Urgent Care as a business model?

[PippyPony]

Curious to hear SDNers' thoughts on the concept of urgent care in a veterinary context.

For some background...we've been experiencing extremely long wait times in the ERs around where I live, and not all of the cases who come in are true emergencies -- a portion of them (although tbh I'm not sure how many exactly) would fall within a category of "urgent but not critical" if we were talking human medicine. It's also sometimes tough to get an appointment at a GP around here, especially as a new patient.

I poked around on VIN for related discussions, and it seems like most people strongly dislike a walk-in model vs scheduled appointments. But... it also looks as though the majority of the doctors expressing dislike on those threads also worked at clinics that saw walk-ins on top of scheduled appointments -- instead of being a dedicated urgent care-type facility. (Or they were doing surgery/other time-consuming treatments that I'd consider beyond the scope of urgent care).

A few people also said these places are not profitable and are a nightmare to staff...but I guess I am wondering if that is true across the board, was true 10 years ago but not anymore, etc.

For more background... I started wondering about this because I am personally a big fan of convenience-driven models like ZocDoc for my own health stuff, and being a busy vet student with a highly irregular schedule means there are some times when I cannot schedule an appointment way in advance (or it's just a lot more convenient to go get a flu shot at Walgreens on the fly, for example). So, just kinda wondering why this doesn't really exist in our field.

Thoughts? Opinions?

...Obviously not an urgent question

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[MOOSEygoosey]

Curious to hear SDNers' thoughts on the concept of urgent care in a veterinary context.

For some background...we've been experiencing extremely long wait times in the ERs around where I live, and not all of the cases who come in are true emergencies -- a portion of them (although tbh I'm not sure how many exactly) would fall within a category of "urgent but not critical" if we were talking human medicine. It's also sometimes tough to get an appointment at a GP around here, especially as a new patient.

I poked around on VIN for related discussions, and it seems like most people strongly dislike a walk-in model vs scheduled appointments. But... it also looks as though the majority of the doctors expressing dislike on those threads also worked at clinics that saw walk-ins on top of scheduled appointments -- instead of being a dedicated urgent care-type facility. (Or they were doing surgery/other time-consuming treatments that I'd consider beyond the scope of urgent care).

A few people also said these places are not profitable and are a nightmare to staff...but I guess I am wondering if that is true across the board, was true 10 years ago but not anymore, etc.

For more background... I started wondering about this because I am personally a big fan of convenience-driven models like ZocDoc for my own health stuff, and being a busy vet student with a highly irregular schedule means there are some times when I cannot schedule an appointment way in advance (or it's just a lot more convenient to go get a flu shot at Walgreens on the fly, for example). So, just kinda wondering why this doesn't really exist in our field.

Thoughts? Opinions?

...Obviously not an urgent question

So, are you talking about having GP's that allow emergency walk-ins vs. emergency/specialty only hospitals?

 

[PippyPony]

So, are you talking about having GP's that allow emergency walk-ins vs. emergency/specialty only hospitals?

Basically, yeah.

I guess I am just curious as to why the fields have not split into servicing "critical and emergent" vs "emergent but not critical" in veterinary medicine the way they have in human med.

I'm assuming there is a reason and I just don't know because I'm not out there in practice.

 

[PippyPony]

Examples:
- dog with diarrhea who is otherwise acting fine
- dogs with hot spots or ear infections
- owner came home from work and noticed cat had puked a couple times but cat appears BAR & wants food
- cat with a UTI

etc etc.

At the clinic where I used to work, we'd try to squeeze these patients in, but it was sometimes really tough on top of being fully booked, and led to a lot of stress on our associates and front desk staff. If we were overbooked, we'd refer them to the local ER, which a lot of people declined due to wait times and cost. Net result --> those animals had to wait longer to receive care.

(To clarify, these weren't the cases we would have sent to the ER straight away regardless of our schedule, e.g. dystocias, GDVs, BDLD attacks, DKA cats, etc.)

