How to Start a Subscription-Based Equine Emergency Practice

This article originally appeared in the Spring 2026 issue of EquiManagement. Sign up here for a FREE subscription to EquiManagement’s quarterly digital or print magazine and any special issues.

During a presentation at the 2025 American Association of Equine Practitioners Convention, Meggan Graves, DVM, and Katie Larson, DVM, presented a recipe for forming a standalone, subscription-based equine emergency practice like the ones they operate. 

They began by reviewing the reasons we need new ways to provide emergency service—namely, that working all day and potentially all night is exhausting, stressful, and incompatible with many veterinarians’ family responsibilities. Emergency duty is a primary reason equine practitioners leave the profession, they noted. 

Determining Your Region’s Need

A subscription-based equine emergency practice works best for services provided to multiple practices, especially when those practices have overlapping service areas. This allows the emergency practitioner to cover for more than one practice while still providing timely care, Graves and Larson explained. To determine if the area being considered will support an emergency practice, the doctors recommended talking with local practices to gauge the level of interest. To generate a reasonable income, they suggested targeting 200-300 emergencies per year and enrolling practices until the estimated total number of emergencies the practices typically see exceeds 500 per year. The emergency clinician will not be seeing all the emergencies; their subscription is likely just a portion of the shifts. 

Setting Your Schedule

Once you’ve established the need and desire for a subscription service, you can determine and distribute a monthly schedule of availability to interested practices. To avoid burnout, Graves and Larson recommended offering no more than two weekends a month and no more than 15 total days per month. They explained how some practices subscribe for monthly emergency coverage year-round, while others use the service more like a relief vet. They emphasized setting up a realistic workflow, establishing rules for forwarding medical records to primary clinicians, and determining a practice radius. Have good boundaries, a payment at the time of service policy, and fees robust enough to offset travel inefficiencies.

Creating a Business Plan

When you start the practice, be economical by keeping a lean inventory of drugs and supplies, buying used diagnostic equipment since it will not be used daily, and devising a plan to run bloodwork, they advised. To create a simple business plan, calculate expected salaries by multiplying the number of anticipated emergency calls by the average invoice, adding the subscription fees to this number and then subtracting the overhead expenses. Subscription fees are established as a flat fee for providing coverage, generally based on practice size and anticipated number of emergencies. Subscription fees are due regardless of whether emergencies are seen, the speakers explained. The emergency practice determines and collects service fees used to create client invoices for patient emergencies. 

Final Thoughts

Graves and Larson emphasized that while there are challenges in working after hours, only about 3% of emergencies are seen between midnight and 6 a.m., allowing the practitioner to get some sleep each night, even though being on call is unpredictable. The emergency clinician must be able to accept interruptions, a degree of on-call anxiety, and a seasonal workload, but the financial return for the number of hours worked and the professional variety of cases can be very rewarding, they concluded. 

Related Reading

• Equine Veterinary Sustainability: Initiating Haul-In Policies for Emergency Care
• AAEP Commission on Veterinary Sustainability: New Paradigms in Equine Emergency Coverage
• The Business of Practice: Shifting to a Haul-in Emergency Model

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