seeing clients from other clinics OOH

RE: seeing clients from other clinics OOH

Julie Innes — Tue, 14 Jun 2016 12:44:20 GMT

I thought that was the point of the thread-if you don't want to see other people's clients at that time, you are not obliged to. Their own vet will have provisions in place, and whether they like them or not, they have agreed to that when they registered.

It is pretty rare, actually, for any of my clients to use other vets OOH, as we are pretty clear in our literature what the procedure is. If they do, I do tend to explain that they shouldn't, as we have our own provisions in place. They are, of course, free to move practices, and those practices who might be actively seeking new clients may be keen to see them (one practice is open on a Sunday, I think) and that is up to them. But the point is that no-one is being forced to do anything!

RE: seeing clients from other clinics OOH

Martin Atkinson — Tue, 14 Jun 2016 10:45:38 GMT

[quote user="Richard Stephenson"] My point is that these OOHs clients are clearly looking for a new vet, have a sick animal, and want treatment - surely an opportunity for a growing business not a problem.[/quote]I think there is a big difference between clients who phone during normal hours wanting to move vets because they are making a rational decision, and those calling out of hours who are looking for a closer vet than their usual one purely for convenience or are phoning round for a cheaper option. They more often than not turn out to be less than good news and even when I was a growing practice I didn't want them. There is a point at which making money at the expense of your quality of life isn't worth it. Clearly that point is different for all of us.

RE: seeing clients from other clinics OOH

Richard Stephenson — Mon, 13 Jun 2016 23:54:11 GMT

[quote user="grumpyoldman"]I did exactly what you said , except the consult was £90.00 , but the point was that 3 call outs a week to 14 is a huge jump if your happy with things as they were, and change is being forced upon you by the actions of others. [/quote]

Couldn't agree more - however the initial post starting this discussion related to a struggling branch practice with insufficient clients and questioned if it was ethically OK to turn new clients away OOHs (which it is not disputed is fine to refer back to normal VS from RCVS Guidance perspective). My point is that these OOHs clients are clearly looking for a new vet, have a sick animal, and want treatment - surely an opportunity for a growing business not a problem.

Your circumstances appear to be different - you are happy with your practice, it has already grown to the size and complexity you want - you feel forced to expand when you don't want to. The guidance gives you the authority to say no - go to your own vet (in the first instance). I fully understand however that once the phone has woken you up at 2 am the damage is done and you end up seeing the case anyway. This is one of the unresolved issues surrounding the delegation of OOHs work to specialist providers, however I doubt that the clock can be set back now.

RE: seeing clients from other clinics OOH

grumpyoldman — Mon, 13 Jun 2016 14:45:55 GMT

[quote user="Bob Russell"]

700 consultations at £70 each (OOH) comes to £49000 (including VAT). Not far off the salary of an additional vet. More if you charge properly for your services.

If I could be sure of that level of increase, I would get someone else in and live with it!

[/quote]

I did exactly what you said , except the consult was £90.00 , but the point was that 3 call outs a week to 14 is a huge jump if your happy with things as they were, and change is being forced upon you by the actions of others.

RE: seeing clients from other clinics OOH

Bob Russell — Mon, 13 Jun 2016 11:29:11 GMT

700 consultations at £70 each (OOH) comes to £49000 (including VAT). Not far off the salary of an additional vet. More if you charge properly for your services.

If I could be sure of that level of increase, I would get someone else in and live with it!

That sort of money is an opportunity not a problem IMO! Some will stay with you long term to sweeten the pill even more.

Doubling the number of OOH consults might be an irritation but not bad for the bank account!

RE: seeing clients from other clinics OOH

Julian Earl — Mon, 13 Jun 2016 08:46:41 GMT

Grumpy... that pie worked well for me, sky-high or not, so why not try it? It has to be better than doing nothing. One has to try.

