Neighbouring practice irks

RE: Neighbouring practice irks

grumpyoldman — Wed, 16 Sep 2015 22:48:31 GMT

I do inform them ,that if their usual vet is not giving them the OOH service they need, then they should go and find one that does, but do not leave it until they need one OOH. The response is usually about personal bonding, familiarity etc. Geographical proximity or they just do not think about it. None of which is going to help their grand mal seizure or decompensated CHF. Some of them feel tied in by a vet plan style direct debit drip feed, some think its insurance and a few think its also transferable. A lot are just desperate and frankly unaware of what the OOH provisions were. They are not apparently being told when they are taken on , although I have seen it on the websites and on the vet plan leaflets.

RE: Neighbouring practice irks

grumpyoldman — Wed, 16 Sep 2015 22:26:29 GMT

[quote user="J G Wray"]

If, as you say, this is a problem for you, then presumably your staff are trained to emphasise that seeing the patient is an exception and your fee scale for non registered clients, which might be treble your usual fees, will apply and get the client to give their card number in advance over the phone.

If these clients are a source of grief for you and the patients need to be seen, no one expects you to provide a routine service for routine cost, do they?

[/quote]

It is irritating , and, whether you see them or not they have impinged themselves on your consciousness, disturbed your peace. I always worry about 2 fee structures ,not sure how any insurers would view those surcharges ,but its a good point. Its the overall slyness because of the degree of nod and wink complicity that is just as irritating. The feeling that they know its going on and just shrug their shoulders instead of doing something about it. If our clients were bugging others OOH like this on a regular basis I would find it personally embarrassing. Pre vetsnow it happened and some were not always very good at picking up the phone, but not to the same extent and with the same regularity.

RE: Neighbouring practice irks

J G Wray — Wed, 16 Sep 2015 07:27:34 GMT

[quote user="grumpyoldman"] in truth when you set your stall out to undercut everyone else vaccines and routine surgeries and attract a horde of bargain hunters in the day time, those bargain seekers are not then going to follow your instructions on the answer phone and go to the most expensive out of hours provider if they can blag someone else into dealing with it. [/quote]

If these clients are a source of grief for you and the patients need to be seen, no one expects you to provide a routine service for routine cost, do they?

RE: Neighbouring practice irks

grumpyoldman — Tue, 15 Sep 2015 21:43:10 GMT

Yes you are justified in being irritated by it , however not a terrible lot you can do practically except deal with the animals immediate needs or refer it to the appropriate service provider ,if there is one . We have this on Sundays as the clients of several smaller practices who use the far and away vetsnow ring us demanding attention . Its worse because the incumbents partially detach themselves from their fault or blame by giving some of their couch breeder clients and long standing groupies a personal mobile number to use as an alternative to OOH provider. This then ensures the loyalty of the would be vetsnow haters ,until they try and use it ,and its switched off. There is a suspicion, of an indirect understanding with one particular practice, propagated by their lay staff and none vet owner, that its ok to bother other people OOH instead of going to vetsnow , in truth when you set your stall out to undercut everyone else vaccines and routine surgeries and attract a horde of bargain hunters in the day time, those bargain seekers are not then going to follow your instructions on the answer phone and go to the most expensive out of hours provider if they can blag someone else into dealing with it.

RE: Neighbouring practice irks

Wren — Tue, 15 Sep 2015 14:24:10 GMT

[quote user="Clive Ansell"]

Same response as that to the original post; you could have "sorry we're fully booked go toy your own vet" or do as you did as take the client.

One has to question to wisdom of a client that signs up with a practice an hours drive away, as well as that of the practice that accepts a client an hour away. What would happen in the event of an emergency, colic etc?

[/quote]

When their own vet has refused to attend then either I go, or some other practice in the same situation has to. Might as well be me! I think the client's views of the veterinary profession, if they had to ring a third practice to get someone to attend an acutely lame horse, would be justifiably low.

And as to the second point, well, quite. We don't have clients that far away for precisely that reason.

RE: Neighbouring practice irks

Wren — Tue, 15 Sep 2015 14:21:29 GMT

[quote user="Robin Grimmer"]Been there, done that! I couldn't go back to working those hours or conditions any more.[/quote]

Fair point, but someone needs to do LA/equine work, and for those of us who do there is no such thing as turning the phones off at 7pm. Out Of Hours services simply do not exist.

