So there is really no way to decide if what this vet is doing is negligent or malpractice without experiencing it first hand because a lot is lost in translation from the vet to the owner, much less the owner to the owners friend, trainer, family, etc. 

I will say hoof abscess type lamenesses are usually but not always hoof abscesses, and can be other things (fracture, laminitis, bone edema, puncture, septic joint/synovial structure, etc).  I can't make any calls on this persons exam and what led him/her to the point of doing nerve blocks on a lameness like that.  I can say for me, when I see a horse who looks like he has an abscess the first thing i do is feel for a bounding digital pulse, and then grab my hoof pick and clean the foot, look for anything obvious like a rock (it happens), and then apply hoof testers. If I don't get the hoof tester response im expecting for an abscess I will take 1-2 x rays of the foot and look for a gas pocket (not all abscesses have gas pockets but its a great help if they do). My second view would be to check for rotation if for some reason I am also suspicious of laminitis (metabolic syndrome horses with histories of chronic hoof abscesses as one example).  If I am starting to doubt theres an abscess, then I reach for the nerve blocks. Again I would probably have already done an x ray or two to make sure theres not a fracture I'm about to block out because no one wants to block out a non displaced fracture and have it blow to pieces once they cant feel it). 

I'm going to tread lightly about using the malpractice word on anyone... but I would say to make a mental note and maybe not use the particular person in the future if you don't like how they work. Vets arent created equally and I'd be lying if I said there weren't bad apples in the bunch (as there are bad apples in every profession).  But the best you can do is just find someone else who fits you better, or you can speak with the practice owner and give your feedback, even if they are the practice owner. Communication is key- ask questions, be involved in the exam, and if they get all huffy about it maybe its a sign to go somewhere else (there's also a fine line between being involved and being rude/pushy, JMO).  If you truly feel like animals are in danger and malpractice has occured you can complain to your state's vet board. That would be better than just word of mouth telling people not to use so and so, because I feel like that could be used against you. 

I love what you are saying.

I asked for xrays, in fact that's what I made the appointment for (farrier views). Vet refused to xray my horse and stated we need to start doing blocks to make sure thats where the soreness was coming from, and he never tested his block to see if it worked and then he sent me on my way and told me to go for a NUC MED bone scan if it didnt get better. 

I work in health care and know that thats absolute BULLS***!! xrays are the cheapest, quickest thing you can do to rule something out. Once I went to Outlaw equine, we did farrier views and my suspecions were proved correct and we were able to efficiently treat the problem. Outlaw blocked the horse as well and did make sure it worked.

I feel like the KC area vet was neglegent if nothing else. I dont want anything from them, I want people to be aware> I feel bad for the people who blindly trust this vet, he is clearly in it for the money NOT the horse.