RE: seeing clients from other clinics OOH

grumpyoldman — Sun, 12 Jun 2016 23:09:18 GMT

[quote user="Julian Earl"]Practices using Vets-Now have a duty to inform clients that this is so, and to suggest that they do not contact neighbouring practices for convenience but use the agreed system. That should help inter-practice relationships as much as anything.[/quote]

Nice idea but practically pie in the sky

[quote user="Julian Earl"] I cannot really identify any abuse going on even though people do get miffed by being called out by non-clients.[/quote]

Pre vetsnow I did 150 OOH consults a year ,immediately post that became over 700 , that distortion in OOH workload was neither welcomed or asked for , it is therefore abusive , it makes it more difficult to employ and retain staff and being worn out dealing with your own clients the following day is not a great situation . Your not going to be nice to people who have dumped their emergency services and in the process made yours worse. When Arbitrary business decisions of others adversely affect your business its reasonable not to be too chuffed about it. Clients play the welfare card on you because they are not able to speak to their usual vet ,that is also abusive.

[quote user="Julian Earl"]communication is critical[/quote] You cannot ring them OOH and the next day they just want the history, when you broach the subject they just respond with tough S**t or snigger . Not the basis for a happy co-existance really.

RE: seeing clients from other clinics OOH

Julian Earl — Sun, 12 Jun 2016 11:16:51 GMT

I think that for this dilemma, that, , communication is key as so often is the case . Practices using Vets-Now have a duty to inform clients that this is so, and to suggest that they do not contact neighbouring practices for convenience but use the agreed system. That should help inter-practice relationships as much as anything.

Regarding this thread, I cannot really identify any abuse going on even though people do get miffed by being called out by non-clients. But surely we are all agreed that the animal must come first and attending to the animal should be the priority. Not having the previous history could be an issue but the same applies to any new patient. I believe that the scenario is best seen as an opportunity not a dilemma , hence my earlier post. A lack of history could be highlighted when you contact the "proper" vet the following morning to discuss the previous night's issue. So again communication is critical, = this is where I came in with this post. Perhaps a formal arrangement with your Vets-Now-using neighbours should be the routine? Perhaps both sides can win this way, and the animals benefit as well?

RE: seeing clients from other clinics OOH

Jo Dyer — Sun, 12 Jun 2016 10:50:39 GMT

[quote user="grumpyoldman"]And that is the problem ,all clients think they are exceptional. [/quote]

"3.36 In all but exceptional circumstances the interests of companion animals will be best served by being taken to a veterinary practice where the attending veterinary surgeon has access to a full range of veterinary medicines, equipment and facilities. Exceptional circumstances might include an entrapped animal that cannot be moved prior to veterinary attention".

I understand that 'concerns' received by RCVS regarding failure to visit have reduced dramatically since this guidance was published.

Obviously it doesn't mean 'don't visit anything' (Wynne ) but it allows the vet to choose only to perform necessary visits rather than owner-blackmail ones.

RE: seeing clients from other clinics OOH

grumpyoldman — Sat, 11 Jun 2016 22:17:50 GMT

[quote user="Jo Dyer"]exceptional circumstances, [/quote]

And that is the problem ,all clients think they are exceptional.

[quote user="Jo Dyer"]The RCVS encourages owners to think[/quote]

Really ?? how ? TV ads ? Major press releases in newspapers ? single page ads in the times ? The clients we visit OOH are no more informed now than they were 10-20 years ago .

RE: seeing clients from other clinics OOH

Jo Dyer — Sat, 11 Jun 2016 07:45:03 GMT

[quote user="grumpyoldman"]it needs to say that if you own a Neapolitan Mastiff or an Irish Wolfhound you need to have transport available when it gets ill ,you need to think about getting it to a vets when its going to die. Also if you own savage unhandlable unloadable feral Alaskan Malamutes you need to be able to handle them and control them and not expect the vet to be some kind of Dances with wolves character. [/quote]

It's there, in nearly as many eloquent words

3.21 Owners are responsible for transporting their animals to a veterinary practice, including in emergency situations. The RCVS encourages owners to think about how they can do this and make plans before an emergency arises. Examples include their own transport, a family member, friend or neighbour’s transport, an animal ambulance or a taxi service that will transport animals.