 

[JaynaAli]

In the area I did my internship there was a dedicated pet urgent care in addition to the four full fledged ERs within a 20-30 mile radius (one university, three private specialty hospitals). It was open from 5 PM to 11 PM and they didn't do overnight hospitalization (that was referred to the full-fledged ER). They occupied the same building as a GP that closed at 5,sorta like an ER is sometimes "separate" from the specialty hospital team there in the daytime. I checked their website and they don't do vaccines and wellness appointments, but it seems like they'd see the cases in your examples. I can't say much about it's success or finances and stuff other than those general facts though since we were a sorta-competitor and didn't refer anything there, but I think they did okay. They still seem to be in business 4 years later at least.

 

[KCgophervet]

The UMN teaching hospital was just starting up an urgent care center when I was in 4th year run mostly by the primary care peeps. Essentially what you're talking about with taking walk in urgent but not emergent cases. Was a cool idea and I assume they're still doing it. It's probably on their website

 

[MOOSEygoosey]

Examples:
- dog with diarrhea who is otherwise acting fine
- dogs with hot spots or ear infections
- owner came home from work and noticed cat had puked a couple times but cat appears BAR & wants food
- cat with a UTI

etc etc.

At the clinic where I used to work, we'd try to squeeze these patients in, but it was sometimes really tough on top of being fully booked, and led to a lot of stress on our associates. If we were overbooked, we'd refer them to the local ER, which a lot of people declined due to wait times and cost. Net result --> those animals had to wait longer to receive care.

(To clarify, these weren't the cases we would have sent to the ER straight away regardless of our schedule, e.g. dystocias, GDVs, BDLD attacks, DKA cats, etc.)

We definitely get those cases in the ER all the time! We love the people who call in and want call-backs! That way we can get a basic history and give them our veterinary advice (whether we recommend they be seen or not and if they need to be seen, does it have to be now, in the morning, or monitor etc.). Of course we always say if anything changes (i.e. gets worse, new signs) to call us back. We recommend they seek veterinary attention at their nearest vet not necessarily us. So we do absolutely get plenty of walk-ins but we also get a lot of people that call in, give us ETAs, etc. Also, if we tell someone that they can monitor we also qualify that, "We're here though if you'd like to come in." Since we're a 24/7 emergency room (in addition to the normal specialties that have normal hours lol).

So, to continue, when an animal gets here (whether they've called or not), we triage (auscult heart, lungs, feel pulses, check MM and CRT). If they're stable we tell the owner's that and have the animal stay up front until a student is ready to collect a full history from the owners and do a PE. It doesn't matter who came in what order, we treat the most unstable patients first! If we are slammed in the back and a patient comes in that's stable, we tell owners that there is going to be a wait. We definitely get owners who just up and leave because they've been waiting for too long. What I like to tell owners who have stable patients (and this definitely seems to assuage their anger) is that, "This is a good thing! You don't want to be the owner who I feel the need to run your pet to the back! Be grateful that your animal can stay with you "

Overall, I feel like our system works well for what it is! Nobody has unlimited staff so you can only take so many critical patients at a time. If people come in with non-critical cases, I get there's going to be a wait (and believe me I know getting a GP appointment for something that's not an annual exam when you have something that needs to be dealt with more urgently is a pain!).

I think some clinics who are GP should consider having some 15-20 minute "emergency appointments" a day. Maybe extend the hours of the day by 30 minutes so you can have 1 or 2 emergency appointment slots open. So you can schedule your normal appts and leave those spots open in case someone has an emergent issue

 

[DVMDream]

At least where I was at, it would be impossible to staff an urgent care type of clinic. The GP and ER clinics are struggling heavily to be fully staffed currently and based on what I have seen in some online veterinary threads/forums, this isn't unique to where I was located. A lot of areas are having an extremely difficult time with getting veterinarians and support staff for already established GP and ER places.

The other reason that I personally don't think it will work is for the same reason we currently have with things. People do NOT understand the difference between normal "wellness" "urgent care" and "emergency" when it comes to pets. They just don't. There are two camps: Holy **** this is horrid, my pet is dying now, see it now (the pet is actually fine) and it is just a minor scratch (the leg is falling off).

