Pros and Cons of Film, CR, and DR Veterinary Systems

Different x-ray machines and modalities come at different price points. Technology accounts for much of the cost variations.

So, which technology is worth the cost, and which isn’t? If your practice is thinking about purchasing a veterinary x-ray unit, here are some considerations…

Pros of Film Veterinary X-ray Systems

Film radiographs have been a tried-and-true method for a long time. It’s what many veterinarians learned to interpret images on—and some practitioners find that by comparison, digital images are easy to “overinterpret” or find false positives for certain lesions. 

Additionally, film x-ray systems and accessories often come with a cheaper purchase price. Like any technology, the price of older generations or models goes down as newer tech is developed.

Cons of Film Veterinary X-ray Systems

This tends to be the most time-consuming method of taking radiographs. Each film must be individually run through a developer. This developing process takes time in and of itself—and then that time can be compounded because a vet team must wait until a film is developed to know whether retakes are needed.

Plus, there is the added cost and maintenance of the developer, chemicals, and even the x-ray films that must be continuously purchased and eventually disposed of properly. There must be a separate dark room for developing images. And more moving parts mean more opportunities for something to break down. 

A practice must also have enough room to store all their physical radiographs. There’s no backup copy if anything happens to the original, and sharing a film is much less convenient than sharing a digital file.

Pros of Veterinary CR Systems

CR (computed radiography) is a form of digital radiography, meaning it produces a digital image rather than a physical one. This makes storage and sharing of images simpler in many ways compared to film.

Images are produced after running the phosphor plate (which captures the image) through a plate reader. While this is typically faster than developing film, it still takes time. Some practices invest in more than one set of plates and readers to help improve efficiency.

Cons of Veterinary CR Systems

Although CR is typically faster than film, there is still time required to run the plate(s) through a plate reader. And for vets who are used to films, there can be a learning curve when adopting digital technology and learning to read digital images that show a high level of detail.

In terms of cost, this is often a middle option between older and newer technology (which could mean it’s more or less expensive, depending on what you’re comparing it to).

Pros of Veterinary DR Systems

DR (direct radiography) is the fastest method of taking a radiograph since there’s no developer or plate reader involved. Instead, the image is captured on a sensor and then directly produced on a screen just seconds after the shot is taken.

This saves time not only by eliminating the developing/reading step entirely but also by letting the team know right away if any retakes are needed. The newest technology is also more likely to have robust options for presets, to help the team set up a study with the right settings and exposure more quickly. 

Digital veterinary software might allow the vet to zoom in or make measurements on the screen when interpreting images.

DR technology also tends to have the smallest footprint, since there’s no need for a separate developer (with its own dedicated dark room) or plate reader—just the generator, table, sensor, and hardware/software for the images. So, this can be a good option for smaller clinics with limited space.

Cons of Veterinary DR Systems

As with many types of veterinary equipment, newer technology tends to come with a higher price tag. However, just like other types of technology like digital cameras or personal computers, the purchase price starts to trend down as it becomes more widely available over the years. Digital x-rays are no exception, and prices have come down a lot since the technology first entered the market.

So, veterinarians might be able to find models within their practice’s budget, including used veterinary digital x-ray machines for sale. It’s also important to consider that a more efficient machine can help increase the number of studies per day or per week, which can help offset the purchase cost.

Which Type of Veterinary X-Ray Unit Is Right for Your Practice?

With all the pros and cons of each in mind, it really comes down to preference. And in addition to film, CR, or DR technology, also consider factors such as…

• Expected x-ray usage or goals for income generated from the new machine.

• Quality of images on all the different sizes of patients you see.

• Financing options.

• Warranty and service plans.

• Availability of replacement parts over the next several years.

• Software costs, updates, reliability, security, and compatibility with practice management software.

Veterinary DR systems certainly offer many advantages. And investing in the newest technology may help in terms of warranties and availability of replacement parts. 

But every modality has its own pros and cons. By considering these, a veterinary practice will have a better understanding of what they’re getting for their money, which will help with choosing the right machine for their individual practice.

Written by: Dr. Tammy Powell, DVM 

Veterinary Digital X-Ray System Features to Look For (That Have Nothing to Do with the X-Rays…)

When choosing a digital x-ray machine for veterinary use, everyone can probably agree that diagnostic, good-quality images are of the utmost importance. That’s the whole point of using radiographs in the first place—to get accurate information about what’s going on with a patient.

