The horse owner not only expects outstanding care for their horse; they also recognize and appreciate a well-run equine practice. They expect their veterinarian to show up on time for appointments; they expect to receive decipherable invoices and statements on a regular basis and they appreciate an assistant who enhances the services that their veterinarian provides. A well-managed ambulatory equine practice supports the ideals of both high standards of care and mobility. In fact, a poorly managed practice will ultimately impact the care that an equine veterinarian attempts to provide the horses in his or her care. Without careful attention to profitability and efficiency, the practice’s ability to grow and develop with emerging therapies and technologies is impossible. Furthermore, a poorly managed practice will significantly contribute to the frustration that an equine veterinarian feels after working long hours and receiving only nominal pay.