Housecall vets

Re: Housecall vets

Martin McDowell — Wed, 07 Oct 2009 15:19:33 GMT

[quote user="Jacquin Mitchell"]

Actually I don't think that because something can be done in a clinic, it has to be done in a clinic. ...

[/quote]

Hi Jacquin

I can see your point. There can be a marketing niche in doing home visits, just as long as you charge them appropriately and do not undercut conventional practices who might not see it as "appropriate" to do house visits on a regular basis. I will not repeat my predecessors on this thread talking about the practicalities of doing house visits.

In our practice we do perform them but only if we have the necessary man/woman-power. I do not think we (conventional practices) should be expected to do house visits for things like vaccinations. We do have a moral and professional responsibility to help when an animal is suffering but not for routine matters. I do sometimes think we forget the responsibility of the owner when aquiring a pet as to what happens when it gets hungry, needs a walk, needs human contact or needs to see a vet. There are costs they have to consider and that they will have to take them to the vet.

Of course if they have the money to request a house visit from vet practices like yourself then that is great. But other vets should not feel responsible for solving our clients social or financial problems. We cannot give the same service as the NHS as we clearly are not the NHS.

Re: Housecall vets

Karen Eggleton — Mon, 05 Oct 2009 23:54:52 GMT

Hi Jacquin, I still think we're a bit thin on the ground. There is no list or association that I know of and I don't know anyone in my area who does the same thing (although my locum is starting a surgical version). I have been running my home visit practice for 17 months and it is 24/7, too busy for me, hence I am looking for a second vet. I am guessing there are a few more housecall vets in the London area but I seem to have a niche market where I am. I think it proves itself as a good business model (although mine needs fine tuning somewhat) Having said that, I find it hard work

Re: Housecall vets

Mialee Blair — Fri, 02 Oct 2009 15:12:45 GMT

I am currently considering buying a small vehicle and adding a home visit service to our practice. We do presently do visits if requested but try and get people to the surgery as they are disruptive.

We have however been looking at expending by setting up another branch surgery as we are in a rural area with our catchement covering several large villages as well as our small town. I have thought however that we might instead implement a more active visiting policy, with very low price "zone visits" like many horse practices do now. So say monday we are in area x and a visit is only a small additional charge to our normal prices, other visits being charged as normal

Am thinking it might be a "green" policy, to reduce client travel and be more effective than a branch surgery in one area.

Re: Housecall vets

Clive Ansell — Fri, 02 Oct 2009 12:24:35 GMT

It can be a dilemma sometimes I know. I sometimes work in busy OOH centres where there are just 2 staff members; usually inpatients requiring ongoing care, a backlog of consults and surgeries to do, and with the instruction that we cannot leave the premises unattended - clearly home visits are impossible in these situations. There is usually a way of getting an animal to the surgery, be it with a friend, or neighbour, an animal ambulance provider or a local taxi firm wiilling to carry animals.

I think there needs to be debate about being able or obligated to provide the ability to carry out home visits 24/7, and if we are expected to how will it be done? by whom? and who is paying given the increased staffing levels and vehicles that would be needed?. Another of the OOH centres I work once had an ambulance and driver initially, but it was taken off the road as it was not financially viable.

Another problem area is sometimes the transport of animals to and from user practices and the OOH centres. we sometimes have cases that are moved back and forth over 3-4 days, as an increasing number of practices do not hospitalise overnight.

On a personal level, I am happy to carryout home visits during working hours if there is time in the daily schedule, and they are within a reasonable distance from the surgery. As a locum I can use my own car and charge the pratice for its use, but I do not transport animals at all.

Re: Housecall vets

Hannah Wynne Richards — Fri, 02 Oct 2009 11:21:48 GMT

Clive, I won't give my actual charges for visits, as I don't want this forum to be accused of price-fixing, which would be illegal I will just say that I estimate charges on the number of consults I won't be doing in the time

I agree with Gillian. Until earlier this year, I used an OOH service. Obviously , the reasons I left were multifactorial, adding up to dissatisfaction over a long period. One of the reasons was that they refused a house visit to an elderly lady-widow living alone in a respectable area of town, so not high-risk. She owned a 35 kg dog which was collapsed. It was physically impossible for her to lift the dog. As it happened , being a considerate old lady, and not knowing that the OOH veterinary surgeon was in the surgery, she had waited almost all night, and although the dog had been collapsed since the early hours, had not phoned till 7am, so there was not much extra delay in waiting until I started. Still, it was the principle of the thing

Wynne

Re: Housecall vets

Jacquin Mitchell — Fri, 02 Oct 2009 09:25:55 GMT

Actually I don't think that because something can be done in a clinic, it has to be done in a clinic. My home visiting service does mainly vaccinations, health checks & minor illnesses.

90% of my clients find it difficult to get to a surgery; they are elderly or disabled, have young children or lots of pets, they have no transporrt or work funny hours. Most of them would not get around to vaccinating their pets if I didn't come out to them. I estimate that 10 % of my patients have something obvious that requires referral to a surgery for- teeth cleaning, lump investigation, lameness or skin conditions are the most common things- right now I just give them a non biased list of local vets and an idea about what services they offer/ likely cost etc.

