting started.

Stacey Cordivano: 4:02

And again, like I mentioned, it was the dark ages and cloud based software was not available and you had to make kind of an investment in this software that you downloaded onto your servers or computer Like mine was just one computer, but I bought a computer software program that I guess I just maybe didn't ask enough questions, but I I liked it a lot.

Stacey Cordivano: 4:25

I thought it was pretty slick from what I saw when I shopped at AAP and then I ended up spending like more than 10 grand because they flew a trainer out to train me and she was supposed to be there for two days and I had to pay for her housing and ultimately I was like pretty tech savvy and learned it in like four hours and she like sat there and then like we went out to dinner and I just remember thinking like this is not going to pay for itself. And that is not to say that you shouldn't have practiced software, because I absolutely believe that you should have practiced software. I think you just need to really ask a lot of questions and you know now there's so many options right, and probably not a perfect equine option for cloud-based software, but there's a lot more options and you can go month to month and make sure you're not locked into some long contract. So that is why this question came to mind for me.

Kelly Zeytoonian: 5:20

Yeah, and mine is a little bit different. So you all kind of talked about software or that startup. I would say the gastroscope was, and continues to be the hardest piece of equipment for me to legitimize from a return on investment perspective. It is more from the actual sale of the medications that are needed if a horse has ulcers, like your gastrointestinal ulcer guard mesoprostol, sucralfate, whatever and you know many people are price shopping those. It's really hard to keep up with price matching. So you know, basically it just it's one of those things that it's a piece of equipment that we have because it's a great service to be able to offer our clients and not have to refer them out for it. But we had a conversation as early as like two weeks ago where I literally said to the team I don't know if it makes sense for us to continue servicing this piece of equipment and having it available.

Stacey Cordivano: 6:20

That's, that's kind of interesting or like nice to hear you say, because I do see people buy them a lot and I have always thought to myself, how would I ever pay for this? And like we're very lucky in our area we have a traveling internist that does them and is excellent at them and, you know, has us do the sedation and all the drug sales and stuff. So it's always been easy not to buy one. But I do always think to myself like should we have one of those? But it's kind of nice to hear that even a bigger practice has a hard time justifying that.

Kelly Zeytoonian: 6:52

That said, like I have a trainer who asked me just this weekend if we could scope a horse that she's concerned about from the show, and so we're getting it done this week. So you know, maybe we're not seeing the ROI in actual finances but we are seeing it in that client care that we're providing. But again, this would not be anywhere at the top of my list. If I'm starting a new practice and getting up and running, I would not recommend purchasing a scope unless you're on a track or somewhere where things just are getting checked very routinely.

Misty Gray: 7:25

All right, let's switch gears. What has been the best purchase and practice, and I want you to give me something big and then something smaller.

Kelly Zeytoonian: 7:35

For me, dental equipment is something that pays for itself in a really short amount of time and requires minimal upkeep, is pretty palatable at. You know, a six to 7,000 price range for getting your basic system and speculum set up, and you know it's one of our sort of standard of care items that we provide for our services, that we provide for our clients. So those machines very quickly pay for themselves. And thinking about something else, another piece of equipment that comes to mind, kind of like a larger investment or financial outlay, would be an ultrasound system. And you know you're looking at 30 or $40,000 for a lot of those machines easily, and that's a lot of money to legitimize, especially if you're not ultrasounding all the time.

Kelly Zeytoonian: 8:30

So I started off with a butterfly system and that is one of the smaller, you know kind of mobile plugin units. There are a couple other brands out there that are a similar price point but at a fraction of the cost of those larger machines I'm able to scan tendons, inject cervical facets, perform colic scans, and so we've gotten to the point now where we have a butterfly in each of the vehicles and then we share a larger system Because if we really want the detail and we really need that larger, larger, more refined system. Then we put it on the truck specifically for those appointments, which means it stays nicer and cleaner and doesn't get beat up. We use those butterflies as our kind of first line of defense how much do butterflies cost these days roundabout I?

