'We're too busy, try somewhere else'

RE: 'We're too busy, try somewhere else'

Evelyn Barbour-Hill — Fri, 02 Jul 2021 17:04:42 GMT

[quote userid="5904" url="~/001/nonclinical/f/life-in-practice-discussions/29885/we-re-too-busy-try-somewhere-else/231054#231054"]And nobody has actually said they always need much longer than 5 minutes to reach any diagnosis,[and they don't][/quote]

I did (no, not always) and it wasn't because I was blood sampling everything. But that's irrelevant – there's a great deal more to a consultation than making a diagnosis.

But if you want to put up your plate (yay!!) and aim for 5-minute consultations (boo!!), well, it's a free country (just about).

I think this discussion has come to an end.

RE: 'We're too busy, try somewhere else'

Anthony Todd — Fri, 02 Jul 2021 13:51:23 GMT

[quote userid="2131" url="~/001/nonclinical/f/life-in-practice-discussions/29885/we-re-too-busy-try-somewhere-else/231047#231047"]But if you had just put up your plate, why would you want to limit your consultations to 5 minutes apiece?[/quote]

No, and we didn't and the numbers were much greater. We were lucky that there weren't as many practices available too.

We tried blocking off appts every so often in the tconsult imes but found that "blocked off" suddenly had more spaces than "appointments" did.....!!

To make it very clear if something needed more time then the next ones had to wait but this was rare, as I think everyone will agree.

Anyway, times change, dogma is established, so clients are trained to accept the full monty, and they have little option anyway..

And nobody has actually said they always need much longer than 5 minutes to reach any diagnosis,[and they don't]

RE: 'We're too busy, try somewhere else'

Evelyn Barbour-Hill — Fri, 02 Jul 2021 02:14:35 GMT

[quote userid="5904" url="~/001/nonclinical/f/life-in-practice-discussions/29885/we-re-too-busy-try-somewhere-else/231039#231039"]

Evelyn Barbour-Hill said:
Wrong approach. (Unless you were being ironic, Anthony?)

Not being ironic at all. I suggest that 90% consults [for want of a name] can be settled in 5 mins and 10% need extra time and/or extra exams etc. Go through your appointments for one day and check

[/quote]

But if you had just put up your plate, why would you want to limit your consultations to 5 minutes apiece? You ain't gonna see any more people in the day.. And some of your clients will be disgruntled at how short a time you gave them. Why not allot at least 15 minutes (and if you want to be cynical, clients love this). Take time with your patient and your client. You'll have fewer "difficult" dogs and cats and your clients will remark "he's really got a way with animals". Less rush, less hassle, vet more comfortable, clients happier.

Before I retired from general work i had the book marked out in 10-minute appointments, but every other one was blocked out and reserved for occasional necessity. So, twenty-minute appointments. . I could often fill the twenty minutes, and if I didn't so what? Time to take another slurp of tea, write a few notes, check on that in-patient, see what annoying new posts are on vetsurgeon.org.....

Of course, if you want to run an El Cheapo "Bad ear, here's some Otomax, call us if it doesn't get better, pay at the desk, next please!" practice you are at liberty to do so.

[quote userid="5904" url="~/001/nonclinical/f/life-in-practice-discussions/29885/we-re-too-busy-try-somewhere-else/231039#231039"]So, if you fancy starting on your own, go for it, you will never work so hard but achieve so much and, be so happy,[/quote]

Absolutely!

RE: 'We're too busy, try somewhere else'

Anthony Todd — Thu, 01 Jul 2021 20:53:01 GMT

[quote userid="2131" url="~/001/nonclinical/f/life-in-practice-discussions/29885/we-re-too-busy-try-somewhere-else/230918#230918"]Wrong approach. (Unless you were being ironic, Anthony?) [/quote]

Not being ironic at all. I suggest that 90% consults [for want of a name] can be settled in 5 mins and 10% need extra time and/or extra exams etc. Go through your appointments for one day and check

, I'll bet everyone graduated more than a few years can diagnose anything includin"for referral" and, for the sometime essential "further exams, tests etc." within 5 minutes.

The rest, today, is taken up with non-diagnostic time.

MJV and RRA used to put another appt between the 2 x 5 minute ones....and their mistakes were very very rare!

