Last night was a nice quiet night on call. A good meal and evening in with my spouse, some mindless Saturday television, uninterrupted by laminitics, stitch-ups or chokes. Until at 10.30pm, just as I was about to get into my bed, my phone bleeped and I ended up awake for half of the night. No, not a colic or a foaling, but a notification of a review being posted on our practice Facebook page. And not a favourable one!
The thing about Facebook reviews is that you can do nothing about them. You cannot delete them, you cannot edit them. You can reply to them, but opinion seems to be split between whether this is a good way of heading off trouble, or an invitation to all the complainant's friends to join the tirade. Thus they are inevitably completely one-sided. I do not know the story behind this lady's tale - I have never met her, nor her horse. She is a relatively new client and has been seen thus far exclusively by my colleague. She may well have a valid complaint, she may not. Most likely the truth lies somewhere in the middle, and the time of posting (10.30pm on a weekend night, three days after we last saw her horse) does make me suspicious that there may have been a glass of wine egging her on.
A previously received bad review was of the 'money-grabbing vets who care more about their bank account than the animal' variety. Now, anyone who has worked in practice for any period of time will probably have heard this line more often than they have applied a hot poultice. It is the usual cri de coeur of any client who has been asked to pay their bill. And most vets would reply that if they were in it for the money they would have picked a different career. However on this occasion the complaint was even more spurious than usual. The client had asked us to visit to vaccinate their horse, we had politely asked that they pay for their last vaccination, over 6 months previously, first. Not entirely unreasonable, but it left us with a rather floridly-worded tirade on our Facebook page for all the world to see as a result. I would happily have given some of my own hard-grabbed money to be able to comment on the post with the truth!
Luckily we have a lot of lovely clients who have left us lovely reviews, and it gladdens my heart to read them. However on occasions like last night, even though I was not personally involved in the lady's grievance, reading something like that really knocks me flat. It's a good thing I'm not much good at anything other than vetting, otherwise I might feel tempted to give it all up on the spot.
In these times of all-invasive social media it's far too easy to spread the vitriol of a bad experience (whether real or perceived) far and wide, to a potential audience of millions. However it is worth bearing in mind, before hitting the 'post' button, that you are talking about real people, whose feelings are as easily hurt as your own. I have spent most of this weekend being in turns angry and upset, which has impacted on my family. As vets we don't always get everything right. I can honestly say however that I do try my very best to do my very best by, and for, every horse and owner I meet. If anyone feels that this has not happened our practice is always happy to investigate and respond to any complaints sent to us. Choosing instead to spread this sort of poison across the internet, where professionalism and client confidentiality prevent us from defending ourselves, would seem like the work of a coward and a bully to me.
Sunday, 19 April 2015
Thursday, 26 February 2015
On Money, and the Value Thereof.
I wrote this blog a month or two ago, then shelved it after re-reading, wondering whether I might just be being a little petty. After a second complaint from another client on exactly the same issue I reconsidered. Publish and be damned!
Yesterday I received a complaint. Now for any of us working in the customer service field - and veterinary medicine is very much a customer service profession - we become accustomed to receiving complaints. Sometimes clients do not agree with things that we do, sometimes there is a breakdown in communication, sometimes people have differing ideas of what constitues a successful outcome. Occasionally we make a genuine error whilst treating a horse. All of these situations, and many more, will probably happen to every vet during the course of their career. However the single factor that drives more complaints than any other is money, and more specifically whether someone feels they have had value for money.
Yesterday's complaint really left me flabbergasted. I had driven out to a client's yard, administered a flu vaccination, and driven back to the practice. The yard was about 25mins away and I was probably there for about 15 minutes. Whilst we don't often carry out a full clinical exam at the time of vaccination we do listen to each horse's heart and ask the owner if there is anything they are concerned about or anything specific they'd like us to have a look at. We also offer to check the horse's teeth. So for the price charged the owner gets nearly an hour of driving time, the vaccination itself, a quick health check and the opportunity to discuss any problems that may have arisen over the past year. The price that I charged for all of the above? The 'gross overcharging' that led to the written complaint? £54.