Stacey Cordivano: 9:20

think 500 yeah, yeah, maybe the other ones are more like six to eight, like the other handheld I mean, that's a significant difference, oh yeah, tenfold, right, almost tenfold to the larger system.

Kelly Zeytoonian: 9:36

So if you kind of need to like prove to yourself that you're going to be needing it and using it, this is a great way to be needing it and using it. This is a great way, and by no means is it like giving me as good of an image or allowing me to do as much of like the detailed cross-sectional area imaging and all of that, but it for sure gets the job done. If I ended up at an appointment last week that was supposed to be joint injections and the horse had an SDFT injury and I didn't have the large ultrasound on the machines but I didn't have to tell her that we had to come back, I pulled to the butterfly out and had an answer for her. So definitely a way to kind of get in there and start showing that you have the service available without that full outlay of cash.

Misty Gray: 10:18

Can you see proximal suspensories with a?

Kelly Zeytoonian: 10:22

butterfly. I mean you can. You can not to the, not to my standards, not to the standards right. If I have concerns about the suspensory, I'm coming back out with the full machine or I'm. If I already know that I'm expecting to have to ultrasound something, I'm showing up with the proper machine.

Misty Gray: 10:44

It probably makes a difference. The horse population that you serve as well right Like our horses are Well and size for sure. That's what I mean, like our horse population is a giant.

Kelly Zeytoonian: 10:56

I mean, if there's a problem and there's bony involvement, you're going to see it with the butterfly. If there's a subtle change, or if it's size difference or whatever, you need a.

Misty Gray: 11:08

All right, I'm going to ask one more question, back up to dental equipment, when you're talking about a basic system. So I'm assuming and for anybody listening my practice currently is chiro and acupuncture, so this stuff is not part of my equipment. But if you're going to purchase what you're considering a basic system, what do you consider a basic system? And I assume that there's a like are you getting top of the line? Are you getting like is this the sort of investment that you buy up? Or can you stick with middle stuff, like what's the?

Kelly Zeytoonian: 11:42

I mean this is, and like we're not getting kickbacks from these companies, by the way, right now, if anyone wants to, by all means.

Kelly Zeytoonian: 11:50

But if anybody wants to, we could certainly always use the help. No, so like we have TerraFloat systems and PowerFloat systems based on doctor preference, and when I think about like a flathead and an Apple core burr plus a headset you know your light source, whatever that may be, plus a proper Illumispec speculum, which that alone would be like something I'd say spend the thousand or twelve hundred dollars on it. Those speculums are amazing. That's what I'm talking about in that kind of six thousand dollar range.

Misty Gray: 12:25

Yeah, that's helpful because when you said like, if I'm starting my new practice and I'm thinking basic system and maybe this is a reflection of me as a, you know, in my view of money I'm probably I was picturing like the old school crank the mouth open. Leather strap. Pearson yeah yeah, so like it's nice to know that what I would, you know, move up to something that I would consider fancy and yeah, we.

Stacey Cordivano: 12:52

I worked for a long time without actually out in Apple Corps and we recently upgraded our system to an HD like backpack system because Rachel does a lot of dentistry and we were probably closer to nine with just the two. But she really likes the setup of it and it certainly paid for itself quickly. So I would second Kelly in dental equipment being a great investment. Dentistry period is just a great profit center. But if I'm answering this question of the best purchase, I think for me, starting out, the digital x-ray was really important.

Stacey Cordivano: 13:30

You know, again back in the dark ages Everyone had digital x-ray around me, different styles of units, but I think in order for me to come out of the gate as a solo practitioner, new to the area, it really legitimized me having an x-ray unit on the truck.

