ASSOCIATION


AAEP News November 2022 III


Success Story: Haul-in emergency policy helps Virginia practice balance horse care and practitioner well-being


Drs. Scott Reiners and Wynne DiGrassie


Having built a successful three-doctor practice with strong client relationships over the course of two decades, the husband-wife team of Drs. Scott Reiners and Wynne DiGrassie recently redefined their after-hours emergency coverage protocols to maintain quality, around- the-clock care for client horses while removing the burden of late-night travel for the doctors.


Dr. Reiners, a board-certified surgeon, and Dr. DiGrassie, a board-certified theriogenologist, established Mountain View Equine Hospital in Steeles Tavern, Va., in 2003. Historically, the three-doctor practice has provided ambulatory services for clients, hospital referral for other veterinarians, and after-hours emergency coverage for clients on a rotating basis with their associate.


Following the birth of their son eight years ago, however, Dr. DiGrassie came off the emergency rotation and tran- sitioned her repro practice from ambulatory to in-hospi- tal. Down to just two doctors covering after-hours emer- gencies for a practice area extending more than an hour away, the late nights behind the wheel eventually became wearisome.


To address the strain, the practice raised emergency fees substantially in 2020. The increase curtailed some of the non-emergent calls that could wait until the next day but didn’t quite remedy the core issue. In early 2022, the practice went a step further. Despite worries about client reaction and potential client loss, the practice began requiring most after-hours emergencies to come into the hospital. Between 5:00–8:00 p.m. Monday through Thursday, the on-call veterinarian will respond to emer- gencies within 40 miles of the practice. After 8:00 p.m. and on weekends, however, all emergencies—with exceptions for a couple of VIP clients within a 30-minute drive—are only seen in the hospital.


When a client calls the practice after-hours, the recorded message gives an option to be connected to the on-call veterinarian’s cell phone. If the doctor doesn’t answer, the client is directed to type “horse911” and the doctor will call back as soon as possible.


The practice notified clients of its policy change in a letter that, to their surprise, was well received by most. “We haven’t had that much of a pushback,” said Dr. DiGrassie. “We lost a few far-away clients, but you know


what? There’s likely another vet closer to service them so it was probably better for them in the long run.”


The vast majority of their clients either own or have access to a horse trailer, which the practice deems as part of responsible horse ownership and a consideration for being a client. If necessary, the practice has a couple of people who can help transport an emergency in a pinch.


Dr. DiGrassie said it’s important to emphasize the benefits for both horse and owner of seeing emergencies at the hospital. These includes having access to more equipment than can be carried on a vet truck as well as potential time and cost savings.


“A lot of the emergencies need more intensive care, especially the colics. And then some of the lacerations—if it’s over a joint, it’s got to come into the hospital anyway. It’s just trying to help the client in general realize that they’re actually saving money sometimes by hauling the horse into the hospital instead of going through multiple steps with the same outcome.”


In August, the practice further refined its after-hours policy when their associate went on maternity leave. During her absence, all non-VIP client emergencies had to be hauled into the hospital. In conjunction, the practice implemented after- hours televet appointments to triage potential emergent cases to determine whether they needed to be seen immediately or could wait until the next day. The televet appointments paid immediate dividends by identifying several non- emergencies in the first few weeks. Dr. DiGrassie indicated these televet appointments have continued since their associate returned.


It’s just trying to help the client in general realize that they’re actually saving


money sometimes by hauling the horse into the hospital instead of going through multiple steps with the same outcome.


The switch to predominantly in-hospital emergency care has maintained the health of client horses and provided a dual benefit to the practice and its doctors: improvements to both quality of life and emergency profits. With Drs. DiGrassie and Reiners living on-site, and their associate just five miles away, the late nights of driving an hour home from an emergency are now just a memory. Meanwhile, having more tools at their disposal and sig- nificantly reducing fuel consumption has put more black in the practice’s bottom line and more green in the pockets of its doctors and techs.


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