However, assuming a machine produces great x-ray images on the sizes of patients you see, there are other factors that can affect practice flow, efficiency, and return on investment.

If you are choosing between two or more otherwise excellent machines, here are some additional factors to consider…

Generator and Table Size

Newer technology, including high-frequency generators, allow some x-ray units to be made smaller and more compact than previous models. 

Many practices have limited space. So, if the table and system are still big enough to accommodate your largest patients, it might be advantageous to purchase an x-ray system with a smaller footprint.

Setup and Installation

Outside of minimum radiation safety standards for the x-ray suite or location, there are options when it comes to installing a new machine.

One consideration is the electric supply. Some newer systems provide the convenience of simply plugging into a standard outlet. Others might have specific electrical requirements, requiring consultation with an electrician or even rewiring the x-ray suite. 

There’s also the matter of setting up the machine and ensuring it’s operating smoothly. Check if your purchase includes installation costs. Inquire about any shipping or transportation timelines and concerns.

User Friendliness

A user-friendly machine can improve efficiency. This means smoother practice flow, fewer frustrations, and headaches, and potentially a higher number of x-ray studies performed per day or per week (and thus a better return on investment).

User-friendliness can mean many different things. But basically, this is anything that makes a radiographic study run more easily and intuitively.

Often, it includes an easy way to input patient and client information. It could also mean intuitive interfaces for setting up a study based on species, views to be performed, and the patient’s measurements.

Presets are popular and can make setting up and performing a study even easier. For example, some systems will automatically adjust settings for the study at hand (for example, cat thorax or large dog abdomen).

Software Compatibility and Reliability

Digital veterinary software is important, since it’s how x-ray images are viewed, stored, and shared. It’s crucial for day-to-day operation (i.e., interpreting radiographs right after they are taken) and can be considered part of the patient’s medical record. Software problems create huge headaches and inconveniences.

The basic requirements are that software operates smoothly, efficiently, and securely. Any software can have glitches from time to time. But there should be confidence that the company prioritizes fixing any issues. Technical support should be available. Protection against hackers or other privacy invasions should be of the utmost importance, too.

Additionally, any software purchased along with your new x-ray system should be compatible with your practice management software. This will improve efficiency and eliminate many frustrations. Also consider how images can be formatted, i.e., DICOM, jpeg, etc.

Support 

Veterinary x-ray equipment represents a significant financial investment. Protection of this investment can take many forms, such as warranties, service plans, and 24/7 technical support.

Ask about these things prior to purchase. In addition to service and repairs being available, remember to ask about the timeline for repairs and whether loaner equipment is available in the meantime to keep you up and running.

Finally, consider whether or not replacement parts are available—and likely to continue being available for the foreseeable future. An x-ray system investment is typically a long-term one, so it’s very frustrating (and expensive) to have no options for repair if a component breaks down.

Extra Bells and Whistles

Here are a few examples of “extras” a veterinary practice might look for on their new x-ray system…

• Tools like measurements (possibly including preset, guided measurements like a vertebral heart score tool) within the software.

• Horizontal beam capabilities, especially for practices that see a lot of exotic species.

• Combination machines, such as one that also includes a modality like a fluoroscopy.

• Everything you need for the new veterinary x-ray system is included in the purchase, such as one or more sensors, hardware, software, a workstation laptop, etc.

• Access to training for the veterinary team, to help with learning the new system and improving efficiency.

Always start by making sure a veterinary DR system meets its primary purpose: taking good, diagnostic-quality images. 

After that, the purchase isn’t always an “apples-to-apples” comparison. Shop around and see if there’s a good system available with features that benefit your practice and make the x-ray process smoother and more efficient.

Written by: Dr. Tammy Powell, DVM

Veterinary Digital X-ray Cost: How Much Should Veterinarians Charge for X-rays?

What to charge for digital X-rays

Pricing strategies can be challenging. But when appropriately managed, pricing can help the clinic meet its bottom line while also keeping clients happy.

Here are some things to consider when determining veterinary digital radiography costs…

Calculate Your Cost Per Radiograph or Study

This involves the sum total of many different factors, including…

• The cost of your radiography equipment. Include the total monthly payment on the x-ray system if you financed it, as well as any service plan, software, or other ongoing payments. 

