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ON-CALL SHARING The Ultimate “No Brainer”. Dr. Henry J. Ceelen Grenville-Dundas Veterinary Clinic Kemptville, Ontario November 21, 2008. Who is Involved?. Prescott Animal Hospital And Grenville-Dundas Veterinary Clinic
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ON-CALL SHARINGThe Ultimate “No Brainer” Dr. Henry J. Ceelen Grenville-Dundas Veterinary Clinic Kemptville, Ontario November 21, 2008
Who is Involved? Prescott Animal Hospital And Grenville-Dundas Veterinary Clinic The practices are in close proximity (20 minutes drive between clinics), and the clientele intersect a great deal. Therefore, SA clients are not burdened with a much longer drive, and the LA vets would need to cover a modestly increased emergency area (response times not significantly greater)
How It all Got Started “Necessity is the Mother of Invention” and/or “There is a silver lining on any dark cloud” Concurrently, PAH had a senior veterinarian that developed incapacitating, non-responsive back problems that became sufficiently severe to require sudden retirement from practice; and GDVC had an associate veterinarian that left the practice to follow a spouse who was pursuing career advancement When: January 1, 2000
Similarities Mixed animal practices Style of medicine and service Fee schedules Quality and skill set of veterinarians Practice philosophy
Differences PAH: All three vets were mixed animal LA: larger equine proportion GDVC: 2 SA vets; 2 LA vets LA: greater bovine proportion
Consequences PAH; From 3 veterinarians to 2 GDVC: LA: 2 veterinarians to 1 I was not looking forward to getting through the busiest time of the year alone (I had done it before). Was able to get locum help for 1-2 days per week (most weeks), with no on-call help. PAH’s appetite for a worse on-call schedule was equally intolerable
How It Works - Schedules On-call is split equally between practices: -every 2nd weekend (Friday 5:30 pm to Monday 6:00 am) -PAH works every Monday & Wednesday night; and GDVC covers every Tuesday & Thursday night (5:30 pm – 6:00 am) -practice that works weekend covers Friday night -Statutory holiday schedules worked out 1-2 months in advance
Schedules Office hours are standardized: Both practices open their offices at 8:00 am and close at 5:30 pm (Monday –Friday) And Are open from 8:30 –4:00 pm on Saturdays If a call comes in between 6:00 am and 8:00 am, the on-call vet contacts the “clients” vet to inform him/her of the emergency call
Billing 1. The after-hours fee schedules (including drug fees) are standardized 2. Each practice bills their own clients. 3. Invoices and health records pertaining to any call are to be submitted to the client’s practice within one working day 4. At the end of each month, each practice invoices the other for any LA calls performed on behalf of the other practice ((ensures that you get paid (in full) in a timely fashion))
Billing All SA calls are to be billed and collected in full at the time of the appointment by the practice that performs the service (no credit) “No service” and “cash only” client lists are shared between the practices
Positive Developments • Stronger relationship -improved collegiality -improved cooperation -eliminated competitiveness -enhanced learning (larger pool of vets to act as resources) -share knowledge
Positive Developments • Improved fees -fees have increased more dramatically and faster than previously -after-hours fees are now substantially higher than the OVMA Fee Schedule
Positive Developments • Much easier to attract and retain new associates - the on-call schedule primary reason (I am positive that our present roster of veterinary associates would have left our practice (or would never had come) had we had the same on-call schedule that was in place before the On-call sharing arrangement – essentially a 1 in 2 schedule)
Biggest Risk May lead to a MERGER of the practices