The Developing and Sustaining a Mutually Functional Relationship With Farriers

Reprinted with permission from the American Association of Equine
Practitioners. Originally printed in the 2012 AAEP Convention proceedings

1. Introduction

Historically, farriers have been recognized centuries before veterinary medicine's emergence as a distinct profession. In fact, before the late 18^th century, what constituted veterinary care at the time was most often administered by farriers.¹ As knowledge of the equine digit's form and function has expanded and medical technology evolved, especially over the past few decades, the opportunities have grown for the two professions to work cooperatively to better the health of their patients. Their mutual clients, the horses' owners, appreciate such cooperative relationships and many have come to expect such.

The equine practitioner and farrier who seek to establish a strong and enduring professional relationship will be rewarded with enhanced development of their respective practices and many opportunities for continued learning.² Establishing and sustaining good relationships with farriers should be a prominent part of an equine veterinarian's practice plan for the simple reason that some farriers are often very highly regarded sources of information by their respective clients. Be aware that farriers working in sizable horse operations are connected to clients on a weekly basis and as such, their opinion on any number of horse-related subjects (for example, equine practitioners) is often sought.

The most important element in the veterinaryfarrier relationship is that the two professionals share as their top priority the health and welfare of the horse. Adherence to this principle facilitates ethical behavior in patient care and owner service and helps build a "best practices" business model for each professional.

It is a reality that many of today's graduating veterinarians enter practice with less than a working knowledge of farriery.³ This deficit often places them in the position of guessing at the best farriery approach to recommend for specific cases. It also leaves the new graduate unversed in the everyday language of farriers. Finally, the confidence of the farrier, trainer, and owner in the equine practitioner is easily lost-and often difficult to restore-if the practitioner is perceived as unprepared or unknowledgeable.

As in all long-term relationships, conflicts will arise. Quick recognition and frank, discreet discussion are indicated to preclude circumstances destructive of the veterinary-farrier relationship.

Effective communication between all parties-farrier, equine practitioner, owner, and trainer-is essential to providing the best care for the horse and service to the owner and, as well, to facilitating the professional development of the veterinarian's and farrier's practices.

2. Discussion

It would be difficult to overstate the importance of a strong veterinarian-farrier partnership in equine practice. Whether the practitioner's case load is restricted to elite performance horses or only partially equine in a mixed-species practice, a productive and professional relationship between the equine practitioner and local farrier community is essential.

A mutually shared dedication to doing what is best for the horse will cause both farrier and veterinarian to examine not only their medical approaches but also important elements of their practice business model. The effective delivery of client service, setting fees that are fair to the client and provide an appropriate return to the professional, the maintenance of meaningful and complete case records, the acquisition of necessary equipment, and the professional's investment in continuing education are all business model elements that are directly affected by the professional's degree of dedication to the health and welfare of his or her patients.

Although both parties' recognized areas of expertise are generally defined by tradition and statute, a common cause of veterinary-farrier conflict occurs when either party-or both-moves beyond his or her professional domain into the other's area of expertise. It is always advisable to discuss the proposed diagnosis and treatment plans clearly and agree on each professional's role in implementation on a case-by-case basis. However, when the prescribing, dispensing, or administration of medicines is indicated, as well as when radiographic imaging is needed, the veterinarian must assume full responsibility for directing and concluding the diagnostic or treatment plan. Conversely, the equine practitioner should solicit and seriously consider the farrier's input on any case and must often defer to the farrier on matters concerning construction and material selection of a hoof appliance, the trim of the foot, and the interval length between farriery visits. It is advisable for the equine practitioner to recognize that effective farriery combines art and experience more than it depends solely on exact science. In most cases, it is the farrier who brings the art and experience to the table. To preserve and strengthen the veterinary-farrier relationship, conflicts must be quickly detected and candidly discussed. Mutual respect and professional behavior will most often lead to conflict resolution and to an enhanced relationship. To criticize privately and praise publicly is a wise approach.

For the equine practitioner, insufficient formal education in and/or experience with farriery can lead to conflict within the farrier-veterinarian relationship and reduce owner confidence in the case management. It is the equine practitioner's responsibility to acquire and maintain competence in understanding the biomechanics of the equine digit as well as familiarity with the current selection of available farriery appliances and materials. It is also important for both parties to understand that progress has been made in clearly defining the terms used in equine podiatry and to attempt to use the accepted terminology properly.^4,5

Effective and timely communication between all parties involved in management of a case is essential to maximizing care for the patient and service to the client as well as avoiding unnecessary misunderstandings or conflicts.⁶ With today's technology, verbal and document communications are easily facilitated, as is the transmission of a variety of image formats between veterinarian and farrier, to the client or to outside experts for consultation purposes. All clients have expectations-realistic or otherwise-regarding prognosis, rate of progress, and costs. Timely and effective communications are essential to addressing these expectations.

References

1. Bullock F. Notes on the early history of the veterinary surgeon in England. Proc R Soc Med. 1929;22:627-633.
2. Merriam JG. The role and importance of farriery in equine veterinary practice. VCNA Equine Pract. 2003;19:2.
3. Kirker-Head CA, Krane G. Farrier services at veterinary teaching hospitals in the USA. Equine Vet Educ. 2010; October:519-525.
4. O'Grady SE, et al. Podiatry terminology. Equine Vet Educ. 2007;19:263-271.
5. Parks AH, Mair TS. Laminitis: a call for unified terminology. Equine Vet Educ. 2009;21;102-106.
6. Moyer W, Schumacher J, Schumacher J. Chronic laminitis: considerations for the owner and prevention of misunderstandings, in Proceedings. Am Assoc Equine Pract 2000;46; 59-61.