Starting Up a New Practice - Help!

RE: Starting Up a New Practice - Help!

Jill Butterworth — Thu, 25 Nov 2021 20:15:03 GMT

I paid £9k/yr for a shop premises, sorry, I cant remember the size. I think the rent was reasonable because it was council owned and they were very keen to have a community based tenant.

RE: Starting Up a New Practice - Help!

Cool — Thu, 25 Nov 2021 14:25:18 GMT

I will vote im3 anyday. Are you renting a premises or buying the building? What is the average rent that one should expect to pay for 1500 to 2500 sq ft? I was told that is what one will need

RE: Starting Up a New Practice - Help!

Sarah Bolt — Fri, 10 Sep 2021 12:07:22 GMT

I got my dental machine from im3 - they have an offer on for 20% off dental machines at the minute, which the rep I was talking to said they wanted advertised, so if you're fed up enough with your machine might be worth a look!?

RE: Starting Up a New Practice - Help!

Sarah Bolt — Fri, 10 Sep 2021 12:06:13 GMT

Thanks, yes after working in a practice with dental x-ray, then working in a small clinic that didn't have dental x-ray, a dental x-ray was one of the first things I got on order!

RE: Starting Up a New Practice - Help!

Bob Russell — Fri, 10 Sep 2021 11:31:48 GMT

We bought the Burtons dental machine and have hated it from the first day. Spiral tubes that try to rip the handpiece from your hand at any opportunity.

Three years later we struggle to live with it!

RE: Starting Up a New Practice - Help!

Rachel Perry — Fri, 10 Sep 2021 08:30:13 GMT

Not sure if this has been covered, but if you plan to offer dental services, you need to invest in dental radiography as well as a dental unit/hand instruments. Contact IM3 who will be able to give you a quote for everything you'll need.

RE: Starting Up a New Practice - Help!

Sarah Bolt — Wed, 01 Sep 2021 20:47:46 GMT

Thanks everyone, I think most of you confirmed what I was thinking, that first hand is preferable due to safety issues and how badly wrong things could go! Thanks for the tip about Avensys, I'll have a look :-)

RE: Starting Up a New Practice - Help!

Miriam Lodewyks — Wed, 01 Sep 2021 17:59:51 GMT

Have a look at Avensys near Kidderminster: they recondition NHS equipment and sell it on privately. Everything from surgical tables to xray equipment and autoclaves…

RE: Starting Up a New Practice - Help!

Chris Milligan — Wed, 01 Sep 2021 17:14:17 GMT

[quote userid="8858" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/29964/starting-up-a-new-practice---help/232746#232746"]I bought a second hand NHS one and it was an absolute workhorse. [/quote]

sounds like you got very lucky - I'm jealous!

RE: Starting Up a New Practice - Help!

Anthony Todd — Wed, 01 Sep 2021 14:02:10 GMT

My last word on monitors, promise!

Just make sure it has an audible apnoea alarm!

RE: Starting Up a New Practice - Help!

Clive Ansell — Wed, 01 Sep 2021 13:06:27 GMT

[quote userid="2131" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/29964/starting-up-a-new-practice---help/232743#232743"]

Clive Ansell said:
Evelyn Barbour-Hill said:
Sarah Bolt said:
Might have to default to VetsNow

Don't even think about it!

There are alternatives to Vets-Now, depending upon where you ae based of course. There are other OOH providers,

My remarks apply to any "OOH provider".

[/quote]

I know.

I was just pointing out, that if one goes down the route of using an OOH provider, for whatever reason, it is worth looking around at the different providers.

I've worked for 4 OOH providers, one of which was Vets-Now. I found the independent ones to be more flexible, accommodating, and empathetic towards the needs of smaller practices.

Of the 4 I worked for only one was able, to my mind at least, to offer a full OOH service. They had a second vet and nurse on a rota, and a vehicle, so were able to cope if it got really busy, were able to transer patients to and from user practices, and were able to do OOH home visits if needed. In addition they could continue daytime care for patients not fit to be transported.

RE: Starting Up a New Practice - Help!

Bob Russell — Wed, 01 Sep 2021 10:40:57 GMT

With second hand never spend more than you can afford to lose!

