AAEP Commission on Veterinary Sustainability: Solutions to Ease the Strain of Emergency Coverage in Solo Practice

There are many ways for solo practitioners to reduce the burden of emergency coverage while still providing the care their patients need.
A horse with a wrapped hock stepping onto the trailer to receive emergency coverage.
Providing emergency treatment at a central haul-in location can help reduce the burden of emergency coverage for solo practitioners. | Getty Images

The beauty of solo equine practice is the ability to shape your business into your unique vision of professional success. A tradeoff can be the absence of a team to share after-hours emergencies, but paradigm shifts regarding ER coverage are easing the strain on solo practitioners.

Veterinarians often consider providing care in emergency situations as part of the veterinary oath—to protect animal health and welfare and prevent and relieve animal suffering. But misunderstanding exists about the exact obligations veterinarians must meet.

The AVMA’s Principles of Veterinary Medical Ethics state that when veterinarians cannot be available to provide services, they should provide readily accessible information to assist clients in obtaining emergency services, consistent with the needs of the locality.

You should also be familiar with your state veterinary practice act, as the requirements regarding emergency care vary by location.

It is impossible to be the veterinarian who sees every horse, every time a case arises. Providing your clients alternatives for care when you are unavailable and communicating this in advance shifts the responsibility to the client to pursue care when needed. 

Reduce the Demands of Emergency Coverage

To begin regaining control of your personal and professional schedule, consider how the following actions may benefit your practice.

Provide After-Hours Care Only to Current Clients. Will you respond to calls from any horse owner after regular business hours or limit your service to current clients? Providing after-hours care only to current clients is one tactic helping solo practitioners better manage after-hours requests. Be sure to define what a “current” client means to you and communicate this to horse owners. 

Require Clients to Bring Horses to You. Providing treatment at a central haul-in location can increase your efficiency and alleviate drive time. There will always be some emergencies that can’t be trailered, but this option shares the responsibility for acquiring care with the client.

Limit Your Hours of Emergency Coverage. Dr. Meggan Graves of the University of Tennessee College of Veterinary Medicine found that only 2.6% of equine field ER calls occurred between 12 a.m. – 6 a.m. Providing instructions on how to proceed to a referral center during these hours decreases burden on the practitioner. 

Use a Third-Party Triage Service. More and more practices are using tele-triage services to answer after-hours calls. Typically, these services—staffed by veterinarians—charge no fee to the practice; the client pays the triage fee. A triage service can address your clients’ concerns and allow you to follow up during normal business hours.

Charge Appropriately. After-hours care is overtime work for you, and you should be compensated as such. Charging for your time—whether or not you actually go out for a call—should be part of your emergency fee structure.

Dr. Michael Clark of South Sound Equine Practice in Tenino, Washington, raised his after-hours emergency fee significantly, and it begins promptly at 5:00 p.m., regardless of whether he’s home from work or not.

“I charge a lot, and you know what? Nobody bats an eye,” he said. “It makes after-hours emergencies less painful and more financially rewarding, which is one of the things as veterinarians we need to be more comfortable with.”

Educate Your Clients About True Emergencies. The more your clients understand when to call you, the fewer non-emergency calls you will receive.

Dr. Ashley Allemand Davidson of Faith Veterinary Service in Hammond, Louisiana, has started educating her clients about the situations that warrant a true after-hours call, but she says it’s a work in progress. “My clients have my cell number, which is something I would do differently if I could do it over,” she said.

Don’t Respond to Client Convenience Messages After Hours. Speaking of cell phones, protect your personal time by not replying to non-emergency text and email messages from clients after normal business hours. You can use an auto-reply message which provides instructions for true emergencies and acknowledges you will respond during regular hours. 

Take Care of Yourself First. Recognize when you are getting overburdened and schedule some time off. Treat this the same as you would any other appointment, and make sure you keep it. Block off vacation and other important dates well in advance and hold to them. Consider hiring help; hiring an assistant is the number one way to increase efficiency.

It is better for your clients and their horses if you limit your after-hours emergency coverage services than face burnout and leave equine practice. “Set your boundaries, and set them before you are burned out and angry because they work a lot better when you are not in that position,” said Dr. Clark.

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