3.22 In all but exceptional circumstances, the interests of companion animals will be best served by being taken to a veterinary practice, where the attending veterinary surgeon has access to a full range of equipment, veterinary medicines and appropriate facilities.

RE: seeing clients from other clinics OOH

grumpyoldman — Sat, 11 Jun 2016 00:12:19 GMT

[quote user="Richard Stephenson"]BUT RCVS Guidance is a public document and widely consulted by the public especially when they want to make a complaint against veterinary surgeons.[/quote]

Only consulted occasionally/rarely when they complaining or trying to get out of a bill would be more accurate.

Its an improvement but does not go far enough ,it needs to say that if you own a Neapolitan Mastiff or an Irish Wolfhound you need to have transport available when it gets ill ,you need to think about getting it to a vets when its going to die. Also if you own savage unhandlable unloadable feral Alaskan Malamutes you need to be able to handle them and control them and not expect the vet to be some kind of Dances with wolves character.

[quote user="Richard Stephenson"]The RCVS does not seek to 'enforce' this [/quote] You cannot enforce it ,your only hope of getting it into their heads would be incorporating it into a coronation street or east enders story line. Trying to persuade these people to bring these animals into the surgery remains a problem, they will be stressed panicking irate .often threatening , tell you they are going elsewhere ,then ring around ,then ring you back and plead and hit you with various forms of emotional blackmail, then threaten to complain ,which then brings you to the next problem ,even a ridiculous stupid complaint with no grounds often festers on for 2-4 months .

RE: seeing clients from other clinics OOH

Richard Stephenson — Fri, 10 Jun 2016 19:48:37 GMT

[quote user="grumpyoldman"]Its not, its wishful thinking and pissing in the wind ,but keeps the great unwashed RFPs more comfortable about trying to make the collapsed great dane come into the surgery at 2am. [/quote]

You are correct the RCVs has no jurisdiction over the public. BUT RCVS Guidance is a public document and widely consulted by the public especially when they want to make a complaint against veterinary surgeons. The current Guidance 3.21 was inserted after an extensive consultation by the RCVS Standards Committee. Some elected veterinary members of Council felt very strongly that the guidance should make it clear what responsibilities OWNERS have, and were very active in getting this inserted into the document - Chris Barker was one such Councillor. RCVS Council completely agreed and the proposed guidance was accepted. Prior to the change the guidance was entirely about vets responsibilities to animals and their owners without the balance of pointing out that actually owners have the prime responsibility in these situations. The RCVS does not seek to 'enforce' this - however it provides a clear defence for veterinary surgeons when faced with allegations of unreasonably failing to visit etc. It was certainly a change I voted for and would do again if I were still a member of RCVS Council.

RE: seeing clients from other clinics OOH

grumpyoldman — Fri, 10 Jun 2016 13:56:36 GMT

[quote user="Matt Hilary"]I don't mean to needlessly pick holes (and I think obligating owners to take responsibility is a good thing) but how is the RCVS encouraging owners to do anything without jurisdiction or enforcement?[/quote]

Its not, its wishful thinking and pissing in the wind ,but keeps the great unwashed RFPs more comfortable about trying to make the collapsed great dane come into the surgery at 2am.

RE: seeing clients from other clinics OOH

Matt Hilary — Fri, 10 Jun 2016 11:44:35 GMT

[quote user="Silvia Maldonado"]

Seeking veterinary attention

3.20 There is no legal requirement for owners to register their animals with a veterinary practice; however, the RCVS strongly encourages owners to do so as it may help them to meet their duty of care obligations under the welfare legislation. Owners are also encouraged to find out what arrangements are in place for their animals outside normal working hours.

3.21 Owners are responsible for transporting their animals to a veterinary practice, including in emergency situations. The RCVS encourages owners to think about how they can do this and make plans before an emergency arises. Examples include their own transport, a family member, friend or neighbour’s transport, an animal ambulance or a taxi service that will transport animals.

