Author’s Note: The referenced survey was created by the author to expand the profession’s knowledge of this topic. All of the veterinarians quoted in this article gave their permission to have their ideas included in this article.
Earlier this year, a young practitioner posed a question about emergency compensation on the AAEP New Practitioners listserv. This led to a short survey being posted on this community’s listserv, and responses were collected from 69 veterinarians.
Because horses are not as mobile as companion animals such as dogs and cats, most equine practitioners must themselves take care of their clients’ needs for emergency services. Although practitioners acknowledge that emergency coverage is a necessary and often-rewarding part of practice, it adds a significant amount of stress to the already busy lives of equine doctors.
One of the questions posed by the survey was: “How do you feel about emergency duty?” The survey showed that 30% of respondents found that emergency work seriously and frequently disrupted their scheduled work, while 32% reported feeling stressed and unhappy due to emergency work. Emergency duty is the most stressful and negative part of equine practice, according to 26%. In fact, the negative effects of emergency work are so marked that 12% said they would be willing to pay somebody else to do their emergency shifts, and 4% responded: “I hate it so much! It is ruining my life!”
However, 20% would like to do more emergency work if they were paid more to do it, and 9% would like to do emergency work exclusively.
Compensation for Emergencies
So how are associate veterinarians paid for covering emergencies? The survey first inquired what method in general was being used for veterinary compensation. It found that 44% of respondents reported being paid a straight salary, while 32% reported they are paid a base salary plus a production bonus. In addition, a significant number of associates are paid strictly on commission, with 21% indicating this compensation type.
A total of 72% of respondents are compensated for emergency work, leaving 28% who are not paid anything additional for their after-hours and weekend work. Of those receiving additional compensation for emergency duty, 40% reported getting 100% of the emergency call fees generated, but 29% get none of the fee.
Responding to the thread on the AAEP New Practitioners Listserv, Dr. Laura White wrote, “I now own my own business, so getting compensated separately for emergency work no longer applies. I am a sole practitioner at the moment, but when I do hire an associate, it will be important to me to compensate fairly for emergency work. It can be stressful, disruptive and downright irritating at times—and we deserve to be paid for it. At the same time, emergency work can also be very rewarding, and it’s definitely a valuable practice builder and important service.”
The survey showed that 80% of the practices where the respondents are employed charge emergency fees for night/weekend calls, and nearly half charge lower emergency fees during the day and evening for calls that can be seen less urgently. Almost half (48%) charge a daytime emergency fee if the veterinarian has to drop what he or she is doing or rearrange an existing schedule. About a quarter of practices (22%) charge an “urgent" fee for same-day service.
With regard to compensation (not the emergency fees) to the attending veterinarian for the services performed at an emergency call, 82% of respondents get their normal method and rate of pay, and 12% are paid a higher amount for services performed after hours.
Dr. Cecile Coulon, a practitioner with a growing solo practice, wrote, “I’m a solo practitioner and as a rule I have a day emergency fee, assuming I have to upend my day (which might include extra child care) to see an unscheduled appointment. But if it’s a slow day and I was otherwise sitting on my bum, I will waive it. Or if it’s a condition that can wait for the next day to be scheduled, even if that requires a little shuffling around, it gets waived. When the practice was new and my appointments were sparse, there were plenty of waived daytime fees. Admittedly this is a rather subjective method.”
This speaks to an important point: It can be hard to establish ground rules for charging emergency fees and comply with them, but it is equally important to capture the extra value that providing prompt emergency services brings to clients.
The AAEP 2012 Horse Owner/Trainer Veterinary Services survey revealed that owners value ambulatory emergency services more highly than just about any other attribute of a veterinary practice.1 Services that are highly valued will support a higher fee structure, and that includes robust emergency fees that compensate veterinarians for the significant stressors that emergency care adds to their lives.
Emergency Call Schedule
During the busy season, most of the responding practitioners see an average of 2-4 emergencies in 24 hours. In the slow season, most see 0-1 emergencies in 24 hours. Although this amount of visits might not seem particularly onerous, it is important to remember that beyond the actual calls that require travel, there are always a number of phone calls that are fielded after hours with no compensation.
Because of the need to be instantaneously available, most veterinarians who are on call curtail their normal activities during their shift; they don’t attend music performances, go fishing at the lake or have friends over for a barbecue. If they are on duty half of all weekends, this can significantly impact their time for personal pursuits.
In fact, 33% of the respondents are responsible for fielding emergencies 50% of the time. Another 17% are on duty 100% of the time (perhaps because they are solo practitioners) and 25% are on call a third of the time.
Some associates receive compensatory days away from work in return for the time they spend fielding emergencies. One responding associate reported, “When I did emergencies, I didn’t get anything extra. I was working for a flat salary, and seeing weekend and after-hours emergencies was just part of the deal. I lived about 13 miles away from the clinic, where I had to drive to pick up the truck for farm calls ... so it actually cost me quite a bit of money for gas, especially on the weekends.”
Many respondents commented that receiving a monetary reward for seeing emergencies makes spending long nights and weekends in the trenches more worthwhile and easier to accept.
Because many associates see rechecks, perform breeding work or provide well-foal exams on the weekends with no extra compensation, resentment can build as the time available for a personal life dwindles.
One respondent said, “I think it’s a nice motivator to get all or some of those ER fees; it makes driving around in the middle of the night (or mostly at dinner time) a little less annoying … it’s easy to get overworked and not feel adequately compensated in situations where there is just a flat salary all the time.”
Whether vets are satisfied with the arrangement at their practices often lies with which they value more: money or time. Because excellence in emergency care is very important in the equine veterinary industry, practice owners should communicate regularly with their associates and seek to understand what compensation will bring long-lasting contentment, or at the very least, stave off departure from that position.
1. AAEP “Horse Owner/Trainer Veterinary Services Survey 2012 Report of Findings” was accessed 5/9/14; the PDF can be found by AAEP members who log into http:// touch.aaep.org and do a keyword search for "Owner Trainer Veterinary Services survey."