Stacey Cordivano: 13:50

I actually distinctly remember a couple of people saying like, oh, when you come, like well, you definitely have x-ray, and I was like, oh, yeah, it's like always in my truck. I think they were used to people sharing maybe, and so that was definitely helpful for me. And then, on a smaller scale but related, I invested in the Asteris Dicom storage pretty early on and you know it was kind of like a few months of making people x-ray CDs and like handing them over and not really being able to send them for referral options or just to a different veterinarian. I quickly realized that having this pretty nifty link from Asteris also made me look like I was professional and kind of knew what I was doing. So those for me were important. But again, right Like my population of horses, was sport horse practice and pleasure practice, but in an area where there were high-end sport horse veterinarians already working. So that one for me was important.

Misty Gray: 14:50

I came at it a little differently, because the type of practice that I was going to be doing just does not have a large overhead, just from an inventory standpoint, you know. Once I got to work, so in my head my first investments were what does it take for me to show up and look like I'm doing a real job, right? Like I wanted the logo and I wanted a website and I wanted, like, how was I going to organize my medical records and bookkeeping? So most of my purchases initially were from like a business perspective, not from an equipment perspective. So I did pay up for G suite instead of just going off of things like Microsoft email is what initially? Like I, we got our website through gosh. Help me out, guys. What is the name of the? It was on the radio Go daddy.

Stacey Cordivano: 15:51

Yes, so it's the. It was on the radio GoDaddy GoDaddy.

Misty Gray: 15:53

Yes, so it's like feels kind of creepy when you listen to the name. Yeah, so when you got your website, your domain through GoDaddy, I think it integrated with Microsoft and I wanted my email address to be, you know, info at rosepointdvmcom, not rosepointdvmat whatever. So I paid up for G suite. I was comfortable using G suite anyway for like a Google drive and that is still what I use to organize. So Stacey may shudder. I don't have a practice software. I don't feel like I see enough patients to justify that sort of monthly expense. I organize everything on Google Drive.

Stacey Cordivano: 16:40

I don't shutter at all. I think that is a perfect example of a practice type with very little overhead and like such a huge perk.

Misty Gray: 16:48

Yep. So I would say G Suite was my go-to and I'm happy that I did it. The equipment type of purchase that I did go ahead and invest in was an electroacupuncture unit. So needles don't cost much and they last long enough and you can get the job done without electroacupuncture.

Misty Gray: 17:09

But I liked the idea that in this new practice model that I was going to be doing, I was going to take my time on the patients and I was not going to be rushing to fit in a million things in a day and I would price myself in a way that I am able to just decide what I want to do. So I priced it in a way that every horse that I treat, their payment would cover the time and use of electroacupuncture, whether or not I utilize it, and I felt like that took away my need to sell it to someone Like there's not a cheaper option. If your horse gets electroacupuncture, that's one cost and then I just spend the time. If it's a patient that I think needs it, I use it, and I use it a hundred times more than I ever used it in previous practice when it was like an additional fee that just I could make it not worth it to myself. So those are my two big and small awesome.

Misty Gray: 18:04

I also, like I also spent money on canva. I did the paid up and, like I use that for everything. I think that is pretty affordable. And we, like I, use it for everything. I think that is pretty affordable. And we, like I use it to generate our letterhead and my medical records and I don't know social media posts, but I have used that in a million different ways. I think that's a yeah.

Stacey Cordivano: 18:22

I remember when I first started messing with Canva the cost seemed like a lot but gosh. Now it's like a no brainer.

Misty Gray: 18:31

And it makes you look more professional. I mean mean like the product that you can turn out for pretty low expense, compared to paying someone to do it or trying to futz around on word to make something look nice is okay to me that it adds a lot to the professional appearance of practice.

Kelly Zeytoonian: 18:48

So yeah, great, great practice hack for sure. Okay, now people are listening and they're like yeah, check, x-ray, ultrasound, g Suite. But how did you all pay for everything? How did you approach and tackle? You know what you were going to buy first and how you were going to afford to do it as you're getting up and running.

