Farm animal and equine out-of-hours calls: the challenge or the nightmare - Veterinary Practice
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Farm animal and equine out-of-hours calls: the challenge or the nightmare

IN my experience the majority of young graduates are highly motivated. They all are very wellinformed but it is accepted by the profession and new graduates that they all require additional knowledge beyond their learning at undergraduate level

IN my experience the majority of young graduates are highly motivated. They all are very wellinformed but it is accepted by the profession and new graduates that they all require additional knowledge beyond their learning at undergraduate level.

Evidence of this additional learning should be recorded when a first-year graduate completes his or her Professional Development Phase (PDP). This is no easy task.

Graduates in mixed practice within their first year have to sign that they have attended a foaling. I was sent to a pony mare which was foaling when I had only been qualified a month in 1966. I am not sure many new graduates nowadays would be very happy with such a call, and rightly so.

So much is expected of the modern graduate. They have so much more to cover in their course. How can they cope?

It is not fair on them and it certainly is not in the best interest of the mare and foal. Certainly, EMS is a very important part of their curriculum. However, as all the recent correspondence has indicated, this is a very hit and miss affair.

What is the answer?

A longer veterinary course might be one answer. I do not think this is the right path. Veterinary students are already burdened with horrendous debt when they qualify. It is not right to make them borrow more and give them less time in their working lifetimes to earn enough to pay it back.

Anyhow, would a longer course give veterinary graduates more hands-on experience? I doubt it. I think the veterinary schools are doing a marvellous job trying to give the modern veterinary student practical experience. However, it is a serious uphill struggle with the massive increase in class size. There are more in single rotation groups than we had at Bristol in 1966, with only 19 of us.

I am particularly impressed with the way modern graduates tackle colic call-outs. Their clinical acumen is extremely high. I think the veterinary schools should be congratulated.

I am sure the equine referral centres are grateful for the early referral of surgical cases. I also imagine they are grateful for the excellent histories, which are phoned through. What gives me nightmares is the thought of a new graduate in the middle of the night tackling a mare foaling, owned by a client who expects Newmarket experience and high-speed attendance but lives in North Norfolk.

Even if we slept in our vans we could not get out to the majority of our clients within 30 minutes. Such a delay, although inevitable, does not get the call off to a good start.

Modern graduates want to provide an out-of-hours service for large animals, both farm and equine, but they need the right circumstances.

Naturally, they require a good vehicle and all the equipment required. I put all in bold to stress to practice owners that it is not fair, sensible or even welfare-friendly to expect the veterinary surgeon on call to go to the practice in the middle of the night to collect the relevant equipment.

The modern graduate requires two other vital things so that he or she can meet the challenges of out-of-hours calls. These are back-up and time to recover.

I can feel all the practice principals putting this article in the bin at this stage. I am sure their argument will be that the financial figures will not add up. They may well be right. Somehow, however, they have got to solve this problem. The labour force of willing volunteers is rapidly disappearing. We are all well aware of the difficulties faced in remote areas. Is North Norfolk a remote area?

Has Vets Now got the right idea?

Twenty years ago, not many small animal practitioners would have imagined they could shut up shop at eight o’clock in the evening and then open up again at eight o’clock in the morning. Now such practices are commonplace and readily welcomed not only by the practitioners but also by the pet owners who value having a fully awake, fully trained clinician ready to help them in an emergency.

I know they would rather see the vet they know and love but equally the majority of clients realise that this is just not practical. Practising veterinary surgeons have not only got to get the right amount of sleep to function properly but also they expect and deserve adequate time off.

In fact, my biggest nightmare is not the mare foaling in the middle of the night but is the thought of me causing a major traffic accident the following day from lack of sleep. How could a “Vets Now” scheme be made to work in large animal practice?

For a start the out-of-hours provider would have to be totally independent from any existing practice. Even with veterinary surgeons being totally ethical, the dangers of poaching clients would be too great if one practice volunteered to do all the large animal out of hours.

The first problem would be the distances involved. Large animal practitioners would have to be stationed or rather have their houses very strategically placed. There would have to be one every 10 miles or so. Therefore, what would be the advantage over the existing situation?

The first advantage would be that each practitioner would be fully trained and equipped. The second would be that there would have to be adequate back-up built into the arrangement. The third advantage would be that there would have to be proper time off.

The clinicians who are working nights would have to have the days off. There would have to be adequate numbers of veterinary surgeons so that they would receive adequate holidays and days off for having worked weekends.

How would such a scheme mesh in with the daytime practices?

I can’t really see this would be a problem. Handing over colic cases, wounds and parturition cases would just require a phone call or a fax to the client’s practice. Accounts would be straight-forward with the out-of-hours practice recording all the clinical data.

The parent practice would then have its own scale of fees and would collect the money. Obviously, every client would have to be registered with a parent practice. They should be anyhow.

How would the out-of-hours practice be financed?

This is not so easy. I suppose each parent practice would have to pay in to the out-of-hours practice on a set scale of fees depending on the size of the practice and the number of hours it required the out-of-hours practice to work.

It is not going to be cheap. However, why should it be cheap? The client is getting a highly trained professional out of normal working hours. He must be expected to pay. The government is quite prepared to pay GP doctors heavily to work out of hours.

I know some farm practices do not charge any more for genuine out-of-hours calls, because they say that it is not the farmer’s fault that a cow is calving in the middle of the night. However, I do not think such an argument stands up in modern times. If a farmer is behind on his arable work and asks a contractor in, who has to work out of hours, he has to pay extra.

So where is the catch to having a dedicated large animal out-of-hours service?

The main problem is the large, aggressive large animal practices which are happy to provide a service mainly to big farms in convenient
locations but are not prepared to provide service to smaller farms or horse owners. These clients at the present rely on the smaller mixed practices. How long are these practices going to be mixed? How long is the RCVS going to insist that practices provide a 24/7 service?

So what is going to happen?

There certainly is not a very clear path ahead. I am sure the European Working Hours Directive is going to be implemented at some stage. I am sure out-of-hours service will become very variable, depending on the area of the UK being considered. The best service will be in the areas of highest stock density.

The worst service may well not be in remote areas but in heavily built-up areas. I imagine a horse owner within the M25 will get no quicker service than our clients in North Norfolk.

In conclusion

If young, keen, dedicated graduates are not treated properly they will become totally disillusioned and give up large animal and equine work. This will be a very great pity. The profession will lose its appeal to the public.

It will also lose its appeal to the young people at school who are considering a veterinary career. There is no easy answer.

The problem, however, is certainly not going to disappear. Hiding our heads in the sand will not solve anything. In the meantime, I will keep getting up in the middle of the night!

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