RE: Neighbouring practice irks

Robin Grimmer — Tue, 15 Sep 2015 12:46:35 GMT

[quote user="Wren"]

[quote user="Robin Grimmer"]So you are doing 12 days continuously without a break?[/quote]

As does any vet in mixed/LA/equine practice! I am on a 1:2 rota and do 12 days (including 7 nights), followed by a weekend (2 days/3nights) off, followed by another 12 days. All year long! I am far from untypical

[/quote]

Been there, done that! I couldn't go back to working those hours or conditions any more.

RE: Neighbouring practice irks

Clive Ansell — Tue, 15 Sep 2015 10:59:19 GMT

[quote user="Wren"]Going back to the original post I had a similar situation on Saturday. Client who lives quite near us rings to ask us to see a lame horse as their vet (based an hour away from them) has refused to come on the basis that they are too far away. I rang the other practice to confirm the story (I was busy enough with my own calls and could have done without another) and was told verbatim that it was too far for them to drive on a Saturday when the roads are busy, that they have fewer staff on a Saturday and couldn't spare one to leave the practice for that length of time to see the client - it was a different matter on a week day when they were fully staffed.... I was livid! I saw the horse, smiled, turned up promptly and have picked up a new client. I am considering writing a strongly worded letter to the practice concerned (I was considering writing one to the RCVS on Saturday, but have cooled off now a little), however I shall probably leave it as the (now my) client has assured me that they will be taking that side of things up anyway.[/quote]

Same response as that to the original post; you could have "sorry we're fully booked go toy your own vet" or do as you did as take the client.

RE: Neighbouring practice irks

Wren — Tue, 15 Sep 2015 09:01:56 GMT

[quote user="Robin Grimmer"]So you are doing 12 days continuously without a break?[/quote]

Going back to the original post I had a similar situation on Saturday. Client who lives quite near us rings to ask us to see a lame horse as their vet (based an hour away from them) has refused to come on the basis that they are too far away. I rang the other practice to confirm the story (I was busy enough with my own calls and could have done without another) and was told verbatim that it was too far for them to drive on a Saturday when the roads are busy, that they have fewer staff on a Saturday and couldn't spare one to leave the practice for that length of time to see the client - it was a different matter on a week day when they were fully staffed.... I was livid! I saw the horse, smiled, turned up promptly and have picked up a new client. I am considering writing a strongly worded letter to the practice concerned (I was considering writing one to the RCVS on Saturday, but have cooled off now a little), however I shall probably leave it as the (now my) client has assured me that they will be taking that side of things up anyway.

RE: Neighbouring practice irks

Gillian Mostyn — Mon, 14 Sep 2015 18:04:55 GMT

Agreed! Occasionally happens to Ian and I when assistants are off and it reminds me of when I was an assistant. Not good memories either!

Anyway, sorry for hijacking the thread everyone!

RE: Neighbouring practice irks

Clive Ansell — Mon, 14 Sep 2015 17:27:00 GMT

[quote user="Gillian Mostyn"]

The vets work a 4 day week every week, regardless of weekend working. (They get the same day off each week, as that makes it a lot easier to plan their lives. It drove me mad as an assistant that I never knew when I'd be off until the week before.) They also finish at lunchtime on the friday after working the Sunday, thus working 3 1/2 days after a weekend.

It is a very good rota for the full time assistants. My husband ( and obviously practice partner) works substantially more weekends in order to facilitate the rota for the assistants. Myself and one other vet work part time and do 1 in 3 Saturdays and 1 in 12 Sundays.

[/quote]

Sounds like a well planned rota with adequate time off. what I don't really like is working weekends days in addition to working all week. I find a 5 day week enough, even 5 full days + Saturday mornings I find too much.

RE: Neighbouring practice irks

Gillian Mostyn — Mon, 14 Sep 2015 16:50:42 GMT

Again, Thomas' situation is almost identical to ours.

Financially, we often make more money in that one hour than we used to all weekend on call. Staff costs are minimal.

RE: Neighbouring practice irks

Thomas Johnson — Mon, 14 Sep 2015 15:52:29 GMT

[quote user="Robin Grimmer"]

So you are doing 12 days continuously without a break? I agree with Clive, I think we are making a rod for our own backs with all this Sunday opening. Particularly if you only open for an hour and expect only 'well-trained' clients with non-critical cases but would rather/better be seen on a Sunday. The reality is you will get cases that will need admitting and hospitalising, in which case they would be better off going to the OOH clinic. Plus you will get a fair number of cases who are registered somewhere else but don't want to use their OOH service, or non-registered clients.

