On many occasions I have been an outspoken critic of the way that “big business” has at times sneakily pushed its way into the world of veterinary practice. There have, as one would expect, been several changes over the past twenty five years, and not all of them have resulted in benefits and improvements in the standard of practice and quality of service provided to our patients and their owners.

 I have been particularly worried by the increasingly large insurance driven referral culture that has effectively turned many formerly routine first opinion procedures into procedures requiring referral. This has effectively, in many instances, prohibited or barred non-insured patients from surgical solutions that in years gone by would have been available to them. The referral culture has also driven up the cost of these procedures exponentially. Part of this has been a result of the introduction of a creature known as the practice manager. This ultra-conservative guardian of the purse strings, being appointed by its corporate masters to oversee the activities of veterinary staff, would effectively replace the old practice partner who would traditionally have passed on his surgical skills to the newer graduates within the practice framework. Without that partner’s guidance and experience, those new graduates are often left floundering and forced to refer cases or euthanase them when funds aren’t available for referral. Corporate practices have consistently failed to realise that a bean-counter has no place in an operating theatre.

Another concern has been the growth of the emergency service provider. In around the year 2000, a corporation started to offer to take our out of hours work away (at a price!). It was marketed as a superior service manned by A&E Specialist vets (which didn’t really exist) because suddenly, after a full days work, we were all far too tired and incompetent to carry on seeing emergencies out of hours, as we’ done for the previous years. Willow Veterinary Clinic has always provided, and will continue to provide, a 24 hour service at the usual point of contact for its clients. We feel that client and their pets should be treated by their usual vets with access to the patient’s clinical records at their usual point of contact. We are able to see out patients out of hours and treat them as required when required in a modern well equipped environment, by vets who are experienced in emergency work AND normal day to day practice protocols. Without corporate involvement, the cost of supplying these services  to the client is considerably cheaper. Corporate control of emergency services has on several occasions created welfare issues  as clients without insurance are unable to afford treatment.

Ironically, the corporate emergency service providers often employ vets from their donor practices to work night shifts, moonlighting as locums - in other words, relying on those very jaded, tired intervals their advertising material was criticising as being incapable and careless, but dumping the work of many practices upon them rather than just the one practice they’d worked for in the day.

 In 1985 when I became a veterinarian, out of hours work was essentially part of the job; it was assumed that the provision of out of hours emergency services after a day of work was part of the way of life for a vet. I am left questioning the motives and motivation of some of the young people coming into our profession. One of the first questions asked at interviews is about the use of emergency service providers. This immediately makes me question the nature of that individuals enthusiasm and commitment to the practice and the patients.  It has never been, and nor should it ever be, that to be a vet is just a job. With so many people coming into the profession without sufficient motivation, it is not surprising that they do not stay in the profession for very long. This type of individual will not be employed by the Willow Veterinary Clinic while I am in charge.

 If you are over the age of 35, and my suspicions are correct, then you remember your old vets seeing the same patients and people all the time. He knew you and your pet by name, and you liked him. You could pop in and ask for a bit of advice on a lump on your dog without needing a second mortgage. Then a few years ago, something changed. Difficult to put your finger on it exactly, the vet was gone as were all the other staff you recognised and every time you went to the practice different staff were there. People started to try to sell you a VIP plan for check ups, masquerading as some kind of insurance plan that isn’t an insurance plan at all, just what your old vet used to do but paid in advance by direct debit each month.  Staff started to ask if Max was insured, and gave you leaflets and vouchers for free month of insurance every time you went through the door. His teeth and his weight were discussed extensively. Then late one night, Max badly cut his foot, and blood was everywhere. You rang the vets, but they were shut, and the answer phone directed you to an emergency centre 12 miles away. Tricky, you’re low on petrol and the garage is now shut. The emergency vets inform you that the appointment costs £120, and treatment is likely to be in the region of more than a few hundred pounds in all, and why didn’t you have an insurance policy? You wrap Max’s foot up for a while, and luckily it stops bleeding. The next morning you go to your own practice and everyone apologises, tutting about the evil greedy emergency service providers, but at 6pm the next evening the calls are redirected there again.

This is what happens when corporate practices take over - if you don’t like it, don’t use them!

CDC.