It started me wondering what the client would have considered a reasonable cost for this service. £45? £25? £10?? It also made me wonder when veterinary medicine became quite so devalued. We are highly trained professionals. We have all spent a minimum of five years studying for our degrees. Many of us also have post-graduate qualifications and every single one of us carries out a bare minimum of 35 hours of CPD every single year, at no inconsiderable cost. We all have cars to run, facilities to maintain, heat and light, drugs and equipment to pay for, a myriad of miscellaneous everyday costs and overheads; and then we have to have enough left over to actually pay wages, not just for the vet that drove out to perform your vaccination, but for the receptionist and the nurses back at the practice. And none of us is even close to being rich!
So, does £54 look like value for money yet? If you took a taxi for that 50min round trip the fare alone would be more than £54. It costs more than £54 to take your cat to a small animal vet for a vaccination. £54 would pay for an hour's individual tuition with a well-known dressage instructor - but not if they had to come to you. £54 is less money than it costs to enter any British Eventing event. It is considerably less than the amount the client will hand over to their farrier every 6 weeks, year after year.
Somehow it seems ironic than the £250 bill for the emergency colic is rarely quibbled, but the £54 bill for the once yearly injection (that is a requirement to be able to compete the horse) is the cause of so much drama. We have plenty of clients who appreciate our efforts to keep routine costs down. Why should we be expected to lower those costs to a point where we are making a loss? Both clients said that the cost was 'extortionate' and that they'd be using another practice in future. Frankly, I wish them, and probably even more so their new vets, the best of luck.
Now, if you'll excuse me, it's time I asked my chaffeur to polish the Bentley...
Yesterday I received a complaint. Now for any of us working in the customer service field - and veterinary medicine is very much a customer service profession - we become accustomed to receiving complaints. Sometimes clients do not agree with things that we do, sometimes there is a breakdown in communication, sometimes people have differing ideas of what constitues a successful outcome. Occasionally we make a genuine error whilst treating a horse. All of these situations, and many more, will probably happen to every vet during the course of their career. However the single factor that drives more complaints than any other is money, and more specifically whether someone feels they have had value for money.
Yesterday's complaint really left me flabbergasted. I had driven out to a client's yard, administered a flu vaccination, and driven back to the practice. The yard was about 25mins away and I was probably there for about 15 minutes. Whilst we don't often carry out a full clinical exam at the time of vaccination we do listen to each horse's heart and ask the owner if there is anything they are concerned about or anything specific they'd like us to have a look at. We also offer to check the horse's teeth. So for the price charged the owner gets nearly an hour of driving time, the vaccination itself, a quick health check and the opportunity to discuss any problems that may have arisen over the past year. The price that I charged for all of the above? The 'gross overcharging' that led to the written complaint? £54.
It started me wondering what the client would have considered a reasonable cost for this service. £45? £25? £10?? It also made me wonder when veterinary medicine became quite so devalued. We are highly trained professionals. We have all spent a minimum of five years studying for our degrees. Many of us also have post-graduate qualifications and every single one of us carries out a bare minimum of 35 hours of CPD every single year, at no inconsiderable cost. We all have cars to run, facilities to maintain, heat and light, drugs and equipment to pay for, a myriad of miscellaneous everyday costs and overheads; and then we have to have enough left over to actually pay wages, not just for the vet that drove out to perform your vaccination, but for the receptionist and the nurses back at the practice. And none of us is even close to being rich!
So, does £54 look like value for money yet? If you took a taxi for that 50min round trip the fare alone would be more than £54. It costs more than £54 to take your cat to a small animal vet for a vaccination. £54 would pay for an hour's individual tuition with a well-known dressage instructor - but not if they had to come to you. £54 is less money than it costs to enter any British Eventing event. It is considerably less than the amount the client will hand over to their farrier every 6 weeks, year after year.
Somehow it seems ironic than the £250 bill for the emergency colic is rarely quibbled, but the £54 bill for the once yearly injection (that is a requirement to be able to compete the horse) is the cause of so much drama. We have plenty of clients who appreciate our efforts to keep routine costs down. Why should we be expected to lower those costs to a point where we are making a loss? Both clients said that the cost was 'extortionate' and that they'd be using another practice in future. Frankly, I wish them, and probably even more so their new vets, the best of luck.
