For ambulatory equine veterinarians who are limited by the work they can do in the field, building a haul-in clinic can be a game changer. The ambulatory component of the practice remains, but the clinic creates critical infrastructure necessary for handling more difficult cases and building a successful business.
A haul-in clinic might be as simple as a roof overhead—or it could be a more complicated building that might one day host more referral services. But regardless of the cost and complexity of the clinic, plan it with care.
As an example of why planning is important, consider a simple treatment room in a northern climate with a roll-up door on one side. If the door faces south, it will be rolled up almost every day of the year, as the low winter sun will warm the inside of the building and the high summer sun will pass overhead. But face the same door to the north, and the biting winter winds and shaded façade will ensure that the door is closed most days of the year.
Where to Build
As with any construction project, planning your haul-in clinic starts with the land. Most veterinarians end up with a rural property, but there are exceptions. Clinics that are associated with companion animal hospitals might be located in town, for example.
Assuming you would be acquiring land, choose a property with a useful area that is at least 10 times larger than the collective area of the buildings that will be placed on it. For example, a 5,000 square-foot haul-in clinic should be placed on a usable parcel of at least 1.25 acres to make room for parking, driveways, septic fields and landscaped areas. If you need turnout areas, you’ll need more land to accommodate them. Likewise, if you think your practice will grow, purchase land for long-term growth rather than short-term use, and consider at least doubling the minimum land purchase rule of thumb. With these concepts in mind, three-plus acres would be much more practical for the 5,000 square-foot clinic in the long run.
Do not neglect your due diligence to determine the extent of easements, setbacks, wetlands and other encumbrances to ensure that the parcel is still large enough once those constraints are identified. A local surveyor or civil/survey company can help you with this work and will be an invaluable team member when you are trying to select property.
When planning the site, consider placement of the building so it is shielded from the worst weather and faces the best direction for the path of the sun. Parking, entrances and barn-door openings work well on the south and east sides of the building, while rooms without openings to the outside work best on the north side of the building, so they can act as buffers.
You can start to mentally organize your building with a rough “bubble diagram” that orients the major buildings per the direction of the sun and wind. Follow this by planning your driveways in relation to this building placement. Loop roads are most effective, so you can get to all parts of the property.
Once the building is generally oriented, it’s time to start planning it. For haul-in clinics, many veterinarians prefer prefabricated buildings because they are cost effective and good for covering large areas. The idea of covering a large area inexpensively is enticing, because it allows opportunities for growth. For example, initially the clinic could be nothing more than a large open space. If you plan for the power and sewer needs, over time you can build offices, restrooms and additional medical spaces.
A prefabricated structure might be a wood pole barn or a metal prefabricated building. Metal prefabricated buildings are more durable and longer lasting, assuming that the fabricator designs the building to meet commercial building codes rather than agricultural standards. To get some good advice on a prefabricated building shell, you should employ the help of a construction or design professional who is familiar with this building type. In cold, damp or maritime climates where metal buildings rot away quickly, it might be best to design a conventional building out of another material, such as concrete block. For example, hurricane codes and damp weather make concrete block buildings more practical in Florida.
Basic Building Blocks
The haul-in clinic centers around a large exam and treatment space. Plan for a room that is at least 20 by 24 feet, keeping in mind that a larger size, such as 24 by 30 feet, is preferred. If you can plan for this larger size, then it is possible to accommodate a set of stocks and a knock-down or holding stall, but be sure not to overcrowd the space. Our rule of thumb is to leave an area of at least 20 by 20 feet completely clear. The exam/treatment room will need adequate infrastructure, as it is the work horse (and sometimes the sum total) of your haul-in clinic. It will need a ceiling that is at least 12 feet tall for safety. Walls will need to be durable, cleanable and insulated from the weather. If you are incorporating a knock-down stall, that has its own design problems. It will need extremely durable walls—such as fully reinforced concrete block—to withstand the forces exerted by horses pushing against them.
The exam/treatment room will need good lighting and ventilation—four air changes per hour at minimum (this is the same standard as would be used for an occupied garage), overhead radiant heating for the winter, and fans for air movement in the summer in temperate climates. The floor will need a drain, and you will need a hose bib and possibly a hose reel for cleaning. We strive to keep this drainage out of the walking path of horses, as many horses are afraid of walking over a drain.
The most practical and cost-effective flooring solution for the exam/treatment room is rubber mats or flooring that is specifically made for horses. Be sure to seal the mats to the substrate underneath and to each other to create a more sanitary surface.
There are many solutions for cabinetry, but considering this exam/treatment room is quasi-indoor/outdoor, is used hard and will need to be cleaned with water, we recommend considering a modular stainless steel or plastic cabinetry rather than typical plastic laminate such as Formica. While this might seem to be an extravagance, stainless steel and other plug-in modular cabinetry can be depreciated like equipment, so it is helpful from an accounting perspective. Further, these types of cabinetry can be moved if you remodel, and they last forever.
Provide some separate storage areas adjacent to the exam/treatment space so the working areas do not become cluttered. The storage area can double as a utility room and contain a washer, a dryer and a janitorial sink.
Finally, the exam/treatment room needs to be a comfortable place. Large roll-up or sliding doors to open in good weather will be a great addition. Use windows in the room to let in outside light at all times of year. We place windows high on the wall for safety.
Beyond your exam/treatment space, you might need other human-occupied spaces, such as offices, a small lounge in which clients can wait, a laboratory, a pharmacy supply room and restrooms. Don’t skimp too much on the client lounge. It can be small, but it should have comfortable seats, coffee, water and something to look at (such as a view outside or a television), or your clients won’t be comfortable there and will instead want to remain underfoot in the treatment area.
Horse Traffic and Housing
Once you have considered your working areas and some client conveniences, think about how you will handle horses that are visiting. A small barn is an important component of most haul-in clinics. This can be used to house day patients, patients that might need to be kept longer for treatment or supervised care, or mares and foals. If you expect to have distinctly different patients that you want to separate (outpatient versus medical), then consider separating their stalls, either with wash racks and feed rooms to provide a little physical separation, or by placing outpatient stalls facing the outside of the building rather than inside.
The barn itself can be attached directly to your clinic, or it can be separated by a breezeway. A covered breezeway is a great feature because it allows for a covered outdoor space to examine arriving horses, and it provides a nice connector between the barn and the clinic.
When building this barn, create a solution that is a step up in durability and cleanability from a private barn. Use cleanable partitions rather than typical wood stall partitions, and provide concrete floors with rubber mats over the top. As in your treatment area, these mats should be sealed to the substrate below rather than loose-laid, to avoid developing dangerous bacterial growth under the mats.
Once you have developed the initial plans for your clinic, double-check the cost of the work with an experienced contractor. If you’re over budget, you might need to install infrastructure such as plumbing, but delay outfitting some rooms initially in order to bring your costs in line.
Unlike most projects that never expand once they’re built, our experience is that haul-in clinics are incredibly useful and will be modified and expanded in the future to meet the needs of growing and successful equine veterinary practices. The first step is to get that roof overhead in an organized and well-considered manner.