Crisis?

RE: Crisis?

cairncross — Wed, 23 Feb 2022 14:03:55 GMT

Norway gdp almost twice that of UK. Take london out of uk and we are even further away in comparrison. Shows how important finance is in this making rules or finding solutions to our issues What might be feasible or a solution in London or Norway might be impossible in the NE or Ni

RE: Crisis?

Nicola Cole — Wed, 23 Feb 2022 13:26:31 GMT

[quote userid="3222" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30192/crisis/235985#235985"]I work 35 hours a week, maybe 1 hour overtime every 6 months, 3 days on call every 8 weeks and get 90 000£+[/quote]

But I also don’t see how that is feasible and sustainable unless fees are significantly higher than in the UK (or you’re in referral practice doing high end stuff)?

RE: Crisis?

Nicola Cole — Wed, 23 Feb 2022 13:20:56 GMT

[quote userid="3222" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30192/crisis/235985#235985"]I guess I have rose tinted glasses then.[/quote]

I didn’t mean that you had rose-tinted glasses, sorry if it came across that way.

I meant that maybe I’m remembering with rose tinted glasses (I’ve not been in practice for a couple of years) but that the ‘traditional’ model in the UK was that you were paid a salary and worked the hours the job required, with give and take on both sides. ‘Overtime’ didn’t come in to it, because it just seemed to work (as long as there was good diary management). It sounds like things have changed a lot due to covid (in terms of how busy practices are), so maybe the traditional model of no paid overtime may need to change.

RE: Crisis?

Stigen — Wed, 23 Feb 2022 11:00:55 GMT

I guess I have rose tinted glasses then. I work 35 hours a week, maybe 1 hour overtime every 6 months, 3 days on call every 8 weeks and get 90 000£+. I try not to stress cause I like to have a life outside my job.

RE: Crisis?

vetbl.locum — Wed, 23 Feb 2022 10:51:27 GMT

https://www.theguardian.com/society/2022/feb/22/my-30-years-as-gp-profession-horribly-eroded-clare-gerada?CMP=Share_AndroidApp_Other

Seems GPs have similar concerns

Rgds

RE: Crisis?

Bob Russell — Tue, 22 Feb 2022 13:27:38 GMT

With salaried staff it tended to be give and take. Stay if busy but head off early if quiet. Now it seems to be all take and employees are doing all the giving.

RE: Crisis?

Nicola Cole — Tue, 22 Feb 2022 13:20:20 GMT

[quote userid="3222" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30192/crisis/235951#235951"]That sounds hellish..I would never work one minute overtime without payment. Are there no laws to protect workers in England.[/quote]

It very much depends on the set up but most (or have I got my rose-tinted retrospectoscopes on?) are salaried and have rough working hours eg 9-7, but can be required to work outside of this when the job demands. It’s quite unusual for a salaried vet to be paid ‘overtime’ as if something comes towards the end of the day that takes you over then it’s part of the job (ie. it’s not overtime).

Traditionally practices worked very well like this. The problem comes if the diary is poorly managed and very overbooked and people are routinely staying late every night.

RE: Crisis?

Julie Innes — Tue, 22 Feb 2022 13:16:18 GMT

When I first set up my dad (business trained, not a vet) told me that 80% of your profit comes from 20% of your clients. And 80% of your strife comes from 20% of your clients.

Has proved true! Pick and choose the clients who are worth keeping- the ones who are pleasant, care about their animals and have some respect and manners.

RE: Crisis?

Bob Russell — Tue, 22 Feb 2022 12:54:58 GMT

Manage your clients would be my first response. If you are in demand, drop those that cause you grief.

We have bent over backwards to advise and help a client with a chronic lame dog. All attempts to provide proper care have been rejected. POM tablets cost too much (even the cheaper ones), have far too many side effects (yet none reported to us). Now gone over to Facebook asking for advice on non-POM medication that can help. Paracetamol has already been discussed.

What is the betting the dog will get Yumove which will cost a comparable amount but will do the square root of bugger all.

Not quite hit the f+ck off letter stahe but getting very, very close.

RE: Crisis?

Stigen — Tue, 22 Feb 2022 11:22:56 GMT

That sounds hellish..I would never work one minute overtime without payment. Are there no laws to protect workers in England. I work in Norway now, and that sort of stuff would be illegal.