Now, if you'll excuse me, it's time I asked my chaffeur to polish the Bentley...
Tuesday, 13 January 2015
Long in the Tooth?
Equine dentistry is an area that seems to be ripe for debate in the veterinary and horse-owning worlds. I see endless articles in magazines about who can do what, and endless discussions on social media about who best to tackle a horse's teeth - vet or EDT?
I'm a vet who loves dentistry. I think that is something that is becoming a lot more common and I suspect those who vehemently proclaim against using a vet to do teeth are probably coloured by experiences from the not-so-distant past when most vets had minimal interest, equipment and, dare I say it, expertise. I qualified less than 20 years ago and distinctly remember being handed a rusty Hausmann gag and two blunt rasps of the old carbide-chip variety. I only got ownership of the gag as my boss thought they were a completely superfluous piece of kit and made a point of never using one! I knew I was doing horses (and their owners) a poor service and I didn't really understand what I should be trying to achieve or how to go about it. A poor workman never blames his tools, but to be honest if I tried to do a horse's teeth now with the kit I had then I would probably still be working on the same horse a week next Sunday.
Something had to change, and my personal epiphany coincided largely with a similar zeitgeist in the equine veterinary world. Meetings were held, committees were formed and discussions with 'equine dentists' led to the instigation of both targeted CPD courses for vets, and exams and accreditation for dentists. I attended one of these early courses and was blown away by the scope of what it was possible to achieve and the display of equipment available from specialist suppliers. And so was born an interest which has remained with me for the rest of my career. I try to keep as up-to-date as possible with my learning and stretch my equipment budget as far as I can. I am a little bit like a magpie - my head always being turned by the latest piece of gleaming shiny-new instrumentation. I am by no means the best dentist in the country, and probably not even in my county, but I like to do a careful, thorough job and carefully assess the work that needs doing and the benefit for the horse. I am always aware that less is often more in this sphere, something that we definitely didn't appreciate in the past.
So, if I weren't a dentistry-orientated vet, who would I have to do my horses' teeth? Well definitely only a fully qualified EDT or a vet with a specific interest in dentistry (and there are quite a lot of us around now). I think most of the approved EDTs do a really, really good job, and they have the benefit of working in horses' mouths all day long, whereas we also see lamenesses and colics and all the other things in between. On the flip-side vets have a detailed knowledge of medical conditions that may have a bearing on what goes on in the mouth, so it's swings and roundabouts. However I do think that the ideal is working on a sedated horse. Even if the horse is generally good to do, the intra-oral examination can be so much more thorough and the work so much more precise if the horse is stationary, with its head still and its tongue relaxed. Obviously it's safer for everyone too, but I am constantly amazed by the things that I see under sedation that I know I would have missed without.
I am quite happy to sedate horses for approved EDTs, with the emphasis on the approved. We are actually not supposed to sedate horses for non-approved dentists. This inevitably causes friction when a client rings and asks for a horse to be sedated for their 'tooth-man' and I have to say no. We have lost business, and on occasion clients, because we adhere to the rules. What really infuriates me are the occasions on which we decline, yet the client manages to find a different vet who agrees to carry this out. Rules is rules, and it really looks bad for the profession when we all seem to have our own personal interpretation of something which is entirely black and white. Some vets either don't know or don't care that it is completely illegal for an un-approved EDT to carry out work with power-tools, but by sedating the horse whilst they carry this out they are giving their tacit approval to these illegal procedures, in the eyes of the client and the dentist.
So, a bit of a serious one from me this time, but something that seems pretty topical. I think the whole situation is actually quite difficult for clients to understand. As a profession we could probably do more to promote the understanding of who can (or more importantly can't) do what, and make sure that our clients are using the best person for the job, whether that be a vet or an approved EDT. After all you wouldn't dream of letting an un-registered farrier shoe your horse!
