Virginia Therapeutic Farriery

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

William A. Moyer, DVM; and Harry W. Werner, VMD

1. Introduction

Historically, farriers have been recognized centuriesbefore veterinary medicine's emergence as a distinctprofession. In fact, before the late 18th century,what constituted veterinary care at the time wasmost often administered by farriers.1 As knowledgeof the equine digit's form and function hasexpanded and medical technology evolved, especiallyover the past few decades, the opportunitieshave grown for the two professions to work cooperativelyto better the health of their patients. Theirmutual clients, the horses' owners, appreciate suchcooperative relationships and many have come toexpect such.

The equine practitioner and farrier who seek toestablish a strong and enduring professional relationshipwill be rewarded with enhanced developmentof their respective practices and manyopportunities for continued learning.2 Establishingand sustaining good relationships with farriersshould be a prominent part of an equine veterinarian'spractice plan for the simple reason that somefarriers are often very highly regarded sources ofinformation by their respective clients. Be awarethat farriers working in sizable horse operations areconnected to clients on a weekly basis and as such,their opinion on any number of horse-related subjects(for example, equine practitioners) is oftensought.

The most important element in the veterinaryfarrierrelationship is that the two professionalsshare as their top priority the health and welfare ofthe horse. Adherence to this principle facilitatesethical behavior in patient care and owner serviceand helps build a "best practices" business model foreach professional.

It is a reality that many of today's graduatingveterinarians enter practice with less than a workingknowledge of farriery.3 This deficit often placesthem in the position of guessing at the best farrieryapproach to recommend for specific cases. It alsoleaves the new graduate unversed in the everydaylanguage of farriers. Finally, the confidence of thefarrier, trainer, and owner in the equine practitioneris easily lost-and often difficult to restore-ifthe practitioner is perceived as unprepared orunknowledgeable.

As in all long-term relationships, conflicts willarise. Quick recognition and frank, discreet discussionare indicated to preclude circumstances destructiveof the veterinary-farrier relationship.

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

2. Discussion

It would be difficult to overstate the importance of astrong veterinarian-farrier partnership in equinepractice. Whether the practitioner's case load isrestricted to elite performance horses or only partiallyequine in a mixed-species practice, a productiveand professional relationship between theequine practitioner and local farrier community isessential.

A mutually shared dedication to doing what isbest for the horse will cause both farrier and veterinarianto examine not only their medical approachesbut also important elements of theirpractice business model. The effective delivery ofclient service, setting fees that are fair to the clientand provide an appropriate return to the professional,the maintenance of meaningful and completecase records, the acquisition of necessary equipment,and the professional's investment in continuingeducation are all business model elements thatare directly affected by the professional's degree ofdedication to the health and welfare of his or herpatients.

Although both parties' recognized areas of expertiseare generally defined by tradition and statute, acommon cause of veterinary-farrier conflict occurswhen either party-or both-moves beyond his orher professional domain into the other's area of expertise.It is always advisable to discuss the proposeddiagnosis and treatment plans clearly andagree on each professional's role in implementationon a case-by-case basis. However, when the prescribing,dispensing, or administration of medicinesis indicated, as well as when radiographic imaging isneeded, the veterinarian must assume full responsibilityfor directing and concluding the diagnostic ortreatment plan. Conversely, the equine practitionershould solicit and seriously consider the farrier'sinput on any case and must often defer to the farrieron matters concerning construction and materialselection of a hoof appliance, the trim of the foot, andthe interval length between farriery visits. It isadvisable for the equine practitioner to recognizethat effective farriery combines art and experiencemore than it depends solely on exact science. Inmost cases, it is the farrier who brings the art andexperience to the table. To preserve andstrengthen the veterinary-farrier relationship, conflictsmust be quickly detected and candidly discussed.Mutual respect and professional behaviorwill most often lead to conflict resolution and to anenhanced relationship. To criticize privately andpraise publicly is a wise approach.

For the equine practitioner, insufficient formaleducation in and/or experience with farriery canlead to conflict within the farrier-veterinarian relationshipand reduce owner confidence in the casemanagement. It is the equine practitioner's responsibilityto acquire and maintain competence inunderstanding the biomechanics of the equine digitas well as familiarity with the current selection ofavailable farriery appliances and materials. It isalso important for both parties to understand thatprogress has been made in clearly defining the termsused in equine podiatry and to attempt to use theaccepted terminology properly.4,5

Effective and timely communication between allparties involved in management of a case is essentialto maximizing care for the patient and service tothe client as well as avoiding unnecessary misunderstandingsor conflicts.6 With today's technology,verbal and document communications areeasily facilitated, as is the transmission of a varietyof image formats between veterinarian and farrier,to the client or to outside experts for consultationpurposes. All clients have expectations-realisticor otherwise-regarding prognosis, rate of progress,and costs. Timely and effective communicationsare essential to addressing these expectations.

References
  1. Bullock F. Notes on the early history of the veterinary surgeonin England. Proc R Soc Med. 1929;22:627-633.
  2. Merriam JG. The role and importance of farriery in equineveterinary practice. VCNA Equine Pract. 2003;19:2.
  3. Kirker-Head CA, Krane G. Farrier services at veterinaryteaching 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.