People can not assess what type of care their pet actually needs and they become irate when they show up at the wrong place and can't be helped there. It is already difficult enough to get them to go to ER for an actual ER.

I think it is something that would be nice and have definitely thought of it myself, but I just think there are too many variables that may make it difficult for it to actually work out.

Plus, how much of a "walk in" basis is this going to be? How long will it be open? And at what time/number of patients are you going to cut it off at? There are some clinics that are walk in basis only and that can be a miserable model if you don't have some good ground rules in place about "we cut off seeing patients at x time or when we hit y number."

 

[DVMDream]

I think some clinics who are GP should consider having some 15-20 minute "emergency appointments" a day. Maybe extend the hours of the day by 30 minutes so you can have 1 or 2 emergency appointment slots open. So you can schedule your normal appts and leave those spots open in case someone has an emergent issue

99% of the issues mentioned above don't need to be squeezed into a busy GP clinic either. That is the problem. Everyone thinks Fluffy is going to die with his one episode of diarrhea, he will be fine until tomorrow. GP clinics do not need to extend their hours, seriously not a good thing to recommend to a GP clinician who is likely already triple booked and will be sitting around for hours after their shift just to type up records or call clients with blood work results.

I have worked in some clinics that have "same day, sick" appointments built into the schedule, usually 3 or 4 but they fill fast.

An "emergency appointment" should NEVER be 15-20 minutes long, though you will see why once you are actually in the veterinarian shoes. You can't get through that type of appointment in that amount of time and any clinic or person that thinks you can, you should run away from. Like not kidding. That frame of mind is what will burn you out. These need to be a minimum of 30 minute appointments.

And don't ever be filling up the last few appointments of any day with "same day, ER issue" unless you really like staying at the clinic and never sleeping. I can't stand when reception puts in that vomiting for 4 weeks cat 30 minutes before close, guarantee I won't leave anywhere near the end of my shift. And yes, we should all be able to leave when our shift ends.

Fluffy's ear infection and skin allergies didn't appear overnight, these are chronic cases that owner's sit on for often days to weeks to months and I have even seen years and then suddenly it is an "emergency". It isn't and I won't short change another client or pet or my mental well-being to stick around to see your dog that you have had weeks to call and make an appointment for.

Cat's don't really get UTI's and male cats showing symptoms of UTI should be seen by an ER to be sure they are not blocked. (Female cats are a possible on this as well, they can get blocked but much less likely).

The couple time vomiting cat doesn't need to come in especially if still eating food and keeping it down. Can be monitored overnight and seen in AM. If continued retractable vomiting, can be seen in ER, not something that you send to a GP 30 minutes before they close because the possible causes of that are numerous and will require a full work up of labs, rads, +/- fast scan ultrasound (that a lot of GP's don't even have), and +/- hospitalization and a GP can't do 30 minutes before close.

Of course, this is all stuff you will get exposed to with time. You get used to what things are emergent need to be seen NOW and anything else can ideally wait until the following day or even 48 hours.

 

[PippyPony]

As an aside... I'm not asking about this cause I am particularly interested in pursuing this myself or anything. Seeing mild diarrhea and vomiting cases all day every day would actually be my nightmare because I sympathy-puke every time I see another creature do it. I guess I'd probably lose weight... but in like, the bad way.

i was just wondering why other people don't do it haha.

 

[PippyPony]

The other reason that I personally don't think it will work is for the same reason we currently have with things. People do NOT understand the difference between normal "wellness" "urgent care" and "emergency" when it comes to pets. They just don't. There are two camps: Holy **** this is horrid, my pet is dying now, see it now (the pet is actually fine) and it is just a minor scratch (the leg is falling off).

Huh. I didn't really think about this, but seeing it typed out, I can understand how it would be an issue. Just because we learn how to triage doesn't mean the clients do or even would care to haha.