I would only buy an autoclave new (lease if you have to). Our supplier allowed us to pay in three instalments when our old autoclave became beyond economic repair.

There are so many rules and regulations regarding pressure vessels that it is not worth the risk of buying second hand unless from someone willing to put it on a maintenance contract. My opinion only!!

We have a hand held capnograph that everyone hates but a very elderly Datex machine out of the ark that I think is wonderful! Cost me £90 plus shed loads to transport it from the US. Absolutely dread it popping its clogs.

On e bay at the moment for example:

https://www.ebay.co.uk/itm/144178080503?hash=item2191aeeaf7:g:dg4AAOSw2oNhErqj

These monitors are pretty bomb proof but the only real guarantee is they can be returned if DOA.

RE: Starting Up a New Practice - Help!

Jill Butterworth — Wed, 01 Sep 2021 07:51:17 GMT

Maybe it depends how many electronic bells and whistles it has. I bought a second hand NHS one and it was an absolute workhorse.

RE: Starting Up a New Practice - Help!

Chris Milligan — Tue, 31 Aug 2021 22:29:54 GMT

[quote userid="11004" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/29964/starting-up-a-new-practice---help/232742#232742"]One thing I would appreciate opinion on is autoclaves - think I read somewhere to be cautious buying second hand, [/quote]

Honestly if you can afford it I'd get your own - they are a pain and probably the main bit of equipment that causes a) the most breakdowns and b) the most disruption to your day when they break. If they're second hand it's usually because the seals or venting is broken, in which case you'll be calling a repair person out regularly. You'll still be doing that with a new one (hopefully less often), but you should be able to get a decent guarantee/replacement agreement.

RE: Starting Up a New Practice - Help!

Evelyn Barbour-Hill — Tue, 31 Aug 2021 22:10:51 GMT

[quote userid="5012" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/29964/starting-up-a-new-practice---help/232719#232719"]

Evelyn Barbour-Hill said:
Sarah Bolt said:
Might have to default to VetsNow

Don't even think about it!

There are alternatives to Vets-Now, depending upon where you ae based of course. There are other OOH providers,

[/quote]

My remarks apply to any "OOH provider".

[quote userid="11004" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/29964/starting-up-a-new-practice---help/232742#232742"]and find a pulse ox[/quote]

Don't waste your money on a pulse oximeter.

RE: Starting Up a New Practice - Help!

Sarah Bolt — Tue, 31 Aug 2021 21:40:15 GMT

Apologies for the lack of response - I was away for the weekend and I'm just catching up!

Thanks for the thoughts re- OOH, I definitely intend to have a back up of some sort in case I had a horrific run of nights, or if I needed to be away for any reason. Need to contact VetsNow to ask about prices as I know a practice a few towns over uses them ad hoc so is a possibility I think.

I've never used an ADE so thanks for the tip, I'll investigate :-) Thanks also for the tip about catering supplies Gillian, definitely looks worthwhile having had a brief look.

I'm trying really hard to make sure I've thought of where I'm going to put everything that I'm buying. I'm sure it's going to fall apart but at least the intention is there to start with, to try and keep the place free of clutter as much as possible.

I need to think more about monitoring equipment, hadn't even heard of an apalert before you mentioned them Antony! Had in mind I was going to try and find a pulse ox/capnograph handheld device but again will be determined by budget I think.

One thing I would appreciate opinion on is autoclaves - think I read somewhere to be cautious buying second hand, but not sure if I'm remembering correctly. Does anyone have opinion on buying second hand/auction (obviously would get serviced before use)? It could be a big cost saving but don't want to risk it if its a wholly bad idea!

Thanks so much again for all the input, it's really helpful and even if I don't respond to particular points, I'm making lots of notes!!

RE: Starting Up a New Practice - Help!

Anthony Todd — Tue, 31 Aug 2021 10:24:31 GMT

Or get an Apalert, Approximately £272.54 and have both, and be safer!

RE: Starting Up a New Practice - Help!

Clive Ansell — Tue, 31 Aug 2021 10:10:32 GMT

It's nice to have one and they are expensive, so is a capnograph an essential or necessary piece of equipment for someone starting up a new practice?