[/quote]

Yes, I do work 12 days without a break, which is certainly not ideal. I get a half day every Thursday, and the week after I work a weekend I get an extra half day on the Friday, it is very rare for me not to get away on time on my half day. The Sunday mornings generally work very well, the first few appointments are usually re-checks from the day before, then we get the people who've phoned the previous evening or overnight and heard the answerphone message saying that we're open for 2 hours on Sunday morning, but they need to call at 9 to get an appointment. The annoying ones are those that call at 10.50am, which means that we occasionally have to stay late to see them.

We don't admit anything, if it's obvious when they call that they need admitting we ask them to call Vets Now. If they arrive and it's obvious they need further treatment I will send them straight to Vets Now without charging them to be seen here, it's only half a mile away. I will sometimes run bloods and then make the decision whether to treat them and send them home, or send them to Vets Now.

Most of the local practices offer a Sunday morning surgery, we are an independent practice but have a CVS and Vets4Pets within half a mile of us. Clients from other practices wanting to come to us on a Sunday morning is not an issue.

RE: Neighbouring practice irks

Clive Ansell — Mon, 14 Sep 2015 15:35:33 GMT

[quote user="Gillian Mostyn"]Our full time vets only work a 4 day week..[/quote]

Does that include the Sunday when they work one?

[quote user="Gillian Mostyn"]Obviously we would prefer to just shut completely, but we are running a business after all! :-)[/quote]

From a business viewpoint, is it financially worthwhile once extra wages etc have been paid?

One of my regulars has extended Saturday surgeries from 9-12 to 9-5. Afternoons tend to be quiet and many that do show up are registered elsewhere and are just avoiding OOH fees, most of the time the practice is out of pocket, plus they are peeing off neighbouring practices by seeing their clients.

RE: Neighbouring practice irks

Gillian Mostyn — Mon, 14 Sep 2015 14:48:08 GMT

[quote user="Robin Grimmer"]So you are doing 12 days continuously without a break? [/quote]

Our full time vets only work a 4 day week..

Weve been running the Sunday clinic for approximately 5 years, and it really does work well. I can see that the drawbacks you mention could be an issue, but we haven't found that to be the case. It has been a compromise between not doing our own OOH care yet trying to provide some continuity for clients, especially for ongoing cases.

Obviously we would prefer to just shut completely, but we are running a business after all! :-)

RE: Neighbouring practice irks

Robin Grimmer — Mon, 14 Sep 2015 13:55:24 GMT

[quote user="Thomas Johnson"]

[quote user="Clive Ansell"]

I recently did a locum for a single vet practice that opens for 2 hours on a Sunday morning. I found it to be a pain in the neck, and don't how the regular vet puts up with it. It means no weekly day off, and effectively writes off the Sunday if you have other interests, such as distance cycling in my case.

As it is only 2 hours, anything very ill needing on going hospital care has to go Vets-Now anyway, the other odds and ends could easily wait, or go to Vets-Now if owners wanted. I wouldn't do it. Seems crazy to pay for an OOH service then to still do the work yourself. Still, funny old world.

[/quote]

I don't particularly like doing it, and I find the worst part is not having a day off, but I only have to do it on 1 in 5 weekends; and clients do really appreciate it, there are a lot of things we can deal with in that time where the animal benefits significantly.

[/quote]

I already can't do a lot of weekend pursuits because I work a lot of Saturdays. I go running every Sunday with a group of friends and don't want to have to give this up as well. As a locum I can choose not to work for a practice that has Sunday opening, but full-time employees don't have that luxury.

RE: Neighbouring practice irks

Clive Ansell — Mon, 14 Sep 2015 13:52:29 GMT

[quote user="Thomas Johnson"]I don't particularly like doing it, and I find the worst part is not having a day off, but I only have to do it on 1 in 5 weekends; and clients do really appreciate it, there are a lot of things we can deal with in that time where the animal benefits significantly.[/quote]

I certainly wouldn't do it on a regular basis. After a full weeks work usually including a Saturday morning I've clocked up around 55 hours, my working week is over. The rest of the weekend off including the whole Sunday is absolutely sacrosanct. Why anyone martyrs themselves like this is beyond comprehension.

The things you deal with in that time could just as easily be dealt with by the OOH provider, which is after all why we use them. If clients have to pay a little more for veterinary care on a Sunday, so be it.

RE: Neighbouring practice irks

Thomas Johnson — Mon, 14 Sep 2015 12:39:07 GMT

[quote user="Clive Ansell"]

[/quote]

RE: Neighbouring practice irks

Clive Ansell — Mon, 14 Sep 2015 10:44:59 GMT

RE: Neighbouring practice irks

Gillian Mostyn — Mon, 14 Sep 2015 09:54:35 GMT

I echo exactly what Thomas said.

