Over the last 10 years, the percentage of AAEP members who are solo practitioners has been consistently between 35-40%. Being the only doctor in a practice makes providing emergency care 24/7/365 one of the most onerous things about equine practice.
Business Briefs columns, authored by Amy L. Grice, VMD, MBA, are available in each issue of EquiManagement magazine and are brought to you in 2022 in the magazine and monthly online by CareCredit.
Small equine practices are the majority in the U.S., with 53% of practices having just one to two veterinarians, according to the 2016 AAEP AVMA Economic Impact Study. With just one or two doctors splitting all of the emergency coverage, situations such as injuries, vacations or maternity leaves can stress practices considerably.
The formation of an emergency cooperative can make all the difference.
Many solo practitioners have successfully reached out to local colleagues with similar practices to join forces in providing emergency coverage. As evidenced by the large percentage of equine practices that are manned by just one doctor, many veterinarians value their independence and desire the advantages of owning their own businesses. This makes independent veterinarians joining together in a collaboration to collectively improve their lives both difficult and rewarding.
Most veterinarians who responded to a survey done by the AAEP Wellness Committee stated that their concerns about starting an emergency cooperative centered around fear. They worried about client loss, losing control of patient care, decreased revenues, “bad” colleagues, the need to treat animals other than horses, and the challenges of a bigger radius to cover when on call. Some were reluctant due to competitive relationships with veterinarians in their areas.
However, at a Table Topic at the 2020 AAEP Annual Convention, multiple practitioners described the positive outcomes that they had experienced by sharing emergency duty with local colleagues.
Strategies that strengthen an emergency coalition include regular monthly meetings of the members, having a common vision, sharing an experience level and type of practice, and having written rules of conduct for members. These written rules—or a memorandum of understanding—might incorporate days and hours of coverage (e.g., Friday at 5 p.m. to Monday at 8:00 a.m.). It might also include the method and time requirement for sharing case records of patients seen with their primary veterinarians, as well as the expectation for returning a client and patient to his or her primary doctor after an emergency visit. Other possible inclusions might be: agreements for handling clients who want to switch to a veterinarian they met through an emergency, and how payment for service will be managed.
Understanding expectations is essential and should be in writing.
For an emergency cooperative to work, creating a schedule at least a month in advance of each quarter (90 days) is helpful. Members might be responsible for trading shifts among themselves, but must commit to recording all changes on a group calendar that is easily accessed, such as a Google Calendar.
Rather than changing a practice’s phone message repeatedly to indicate what number to call for after-hours service, utilizing a VOIP phone system such as Grasshopper can be best. This service offers call forwarding that works by redirecting any incoming call to another phone number or service, and it can be scheduled in advance.
Having ways to share the burden of covering emergencies in equine practice has the potential to help our industry retain talented veterinarians. The number of new graduates entering the equine sector has fallen, and nearly half of equine practitioners are leaving the field within five years of graduation. Therefore, minimizing emergency duty through the formation of emergency cooperatives could make a difference in the quality of life of horse doctors.
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