[/quote]

I don't mean to needlessly pick holes (and I think obligating owners to take responsibility is a good thing) but how is the RCVS encouraging owners to do anything without jurisdiction or enforcement?

RE: seeing clients from other clinics OOH

Gillian Mostyn — Fri, 10 Jun 2016 11:05:08 GMT

[quote user="Julie Innes"] I'm a small practice because I like it that way. I don't like managing lots of staff, I find it stressful[/quote]

I wish I had done the same. We expanded to 2 practices, 5 vets and 20ish staff. Would I do it differently if I had my time again? Yes. If you enjoy your current workload and lifestyle, stick with it. You owe nobody any explanation - colleague, client or an internet stranger.

RE: seeing clients from other clinics OOH

Silvia Maldonado — Thu, 09 Jun 2016 23:19:37 GMT

Copy&paste

CODE OF PROFESSIONAL CONDUCT FOR VS

3. 24-hour emergency first aid and pain relief

Seeking veterinary attention

[...]

Part 2 – Additional guidance for veterinary surgeons

Providing information about the 24-hour emergency cover provision

3.23 Veterinary surgeons should provide their clients with full details of their 24-hour emergency cover provision. This should include relevant telephone numbers, location details, information about when the out-of-hours service is available and the nature of the service provided. Veterinary surgeons should also inform their clients about the likely initial costs of the service.

[...]

3.25 Veterinary surgeons should use all possible means to provide information about their 24-hour emergency cover provision. Examples include client information leaflets, notices or posters in the practice, clear statements on the practice website / social media, other advertisements and providing additional information on vaccination record cards.

3.26 Information about the practice's 24-hour emergency cover provision should enable clients to make an informed decision about their animal’s veterinary care, particularly, where to go in an emergency. Special consideration should be given to clients registered as disabled who may have difficulty travelling, especially outside normal working hours.

3.27 Those who outsource their 24-hour emergency cover should ensure that their clients are given full information about the service, as above. It is not acceptable for such veterinary surgeons to state that they provide 24-hour emergency cover (or words to that effect) without providing full information about the service.

[...]

Dealing with requests from non-clients

Non-clients – clients of another veterinary surgeon / practice

3.45 A client of another veterinary surgeon or practice who requests an emergency consultation may be redirected to that veterinary surgeon or practice (or the emergency service provider for that veterinary surgeon or practice). The on-duty veterinary surgeon to whom the initial request has been made may decline to carry out the consultation. First aid and pain relief should, however, be provided to the animal if, for whatever reason, the owner cannot contact his or her usual veterinary surgeon or practice or the circumstances are exceptional and the condition of the animal is such that it should be seen immediately.

Non-clients – owners have no veterinary surgeon / practice

3.46 First aid and pain relief should be provided to an animal if, for whatever reason, the owner does not have a usual veterinary surgeon or practice. Holidaymakers, new owners and other categories of animal owner may not have a usual veterinary surgeon or practice in the locality.

RE: seeing clients from other clinics OOH

George Cooper — Thu, 09 Jun 2016 19:11:36 GMT

[quote user="Martin Atkinson"]

[quote user="George Cooper"]

I'm so enjoying this thread.

i think the OP has ALL the answers and is unprepared to heed the thoughts of those vastly more experienced, is also building up a nice head of steam resenting clients who call ooh, and so on and on.

There is ONLY one course of action, otherwise there will be one VS disappearing up its own jaxi in a flurry of righteous indignation - and that is to go, and then set up your own business where you will very soon learn the realities of life.

[/quote]Nothing aimed at you personally George (although I'm sure you will think it is) but your reply is a microcosm of the general mood on here.

What amazes me is that most on here are having a dig at the OP in this thread and anon in the 'Vet Nurse Chatter FB page' thread when they have a valid argument but universally help the OP in the 'I've F***ed up' thread to continue to wallow in self-recrimination and condemn me for trying to get her to see a way out.

I'm not sure what this tells me about the profession.

