ASSOCIATION Success Story: Partial emergency coverage Data, staff feedback on overnight coverage led to new policy—and less burnout
As one of four veterinarians at Fredericksburg Equine & Small Animal Veterinary Services in rural Texas, AAEP Immediate Past President Dr. Rob Franklin knows as well as anyone how all-con- suming the veterinary life can be. The clinic’s new partial emergency coverage model aims to ease that pressure.
Dr. Rob Franklin
Prior to purchasing the clinic in 2018, the practice had
provided 24/7 emergency service to clients by a single practitioner. Once Dr. Franklin and his partner Dr. Matt Moskosky purchased the clinic, they continued providing 24/7 care and compensated on-call staff with 50% of the total emergency bill. This continued for 3 years with the expansion of the practice to 4 veterinarians.
“My partners have kids, and we’re just all in a busy part of our lives, personally and professionally,” Dr. Franklin said. “So we thought, ‘Hey, we need to get some space here in our schedule.’ We’d hired as many veterinarians as our practice can currently take, and still, spreading the on-call around, it was still more than we all wanted to be on call. The impetus for a new policy was to try to give a better lifestyle for our veterinarians.”
Taking a Close Look at Current Calls Fredericksburg Equine is one of several practices serving a county of about 22,000 residents. Most of the other practices offer mixed care, including ruminants. Fredericksburg Equine doesn’t treat ruminants, and that difference in clientele made sharing after-hours emergency coverage with neighboring clinics impractical.
Because Fredericksburg Equine already saw most of its equine patients on a haul-in basis, the next step was to consider ways to trim emergency coverage outside its regular 8 a.m. to 5 p.m. hours. They started by assessing when the majority of after-hours calls came in.
“When we looked at the frequency of after-hours calls, it was almost a lightning-strike event for someone to call in the middle of the night,” Dr. Franklin said. “Most of our emergency calls were happening first thing in the morning or in early evening when people were doing evening chores or finishing work and spending time with their animals.”
But being on-call for those relatively rare events was mentally draining for staff, whose personal lives and a good night’s rest were essentially on hold during that time.
“That’s how we arrived at the decision to stop seeing patients between 9 p.m. and 6 a.m.,” Dr. Franklin explained. “We’d been stressing about something that happened infrequently, and once we looked at the data, it was easy to say, ‘We can turn this off and we’re not really disappointing anyone or eliminating care for any measurable number of our clients.’ Not having to worry about being on call freed up the mental capacity of our team.”
Offering a Blend of Options Today, the practice offers on-call emergency care daily from 6 a.m. to 9 p.m. (including on weekends when the clinic has no regular office hours). As a first-line resource between 9 p.m. and 6 a.m. when coverage is not provided, Fredericksburg Equine offers VetTriage veterinary telemedicine services for callers; for a small fee, an online veterinarian can help the client determine if the horse needs to be seen and can recommend several referral centers for those that do need veterinary attention. Those 24/7 referral centers range from 30 minutes to 3.5 hours away and are also listed, along with maps, in a dedicated “Emergency” tab on Fredericksburg Equine’s website.
“We’re centralizing emergency care to an emergency practice so clients can seek those services,” Dr. Franklin explained.
As part of the move to a partial emergency coverage policy, the practice raised all of its fees and added daytime emergency fees for cases that require schedule adjust- ments. They communicated the policy change through client statements, social media and outgoing messages— including detailed information about the referral centers—on the clinic’s phone system.
“We’ve been doing this for over two years, and we’ve had zero client complaints,” Dr. Franklin said.
Fredericksburg Equine also provided all veterinarians a one-time pay raise based on the average former emergency bonus. But the message from staff was clear: being on call was about time and stress, not money.
“We needed to create more downtime,” Dr. Franklin said. “We couldn’t just throw money at the situation. That works temporarily, but there comes a time in people’s lives where the money’s not worth missing kids’ events, spending time with your family or simply creating some downtime to recharge for the next workday.
“This change has really helped support bandwidth we allow people to create in their lives, to not get burned out,” he added.
AAEP News July 2024 III
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