RE: Crisis?

cairncross — Tue, 22 Feb 2022 07:45:14 GMT

Thank you for providing an another example of real world circumstances I guess the economics of greyhound world is similar to regions with lower economic circumstance and or rural. Here the average disposible family income is lowest in uk and most are below average and will have less total disposible income to spend on kids socialisation etc than an average pet insurance policy

I would like to know how many are contributing to out of hours provision now as compared to 20 years ago. My guess is it would be measured in tens of thousands 2 decades ago and its now a few thousand. Added to that some/many are now making it economic by providing a high end care to a very few cases rather than in the past we homogenised costs s to provide for all

RE: Crisis?

Olivia Cook — Mon, 21 Feb 2022 21:10:05 GMT

I wish I knew what the solution was. As a greyhound track vet I have many times been beholden to the goodwill of colleagues prepared to take an OOH case late on a Sunday night, but over the years the number of options open to me had declined, and many of those colleagues are also working short handed (and bear in mind I work almost exclusively with animals which are both uninsured and uninsurable so that even with the welcome arrival of the industry funding from the Greyhound Recovery Scheme the costs to the owner have to be carefully managed. There has been discussion within the industry about the setting up of one or more centralised hospitals able to receive casualties and managed by an RVN team with an on call directing veterinary surgeon, to give somewhere for a casualty to be taken while arrangements are made for surgical follow up - but to the best of my knowledge the scheme has got no further than the discussion stage and may yet founder on impracticalities. Given that the NHS has not solved this problem, with A&E patients on trollies for twelve hours while beds are found, it seems unlikely that our exhausted profession is going to manage the miracle our colleagues in human medicine cannot.

RE: Crisis?

cairncross — Mon, 21 Feb 2022 20:26:40 GMT

Thank you so much for the reply I didnt mean to upset and am so pleased you responded.

There is a huge call for daytime work genuinely double figures of new client requests every day now but each one is a potential ooh liability no way round that. I could possibly recruit a part time or daytime person for this extra work but how do I service the percentage who would then call at night or weekends ?

Elsewhere on the thread I explained that there are 9 local practises which provide their own ooh, within 20 min of here the dedicated ooh is 25 min away . 2 of those that do their own ooh are part of the same group which runs the dedicated ooh and they are closer than me to the dedicated ooh. . We are in an area where the gdp and disposible income is lowest in UK the dedicated ooh isn't a viable financial option for most of local pet owners so choosing a practise where they can access ooh is not just important or beneficial but essential. It is not just me but every practise around that has made the calculation that switching to the ooh provider wont work. That and the fact that the few examples that did arnt examples anymore.

Sharing a rota would have been good but the mix of practises no longer matches . Some sa only some fully mixed some with sa and equine . That option has gone now anyway as not enough of us has enough stable ooh staff to contribute reliably. One practise is trying the in house night vets route but so far hasn't recruited anyone nevermind enough to form a rota and start another i discussed this with had discussed the option with staff and was in the process of some staff moving to this but then 2 resigned so the viability went .

I don't think I was moaning that no will work ooh anymore in hope somehow that would help the situation I fully accept there is zero likely hood that a cavalry of ooh vets or any vets is riding to the rescue not in the remains of my career lifespan anyway. I felt my initial premise that i couldnt employ a daytime only or part time vet as I could no longer service their ooh liability was an honest realisation and acceptance of that and was me moving with the times I live in it has to be a factual statement , we cant operate without ooh cover That greatly limits me in all sorts of ways but it eventually limits employees to an ever smaller pool of potential employers too As all the once thriving small 4 to 10 vet practises diminish due to lack of recruitment as we all are there eventually may only be 3 or 4 employers left at some point. .

RE: Crisis?

Andreas Ege — Mon, 21 Feb 2022 17:13:20 GMT

In regards to ooh: we actually got an agreement with a referral centre to take some of our ooh on, i.e. intensive care patients that need constant/ frequent monitoring over night or on weekend. Being on call Friday evening through to Monday morning a 12+ hour seizure watch at night just isn't sustainable. We rarely need it, but just knowing it's there gives some piece of mind and reduces stress.

Other practices do similar. Locuming for a VetsNow branch I was surprised to notice one of my former permanent practices on their registered list. As far as I knew they were still doing their own ooh, which the webpage confirmed. Staff at VetsNow said they couldn't remember having seen one of their clients. Pretty certain it must have been a fallback provision in case they struggle seeing something.

That might be a way forward for some practices to reduce ooh pressure without completely giving up doing their own.

RE: Crisis?