 

[DVMDream]

As an aside... I'm not asking about this cause I am particularly interested in pursuing this myself or anything. Seeing mild diarrhea and vomiting cases all day every day would actually be my nightmare because I sympathy-puke every time I see another creature do it. I guess I'd probably lose weight... but in like, the bad way.

i was just wondering why other people don't do it haha.

I honestly just don't think there are enough vets and veterinary support staff to support having GP, urgent care and ER clinics.

 

[DVMDream]

Huh. I didn't really think about this, but seeing it typed out, I can understand how it would be an issue. Just because we learn how to triage doesn't mean the clients do or even would care to haha.

People can barely triage themselves. ERs are full of sniffly people around this time of year that have viruses....go the **** home, you are not dying.

 

[MOOSEygoosey]

99% of the issues mentioned above don't need to be squeezed into a busy GP clinic either. That is the problem. Everyone thinks Fluffy is going to die with his one episode of diarrhea, he will be fine until tomorrow. GP clinics do not need to extend their hours, seriously not a good thing to recommend to a GP clinician who is likely already triple booked and will be sitting around for hours after their shift just to type up records or call clients with blood work results.

I have worked in some clinics that have "same day, sick" appointments built into the schedule, usually 3 or 4 but they fill fast.

An "emergency appointment" should NEVER be 15-20 minutes long, though you will see why once you are actually in the veterinarian shoes. You can't get through that type of appointment in that amount of time and any clinic or person that thinks you can, you should run away from. Like not kidding. That frame of mind is what will burn you out. These need to be a minimum of 30 minute appointments.

And don't ever be filling up the last few appointments of any day with "same day, ER issue" unless you really like staying at the clinic and never sleeping. I can't stand when reception puts in that vomiting for 4 weeks cat 30 minutes before close, guarantee I won't leave anywhere near the end of my shift. And yes, we should all be able to leave when our shift ends.

Fluffy's ear infection and skin allergies didn't appear overnight, these are chronic cases that owner's sit on for often days to weeks to months and I have even seen years and then suddenly it is an "emergency". It isn't and I won't short change another client or pet or my mental well-being to stick around to see your dog that you have had weeks to call and make an appointment for.

Cat's don't really get UTI's and male cats showing symptoms of UTI should be seen by an ER to be sure they are not blocked. (Female cats are a possible on this as well, they can get blocked but much less likely).

The couple time vomiting cat doesn't need to come in especially if still eating food and keeping it down. Can be monitored overnight and seen in AM. If continued retractable vomiting, can be seen in ER, not something that you send to a GP 30 minutes before they close because the possible causes of that are numerous and will require a full work up of labs, rads, +/- fast scan ultrasound (that a lot of GP's don't even have), and +/- hospitalization and a GP can't do 30 minutes before close.

Of course, this is all stuff you will get exposed to with time. You get used to what things are emergent need to be seen NOW and anything else can ideally wait until the following day or even 48 hours.

I understand everything you're saying. I get that people get burnt out easily and that these issues don't need to get squeezed into a GP. I was merely offering a suggestion. Pips said that her patients won't wait at the ER or can't afford it. I never said they should be the last appt! That's ridiculous! I wouldn't want that in GP. I get it, I'm not a vet yet but I understand everything you're saying. That's why we encourage people who can monitor to do so! Because, yes you're triple booked but in the ER when you have multiple patients crashing, they get priority and everything else goes on the backburner (as it should!) so if a GP has to add 1 30 minute same-day appt to ensure their patient gets adequate veterinary care, then that's what needs to be done! The vet's wellbeing is of the utmost importance but so is the pet's (obviously when it's a legitimate issue, not an owner who is bringing in a cat that has been vomiting 1x/day for months and NOW it's a problem, if it's holding down food, drinking, u/d normally, it can wait for an appt unless it worsens).

 

[PippyPony]

I honestly just don't think there are enough vets and veterinary support staff to support having GP, urgent care and ER clinics.

True... This in particular is a big problem in our area right now. (Might be we also have a shortage of vets. I'm just acutely aware of the support staff shortage because I have a student tech job and get called in about 3x the amount of time I used to.)