If it’s easier, break down the monthly cost into weekly amounts or any increment that tells you how much income the equipment needs to bring in per day or per week.

• Staffing costs. How many team members are needed per radiographic study? And how long are studies expected to take? This should give you a rough idea of the staff costs per study. Allow some margin of error for reshoots, as well as a bit of a learning curve in the beginning. 

It would also be good to budget for team training. Any new piece of veterinary equipment (even a user-friendly one) requires time for people to build familiarity and maximize efficiency. While training requires an up-front time and cost investment, it will likely promote efficiency and maximize equipment usage and ROI in the long term.

• Lost income opportunities. This is where things start to get a bit more complicated. It can help to work with a business professional, especially one familiar with veterinary medicine. 

Opportunities lost basically means that during the time your team is performing radiographs, they are unable to do anything else, such as take in appointments. So, perhaps fewer appointments can be scheduled, which leads to a loss of income in one area (routine appointments) while gaining in another (x-ray studies).

• Overhead costs. Every business needs to pay for its building, utilities, waste management, and other costs of daily operations. More than likely, this is already included as a percentage or markup in many of your products and services. Radiographic studies should also take this into consideration, as it’s a necessary cost of doing business.

For radiographs specifically, this might also factor in patient positioning aids, protective lead aprons and gear for team members, and safety/regulatory compliance such as radiation badges.

How Much Income Will Radiographic Equipment Produce?

Here are a few considerations that may help you come to an expected dollar amount…

• How many radiographs does your practice expect to perform per day/week/month? Also, could this number be increased? For example, maybe more studies will be performed after teaching team members how to convey the value of radiographs to clients, or thanks to a new veterinary DR system that improves efficiency and allows for more studies in less time.

• What do you expect that clients will pay for a radiographic study? This is based on knowing your area (including factors like cost of living) and your clientele. 

Remember, it’s important to factor in a client’s perception of what a service is worth. This is called value-based pricing. For example, some vets note that clients are willing to pay more for emergency services (emergency x-rays) versus routine or preventive care (senior wellness screenings), because the perceived value is higher to them. 

If your practice discovers that costs are high compared to what clients will likely pay, it might be necessary to lower costs as much as possible. For example, maybe buying used veterinary equipment would be the best option, so long as it is in good condition.

• Learn the going rate in your area. Never discuss prices directly with other clinics, as this can be considered price fixing and run against antitrust laws. However, it’s usually okay to have a team member call and “secret shop” certain prices. If you’re not sure what’s permitted or not, check with a legal professional. 

Also, keep in mind whether your practice is focused on high-end service or on offering the best prices relative to other practices in your area. It’s not always an “apples to apples” comparison, even for local competitors.

• Consult helpful resources. Many vets refer to AAHA’s Veterinary Fee Reference as a general guideline for pricing services. Keep in mind recommendations must be adjusted to factors at your clinic or your local area. Also, investigate continuing education resources for practice management, which often include pricing strategies. The Veterinary Information Network (VIN) offers practice management courses, and many conferences might also have this specialty available.

Consider Combining Costs When Relevant

Here are some examples for consideration…

• Lower prices for each set of additional images. A lot of the up-front cost involves setting up the study. But once the patient is measured and ready to go, additional views generally go faster than the first ones. So, a five-view study might include a set price for the first two views, then a lower cost per view for the next three. Or a GI contrast study—which might involve at least 10 shots—could include decreased costs for such a large number of views, or even be priced as a package deal.

• Combine radiographs with other services—such as sedation or surgical procedures—when relevant. A sedated or anesthetized pet is often easier and faster to position for their x-rays.

• Bundle other services when appropriate, such as senior wellness checks that include bloodwork and imaging to screen healthy pets.

Adjust Prices as Needed

Pricing strategies can be an art as much as they are a defined calculation. So, it’s important to be adaptable over time. Circumstances might change in your community. And routine price increases are expected in most industries due to the real costs of inflation.

Consult a Business or Financial Professional

This can all get quite complicated. And most veterinarians and team members much prefer working with animals to managing a business.

Professionals exist for a reason, so be sure to use them to your advantage as needed. This could include business consultants, financial professionals, or others relevant to your situation who are familiar with veterinary practices. 