I don't usually deal with animals that are very ill or need intensive work ups or surgery. If people ring with an animal in this state, I explain why they should go to a surgery, help them locate one if they need assistance and make sure they have a way of getting there. I explain that if I come out I will be charging a consult even though they will get referred to a clinic and a couple have still asked me to come out; I went and charged then as promised. Sometimes I go to vaccinate an animal and it's really quite ill, I have ended up being a veterinary ambulance on occasion.

I use a local 24 hour clinic as my OOH as I do not ask that the client be referred back to me for the work done.

When I take on a client, I explain carefully how my service works and what it's limitations are and I haven't had any trouble yet. I am readily avaliable to talk to client about their pet even if it's something I can't help them with and they seem to appreciate this.

Re: Housecall vets

Clive Ansell — Fri, 02 Oct 2009 08:25:08 GMT

I don't work in any practices where they have an actual policy of no home visits, although they are often not encouraged and the resources are not made available; insufficient staff, not enough time or no vehicle for example. In an ideal world maybe we would be able to do more and offer it as part of a usual service.

Some of the areas I work in have very good pet transport/ambulance providers. very useful.

There are exceptions I agree, but I still think best approach for the very badly injured or sick animal is to be brought to the surgery as quickly as possible. I have found home visits in some cases just delay the onset of essential treatment. Many people who request home visits often change their mind when the costs are quoted.

What do others charge for home visits both during normal hours and ooh?

Re: Housecall vets

Gillian Mostyn — Thu, 01 Oct 2009 20:33:26 GMT

[quote user="Clive Ansell"] The only instance I can think of where a visit would be essential would be entrapment, in all other cases animals should be brought to the surgery. [/quote]

I disagree. Although most animals would need to end up at the practice eventually, I think there are many many instances where veterinary care in the home/roadside can be very valuable, if not essential. How about a large dog with a fractured spine/pelvis? Would you really expect one person to be able to bring it to the surgery without causing a massive amount of further trauma and pain? A dog in status epilepticus? A collapsed dog that needs euthanasia?

Obviously every case is unique - and should be approached uniquely. But I do think there will always be a place for house visits, either by the practice or a seperately run service. I do not like the recent trend of practices saying "we don't do house visits because ......" and making it the practice policy.

Re: Housecall vets

Clive Ansell — Thu, 01 Oct 2009 18:43:50 GMT

[quote user="Hannah Wynne Richards"]

I own a conventional practice and will do house calls if requested. It worries me when you say that you get contacted by people from other areas. This suggests to me that none of their local practices will do house calls. The Guide to Professional Conduct says that all veterinarians must do so if it is necessary in the animals interest

Wynne

[/quote]

Home visits are sometimes difficult, sometimes not even possible, particularly in a one man busy practice. I have had to turn down requests for home visits on many occasions, simply because the time and staff are not available.

As a locum I have worked in 5 different emergency clinics, only one was able to provide OOH home visits by having a second on call vet on standby. The other 4 only had 2 members of staff who were unable to leave the premises with no standby vet, and no vehicle.

In any event, in an emergency situation a very sick or badly injured animal needs to be in a hospital environment, emergency care in someones frontroom is a non starter. The only instance I can think of where a visit would be essential would be entrapment, in all other cases animals should be brought to the surgery.

In addition, there is the health and safety aspect. The are areas of Birmingham where the police go in fours with dogs, there is no possible way I would be carrying out a home visit in such an area unless escorted by the police.

Re: Housecall vets

Ian Mostyn — Thu, 01 Oct 2009 17:52:39 GMT

I know that we are the only local practice who will do a house visit judging by the number of phone calls we get from disgruntled clients of other practices. We do one or two a week, not usually a problem as long as it is not at 6pm on a Friday in the middle of a mad evening surgery.

Ian

Re: Housecall vets

Hannah Wynne Richards — Thu, 01 Oct 2009 17:38:06 GMT

Wynne

Re: Housecall vets

Jacquin Mitchell — Thu, 01 Oct 2009 17:11:55 GMT

I know this thread is almost a year old but I wanted to reply in the hope that there might be some other Housecall vets out there who would reply.

I've been running a very small home visiting service in Middlesex/ NW London for the last 5 years to fit around the kids. My youngest is about to start nursery and I'm trying to work out whether to expand the home visiting service a little or to try and find a part time job in a surgery somewhere.

I'd love to be able to contact other vets who do this and it would also be useful if there was some sort of list somewhere as I very often have people from other areas emailing me, asking if I know of any mobile vets in their area?

Jacq

Re: Housecall vets

Karen Eggleton — Thu, 20 Nov 2008 22:50:27 GMT

Hi Sam

Great to hear from you and happy to swap tips! I also provide transport if required to and from a designated practice for surgical cases, probably at a loss in both time & financial renumeration, but I do not want to offer a less tham complete service. I will also do POCs if required FOC-perhaps not great business sense but I see it as goodwill.

