Photo by Dr. Sue Rancurello
High demand for veterinary services is leaving practitioners scarce on time. Describing the day she euthanized her dog, Noah, Dr. Sue Rancurello said, "While I had one client waiting to see me, another waiting out in their vehicle, and another on hold on the phone, I had to quietly say good-bye to my own pet in a back room of our clinic, quickly wipe away my tears, put on a smile and walk in to see the waiting appointment."
Oct. 1 was an exceptionally hard day for Dr. Sue Rancurello.
The owner of Dr. Sue's Animal Clinic was nonstop busy, a trend that started in May and intensified since. Clients at her solo practice in Bellbrook, Ohio, were waiting, socially distanced, in the parking lot; others wanted to speak with her on the phone.
Somewhere in the mix, Rancurello needed to squeeze in euthanizing her own dog, Noah, an 18-year-old Maltese, who had been uncharacteristically subdued recently and then collapsed.
So when Rancurello read an opinion piece titled My Dog Broke His Leg by someone vexed that he wasn't given more personal attention while seeking urgent care for his pet, she hit an emotional wall. And the fact that the article author is a veterinary practice consultant felt like too much.
"I am angry — no, make that furious — that someone who professes to understand the profession so well can sit on his high horse and tell us how we are failing and how we should be doing better," Rancurello wrote in a rebuttal published by the same publication, Today's Veterinary Business. "Come sit in my clinic trying to field the 60-plus phone calls I get in a few-hour time frame, mostly from people who want to speak to me directly or be seen today, and then tell me as I am walking out the door at 10 p.m. every night that I need to be 'handling' my clients better."
Rancurello wasn't the only veterinarian who reacted with fury. The piece by Mark Opperman, founder of Veterinary Management Consultation Inc., has generated more than 100 comments, the majority calling his attitude entitled, arrogant and out of touch. Comments rolled in as recently as a week ago, following the article publication in October.
A discussion of the article also broke out and is continuing on message boards of the Veterinary Information Network, an online community for the profession and parent of the VIN News Service. While a few veterinarians posted support for Opperman's view, most were insulted. Some said the value of any constructive criticism he intended to provide was negated by how he delivered it.
"I wish I never saw this article," lamented Dr. Mary Schwacha, a practice owner in Wexford, Pennsylvania. "I know I'm letting my clients down. I really didn't need this person pointing it out in such a callous way."
Opperman, who lives in Colorado, recounted in the article what happened when his young Great Dane broke a leg while playing in the yard one afternoon.
"I called the veterinary practice where we have been a client for over a year. Now, bear in mind that we have five cats and two dogs, all covered by pet health insurance, and we spare no expense in caring for our animals," he wrote. "Safe to say we are a rather good and substantial client."
So he "was not happy" to learn that the practice had no openings available and he would need to go to the 24-hour emergency hospital in town. "I thought I had built a relationship with my veterinarian," Opperman said. "... yet I was told (somewhat rudely) that Ben could not be seen that day because they were too busy."
He went on to report that the emergency hospital "provided excellent medical care to Ben," but could have communicated better. In keeping with standard veterinary clinic protocols during the ongoing COVID-19 pandemic, Opperman was asked to wait in the parking lot while Ben was evaluated and treated.
"I never laid eyes on the veterinarian," he wrote. "I spoke to her by phone three times. She recognized my name and asked if I was a veterinary consultant, but not once did she come outside. The overall wait time wasn't excessive, but the hospital team could have been more accurate with time estimates. I would have appreciated being called more often to hear about Ben's progress."
Opperman recommends that practices enable clients to be virtually present for exams by audio connection or via platforms such as Zoom or FaceTime.
Some do that, as reported recently by the Washington Post. But not all clinics have the necessary tools and infrastructure. One veterinarian commenting on the Opperman article wrote: "While I love the idea of video or audio visits, my clinic legitimately was not equipped to handle either form. We had three phone lines, and running two doctors a day and still needing to take medication refill requests and book appointments, it was not feasible. Nor did we have clinic phones that could be taken into rooms. ... We recently got a new phone system to help. But we don't have the means to accommodate video."
Some noted that adopting new technology on the fly could end up worsening the schedule crunch.
Dr. Joe Frost, a practitioner in Loves Park, Illinois, quipped on a VIN message board: "I think the challenge is, how do we communicate more without spending any time doing it? (If only there was a practice management guru who could help us with this LOL)."
Dr. Robert Maruna, a practitioner in Bakersfield, California, said he tried to be receptive to Opperman's message but was struck by the author's apparent lack of awareness of the challenges of veterinary practice mid-pandemic.
