The Slow Death of the On-Call Small Animal General Practioner
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.
I can’t imagine having “on-call” be a part of my job (admittedly, web design doesn’t have many emergencies!)
We live in a small town on the Oregon coast. There is only one vet office in our town, and we actually drive to another town for our vet care. I know that our vet offers on-call service, which they share with another vet office in the town. I appreciate that they have the service – but I would definitely hesitate to call, unless it was a dire emergency! The closest 24-hour emergency clinic is more than two hours away though, so on-call is pretty needed in an area like ours!
1I did emergency ONLY as a relief doc during my internship on that rare day off to supplement my measly salary as an intern so I could pay the rent and on those forced overnight shifts (but then again we got to go HOME during the day to sleep/recharge). Some vets still do it in very rural areas and some clients find it endearing but I myself want BOTH my vets AND my MD’s WELL rested so they can clearly diagnose and perform surgery as needed. I also want them happy and fulfilled in their careers AND their personal lives so they don’t burn out and quit to go do something else. A 10 hour day is ENOUGH and then our brain starts to make little mistakes–why put an animal at risk? And as you mentioned, then a tech HAS to be on call and then if its TRULY an emergency it will be turfed to ER for overnight care and monitoring with docs/techs that work the nights shift and are refreshed.
2Tammy: I admit that on-call is a necessary evil in rural America. But, there was an emergency clinic even where I grew up in the mountains of Pennsylvania. They are popping up everywhere. And my husband is IT. He does software design, primarily. There was a job he had a few years ago that required him to be availalbe 24/7 if the website or server went down. Yuck.
VetlovingPetsHB: “some clients find it endearing but I myself want BOTH my vets AND my MD’s WELL rested so they can clearly diagnose and perform surgery as needed”
3Preach it, sister. I wake up on the cranky side, especially at 2am. After a 10-hour workday, I need decompression and brain dump. Call me in the middle of night, I can tell you I’m not crisp.
I’m very relieved to see I’m not the only one who resents on-call so much. When I’m on call I always have the option of calling our tech to assist me, but some of these animals need close minding after the procedure/tests are done. If I don’t go home and get some rest, I’m scrambling to focus and do no harm the next day. If I do go home and get some rest, I feel I’m providing a half-#$$ed service and that eats away at me. Taking the animal home wouldn’t change that (I’m only 5 minutes’ walk from work) – I’m still working if it needs attention. On-call is one of the reasons I’m leaving my present job.
The cat-exclusive clinic where I start in June has sky-high standards, a much smaller client base, with two emergency hospitals in the vicinity. The veterinarian welcomes after-hours calls from long-established clients with seriously or interestingly ill cats, and returns these calls till 10 pm. This I do not mind at all, and would be happy to provide this service. I’s very different from being officially on duty, awakened at night and scrambling to understand what’s going on with an animal I’ve never seen before. On the other hand, this veterinarian (my prospective boss) has chewed out one of the said emergency clinics for providing sub-standard care to one of her patients who was seen there on emergency at night. So an animal is not necessarily worse off in our weary hands than it would be in a 24-hour facility; but we’re the ones who are worse off
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