I'm not suggesting this today with the policy of "informed consent" which seems to me largely to display the vet's voluminous knowledge, which may or not have any bearing of the patient before him or her.

Most of which is way beyond the client anyway and not really necessary, nor desired but imposed.

I've never had any medico, NHS or private, go through all the possibilities when I attend. and they are usually very accurate and effective.

But if, to fill the day, you have time for 15 minute appts then you have to do something, 'cos the old "say something, do something, give something" still applies.

Anyway nothing I say, as a dinovet, will change anything except that it is surprising how few mistakes are made with 5min appts, and how, IMHO, the success rate doesn't go up with 50minute appts.

So, if you fancy starting on your own, go for it, you will never work so hard but achieve so much and, be so happy,

With the change in practice "management" now is the time!!

RE: 'We're too busy, try somewhere else'

Evelyn Barbour-Hill — Wed, 23 Jun 2021 17:44:00 GMT

[quote userid="5904" url="~/001/nonclinical/f/life-in-practice-discussions/29885/we-re-too-busy-try-somewhere-else/230915#230915"]

Nobody starting up on their own? Wish I was still 25!

it's amazing how few mistakes are made with 5 minute appointments and how many things can be fixed in that time, or seen again if not.

[/quote]

Wrong approach. (Unless you were being ironic, Anthony?) The great thing about starting up single handed is that you have plenty of time to give your clients. 15-minute minimum appointments can be the norm Nobody breathing down your neck to get on and jam a few more patients in, screw the public for a few more quid, meet your targets for flogging them stuff they don't need.

RE: 'We're too busy, try somewhere else'

Anthony Todd — Wed, 23 Jun 2021 11:56:50 GMT

Nobody starting up on their own? Wish I was still 25!

it's amazing how few mistakes are made with 5 minute appointments and how many things can be fixed in that time, or seen again if not.

Of course I'm permanently speaking from my nuclear shelter......

RE: 'We're too busy, try somewhere else'

Anthony Dennison — Thu, 17 Jun 2021 13:58:03 GMT

It's interesting to see that it's not just us then! I think we may have to consider screening the non-urgent appointments from non-clients, just have to make our reception team aware of it. Issue is, descriptions from clients can be hard and if something is underplayed and the animal becomes severely unwell/dies, there is a risk of a complaint.

[quote userid="8958" url="~/001/nonclinical/f/life-in-practice-discussions/29885/we-re-too-busy-try-somewhere-else/230794#230794"]In days of old practices were vet owned. Any extra clients they saw was seen as a little extra in the bank account, a nice meal out to compensate. With so many practices owned by corporates there is a disconnect. Managers saying 'work smarter' yet have remained in their bedrooms throughout COVID[/quote]

We are IVC, but we were big before we were acquired so they've kind of left us alone to just get on with it tbh, there's not a huge amount of meddling. Our CDs are pretty good, end of last year everyone got an extra day's holiday alloted to them in light of the high workload from the previous 6-8 months.

RE: 'We're too busy, try somewhere else'

Clive Ansell — Wed, 16 Jun 2021 20:20:21 GMT

[quote userid="8958" url="~/001/nonclinical/f/life-in-practice-discussions/29885/we-re-too-busy-try-somewhere-else/230794#230794"]I'm working in a fabulous practice, they can't get a vet and have been trying for over a year[/quote]

Yep, agree.

One of my regular practices has been looking for a new vet for over a year now. great practice, small independent 2 vet practice, 4.5 day week, 1 in 3 Saturday mornings, no OOH, 1830 finish on the nose, nice area, good clients, work up cases to a good standard, no riff raffs, Worcestershire semi-rural, 15 minutes from Birmingham centre yet countryside on the doorstep.

Would have thought idyllic, yet no takers.

RE: 'We're too busy, try somewhere else'

Charlotte Marshall — Wed, 16 Jun 2021 18:19:15 GMT

We have just said no to new clients as well, we may allow people who have never been registered elsewhere. We were getting a lot of people trying to register with us to get an earlier appointment then their own vets had given them for non urgent issues. These we had already been declining. Our main issue was people registering online and booking appointments which has now been stopped thank goodness. We have taken on another vet recently and we are doing I think we worked out 14+ more hours of consults a week than before covid. But still we are struggling for space. The number of new puppies and kittens is staggering! We just don't have the consulting rooms to fit more in.