Doing some research and using available resources can help a veterinary practice develop the most effective pricing strategy—and balance client expectations with a good ROI on their new veterinary equipment.

Written by: Dr. Tammy Powell, DVM

10 Considerations for Choosing a Veterinary Portable Digital X-Ray System

There are many possible reasons why a veterinarian might need a portable x-ray machine. This is especially true for mobile or farm call practices, which must perform diagnostic procedures on-site.

Even a brick-and-mortar practice might occasionally need portable x-ray capabilities, for example, to perform horizontal beam shots.

How much to invest, which features to look for, and other purchasing requirements vary from practice to practice. Here are 10 factors to help a busy practice decide which veterinary portable DR machine or system might best suit their needs…

1. Cashflow/return on investment plan. An equine specialist who takes frequent, detailed images of the limbs and hooves might want a top-of-the-line machine. On the other hand, a small animal house call practice that specializes in hospice and end-of-life care might not perform nearly as many x-rays.

Think about how often your practice performs radiographs, and whether this number is expected to increase due to demand. Do clients in your area expect radiographs, and what is the going rate for x-ray studies?

Once expected income from the equipment is known, that can help determine how much a practice should spend on its new system.

1. Imaging requirements. Which patients will your practice see and take radiographs on? Which types of studies will be performed? 

Look at imaging capabilities and technical specifications to determine which portable x-ray machines can get the job done. Ask to take the machine on a trial run for different size patients (or body versus extremity shots, etc.) to make sure it provides the level of detail required on different types of studies.

1. Durability. Conditions outside the clinic are not nearly as controlled in terms of temperature, movement/transport in a truck or van, accidental drops, and elements like dust, dirt, humidity, or precipitation. This is especially true for farm calls or remote destinations in hot or cold climates. 

If this sounds like your practice, it’s important to make sure your x-ray system stands up to all these conditions, lasts long enough to make your investment worthwhile, and still delivers results without malfunction or loss of diagnostic quality. Protective cases and screens, especially waterproof ones, can also be a necessity.

1. Warranties. Even with a durable machine and good protective measures, accidents happen. Ask about warranties—is one in place, what it covers, how long it last, and how much it costs to extend? 

2. Support and maintenance. Ask about routine maintenance, what’s included, and any additional costs. Even brand-new machines need proper maintenance to keep running at their best.

Also, is there a 24/7 tech support line available?

Finally, many veterinarians inquire if a loaner x-ray system is available should their equipment need to be sent back to the manufacturer for time-consuming repairs. That way, a practice can stay up and running in the meantime.

1. Cords or cordless/wireless. Unlike large machines that must be installed in a standing facility, some veterinary portable DR systems are wireless. 

This could mean “cordless,” in terms of having a rechargeable battery so the generator doesn’t need to be plugged in. This is advantageous at locations where there’s not a convenient electrical hookup inside a barn. On the other hand, some vets note a battery might not last the whole day if they have a lot of appointments or drive long distances.

It could also mean “wireless” in terms of sending images from the sensor to a digital reader/storage software through a wireless internet connection. This can be convenient because there are less wires that could be tripped over or damaged. On the other hand, it could be a disadvantage in places with reception issues.

1. Ease of use. Although there’s a learning curve for any new veterinary equipment, some machines are much easier than others to learn. 

Look for intuitive interfaces that will be easy for the team to start using right away. Presets for different types of species and x-ray studies are also very helpful, potentially reducing errors and saving time.

Additionally, something that is lightweight, compact, ergonomic, and easy to hold and operate will help reduce the risk of drops or other accidents.

1. Digital veterinary software compatibility. It’s common to integrate DR images directly into practice management, image viewing and sharing, or electronic medical record software. To avoid headaches and extra work, make sure the portable veterinary x-ray system you are purchasing is compatible with your practice’s software. 

To avoid future expenses as much as possible, ask if software upgrades are included and if tech support or a guarantee is provided in case of any malfunctions. 

Finally, ask about the privacy/security of the software.

1. Where to purchase. Consider speaking to vendors you know and like. It might make sense to bundle purchases (such as an x-ray system and laboratory equipment) together for a discount. Just check the fine print, as some of these deals tie a veterinarian to a contract for minimum ongoing purchase requirements (for example, a minimum number of lab tests per month).

Other sellers, including used equipment sellers, can also offer some great deals. Look for reviews, reputability, and specifications of the equipment. Ask colleagues for their recommendations, too.