Stacey Cordivano: 19:26

I did do a formal business plan, like I potentially would have applied for a loan whether like an SBA loan or at a bank made sure I thought I was choosing equipment x-ray and ultrasound that I could afford on a month to month basis. I, you know, I didn't buy the fanciest ultrasound to start or the fanciest x-ray machine, but, um, those were all financed through the companies. I did try to make sure there was no prepayment penalty. That was something I learned about because I was hoping to pay those off sooner and then I probably didn't utilize this as much as I could have. But every distributor will do a new practice order. They'll give you better financing and longer term. So usually it's like a six month term that you don't have to pay back and you can get started with your ordering through there. So I definitely didn't utilize my distributors and reps as much as I could have in the beginning. I think it was probably just a little overwhelmed.

Kelly Zeytoonian: 20:26

Sorry, pro tip on that. Before you would be set up with one distributor, take advantage of their ordering program and their delayed billing. Get a bit of a flow going to see what you will use and how much of things you will need, and then open up a second account with a second distributor and take advantage of their program and you will have a better idea of what you do or don't need from a numbers perspective. And you will have a better idea of what you do or don't need from a numbers perspective. Like I grossly under-ordered in the first round because I didn't want to have too much on my shelf and like have to pay for that I wasn't going to use, and then the second time around I felt way more comfortable bumping up my numbers based on what I had sold in the prior six months. So start with one and then open a second one and take advantage of a second one's delayed.

Stacey Cordivano: 21:17

I mean in theory, you could go for like two or three years.

Kelly Zeytoonian: 21:20

Yes, in theory you absolutely could, if you want to open that many accounts for sure.

Stacey Cordivano: 21:26

I ultimately have that many now right. So it's like I should have been better about strategizing that from the get go or even as I went on, and then, maybe a little surprisingly, my former boss lent me a bunch of medications in a box and was like get started with these and you can just replace them later, and there's nothing formal about that. But it was very nice to not have to buy Hyalavet when you know you were just starting out, and so I am actually very grateful for that. And that reminds me and I'll link it in the show notes Two years ago at AAP there was a whole lecture on financing a small practice, like one veterinarian financing another's in a slightly different practice area but local. So I'm going to link that because it was a really interesting lecture and there's a write up on the finances of it, so you know something to consider if you're starting out kind of close to somewhere you've previously worked or something like that.

Misty Gray: 22:28

Like I said, my initial overhead was quite low, so we were able to just do a loan, a very small loan out of our own personal finances and pay that back pretty quick. Nothing exciting, but in our group, even in our decade one group, we have a large population of veterinarians who are starting that sort of practice. So Absolutely.

Kelly Zeytoonian: 22:55

I kind of was like the hybrid of the two of you. I dipped into my savings to get things up and running, had a personal loan from mommy who helped me purchase equipment. Thanks, mom and um, a very supportive partner who enabled me to get the practice up and running and not pay myself a salary for the first bit, so that I just had the cash flow to feel like I could keep investing in additional equipment and products and support. You know, like success begets success, you kind of have to like pay to play. So it gave me that opportunity in that breathing room to kind of get up and running like I needed to. And then the other thing I was very lucky, much like Stacey, to have a fellow practitioner in the area who lent me needles and drugs and I rented his x-ray machine from him for the first month or two while I was getting going.

Kelly Zeytoonian: 23:52

And just like I kind of started up very suddenly and quickly and so needed um, needed the equipment, but also needed a little bit of time to do my own research and figure those things out. So, um, now as I'm looking at it, there's somebody that's listening to us, that's kind of already out and doing the things I try and think about any large purchases that are coming up for me whether it's another x-ray machine, one that's like on the fritz, is going to need to be replaced, or a new practice vehicle and I start to stockpile enough cash that I can cover it in cash when possible, or I'll finance it if I can get competitive rates. Rates have not been great as of late, so when I can pay with cash, I do. Anyway, that's just sort of. If you're listening to this and you're not exactly starting a new practice, but you're just thinking about new purchases or growth, that would be. A consideration is just have a little bit of cash on hand for yourself.