We would tell someone to contact their registered vets if they had one but would not send an unregistered client on to another practice with a sick animal. We always squeeze in emergency cases when needed even if it means running behind on the routine stuff.

RE: 'We're too busy, try somewhere else'

bob lehner — Wed, 16 Jun 2021 16:28:17 GMT

[quote userid="7811" url="~/001/nonclinical/f/life-in-practice-discussions/29885/we-re-too-busy-try-somewhere-else/230800#230800"]Someone needs to help absorb the huge increase in pet ownership since Covid. [/quote]

Just hoping that the 'Covid pets' don't get dumped in large numbers when the novelty wears off, or people need to go back to work....

RE: 'We're too busy, try somewhere else'

Julie Innes — Wed, 16 Jun 2021 11:25:54 GMT

We will always see our own clients if urgent, even if we are crazy. Currently we are trying to do same day only appointments to ensure that anything genuinely sick gets seen that day, then, if someone wants "a general check over" they can call on the day to see if we have availabilty that day. If not, they are asked to try another day. We have never advised them to go elsewhere, especially without asking- I would consider that rude!

We are not taking on new clients just now, and are turning away lots of people every day- while I do feel bad about that I have to protect my staff. we don't have space/ facilities to take on another vet, and I never wanted to be a bigger than 3 vet practice, so things need to be manageable. If you take on too much, people will burn out, mistakes will be made and service will ultimately be worse for existing clients. Arguably it will even compromise animal welfare, the very thing we are trying to defend.

I see lots of space in the market for enterprising young independent practices, here's hoping! Someone needs to help absorb the huge increase in pet ownership since Covid.

RE: 'We're too busy, try somewhere else'

Beats — Wed, 16 Jun 2021 10:13:29 GMT

[quote userid="8958" url="~/001/nonclinical/f/life-in-practice-discussions/29885/we-re-too-busy-try-somewhere-else/230794#230794"]

employ another vet

There aren't any.

[/quote]

I think that depends on locality and will be pretty variable. Just hired a new vet, 7 years qualified.. 4 excellent applicants to locally placed job ad. This one was a vet student with me 10 years ago. Last new vet to be hired was a student with us from school days and taken on once qualified. We are in an urban area. Both settled locally. I suspect very different in rural setting. Not a short-term strategy, but I think ensuring take on plenty of work-experience and vet students helps in long-run, folks are cautious to leave a job they have to join you if they don't already know you.

Sometimes I will say that we don't have time for something and will suggest that owner phone round other local vets to see if can be accommodated sooner, but always say to get back to us if can't get seen sooner elsewhere. I certainly don't expect other vets to be any less busy, but there will be some random variation day-to-day.

RE: 'We're too busy, try somewhere else'

Neil Wheadon — Wed, 16 Jun 2021 09:31:11 GMT

[quote userid="11308" url="~/001/nonclinical/f/life-in-practice-discussions/29885/we-re-too-busy-try-somewhere-else"]I'm never going to turn a sick animal away. Even if it means we're mad busy all day and I eat my lunch at 5pm with a 10 minute gap between consults whilst my colleagues cover. Why do other practices feel that it's ok to do? [/quote]

Sleep, work, eat, sleep

Our son has just taken a fabulous engineering job, he was concerned that the umbrella contract said 0830-1800. In reality it's 0900-1700, yes Ford wil drive him hard but by 1700 he would expect to be at home. I see this so often in practices, you burn out, go part time, retire, leave, it's happening that's the root issue

[quote userid="10813" url="~/001/nonclinical/f/life-in-practice-discussions/29885/we-re-too-busy-try-somewhere-else/230780#230780"]employ another vet[/quote]

There aren't any. Experienced vets are like hens teeth. Plenty of new graduates on the train to 7 years and find something else to do. I'm working in a fabulous practice, they can't get a vet and have been trying for over a year

[quote userid="11249" url="~/001/nonclinical/f/life-in-practice-discussions/29885/we-re-too-busy-try-somewhere-else/230793#230793"]There is only so much we can do. Chronic fatigue / pressure generates mistakes and I'd rather not be in that situation. We are at capacity.[/quote]

I see this in nearly all the places I work in

Finally my own thoughts

In days of old practices were vet owned. Any extra clients they saw was seen as a little extra in the bank account, a nice meal out to compensate. With so many practices owned by corporates there is a disconnect. Managers saying 'work smarter' yet have remained in their bedrooms throughout COVID

I'm burnt out after 30 years, I'm now doing 2-3 days a week maximum, that is all I can cope with now, but at least I'm still in the profession.