 

[DVMDream]

I understand everything you're saying. I get that people get burnt out easily and that these issues don't need to get squeezed into a GP. I was merely offering a suggestion. Pips said that her patients won't wait at the ER or can't afford it. I never said they should be the last appt! That's ridiculous! I wouldn't want that in GP. I get it, I'm not a vet yet but I understand everything you're saying. That's why we encourage people who can monitor to do so! Because, yes you're triple booked but in the ER when you have multiple patients crashing, they get priority and everything else goes on the backburner (as it should!) so if a GP has to add 1 30 minute same-day appt to ensure their patient gets adequate veterinary care, then that's what needs to be done! The vet's wellbeing is of the utmost importance but so is the pet's (obviously when it's a legitimate issue, not an owner who is bringing in a cat that has been vomiting 1x/day for months and NOW it's a problem, if it's holding down food, drinking, u/d normally, it can wait for an appt unless it worsens).

I've worked both ER and GP, I get it. But GP is just ER with scheduled appointments tossed in. You're expected to be on time in GP. Imagine handling all the ER things which we do get on GP while also needing to keep a schedule. You've got crashing **** but you've also got to not keep Mrs Jones waiting, she's a great client and shouldn't be sitting around for hours. On ER you can tell them to sit down and shut up, the expectation is to wait. Then imagine someone who works in ER telling you that you should extend your business hours because the ER is seeing too many ear infections.

GP isn't controlling what shows up to ER. I've never recommended an ear infection or anything that can wait to go in. People just go.

 

[PippyPony]

Cat's don't really get UTI's

Spoiler: ...Oops

This is the part where I act embarrassed that I need to be reminded that my friends' old female cat with recurrent UTIs was not the norm. That darn cat messed me up in renal phys last year too

 

[DVMDream]

Spoiler: ...Oops

This is the part where I act embarrassed that I need to be reminded that my friends' old female cat with recurrent UTIs was not the norm. That darn cat messed me up in renal phys last year too

 

[PippyPony]

Of course, this is all stuff you will get exposed to with time. You get used to what things are emergent need to be seen NOW and anything else can ideally wait until the following day or even 48 hours.

Hopefully this is true, but this is also where I saw a struggle at my old job tbh. Sometimes we just didn't have the space to cram in a last minute appointment the next day...or the following day...or the following day...and at a certain point there starts to be a pressure overload stemming from both wanting to help the pet and not losing that client. Hard to tell a good client that you would love to help but can't see their dog who is smearing diarrhea all over their crate because you're already double or triple booked for the next 3 days. And that's when I saw those appointments get squeezed in anyway, which created the exact stressful "it's5pmbutcanyoumaybejustlook@Sparkyrealquick" situation you describe.

But I guess that all fits in with your point about the overall shortage of vets & staff vs some kind of issue with the partitioning of available labor.

 

[PippyPony]

Can always tell when I have tests coming up cause I get real interested in things that have no immediate relevance to the notes in front of my face lol

This morning I spent ~45 minutes chatting about stocking densities and impact on net production in dairy barns; next test is on tarantulas.

This kind of topic is always interesting to me though (and not just from a procrastination standpoint ). Thank you for the discussion!

 

[DVMDream]

Hopefully this is true, but this is also where I saw a struggle at my old job tbh. Sometimes we just didn't have the space to cram in a last minute appointment the next day...or the following day...or the following day...and at a certain point there starts to be a pressure overload stemming from both wanting to help the pet and not losing that client. Hard to tell a good client that you would love to help but can't see their dog who is smearing diarrhea all over their crate because you're already double or triple booked for the next 3 days. And that's when I saw those appointments get squeezed in anyway, which created the exact stressful "it's5pmbutcanyoumaybejustlook@Sparkyrealquick" situation you describe.

But I guess that all fits in with your point about the overall shortage of vets & staff vs some kind of issue with the partitioning of available labor.