"And as I read his article, I try to do so with charity," Maruna wrote on VIN. "I understand he is trying to help us see the struggles of the pandemic environment and the run on veterinary medical care from the perspective of the client. It can be a difficult perspective for us to remember or even realize.
"At the same time, it would appear clear that he has no idea what's going on in the back right now. I work at a 24h hospital and most days where I work, he would have had a longer wait time and less communication from the Dr., more with the staff. We are not lounging in the back, sipping tea and talking of the current political climate. We are trying to keep our nostrils above water in the face of a wave of sick and suffering family pets."
The pandemic has driven multiple trends contributing to a surge in demand for veterinary care. Why has my veterinarian been so busy?, a video by VINx, a client-communication service of VIN, points to these factors: increased pet adoptions; people spending more time at home with pets, resulting in more chances to detect problems; and the need for routine veterinary care that was postponed earlier in the pandemic.
Meanwhile, the video explains, it takes longer for veterinarians to deliver care in socially distanced fashion. On top of communication challenges and a big increase in telephone time, practices often are short-staffed due to employees' own challenges with COVID-19, such child care or illness in their households.
"This is the most stressful time for my staff in my 30-year career," Dr. Rex Riggs, a clinic owner in Powell, Ohio, wrote on VIN.
Elaborating by email, Riggs told the VIN News Service, "It is just incredibly busy. To start, we have had hundreds of new puppies; people figured since everyone is home, it would be a good time to raise a puppy."
And while people are home, "they are more observant of their pets and have noticed more illness and injuries," he said. "I also think with the increase in activity of people walking and playing with their dogs, it has led to more injuries."
He described how keeping owners at a distance during appointments is less efficient. "Our staff is working so hard moving dogs and cats back and forth" from the curbside, he said, and answering "the never-ending ringing of the phones."
At the same time, Riggs added, "We all are very appreciative to be working."
In an interview, Opperman said he wasn't focused on the plight of veterinary staffs when he wrote the article; his intent was to convey the view of a pet owner. The backlash from veterinarians took him by surprise.
"I've gotten emails, cards, really nasty letters," he said. "I really don't understand why people are so hostile and acting the way they are. It blows me away."
He added, "I know that practices are busy, it is stressful and veterinary teams are working very hard, no question. But ... we can't ignore the fact that the client is having a very difficult experience, as well."
Asked if he regrets how he couched his message, Opperman said, "Well, certainly with the knowledge of what has happened, I would have written it differently. I would have brought to light the side of the practice and certainly acknowledged what they're going through. I think I did, but to a minimal extent. I could have done it to a greater extent."
Still, Opperman said his essential point is unchanged. Noting that he has worked with the veterinary profession for more than 37 years, he said, "There are ways to be efficient and productive, and being open to doing that rather than [saying], 'Oh, woe is me,' can make a difference." He added, "Seeing what you can do to improve upon the client experience is important now as well as in the future."
Rancurello, the veterinarian who wrote the rebuttal to Opperman's piece, told VIN News that veterinarians are just as frustrated as clients when their clinic can't accommodate all requests for appointments.
Directing her comments to owners, she said by email: "Our priority is, first and foremost, providing excellent care to your pet. We are working as hard as we can to do that, often with little time to do 'small' things like grab a meal, take a bathroom break, or just take a moment to breathe. We, too, have families and pets and personal obligations that we struggle to 'fit in' when our days at work often run 12 to 15 hours or longer.
"Our profession is one that consistently puts our clients and their pets above all else," Rancurello continued. "We are physically, emotionally, and mentally exhausted as a result. Please be patient and understanding if your veterinarian cannot see you right away, or chooses, because of concern for your pet’s well being, to refer you elsewhere. If you are unable to speak with your veterinarian and instead are relayed messages through technicians or front office staff, rest assured that information is ultimately coming directly from your vet, and should be treated as such.
"If you ... are frustrated that the veterinarians there are unable to pop out to the parking lot to speak with you directly or maintain frequent phone contact with you, it is because to do so takes them away from actually providing the care to animals in urgent need, which may include your own pet.
She concluded: "We are doing the best that we can to continue to provide the quality care that you have grown accustomed to, fitting in as many pets in need that we can every single day, until we physically can see no more. We need your patience, your understanding and your trust that we are doing everything we possibly can for you and your pet, in as timely a manner as humanly possible."
VIN News Service commentaries are opinion pieces presenting insights, personal experiences and/or perspectives on topical issues by members of the veterinary community. To submit a commentary for consideration, email firstname.lastname@example.org.