Musings of a Veterinarian

Archive for February 20th, 2010

The Slow Death of the On-Call Small Animal General Practioner

February 20, 2010 By: Dr. K Category: Opinion

I hate on-call. I loathe, detest, and lament on-call. Every time I have that ringing beast in my possession my stomach churns when it sings it melodic tune. Most small animal general practitioners would agree on-call just plain stinks. Calls during dinner, holidays, and the middle of the night coupled with the constant threat of changing plans and interruptions give on-call its much deserved bad reputation. No one likes a leash. Shifting trends in veterinary medicine are making on-call obsolete, though its archaic status is not uniform across the veterinary world yet.

Many new practitioners look for positions with limited or no on-call. It’s very difficult to balance home and work when works comes home and calls you in the middle of the night. The new generation of veterinary medicine recognizes the need to better balance work and life which has culminated in less hours, more vacation, and flexible schedules. Requirements to see patients on emergency add long and irregular hours to an already stressful, tiring job.

A majority of the push to eliminate or limit on-call is probably traceable to the changing demographic and ideals of the newly female-dominated workforce. Women must exercise caution when meeting a client alone in the middle of the night for an emergency. Ketamine, among other drugs, has increasing street value and veterinary hospital robberies are not uncommon. Additionally, phone calls and travel throughout the night do not provide a family friendly schedule and mothers of young children may find it impossible. Employers have noticed and many have begun advertising positions with no on-call in the banner.

On-call is more than an inconvenience for veterinarians forced to hastily jump from bed.  If not executed properly, the on-call vet can find herself providing sub-par care overnight or on the weekend. On-call compensates for a closed office and closed offices rarely provide 24-hr care. While leaving an unsupervised but stable animal in the hospital overnight may be okay in some circumstances, sick and unstable animals typically require more extensive monitoring, medications, and treatments. I am in the camp of “If it’s sick enough for you to call me at 3am, it’s sick enough to warrant 24-hr care.”

If a veterinarian offers to see a pet at an owner’s regular hospital on an emergency basis, it’s important the owner know what types of services the vet can provide. Without support staff, usually simple tasks like drawing blood or taking an x-ray can prove challenging. Having owners help retrain their pets is dangerous and a potential legal nightmare.  Will the vet or a technician stay at the hospital that night to observe the animal? Most times the answer is no. Many pet owners may find more comprehensive care at an emergency hospital, and given the rising cost of GP’s emergency fees, the price difference probably won’t amount to much.

Many stalwart veterinarians insist they are providing a service to their clients. In rural areas where the nearest emergency center is miles away, I can see that point. But the majority of people live in or around cities where overnight and 24-hr hospitals abound. Those hospitals are equipped with multiple technicians, multiple veterinarians, and the ability to care for a sick pet quickly and efficiently. I challenge those stalwarts to examine if they are looking out for the animal’s best interest or their bottom line.