Agreed and have seen this quite a bit. Clinics double and triple booking the schedule weeks in advance. This is a management issue. You have to have a management team that doesn't see # of clients and dollar bills. Which is hard to find. You have to limit the number of healthy pets you put in, hence "same day, sick" appointments. And you have to train your staff that a "same day, sick" appointment really means SAME DAY, SICK, not day before sick, or two days before, sick or a week before, sick. Have had clinics put in "same day, sick" slots only for reception to fill them all two days before. So you have to stick to it. Even if someone calls in 10 minutes before close the day prior, you do not fill that slot.

My Dr in Scotland did this. They had so many same day sick slots open, you call in the AM and if they have an opening, you can get one, but they did fill up fast, so you had to call first thing. This is what I would recommend for vet clinics, multiple same day sick appointments that do not get filled until that day.

I think veterinary clinics are just so eager to please everyone all the time that they just try to overbook everything right away instead of being realistic. Or they fill in all healthy pets and have no space for sick ones. It is an issue I see everywhere and granted same day, sick appointments aren't going to resolve everything, but they can help. There are going to be times where there are just too many sick pets and there is just not a way to see them all.

 

[DVMDream]

Can always tell when I have tests coming up cause I get real interested in things that have no immediate relevance to the notes in front of my face lol

This morning I spent ~45 minutes chatting about stocking densities and impact on net production in dairy barns; next test is on tarantulas.

This kind of topic is always interesting to me though (and not just from a procrastination standpoint ). Thank you for the discussion!

Spoiler: Random fun fact

Avocados can be deadly to many species of animals

 

[PippyPony]

My Dr in Scotland did this.

Forgot you spent time in the UK. Might PM you about that at some point if that's ok?

 

[DVMDream]

Forgot you spent time in the UK. Might PM you about that at some point if that's ok?

Sure, any time. PM box is open.

 

[CalliopeDVM]

Yes to so much of above: they will be a nightmare to staff (both vets and staff), and owners simply don't know or don't care about the difference between emergencies and non-emergent but urgent needs. Owners will try to book a 3 pm appointment for a dog hit by car the night before, not caring that the clinic closes at 5 pm. (!?!). Personally, I have done walk-in only clinics (both emerg and GP), and I didn't like it.......I think it takes a particular type of personality to be OK with that kind of lack of preparation and/or control. It was managable, but if I had other employment options, "walk-in only" would be a big black mark against a clinic. (Actually, I think of it as something I've passed now; at this stage of my career, I want more of both - preparation and choice - over what I work with .)

 

[Minnerbelle]

It already kind of exists in my area even if it doesn’t seem like it. My previous practice used to be open until midnight and also full days on Sun for exactly this purpose, and the policy was that no patient ever get refused so they saw 100% of all walk ins. There are multiple other clinics open until 7-8pm for the same reasons. The 10pm to midnight part turned out to be not very profitable at all. Maybe a few cases each night and wasn’t worth it, so it was closed and hours were scaled back to 10pm. I personally don’t like to refuse things especially if it’s surgical, and a lot of my staff likes being a part of emergency procedures so maybe once a week I’m cutting a wound or FB or something of that nature after hours.

The problem is during busy months esp in the summer, it’s crazy busy everywhere and there just aren’t enough veterinarians to take care of the caseload. I could produce like $80k in a busy July myself on a 4 day work week because the patients won’t stop coming in. But come mid Sep after school starts, then it can be crickets. I could produce as low as <30k in the worst month, where I’m twiddling my thumb. So for a clinic to sustain those types of hours during these slow months would be a killer. Sucks for the doctor if they are on production needing to work those hideous hours and earning nothing. Sucks for the clinic to need to hire the staffing for it, and doubly so if their doctors are on production. It just makes more sense to hire an additional seasonal doctor, but there just aren’t any around. Especially because there are hospitals in vacation spots that also need seasonal doctors. Every practice around here is dying for additional associates in general. I get texts/emails from clinics trying to poach me all the time. Some ERs are needing to cut hours and not be open 24/7 even because they can’t keep staffing. So opening another clinic for urgent care hours just wouldn’t be sustainable. The case load just isn’t enough to justify the associated costs throughout the year, and there are no doctors to staff it. The amount you’d have to charge to make it worth it will be more than the typical ER fee, at which point clients will likely choose to just go to the ER esp if the pet is truly ill and likely needs more than can be provided in the few hours that the urgent care clinic is open, or will wait until the next day to see their regular vet if not dying.