What is the surgical caseload lileky to be? numbers? numbers of higher risk cases? routine neuters in young healthy animals?

A good experienced RVN may be better investment?

RE: Starting Up a New Practice - Help!

Anthony Todd — Tue, 31 Aug 2021 09:58:10 GMT

You make my point very well! It's when so called "observation" stops, or is "distracted", that any respiratpry audible alarm pays for itself!

Does the "visual Capnograph have an audible alarm, as every aircraft cockpit, and sensible vet's alarm system should have.

If so fine.

Sheet, this one https://www.vettimes.co.uk/app/uploads/wp-post-to-pdf-enhanced-cache/1/understanding-capnography.pdf

doesn't mention any alarm, just a change in shape on a screen, [or no shape at all?? wouldn't suit me!

RE: Starting Up a New Practice - Help!

Clive Ansell — Tue, 31 Aug 2021 09:43:27 GMT

[quote userid="2131" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/29964/starting-up-a-new-practice---help/232708#232708"]

Sarah Bolt said:
Might have to default to VetsNow

Don't even think about it!

[/quote]

There are alternatives to Vets-Now, depending upon where you ae based of course. There are other OOH providers, including some indepentent ones. There are 7 within a 30 minute drive from my home.

Vets-Now tend to be based in PDSA clinics, and like to kick cases out 0830. When I worked for them , PDSA didn't to take on cases during the day. Also, current staffing issues with Vets-Now, but this is likely common across the sector.

Having worked in OOH clinics, I think the main pitfalls, and the 2 things clients dislike the most are; ones that cannot hold on to critical cases through the day meaning a to and fro twice daily of cases, and excessive distances from user practices, in some cases in the order of 40-50 miles and over an hour by car.

RE: Starting Up a New Practice - Help!

Bob Russell — Tue, 31 Aug 2021 09:28:46 GMT

Was not going to bite but will!

Apalert tells you little that cannot be detected with observation. Capnograph gives really early warning that something fundamental may be starting.

They are not mutually exclusive but they are not interchangeable either. Neither should lengthen the anaesthetic time.

Buy what you are comfortable with. This will all be stressful enough without added stress.

RE: Starting Up a New Practice - Help!

Anthony Todd — Tue, 31 Aug 2021 07:05:48 GMT

[quote userid="8958" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/29964/starting-up-a-new-practice---help/232709#232709"]This is about 'starting up a new practice' [/quote]

But about costs mainly. and as the difference between an Apalert and a more complex monitor is about £1000 it's worth mentioning, I would think.

As well as the time, with one nurse?, will be longer when clipping on the sensors for a quick procedure??

RE: Starting Up a New Practice - Help!

George Cooper — Mon, 30 Aug 2021 19:16:46 GMT

This is SO right - BUT it has to be within your own philosophies of care.

make your OWN mind up - about rest, personal time, and the cost of out-sourcing. There is undoubtedly a balance that you can achieve.

RE: Starting Up a New Practice - Help!

Evelyn Barbour-Hill — Mon, 30 Aug 2021 18:45:59 GMT

[quote userid="11004" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/29964/starting-up-a-new-practice---help"]My practice is going to be compact, so any space-saving ideas also welcome. [/quote]

Have everything either ceiling-mounted or on wheels! If it hasn't got wheels on, put some on.

RE: Starting Up a New Practice - Help!

Neil Wheadon — Mon, 30 Aug 2021 17:37:25 GMT

[quote userid="5904" url="~/001/veterinary-clinical/small-animal/soft-tissue-surgery/f/discussions/29964/starting-up-a-new-practice---help/232707#232707"]

As the thread is about essential equipment then starting up, it seems pretty relevant to decide which piece of kit is more important than others?

An apalert, of similar, or better, would be on my short list!

[/quote]

Evelyn is right. We have been through this in another thread. This is about 'starting up a new practice' not about the anaesthesia. Too many discussions start well and then get sidetracked to the absolute detrimet of the information. What happens is people switch off. Look at the subsciribe to thread button below, everyone gets an alert.

Neil