[/quote]

Nope - not taken personally - and perhaps a surprise that I agree with you. The recent tone of some threads has moved me to shut down and go have a GnT in the p[eace of the Welsh Hills i.e. the garden, otherwise I could be just as "arrogant" and mini-vetistic, and abrasive etc etc and I'd rather not, right now.

RE: seeing clients from other clinics OOH

grumpyoldman — Thu, 09 Jun 2016 15:54:55 GMT

[quote user="Julie Innes"]Erm, somewhat judgemental??!![/quote]

Not really ,just a view .

[quote user="Julie Innes"]I don't like managing lots of staff, I find it stressful[/quote]

but lots of clients are not ?

[quote user="Julie Innes"]the clients like a more personal service.[/quote]

exactly the kind of people who are not going to want vetsnow OOH then?

[quote user="Julie Innes"]they are under no obligation to see my clients OOH, as we have provisions in place (which we used to pay plenty for!)[/quote]

Your fundamental boob , the assumption that all your clients are honest and going to do as you tell them , you often find they are someone else client when its on the consult table ,they will get in by lying about previous treatment and their usual vet.

[quote user="Julie Innes"]Nobody is being "abused" by my clients![/quote]

you admitted yourself that you ring the practices in question for the histories ,so that is not true really is it? They have had someone else out of bed because your on the chateau neuf or reading bedtime stories to the bisto family ?

[quote user="Julie Innes"] If they want to see them, they can. [/quote]

so much for the [quote user="Julie Innes"]more personal service. [/quote]

[quote user="Julie Innes"]Should everyone who uses Vets Now be embarrassed about it?[/quote]

Depends upon the local circumstances , when local geography dictates ,clients will just gravitate to somewhere nearer in an emergency and then go back to the shop down the road in the daytime. So if that is the case then yes you probably should be .

Not having a go at anyone ,just playing Devils Advocate.

RE: seeing clients from other clinics OOH

Martin Atkinson — Thu, 09 Jun 2016 14:26:35 GMT

[quote user="George Cooper"]

I'm so enjoying this thread.

i think the OP has ALL the answers and is unprepared to heed the thoughts of those vastly more experienced, is also building up a nice head of steam resenting clients who call ooh, and so on and on.

[/quote]Nothing aimed at you personally George (although I'm sure you will think it is) but your reply is a microcosm of the general mood on here.

I'm not sure what this tells me about the profession.

RE: seeing clients from other clinics OOH

Julie Innes — Thu, 09 Jun 2016 14:21:05 GMT

Erm, somewhat judgemental??!! I'm a small practice because I like it that way. I don't like managing lots of staff, I find it stressful, and the clients like a more personal service. We certainly aren't "cheap and cheerful"- our prices are easily comparable to other practices. Very few of my neighbouring practices do night work anyway, and they are under no obligation to see my clients OOH, as we have provisions in place (which we used to pay plenty for!) , so I don't really understand why you are having a go at me! I'm sure many vets use OOH providers. And if clients move to the ones who don't that is fine! Nobody is being "abused" by my clients! If they want to see them, they can. If they don't they can redirect them to our OOH provider, who is just as close by. Should everyone who uses Vets Now be embarrassed about it?

RE: seeing clients from other clinics OOH

Bob Russell — Thu, 09 Jun 2016 13:30:28 GMT

[quote user="An On MRCVS"]

[quote user="George Cooper"]I'm so enjoying this thread....vastly more experienced...[/quote]

Ah, the old favourite..bashing the new graduate.

I have been practising veterinary medicine for 15 years. I seem to have really gotten backs up in this thread with my questions and comments and that was totally unintentional, but I don't appreciate the hostility in this post in particular.

[quote user="Bob Russell"]Nobody has mentioned 'stealing' clients.[/quote]

I mentioned stealing clients. If you accept people who phone your phone number OOH without gently directing them to at least try their regular veterinarian, you are attempting to steal them from your local practice. This may be a contentious opinion but thank Jeebus we are all entitled to at least one each!