 

[mmmdreamerz]

This is interesting because my school is in the process of doing exactly this at a separate offsite location from our regular ER.

 

[KCgophervet]

Found the website. They do a pretty good job explaining the difference between urgent Care and emergency. It also helps to have it all at the same place with well trained reception staff to triage appropriately.

Urgent Care

The Veterinary Medical Center now offers convenient hours for companion animals needing to see a veterinarian after normal office hours but not requiring a visit to the emergency room.

www.vmc.umn.edu

 

[DVMDream]

Found the website. They do a pretty good job explaining the difference between urgent Care and emergency. It also helps to have it all at the same place with well trained reception staff to triage appropriately.

Urgent Care

The Veterinary Medical Center now offers convenient hours for companion animals needing to see a veterinarian after normal office hours but not requiring a visit to the emergency room.

www.vmc.umn.edu

If only people would read. I also question the dribbling urine/straining to urinate being in urgent care section. For a dog maybe, for a cat, hell no. But if they can easily transfer over to ER without hopefully too much complaint from the owner then should be ok.

 

[that redhead]

So we have a relatively new urgent care that started in our area. They open around the time most GPs close and stay open until midnight. Truly emergent cases can be dealt with but will be transferred to full ER for continued care.

I think it’s a fine idea in that set up. If you’re open during normal business hours you’re going to have a lot of resentment from GPs presumably. Where I am, we see people that want to be seen. If we’re completely booked, you can pay an additional ER fee to be squeezed in. It sucks, yes, but I assume it’s good business to do it that way. I try to think of how I feel when my dog is sick and I’m freaking out- as annoying as some of these “vomited once this morning” appointments are, these people care about their pets and want to make sure it’s OK. I’d rather than not eating or keeping anything down for three weeks!

We’ve had some peeved clients with the ER fee, but they pay it 9/10. Maybe they’ll stop waiting until five minutes before close on a Friday to call about the week long diarrhea...

We also have built in blocks, many listed as “same day sick” and while they fill quickly especially on Saturdays, they do help. I agree with DVMD that in no way is a new patient sick animal in the last 30mins of the day going to make me happy, but I do my best to give benefit of the doubt- maybe they couldn’t come because they work or care for a sick parent or whatever. Maybe (and this has definitely happened!) their usual vet brushed them off and wouldn’t see them. They are often very thankful just to have someone see their animal.

Obviously there are people who abuse the system (my Saturday was a nightmare in this regard, UGH) but I find many people are thankful to be seen in short notice.

Overall I like the concept as an after-hours model but agree staffing during day time hours would be tough.

 

[dyachei]

If only people would read. I also question the dribbling urine/straining to urinate being in urgent care section. For a dog maybe, for a cat, hell no. But if they can easily transfer over to ER without hopefully too much complaint from the owner then should be ok.

we live in totally different areas for sure. Because the majority of male cats presenting for UTI that are actually blocked where I am is low. And I can usually at least catheterize (urinary) or refer quickly without any major hassle.

 

[ANSohschm]

I remember UrgentVet (link: After-Hours Veterinarian | Urgent Pet Care | Open Nights & Weekends ) coming to our school and talking about how they are trying to differentiate urgent care vs ER. The 24 hour emergency practice is also owned by the same entity so it is easy to refer them over if needed.

 

[Trilt]

So we have a relatively new urgent care that started in our area. They open around the time most GPs close and stay open until midnight. Truly emergent cases can be dealt with but will be transferred to full ER for continued care.