Now add in 13% increase in dog ownership, vets just can't cope

Neil

RE: 'We're too busy, try somewhere else'

ian bates — Wed, 16 Jun 2021 08:37:11 GMT

Hi Anthony - whatever approach you take needs to be sustainable for you and your staff. That is more important than anything else - if someone goes off sick / stressed your situation is worse, capacity falls and fewer animals will be able to receive treatment. Everyone loses.

We have not been taking on new clients for a while now - we are short on vets and cannot recruit. If we are full, we will offer for the animal to be left with us and a vet will look at it between consults / ops when someone gets chance. This happens a lot. Takes half the time of an actual full consultation and the animals still gets the treatment needed. Owners have been grateful knowing we are fully booked but will see the animal anyway.

We have turned away non registered / holiday clients.

There is only so much we can do. Chronic fatigue / pressure generates mistakes and I'd rather not be in that situation. We are at capacity.

There is perhaps another conversation to be had about the the whether your neighbouring practices should have the courtesy / ?decency? to ring and ASK if you are prepared / able to see the animal rather than tell clients to ring you and just assume.............

Regards

Ian

RE: 'We're too busy, try somewhere else'

Anthony Dennison — Tue, 15 Jun 2021 14:16:43 GMT

[quote userid="10813" url="~/001/nonclinical/f/life-in-practice-discussions/29885/we-re-too-busy-try-somewhere-else/230780#230780"]So yesterday I went to Sainsbury’s for some milk. They told me they were too busy - go to Tesco. Then Tesco were on the internet complaining about having Sainsbury’s customers being sent to them. [/quote]

Bit of a weak analogy.

I'm not moaning about the extra work per se - we probably have slightly more capacity to absorb extra work but then when we are slammed and practices ring up telling us they're sending something over because they're too busy rather than asking if we can see it when we're just as busy, I wonder if it's just me that finds it a little frustrating or if I'm just being grumpy. It's more trying to see whether we're pushing ourselves too hard to absorb the overflow where other practices have just turned around to say no.

It was also to see if this was something that is being seen around the country or just by us being a tier 3 hospital with our own OOH service.

The extra work sent to us by other practices has given vets here a pay rise, a good Christmas bonus, we've got one multiparameter monitor and getting at least another one, potentially two, and hopefully enough room in the budget for a high level ultrasound scanner for me to use so there are rewards for it.

[quote userid="10813" url="~/001/nonclinical/f/life-in-practice-discussions/29885/we-re-too-busy-try-somewhere-else/230780#230780"]employ another vet [/quote]

As with the whole country, we're trying but it's not that easy!

RE: 'We're too busy, try somewhere else'

Clive Ansell — Tue, 15 Jun 2021 14:03:37 GMT

Where I have recently been working, they have had a lot of this too. They have become so busy, that the books are now closed to new clients. A local low cost clinic closed about 2 years ago and hasn't reopened which has increased case load because clients don't want to travel to their other branches

Clients registered elsewhere are redirected back to their own practices, who are obliged to provide cover and see them. Clients of the closed low cost are redirected to their other branches.

Unregistered clients are seen for emergencies or sick animals, but there is a registration fee. Strictly for sick animals only, no routine stuff.

RE: 'We're too busy, try somewhere else'

David Shepherd — Tue, 15 Jun 2021 12:53:59 GMT

So yesterday I went to Sainsbury’s for some milk. They told me they were too busy - go to Tesco. Then Tesco were on the internet complaining about having Sainsbury’s customers being sent to them.
Something wrong with the veterinary business model here. Maybe put your fees up, employ another vet and buy a Porsche?

RE: 'We're too busy, try somewhere else'

Bob Russell — Tue, 15 Jun 2021 11:37:26 GMT

We have done this only once or twice and only when we were desperately under pressure. None were registered clients.

We are taking the opportunity to be selective as to who we allow to register as a new client.