Is the doctor in?

Veterinarians grapple with demand for extended hours

December 5, 2012
By Phyllis DeGioia

Series

Photo by Phyllis DeGioia

Veterinarians who work solo often put in long hours to accommodate clients’ need and desire for appointments outside of traditional business hours. The clinic of Dr. Kristine Collins in Madison, Wis., for example, is open 57.5 hours a week.

Dr. Thomas McCain works as a veterinarian in Southaven, Miss., for nearly 50 hours, six days a week, often without a lunch break. He worries that’s not enough, and suspects not being open evenings is hurting his practice.

“Unfortunately, I see this as one of the reasons my business has declined,” McCain lamented recently on a message board of the Veterinary Information Network, an online community for the profession.

But how to add hours without losing his sanity is a quandary for the solo practitioner.

“I don't see how I can do late appointments without making myself even more burned out and seriously impacting family time but I'm beginning to see no choice,” McCain wrote. “The real hard part is that the days that would be most lucrative for extended hours are also the days that tend to be full during normal hours. I just don't see how I can work any more without a breakdown.”

Generations ago, veterinarians regularly were accessible 24/7. James Herriot, the best-known veterinarian of the 20th century thanks to his books about life as a country doctor in England, lived in the same place as his surgery. He was available to clients there whenever he was not out on a farm call. Herriot (a pseudonym for Dr. Alf Wight) began practicing in 1939.

By the end of the century, the situation was markedly different for the profession. Veterinary medicine was — and is — practiced predominantly in urban clinics with companion-animal patients. The proliferation of round-the-clock emergency veterinary hospitals enabled general practitioners to keep conventional business hours, for the most part. “Work-life balance” became a popular concept.

But with the housing and banking crash of 2008 precipitating fundamental shifts in the economy, the pendulum seems to be swinging toward longer hours.

This may be particularly true with larger practices and corporate-owned practices. Dr. Brian Holub, chief medical officer of VetCor, a company based in Hingham, Mass., said 10 of the chain’s 80 hospitals have opted to be open on Sundays.

“Extra hours are very popular,” Holub said. “Why would the veterinary industry be different from any other industry?”

Holub said VetCor clinics are not unique. “We are following the trend of our industry for Sunday hours,” he maintained. ... “I think vets are looking for opportunities now even though they maybe dismissed it a decade ago. They are not as complacent as they were 10 years ago. If customers want (extended hours), we should give it to them.”

Countryside Veterinary Hospital in Chelmsford, Mass., which Holub owned before selling to Vetcor this year and where he continues to practice, is open 73 hours a week. The shortest day is Sunday, at six hours. The longest is Monday, at 13 hours. The hospital is staffed by nine doctors.

A champion of accommodating clients’ desires, Holub noted that even relatively small clinics can manage to stay open seven days a week. For example, he said, in a practice with four doctors, each could work every other Saturday and one Sunday per month — a schedule that would still allow each practitioner some full weekends off.

That particular set-up wouldn’t be feasible, however, for the majority of American veterinary practices, which have fewer than three doctors, according to figures from the American Veterinary Medical Association.

Doctors working solo like McCain have an especially challenging puzzle.

McCain said in an interview that he takes a lot of time off to be with his family. He wants to be able to eat dinner with them regularly. It’s bad enough, he said, that his wife, a teacher, can take vacations only during the summer, which is his busiest season.

He once tried taking off one Saturday a month, but kept getting called in. "These days, people expect you to be available on their schedule," he said.

On the same VIN message board where McCain posted, other veterinarians noted a shift toward fewer morning appointments and more late-afternoon and evening appointments. Some surmised that clients are worried about keeping their jobs and therefore are less willing to take time out for a veterinary visit in the midst of their work day.

Dr. Thom Haig, a practice management consultant and practice owner in Powell, Tenn., said pressure on clinics to expand their hours isn’t new.

"I've been open seven days a week for years,” he told the VIN News Service. “In 1981 or 1982, my clinic was the first in Las Vegas to be open seven days a week. (At that time), it was the mobile vaccine clinics from California that we were worried about. I've always been a proponent of longer hours. More people are talking about it now because of the economy."

Haig believes that keeping classic business hours just doesn’t cut it in today’s busy society. "Being open 8 to 5 is asking for a disaster by not catering to a large segment of clientele. I understand the whole quality-of-life thing," he added, "but there's a large chunk of our population for which Saturday may be the only day they can go to the vet."

Extended hours may be difficult for one-doctor practices, but not impossible. Dr. Jodie Heekin, a solo practitioner in Taylor Mill, Ky., has figured out a system that works for her.

Most weekdays she is open until 6 p.m. but on Tuesdays, the clinic is open until 8 p.m. To compensate, Heekin doesn’t begin her work day until 2 p.m., although a staff member answers the clinic telephone in the morning. Heekin uses the time to take a yoga class.

On Saturdays, Heekin works from 8 a.m. to noon. Four or five times a month, she hires a relief veterinarian.

The extended hours are meant as a courtesy for clients whose pets need routine care and can’t come during conventional hours. Heekin said she is not trying to attract business that otherwise would go to an urgent-care clinic.

Heekin has found the weekend and evening hours to be popular, so much so that she’s contemplated bringing on a second doctor and adding more evening hours. But she’s not sure, since the popularity of after-hours visits seems seasonal.

“In the winter, on that Tuesday evening when it's dark early, I don't think people (will) break down the doors to come out for an evening appointment," Heekin said.

Another solo practitioner, Dr. Kristine Collins, employs staggered hours as a way of being available to clients a little earlier in the morning and a little later in the evening on alternating days.

Specifically, her clinic in Madison, Wis., opens at 7:30 a.m. on Mondays, Wednesdays and Fridays, closing at 6 p.m.

On Tuesdays and Thursdays, she’s open 8 a.m. to 7 p.m.

Saturdays are a half day, 8 a.m. to noon.

Collins established those hours when she opened the practice in March 2010. To extend her availability further, the doctor provides her cell phone number to clients. That way they can get her opinion on whether an after-hours problem can wait or they should take their pet to an emergency hospital.

Haig, the practice management consultant in Tennessee, owns a clinic staffed by three doctors: himself and two other veterinarians, each of whom works less than half-time. (As women with children, the associates prefer part-time schedules, Haig said.)

Among the three of them, the veterinarians are able to offer early and late weekday hours and Saturday hours. While Haig has been open on Sundays elsewhere, he said the demand in his community now doesn’t warrant it.

One advantage of keeping unconventional hours is that one’s days off can fall on unconventional days, Haig said: “(It) addresses quality of life in a different way. Having an entire weekday off can be amazing!”

Haig believes that, as with the rest of the country, the veterinary profession is going through what he calls a reality check. “It's not like there's this expanding pool of clients,” he said. “If anything it's shrinking, particularly if you are open 8 to 5 and won't take late calls. Expanded hours and/or novel services are two ways to address the problem.”

URL: //news.vin.com/doc/?id=5620942