I think it’s a fine idea in that set up. If you’re open during normal business hours you’re going to have a lot of resentment from GPs presumably. Where I am, we see people that want to be seen. If we’re completely booked, you can pay an additional ER fee to be squeezed in. It sucks, yes, but I assume it’s good business to do it that way. I try to think of how I feel when my dog is sick and I’m freaking out- as annoying as some of these “vomited once this morning” appointments are, these people care about their pets and want to make sure it’s OK. I’d rather than not eating or keeping anything down for three weeks!

We’ve had some peeved clients with the ER fee, but they pay it 9/10. Maybe they’ll stop waiting until five minutes before close on a Friday to call about the week long diarrhea...

We also have built in blocks, many listed as “same day sick” and while they fill quickly especially on Saturdays, they do help. I agree with DVMD that in no way is a new patient sick animal in the last 30mins of the day going to make me happy, but I do my best to give benefit of the doubt- maybe they couldn’t come because they work or care for a sick parent or whatever. Maybe (and this has definitely happened!) their usual vet brushed them off and wouldn’t see them. They are often very thankful just to have someone see their animal.

Obviously there are people who abuse the system (my Saturday was a nightmare in this regard, UGH) but I find many people are thankful to be seen in short notice.

Overall I like the concept as an after-hours model but agree staffing during day time hours would be tough.

This is basically what we do. We'll work you in, BUT you're gonna pay extra for it. They're usually nice clients who are just worried, so it's not the end of the world. I would guess we get a huge amount of our new clients that way, too, since we're a bigger practice and can accomodate extras in the schedule vs. small clinics where it's really just not feasible on top of being fully booked.

 

[that redhead]

This is basically what we do. We'll work you in, BUT you're gonna pay extra for it. They're usually nice clients who are just worried, so it's not the end of the world. I would guess we get a huge amount of our new clients that way, too, since we're a bigger practice and can accomodate extras in the schedule vs. small clinics where it's really just not feasible on top of being fully booked.

We’ve definitely had people switch to us because we were able to get them in when their usual vet couldn’t or wouldn’t. We’ve had people whose vet’s office basically told them eh, no biggie just monitor it and it was a serious issue. Yeah, I have a few of those times too (your 100lb lab that maybe licked a drop of bacon grease off the floor three days ago is probably going to survive) but more often than not I’m offering to do an exam and if people decline, that’s on them.

 

[Trilt]

we live in totally different areas for sure. Because the majority of male cats presenting for UTI that are actually blocked where I am is low. And I can usually at least catheterize (urinary) or refer quickly without any major hassle.

My "UTI" male cat this afternoon was sheet white and had a bicavitary effusion... people suck at triage lol.

 

[PetVet7]

I worked in a walk-in only clinic before vet school. The only thing we scheduled was surgery. It was a very small practice and grossly understaffed. We usually only had one doctor, one tech, and one receptionist working at a time.

I enjoyed the fast paced environment of walk-in. My main complaints would be the lack of staff. It kinda sucks when you’re trying to work with an aggressive dog or fractious cat and you have no one to help restrain. Or when your one doctor is in surgery and people are angrily waiting to be seen. A lot of times we would stay 1-2 hours past close to finish seeing patients.

I think walk-ins can be successful when done correctly. I’ll be working for a large scale walk-in clinic over winter break, so hopefully I can get more insight on how a properly staffed walk-in clinic runs.

 

[TheGoldenMila]

Thought I would throw my experience in with this. During undergrad I worked in an urgent care clinic. We did emergencies and routine care. There are 3 other ER clinics within 30 miles of us. We were open every day of the week from 8am-8pm. Monday-Friday functioned more as a GP and after hours and weekends was more for urgent care. No emergency fees are charged. From what I can tell, clients loved this. We have a ton of flexibility in scheduling and were always available for sick patients. The GP around us always sent clients to us when they were full. The only downside for me personally are the 12+ hour shifts, but the staff only had to work 3 days a week. The clinic did really well and the doctor who started it 10+ years ago ended up selling it and retired very well off in her late 40's. From my perspective, she put in crazy hours to get the clinic up in running, but it paid off in the end. I don't know if this is the case for all urgent care clinics, but my experience with this one was great.