My client base has mainly grown through word of mouth. I have lived locally for several years. I advertise in the local village magazines which is very cost effective and also advertise in the local Post Offices etc. Not hard hitting but it all works! I have also joined a local business breakfast group which may not so far have given me many referrals but it gives me business support and advice and through it I have met many good contacts and great plans for the practice. My best referrals actually come through local dog groomers with who I have a very good relationship. I do have a website but do not be drawn in by cold callers- I joined TouchLocal when I first started and it has been my biggest waste of money. It is also worth getting involved locally. I did a few hours one Sunday morning at a local Dog Day which was no hardship and I met 2 great contacts there, with invites for future events.The more local practice apparently consistently refused to attend-their loss.

A sign written car/van is essential and don't be afraid to hand out business cards.

I know RCVS has strict rules on advertising so hope I'm not flouting them!

Re: Housecall vets

Karen Eggleton — Thu, 20 Nov 2008 22:32:28 GMT

Hi Chris,

Thanks for the interest-hopefully answered some of the questions in the post to Evelyn. I find it works fantastically in the local villages here but not just for the elderly-they actually make up quite a small percentage of my client base, bizarrely as I live in a retirement area. I get a lot of clients with young families who don't want to cram everyone up into the car, disabled clients and obviously clients with fearful pets. I also get a lot of work from clients who work full time as I am willing to do evening work as required, although I appreciate many practices also offer evening appointments. I am housecall rather than mobile so I do have to refer work on which is frustrating at times from an interest/financial point of view but my long term plan is to be able to offer the whole package. If I thought it was practical, I would consider an Animedic mobile clinic as apposed to an ambulance. The American La Boit mobile clinics are amazing but perhaps not practical for driving down the lanes!

Re: Housecall vets

Karen Eggleton — Thu, 20 Nov 2008 22:21:26 GMT

Hi Evelyn

Thanks for the comments.

I am 100% housecall, with a view to building up enough of a client base to then run a surgical facility. I can obviously do all medical consults/preventive medicine. Surgical or hospitalisation cases are referred to a local practice with whom I have an agreement.Certain housecall services advertise themselves as an add on to a client's regular practice, which seems to be the American model, but although, as RCVS states, a client can be registered with several vets, I do wish to have bonded clients. I am very careful with supersession. I do not wish to antagonise local practices-I do all my own on call, the phone's are not switched off at 6pm, infact I routinely work appointments late into the evening. And my service is certainly not second rate.Certain local practices are negative towards me but as a sole practitioner, I can hardly be a threat and competition is healthy. If the model works, perhaps they need to consider offering a similar service-however I can see that this may not be viable alongside a traditional practice. Other practices could not be more welcoming & I truly appreciate this.

I have an Animedic ambulance which is working out well. So far I have not had the nightmare scenarios you mention but the work is quite physical, mostly from lugging equipment around, which has already had a detrimental effect on my back but no pain, no gain!

Re: Housecall vets

Sam — Wed, 19 Nov 2008 21:15:10 GMT

Hi I've just started a new (limited services) practice in a very small village and in order to get a reasonable number of clients I am offering a housecall service too. So far it seems to be going well but finding the best way to advertise the housecall service is something which I am struggling with. Any tips would be most welcome. Do you have an arrangement for surgical cases etc? I understand that many housecall vets have a friendly "parent practice" for these types of cases. This is something which I felt I needed and by providing transport to and from the practice providing these services I feel that I can offer my own clients a more complete service than I would otherwise be able to. It is great to hear from another person who has started a visiting service and it would be good to swap hints and tips.

Re: Housecall vets

Christopher Tansley — Wed, 19 Nov 2008 17:08:15 GMT

I am intrigued as well, we have many elderly clients in outlying villages so a mobile clinic could be useful to them. Indeed the practice did used to have one many years ago. How do you work it? What are the OOH arrangements? What do you do with GDV for instance? Sorry I'm not much use but I am very curious.

Re: Housecall vets

Evelyn Barbour-Hill — Wed, 19 Nov 2008 15:37:26 GMT

A bit more. I must be in blethering mode today.

I'm intrigued. Are you strictly house calls only, or are you a "conventional" practice that does house calls? If the former, what do you do about stuff that can't be done in the house?

Do you transport animals? What sort of vehicle do you have? How do you cope with the 200-pound obese collapsed Bernese Mountain Dog? Or the dread phone call, "I don't know how you're going to manage, we can't get near 'im"?

Re: Housecall vets

Evelyn Barbour-Hill — Wed, 19 Nov 2008 15:28:48 GMT

[quote user="nobbygonzo"]I'm reading Carin Smith's housecall manual but it's pretty much all basic common sense and geared to the American market.[/quote]

As indeed one can say about almost everything published about practice management.

The best management advice I can give is "ignore all management advice, use your own brain".

Sorry, Nobby, this is probably not what you're looking for. All I can say is, although housecalls are my idea of the milder levels of hell, I'm sure there's a demand and I wish you success. Just make sure you a) charge enough and b) get paid. In your place I'd be getting one of those mobile credit-card-accepting machines.

Oh, yes, try not to antagonise existing practitioners. I can stand competitors undercutting me on price (because I compete on quality) but what really hacks me off is having their clients ring me up after hours, because they've neglected their 24-hour obligation.