Claire Applewhite — Mon, 21 Feb 2022 16:49:18 GMT

Haha! I’m far too old, cynical and thick skinned to be upset! (But thanks!)

To be honest we probably agree, the industry cannot continue in the vein it is. And I get your dilemma. I’m simply saying just because I choose to work part time doesn’t make me less valuable or less knowledgeable (or less willing to go the extra mile).

There are a huge number of jobs in my county at present too, both with and without OOH. Some practices with great facilities, some with more basic, but they are all struggling to recruit (our area doesn’t help),

But in your scenario about needing less daytime vets to create less nighttime work, I would argue with this.

If there is the call for the daytime work, then you need the vets, otherwise your practice will not grow/prosper, but in this scenario you need to reassess how your OOH is provided. (Dedicated OOH/ having night vet(s) in house/ getting together with other practices locally to share/etc etc.)

You wouldn’t want to take a thriving 4 vet practice to a 1 vet practice just so there is less ooh work generated surely?

And you can’t just sit and moan that no one wants to do it anymore, you gotta work with what you can get, and change accordingly. (Don’t mean that exclusively at you! In general terms!)

Times have changed, for good or bad, they’ve changed, and we have to change our way of working too, or we will all end up grumpy/left behind/even more cynical than we already are!

RE: Crisis?

cairncross — Mon, 21 Feb 2022 16:00:53 GMT

Sorry i have been taken up as criticising those who do part time this is not what i mean at all part time are very valuable and hopefully not an exhausted grumpy old bugger like me.i am pretty sure an alert part time or daytime only vet can do nore work better than someone who has worked too many nights. I think it is fair to criticise those working too many hours as at somepoint they endanger.

I am trying to point out that if no one is willing to do ooh and provide the obligatory ooh back up then you cant organise the daytime you either shut or only do what daytime work you can meet the ooh obligation for. Therefore as those willing to do ooh diminish we also have to employ less daytime staff. If 4 people comfortably mamaged a night time rota of 4 daytine vets work and now only 1 is willing to do ooh they cant sustain that and the amount of daytime work needs to fall. You dont need more daytome workers you need less.

I am not critical of anyone working what ever hours they can too many too few who is to judge. I am critical of a system that is broken and nobody is fixing. Afaik every practise in the county here cant recruit judging by the increasingly despirate ads. So its not just me or some grumpy old bosses.

Really sorry if my meaning wasnt clear and upset you i felt it was a simple sum

Not enough / less vets availible to meet night time obligation then daytime work generating this has to fall..

RE: Crisis?

Claire Applewhite — Mon, 21 Feb 2022 15:27:45 GMT

I don’t usually respond on these things, but this has really hit a nerve.

I was working part time (2-3days) a week for a large hospital at the start of COVID, had been the several years, it turned into a living breathing hell. (Before COVID I locumed so still worked full time, but liked the flexibility this arrangement gave me).

Throughout COVID, I worked on average 4-5 unpaid overtime hours every evening, sometimes more, received phone calls on my days off/WhatsApp’s etc. Got that many calls OOH from junior colleagues (I wasn’t on the rota) because their back-up wasn’t answering their calls, that my husband thought I’d agreed to do OOH. (Their back up was my boss!) without so much as thank you.

The day my boss walked out one evening, because he was tired and stressed, and left me (already 3hrs into overtime, and yet to have had a break all day) and a panicked new grad with procedures he couldn’t do, any respect I had left vanished.

Needless to say, I’ve left, alongside every other vet bar one, and they can’t recruit.

I took a job part time with a practice I’d locumed for for years, I do extra when needed, (I offer!) and I no longer dread and loathe my work. We are still short staffed, but we are far more realistic with the workload. I don’t locum anymore, although I’m regularly asked.

The bottom line is, if you organise your practice well, a part timer (for whatever reason it’s not just children!) can be a valuable asset. And treat them well, they’ll go above and beyond. Treat everyone like a number, it doesn’t matter whether you are part time or full, you will never keep your staff, or even worse, maybe you’ll have worked a decent vet so far into the ground they give up the profession entirely.

OK rant over!

RE: Crisis?

cairncross — Sun, 20 Feb 2022 17:06:35 GMT

Yes I don't really mean part time I mean jit contributing to the ooh . I don't in any way mean to criticise anyone doing this they really should be able to. It's the system that then creates a problem as someone has to provide the ooh cover and no one now quite rightly wants to

RE: Crisis?

