The AAEP officers appointed leaders and members to the Commission for Equine Veterinary Sustainability’s Emergency Subcommittee in August 2022. Drs. Leann Kuebelbeck and Mike Erskine were appointed the co-chairs, and Dr. Rob Franklin was appointed officer liaison. Members serving include Drs. Andrea Basque, James Beckman, Meggan Graves, Tyler Holtmeyer, Racquel Lindroth, Olivia Lorello, Jessica Martin, Leah Martin, Ginger Reagan, Tamara Swor, Karen Wolfsdorf, and Cara Wright.
Emergency Subcommittee Goals
The subcommittee’s goal was to cultivate and identify creative solutions for handling emergency coverage work. They also aimed to create educational opportunities for members highlighting various models used in all types of practices, including examples of client communications that can be utilized when creating co-ops or other networks for coverage.
Subcommittee member Cara Wright, DVM, MS, IVCA, suggested that in addition to limiting the number of on-call hours, changing the demands of on-call shifts is paramount for improving equine veterinary retention. For example, she said, only allowing haul-in emergencies preserves the doctor’s time. She also recommended giving veterinarians autonomy to talk to clients directly and determine if the case is a true emergency that must be seen in person or if it can be managed over the phone. “Maybe the answer is more,” she said. “More haul-in, more autonomy, more sharing of on-call with other doctors, more compensation, and more understanding from clients about after-hours communications.”
Emergency Coverage Solutions in Rural Areas
Veterinarians in very rural areas, with few or no local colleagues, can cope more successfully with emergency coverage if they have boundaries that limit access to themselves after hours except for true emergencies. “It is so hard when you are the only doctor in a couple of hours radius, but client education and preparation for basic ER cases can be game-changing to give these doctors some time out of the truck,” Wright said. She recommended educating clients on first-aid kits, basic first aid, vital signs, and the importance of having medications on hand.
Subcommittee member Leah Martin, DVM, CVMM (equine), is working on a resource document addressing the pain points of rural solo practitioners and suggesting ways to implement change within their practices. Martin has personal experience with this challenge, as her solo practice radius measures several hours.
Telehealth and Outsourcing
The most exciting and innovative developments in emergency coverage, in Wright’s opinion, include using telehealth to capture fees for the doctor’s time or outsourcing emergency calls to another practitioner.
“This is a great way to ensure you are getting paid for the advice you give or, in the case of outsourcing, ensuring that your clients get solid veterinary advice in the absence of talking to you,” she said. “There are lots of state-specific details as far as VCPR goes, but this is an option to take the sting out of talking to people after hours and not collecting revenue for an appointment when it is something that does not need to be seen immediately. This is a simple way to change the burden of those after-hours phone calls that are so draining.
“I love the ER-only doctors who are either working full-time for practices or working for a separate entity and then covering ERs for their local doctors (sometimes a subscription service).” Wright continued. “This is much more similar to the small animal model of centralized ER care, which has changed the day-to-day life of many small animal GPs.”
Final Thoughts
As new paradigms take hold in equine practice, changes in the way emergency services are provided will continue to lead the way. The resources available from the AAEP Commission’s Emergency Subcommittee can help you foster innovative ways to cover emergencies for the patients in your practice.