Stacey Cordivano: 24:51

Kelly, let me just add another question here for you, for yourself, kelly, let me just add another question here for you. I've given a talk to VBMA students about how mobile practice is like a really doable option, you know, whatever species you're in especially compared to like a small animal brick and mortar startup. So I'm curious I feel like I've heard this before Do you have a number of for someone just like looking to go all out and start a brand new practice all on?

Kelly Zeytoonian: 25:14

their own. Yeah, so, and my like kind of throwing it in there is it's obviously going to depend upon where you live, what you need your base salary to be and exactly what equipment you need to be purchasing. But with some general assumptions of like basic x-ray ultrasound dental equipment and a salary of $75,000, which is low, right, we know from the numbers but you know, if you're getting started and out on your own and all of that, you need to have around $250,000 to pay for equipment over a three-year period of financing and be able to pay yourself that salary. So 250k is the number.

Stacey Cordivano: 26:02

Yeah, I mean certainly, compared to like a 1.8 million dollar small animal startup, it's better yeah, and that's like full bells and whistles.

Kelly Zeytoonian: 26:11

Right, that's not someone slowly starting yeah, that's, that's getting yourself up and running in a nice vehicle with nice equipment, paying yourself a salary. Is it the end goal? Probably not, but it's enough to kind of pay the bills and get things going. And that's with, obviously, financing on the equipment. It's not paying for it all outright, but that gives you that opportunity for cashflow and, um, you know to, to get things going. And I think you know I've definitely I've seen plenty of practices that do it and decide not to go the route of putting together a whole business plan to go to the bank to try to get money. They bootstrap and do it themselves and, um, do quite well with it.

Stacey Cordivano: 26:51

Yeah, get started in a Subaru Outback, like I did with it.

Misty Gray: 26:54

Yeah, get started in a Subaru Outback, like I did. We need an action plan. I like to end things, wrap things up with an action plan. So, for our listeners, if this is you, you're going to start by developing your shopping list and your priorities. So some thought, work is required. What type of clients are you going to work for? What type of horses will you be working with, what are the top five services that you think you will provide, and what equipment do you absolutely need for those?

Stacey Cordivano: 27:30

And then also, are there any practitioners in your area you may want to share with or rent equipment from, and years I shared a technician. I've always lent things to other practitioners in the area, whether theirs was down or they just didn't have it, and I think hopefully in this day and age, everybody realizes that collaboration is key and we don't need to be super competitive with each other. I think supporting each other, even if you're in the same market, is only going to benefit you in the long run.

Misty Gray: 28:13

It's great to think outside the box. We're all the type of people that feel like we need to get it all done and do it all and provide it all and do it ourselves, but it doesn't need to be that way. So think outside the box. What ways can you? Kelly, her practice is very. I always think the way that they utilize the shared truck and equipment situation is really unique. So be creative, for sure, all right.

Stacey Cordivano: 28:39

So let's wrap things up so we're not taking everybody's time. I think we are all of the belief that practice ownership is awesome, but it may not be for everyone. If that's the case, then you know, hopefully you can find a supportive practice near you if you're looking for a change. But if you are looking for a change and don't find that supportive practice and you do decide that ownership is right for you, then I think we can all agree that it can be incredibly rewarding and it doesn't have to be so emotionally and financially stressful. I think there's ways to do it on a growth basis that make it more doable.

Stacey Cordivano: 29:20

So hopefully you got some ideas from us today. If you have any questions, feel free to reach out. We'll be happy to get right back to you or dive into it in another episode, but next time, next month, we'll probably be talking about ways to grow your practice, since we just talked about ways to start a practice. So hopefully that will also be helpful and interesting to you guys. And I just once again want to say thank you to our Decade One partners CareCredit, merck, animal Health and Hilltop Bio for their continued support of this program and of equine veterinarians and helping them sustain themselves in real world practice. So thanks again, ladies, for your time. It's good to see you.

Kelly Zeytoonian: 29:58

Good luck everybody, Thanks.