The world of veterinary practice is in a state of flux. The delicate balance of providing veterinary care to animals 24 hours a day, seven days a week, is one of the factors that can, for all its difficulty and issues for those of us tasked with providing it, be one thing that helps maintain the status quo. I recently had some communication with a friend in practice who described an episode that has rocked the local boat somewhat – and includes some pertinent points for all of us.
The area in question is a rural one where all the practices do their own out of hours (OOH) work. Up until five years ago, most of the practices were mixed independent practices and on call was par for the course. After a few years of mergers and acquisitions, corporate takeovers, etc, there is now one large farm and equine group, one large mixed practice and several small animal practices and hospitals. Standalone corporates had largely stayed away as they could not find a vet to start up a new practice and do all their own on call work. A corporate had even built a practice, but it stood empty for half a year. Such is the recruitment crisis, but that’s another story.
So, it came as some surprise to the local vets when a new corporate practice opened a few months ago. Some simple research and phone calls revealed that the practice was not doing its own OOH work. They had found a practice over an hour away to cover the OOH callouts and OOH inpatient and post-op care. To the local vets, this seemed a bit of a stretch. Some clients may make inquiries about OOH cover but not many will ask about inpatient cover, and a one-hour drive post-op was considered less than ideal.
One of the local practice owners put in a call to the RCVS practice standards department and was informed that OOH provision over an hour away was now not unusual. A bit more probing of the practice some time later then threw up a surprising finding: when ringing in to make inquiries, people were being told by this new corporate that at night or weekends, if they had an emergency, they should “… just phone their local vet’s as it’s much nearer than our out of hours practice. And out of hours they have to see you.”
To a lay person this may seem perfectly reasonable: surely local vets would be glad of the business. And in a purely financial market, there would be an argument that this may be OK. However, we are in a recruitment crisis and staffing a vet practice that does its own OOH and inpatient care overnight is not easy. Moreover, the costs and overheads of running a 24-hour-ready clinic are significantly more than a daytime-only premises.
One local practice (also a corporate – but a different one) had already lost a vet to the new practice as they could work in the same town and not do OOH. That vet has not been replaced and its clinical director ended up picking up extra on call over Christmas.
Another phone call was made to the RCVS and the practice owner was informed that it was definitely not OK for the new practice to do this. The RCVS said they would look into it.
However, even if they are asked by the RCVS not to tell clients to do this, there is nothing to stop clients ringing round to find somewhere nearer for OOH, and this is indeed quite common in areas where OOH is contracted out to a provider a long way away. Many vets unwittingly and unwillingly end up providing ad hoc OOH cover to other practices’ clients. I have also seen various stories in vet social media about clients being unable to afford OOH treatment at OOH providers as the fees there are so much higher than their usual vet’s.
The finances and geography of OOH cover has many implications for the business and quality of life of veterinary surgeons and veterinary practices. We seem to be in a state of change about how this is being provided. At least one thing has been made clear to the local vets in this story: it is not OK just to shut up shop and tell clients to ring round.