[/quote]

Nobody else mentioned stealing clients. Clients will go wherever they chose and are free to do so. If a client does not want to use an out of hours service then it is their choice and practices must take this risk into account when making their choices. I did use VetsNow but now work with our neighbouring practice, happy with both.

Stealing is taking something you are not entitle to! We do not have a right to expect custody of clients, just to be treated in a fair and honest manner.

RE: seeing clients from other clinics OOH

Richard Stephenson — Thu, 09 Jun 2016 13:23:12 GMT

[quote user="Francisco Gomez"]But If it were my pet, I'd like to know that there is a potential benefit of going to my own vet initially as other practices are unlikely to have a clinical history. Things like 'allergic to synulox', 'meloxicam causes diarrhoea', 'splenectomy 2 months ago with hemangiosarcoma' are a few of the examples that spring to mind. I agree that most people (clients) will be aware of all these, but some pets can have a very long and complicated history.[/quote]

Yes I don't disagree but that is not the reality for 38% of practices (and by extrapolation 38% of owners) anymore. Where OOHs is subcontracted to a specialist provider it is accepted that they won't have any of the history or information you describe. Clients of those practices are sometimes unaware of that situation (despite signs in waiting rooms etc) and therefore cannot exercise choice prior to an OOH emergency. Where practices contract out OOHs it makes no difference in terms of history being available if the client goes to the nominated OOH provider or a practice that they select themselves OOH - no history.

As someone who is on call regularly I appreciate it is sometimes frustrating to have to deal with other peoples' clients (who specifically have chosen to go elsewhere for a discount daytime service) but I have always found it less stressful and more satisfying just to sort out the animal for them - and charge appropriately (which does mean a supplement for non - client call outs).

The only point I am making is that you can see these clients (often desperate to find veterinary care) as a nuisance to palm off to someone else or a great business opportunity. There's no right or wrong here it just depends on whether you want your practice to grow faster. However I have no sympathy for the position my practice is very quiet but I want to turn away business - that makes no sense to me at all!! Some one man practices are very content with how much work they have, don't want new clients and would rather sent clients back to their prior vets (that's fine) but I bet they didn't take that approach when they were 'growing' their business.

Yours,

Richard S.

RE: seeing clients from other clinics OOH

grumpyoldman — Thu, 09 Jun 2016 12:46:52 GMT

[quote user="Julie Innes"]I don't see why that should be embarrassing[/quote]

That maybe one of the problems.

Also if your oversubscribed with clients registering maybe you need bigger premises and more vets ,but then you would have to charge them more to pay the wages ,which suddenly makes you much less attractive to the daytime shopper. I never like the one man band clients bugging us OOH then going back to the discount charm merchants the next day because its cheaper. It usually because they provide a cheap and cheerful limited daytime service ,then try and send the clients to the most expensive OOH provider 10-20 miles away. It grates but there is not much that you can do about it . When i was single handed it was my best ever business model , 1 vet and 4 nurses turning over 500k a year ,but its hard if your also doing OOH with a family , in those days there was no alternative. Its also harder to expand to 5-6 vets now with the market at saturation point. I do retain a lot of sympathy for your other local practices if they are being regularly abused by your clients because while what you are doing is fine for you ,its damaging and skewing their night work load. And that is what should be embarrassing!!.

RE: seeing clients from other clinics OOH

Matt Hilary — Thu, 09 Jun 2016 12:34:27 GMT

[quote user="Francisco Gomez"]I don't agree that you should not going to work because you want to be in bed - even as an employee I think that if I make money during the night, the practice will grow and it will have a beneficial impact on me indirectly - that's not what I'm about.[/quote]

While I admire this attitude I'd find it pretty difficult to be so positive as an employee if I'm being regularly woken up by other practices' clients purely on the basis of convenience. I don't think the possibility of future investment made by ownership would compensate for loss of sleep.

From the point of view of a practice owner I'd be delighted to be busy out of hours with others' clients and see no issue with matching OOH consultation prices with competing providers.