1. Financing and money considerations. Is purchasing the equipment outright an option? Or does financing make more sense in terms of cash flow? Remember to check on tax benefits as well. 

Research and discuss everything with decision-makers at the practice.

Consider including team members who would be using the portable veterinary x-ray system—they might have very valuable input for what would improve efficiency.

Consult business, tax, or financial professionals as needed.

Although a large equipment purchase is a significant investment, it can also be a way to bring new income to the practice—not to mention boost patient care and improve workflow and efficiency. 

Written by: Dr. Tammy Powell, DVM

10 Considerations for Choosing a Veterinary DR System

A veterinary DR system (digital direct radiography) is a common wish list item for veterinary practices. But how to know when it’s worth the cost? How much to invest? And what’s the best veterinary digital radiography system?

The answer will vary from practice to practice. In addition to looking at just the purchase price, here are 10 important considerations that can help a veterinary practice choose a new x-ray system that’s perfect for their needs…

Cashflow/return on investment plan

Knowing how much income a veterinary digital x-ray machine will bring in can guide the decision on how much to budget for the purchase. 

Factors to consider include how busy the practice is (and expected to be in upcoming years), how much clients are willing to spend on their pets, and more. A veterinary business or financial consultant can help create a financial plan for new income and expenses and determine how much it makes sense to spend. 

It’s also helpful to research different financing options

1. Where to purchase. Many veterinarians start by speaking to vendors they know well. This might bring extra perks, such as discounts for bundling services (say, purchasing an x-ray machine and lab services from the same provider). Just be sure to check the contract for minimum ongoing purchase requirements (such as the number of tests performed per month or per year) and see if this makes sense for your practice or not. 

You might find deals from other sellers, too. Look for reviews and reputability, along with looking at the x-ray system itself. There are also many used veterinary digital x-ray machines for sale on sites such as eBay or usedvetequipment.com.

Imaging capabilities

Of course, you’ll want to make sure the machine has all the technical specifications your clinic needs, for all the patients you see. A feline-only hospital would have very different needs from a large animal mobile practice. 

For small animal general practices, it’s advisable to test the machine on a cat’s limbs and a large dog’s abdomen and thorax, to make sure images stay high-quality and diagnostic at these different size ranges.

Ease of use

Although there’s a learning curve for any new veterinary equipment, some machines are much easier than others to learn. 

Look for intuitive interfaces that will be easy for the team to start using right away. Presets for different types of species and x-ray studies are also very helpful, reducing errors and saving time.

1. Shipping and installation costs. Ask about potentially “hidden” costs such as shipping and installation, as well as electrical requirements (some require rewiring at the practice).

2. Support and replacement parts availability. Where is the company located? Is there a 24/7 tech support line? Also, find out about the availability of replacement parts, especially for older models. 

3. Ongoing costs. Inquire about a warranty, including how long it lasts, what it covers, and if it can be renewed (and how much that costs). 

Loaner machine

Also, look for information about service and maintenance requirements. See if a loaner machine is available if repairs will take a long time.

1. Digital veterinary software compatibility. It’s common to integrate DR images directly into practice management, image viewing, and sharing, or electronic medical record software. To avoid headaches and extra work, make sure the x-ray system you are purchasing is compatible with your practice’s software. 

To avoid future expenses as much as possible, ask if software upgrades are included and if tech support or a guarantee is provided in case of any malfunctions. 

Finally, ask about the privacy/security of the software

1. Any extra requirements or options. For example, maybe your clinic needs a portable system or horizontal beam capabilities. Or, maybe the practice would benefit from a digital x-ray unit that also has fluoroscopy capabilities. 

2. Tax benefits. Sometimes, tax benefits alone can help a practice’s bottom line and justify an equipment purchase. Always consult a tax professional on this matter to file correctly, avoid pitfalls, and gain the maximum benefit.

It’s important to discuss everything with decision-makers at the practice and to consult business professionals as needed. It can also be helpful to include team members who would be using the x-ray system: they might have great ideas on what would make the practice flow go better and thus maximize the ROI on the new equipment.

Although a large equipment purchase is a significant investment, it can also be a way to bring new income to the practice—not to mention improve patient care and save staff time. 

Written by: Dr. Tammy Powell, DVM