Andreas Ege — Sun, 20 Feb 2022 15:13:05 GMT

[quote userid="19228" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30192/crisis/235913#235913"]It's the system I cant employ them unless uncover the ooh workload obligation they generate.[/quote]

Part time doesn't automatically mean they're not doing out of hours. I work part time for day work but am fully integrated in the rota (my offer, I like out of hours and did for some time almost only ooh work). If childcare allows, I also sometimes cover times not normally working if needed, e.g. short staffed due illness or holiday. Don't know how many part timers are out there doing that, but can't imagine I'd be the only one.

Not sure if I really generate more workload from my day work, the practice started getting more busy before I joined the team as a permanent.

I do agree that ooh would need some solution/ modification. Unfortunately I haven't any brilliant ideas, though I think it would need to include educating clients in some way. We get infrequent calls from not registered owners who think their own vets ooh is too far (and possibly too expensive, though they usually don't admit that) and while the majority is grateful if I do see the animal, there were a few behaving really a..sy which nowadays makes me check if a client is registered with us before seeing it. Especially if I already have a very busy weekend.

Could I respectfully ask you check your spelling a bit more thorough? I find a lot of your posts rather difficult to read.

RE: Crisis?

cairncross — Sat, 19 Feb 2022 20:13:59 GMT

The two local corporate practises , do not use their own corporates ooh centre 25 min away from them .

RE: Crisis?

cairncross — Sat, 19 Feb 2022 19:43:26 GMT

There are 9 practises arround me within a 20 min drive all offering their own in house ooh service, The nearest dedicated ooh servicd is also just 25 min away in Belfast. My 2 nearest "competitors "are owned by the same corporate that eventually owns the dedicated centre in Belfast which is even closer tonthem than me but even they do not use them , they still also provide their own in house service. They with better figures than me know it isntva viable option , clients wouldnt gontobthe ooh servicevthey woikd sign up with one of the 8 other nearer cheaper options. Pre covid another dedicated ooh provider did do some ground work looking to start in the ares but abandoned it as non viable.

I post to represent my niche rural independant in a poorer part of the country , what is a solution in some circumstances isnt in another. I am probably no more stressed than i woukd be in any other profession i woukd be the same idiot in different clothes.

RE: Crisis?

cairncross — Sat, 19 Feb 2022 19:29:33 GMT

Its ooh that onerous and impacts family life thats why no one wants it they want daytime work. I have family kids too what would i do with the few hoursboff middle of day , sleep? Then back to work when kids and wife are home or would like to go out etc. Itbwouldnt alkeviate the diwndide of ooh.

Not attacking those who do only work daytime , they didnt create the situation and they work hard abd well during the day . Wish i could employ part time vets do more and better daytime work but until i have a solution that meets the ooh obligation generated from that i cant

RE: Crisis?

Stephen Courtney — Sat, 19 Feb 2022 19:26:28 GMT

James it seems to me you are driving yourself into the ground, because you fear you will lose clients to competitors.

Can I politely suggest you let them go?

Asa Julie Innes said earlier in this thread, these people will drive you into your grave quite happily, but have no loyalty to you. Let them go.

You might not mean to come across as unhappy and stressed as you do, but I feel you are destroying yourself

You can't solve the world's problems, and your clients' unwillingness to pay properly for services is not your fault.

We have had to outsource our OOH to Vets Now as we are unable to staff it reliably without decimating the daytime rota. They are MUCH more expensive than we were, yet true emergencies are seen promptly and the Imaginitis cases discover they can after all wait till daytime. We were killing ourselves for no more than pandering to people because they wanted to be seen, not because they needed to be seen.

RE: Crisis?

cairncross — Sat, 19 Feb 2022 19:21:47 GMT

Absolutely , if there is no ooh obligation on the practise then there is no ooh obligation generated by the daytime staff . If you arevin sn area where dedicated ooh is the norm , is affordable by clients and is used bybtge majority ov practises then my argument is invalid.

RE: Crisis?

Gillian Mostyn — Sat, 19 Feb 2022 19:21:28 GMT

[quote userid="19228" url="~/001/veterinary-clinical/small-animal/f/misc-case-discussions/30192/crisis/235912#235912"] I cant outsource ooh as my clients simply would not use it.[/quote]

You do realise, i assume, that the vast majority of your clients will never use your OOH service? I suspect the impact of outsourcing would be much less than you imagine - but I guess you know your own practice best.

I expected a big backlash when we stopped doing our own OOH. Apart from a couple of very high maintenance clients (who I was happy to wave goodbye to) there was hardly a ripple.