Also useful for check-ups/rpt injections/ insulin dosing etc for ongoing cases that require care but not hospitalisation. We charge significantly less than our OOH provider, because our overheads are lower.

We recommend any serious or surgical cases go to our OOH provider.

RE: Neighbouring practice irks

Thomas Johnson — Mon, 14 Sep 2015 09:39:29 GMT

[quote user="Braden Collins"]

I do question the idea of opening for an hour to deal with emergencies/urgent cases. My belief is that if they're emergencies/urgent, they can pay an OOH fee to be seen. If they're not urgent, they can wait. To open for an hour I think runs the risk of training clients poorly when it comes to what is urgent and what isn't.

[/quote]

We open for 2 hours on a Sunday morning, it's not my favourite shift to work, but I think it's a really good service for our clients. We charge a small supplement, but a lot less than our out of hours provider. It's aimed at dealing with those cases that aren't a genuine emergency, but are definitely in the animal's interest not to have to wait another 24hrs, such as a cat with cystitis, a dog with a painful ear, a vomiting animal that just needs a dose of Cerenia. Anything more complicated I send straight on to Vets Now, which is only half a mile up the road, and usually I don't charge them.

RE: Neighbouring practice irks

Silvia Maldonado — Mon, 14 Sep 2015 03:55:50 GMT

Agree with Evelyn. We cannot even tell whether the receptionist was acting on vet/vet nurse advice, or it was her decision, being that inexperience, lack of knowledge, stress, wishing to leave in time to meet her boyfriend, or pure laziness

RE: Neighbouring practice irks

Braden Collins — Mon, 14 Sep 2015 02:51:26 GMT

Frustrating if you're an employee, a great opportunity if you're a boss.

If you're an employee, maybe it's a great chance to go to the boss with a win-win solution.

In my first job, I lived in a flat at the back of the clinic. We shared the OOH work with the two other clinics in town, but inevitably clients would be banging on my door on weekends when we weren't on call.

My boss agree that if I see these cases and treat them, I could keep all the professional fees they generated. That way it was financially worth my while to do the work, while the practice gained good will and a little bit in drug sales. I found it was almost always worth while to see these cases, and the clients became strongly bonded to the clinic as a result. Everyone wins. Of course, I only got paid once the clinic was paid, so I made sure there was no bad debt coming from such jobs. This also meant the boss didn't have to worry about the cost of a bad debt plus having to pay me to accumulate it.

RE: Neighbouring practice irks

Clive Ansell — Sun, 13 Sep 2015 19:52:11 GMT

[quote user="Michael Woodhouse"]The money practices spend on advertising, and you have people coming to you in their hour of need and you want them to go away? Myself I'd fix the animal, request a history on Monday and have a happy, bonded client for life. The only person losing out is the one abandoning their clients OOH.[/quote]

It depends very much on the circumstances and the case.

If I were a practice owner and on call anyway, yes I would probably just get on with it and hope to gain a trusted client. Equally in my first position as a paid assistant, if on call anyway, I would have just got the job done.

Imagine though being a paid assistant that has just pulled a 60 hours week and is knackered, and gets paid no extra for staying on late to carry this out. They would be perfectly justified in bouncing it back to its own practice or to an OOH facility.

Similarly as a locum that finishes at 1200 on a Saturday and has a 150 mile journey home, I would probably kick it to touch. It is not only the time for the procedure and ga, but also recovery time. If it came in 1000-1030 I would do it in between consults, but if it rolled up at 1150 it would get bounced. AS Gillian points out, one doesn't pay for an OOH provider to then do the work yourself.

Real life situation earlier this year in one of my regular practices; an employed assistant and a nurse stay behind after their 1200 finish one Saturday for about an hour to do a stitch up. walk in client, no vet, SBT. Despite agree to the estimate, client collects dog and has no money. Address and telephone number don't exist. Not only does practice not get paid, but boss man has to fork out £75 in extra salary for the staff as per their employment conditions. Serious sense of humour failure followed.

RE: Neighbouring practice irks

Clive Ansell — Sun, 13 Sep 2015 18:55:24 GMT

[quote user="Anthony Todd"]And you'll have a bonded client for life who will tell almost everyone. They'd tell everyone, and their neighbour, if you'd turned them away![/quote]

Maybe, maybe not. I think the idea of bonded clients and loyalty is becoming a dated concept, people shop around for the best and most convenient service in our consumeristic society.

You may gain a life long decent client yes, on the other hand the original practice may have off loaded a serial bad debtor and arse pain member of the local travelling community. Hypothetically of course.