Friday, October 10, 2014

BEVA Congress: Ohio State’s Professor Belknap Reports on US and UK Farrier-Vet Relations Survey

At the British Equine Veterinary Association (BEVA) 2014 Congress in Birmingham, England last month, Professor James K. Belknap DVM, PhD, Diplomate ACVS, of The Ohio State University College of Veterinary Medicine reported on an Internet survey he conducted this summer.

Professor Belknap surveyed farriers in the United States and Great Britain about their involvement with veterinarians in the treatment of laminitis and asked for their feedback about working relationships with veterinarians on foot cases. The survey also asked how farriers perceived the level to which the success or limitations of the farrier-vet relationship may affect the outcomes of cases or the perceptions of clients.

Belknap spoke quickly and flipped through his PowerPoint with speed that made it impossible to read to read details in the slide result charts. His presentation was based on tabulation of raw data rather than an in-depth analysis, and he noted that he will probably publish or present the results in a more formal format in the future.

The survey attracted the participation of more than 800 farriers on both sides of the Atlantic. Some questions were worded slightly differently for British farriers, since the farrier profession is regulated there and the education and training are standardized. British farrier Simon Curtis reworded the survey for British farriers.

The actual participation was 455 for the USA and 350 for the United Kingdom. In both groups, the farriers participating described themselves as highly experienced, with a large number claiming more than 20 years of experience as a farrier (see reference slide above: 59% of participants had 11 or more years of experience, and 34% had 20 or more years of experience).

Throughout the series of questions, Belknap noted similar answers and similar frustrations from British and American farriers, indicating that treating laminitis is challenging regardless of location. “Amazing close themes (emerged) between US and UK farriers, despite their differences in training --three-year apprenticeship required, regulated etc.-- compared to the U.S.,” Dr. Belknap noted.

The survey did not drill down to specific shoes or treatments in use for laminitis cases, so there is no trend to report on whether particular shoes or treatments are gaining or losing in popularity. He did mention in passing that US farriers listed cryotherapy (icing the feet and lower limb as soon as possible after discovering that a horse has laminitis) as an effective early treatment, while British farriers did not mention cryotherapy.

Dr. Belknap delivering his survey results in Birmingham, England
The value of the survey results, at least on the surface before any in-depth analysis of the numbers, is the commitment that farriers have to being involved in laminitis treatment.

Dr. Belknap concurred: “Farriers want to be involved from the initial time a veterinarian examines a laminitis case (even with a call at night or weekend if emergency for the majority of farriers), and work as a team from the start.

“My overall take is that the best approach is for the veterinarian to provide the initial care needed, but inform the owner that they will work with the farrier to come up with a treatment plan which they will then communicate with the owner,” he continued. “There was an overwhelming feeling from both sides of pond that most client problems would go away if client communication was done--on a regular basis--as a team, instead of as two individuals putting the client in the middle.”

To learn more:
Dr. Belknap’s presentation on the survey results is available as a feature of the BEVA Congress’s “EBeva” video education platform. The videos are subscription-based and accessible at

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Kevin Alcock said...

Dr Belknap's "overall take" is spot on!

All too often, we, as farriers and veterinarians don't speak directly with one another about lameness issues. This creates poor customer relations.

We usually agree with a diagnosis, a prognosis or treatment plan, but when it's delivered to the client in different words, it becomes confusing and quite often contradicting in the client's perception.

There also seems to be a societal hierarchy between doctors and farriers. We are both specialists in our own ways and each have equally valuable skills or abilities. Doctors are perceived as having more knowledge. This does not include experience.

However in the eyes of a client, the doctor is perceived as the professional "in charge" of the issue, whether they are correct or not. Quite often the farrier feels inferior because of this perception, causing animosity. This will only snowball into poor working relations.

The same is true when a young veterinarian is working with a well experienced farrier.

In fact, for a team to work efficiently and positively, each individual needs to be recognized for their own expertise, and allowed by one another, and the client, to act as part of the team.

All three parties involved must agree with a plan. This takes communication on a personal level.

Relations of any kind is a skill to be developed. It's understanding and acceptance of our own unique personalities. It's the ability to communicate with anybody in a way so that you yourself are understood correctly. We must be professional yet diplomatic.

And finally, our biggest mistake is not taking the time to communicate.

Most often the veterinarian takes radiographs, makes a diagnosis and leaves instructions with the client for the farrier. The farrier shows up at a later date and is "told" what to do by the client.

When this happens to me, I have a million questions and immediately begin to assume.

We do this over and over again on each case we see and frustration builds. The vet begins to assume how the farrier will react and vice versa whenever a farrier knows a vet is being called.

Yes, things are better these days as we email radiographs or leave notes. But none of our technology will ever replace human interaction on a face to face personal professional level.

Communication is key with all three parties present at the time of presenting information to the client.

Communication privately between farriers and vets that don't work together regularly before speaking with a client is useful.

And assumptions will always be bad.

Thank you, Dr Belknap, for taking on this subject.

Fran Jurga said...

Thank you, Kevin, for your thoughtful contribution.