I'm a vet who loves dentistry. I think that is something that is becoming a lot more common and I suspect those who vehemently proclaim against using a vet to do teeth are probably coloured by experiences from the not-so-distant past when most vets had minimal interest, equipment and, dare I say it, expertise. I qualified less than 20 years ago and distinctly remember being handed a rusty Hausmann gag and two blunt rasps of the old carbide-chip variety. I only got ownership of the gag as my boss thought they were a completely superfluous piece of kit and made a point of never using one! I knew I was doing horses (and their owners) a poor service and I didn't really understand what I should be trying to achieve or how to go about it. A poor workman never blames his tools, but to be honest if I tried to do a horse's teeth now with the kit I had then I would probably still be working on the same horse a week next Sunday.
Something had to change, and my personal epiphany coincided largely with a similar zeitgeist in the equine veterinary world. Meetings were held, committees were formed and discussions with 'equine dentists' led to the instigation of both targeted CPD courses for vets, and exams and accreditation for dentists. I attended one of these early courses and was blown away by the scope of what it was possible to achieve and the display of equipment available from specialist suppliers. And so was born an interest which has remained with me for the rest of my career. I try to keep as up-to-date as possible with my learning and stretch my equipment budget as far as I can. I am a little bit like a magpie - my head always being turned by the latest piece of gleaming shiny-new instrumentation. I am by no means the best dentist in the country, and probably not even in my county, but I like to do a careful, thorough job and carefully assess the work that needs doing and the benefit for the horse. I am always aware that less is often more in this sphere, something that we definitely didn't appreciate in the past.
So, if I weren't a dentistry-orientated vet, who would I have to do my horses' teeth? Well definitely only a fully qualified EDT or a vet with a specific interest in dentistry (and there are quite a lot of us around now). I think most of the approved EDTs do a really, really good job, and they have the benefit of working in horses' mouths all day long, whereas we also see lamenesses and colics and all the other things in between. On the flip-side vets have a detailed knowledge of medical conditions that may have a bearing on what goes on in the mouth, so it's swings and roundabouts. However I do think that the ideal is working on a sedated horse. Even if the horse is generally good to do, the intra-oral examination can be so much more thorough and the work so much more precise if the horse is stationary, with its head still and its tongue relaxed. Obviously it's safer for everyone too, but I am constantly amazed by the things that I see under sedation that I know I would have missed without.
I am quite happy to sedate horses for approved EDTs, with the emphasis on the approved. We are actually not supposed to sedate horses for non-approved dentists. This inevitably causes friction when a client rings and asks for a horse to be sedated for their 'tooth-man' and I have to say no. We have lost business, and on occasion clients, because we adhere to the rules. What really infuriates me are the occasions on which we decline, yet the client manages to find a different vet who agrees to carry this out. Rules is rules, and it really looks bad for the profession when we all seem to have our own personal interpretation of something which is entirely black and white. Some vets either don't know or don't care that it is completely illegal for an un-approved EDT to carry out work with power-tools, but by sedating the horse whilst they carry this out they are giving their tacit approval to these illegal procedures, in the eyes of the client and the dentist.
So, a bit of a serious one from me this time, but something that seems pretty topical. I think the whole situation is actually quite difficult for clients to understand. As a profession we could probably do more to promote the understanding of who can (or more importantly can't) do what, and make sure that our clients are using the best person for the job, whether that be a vet or an approved EDT. After all you wouldn't dream of letting an un-registered farrier shoe your horse!
Thursday, 4 December 2014
A Risky Business
The results of the recent BEVA survey into injuries sustained by equine vets whilst at work will have surprised no-one. Every one of my colleagues has ended up in A&E at some point with everything from minor wounds to serious head injuries. My personal injury list would probably be typical - knocked out three times, stitched up twice (should have been more than that, but equine vets seem to come from the Monty Python ' 'tis but a flesh wound' mould - if it ain't actually hanging off then it's nothing a self-applied vetrap can't cure), a sundry array of black eyes and bruises. I'd like to think that after all these years I can read horses pretty well - I can generally tell when the explosion is imminent. With most horses I know when to push to get something done and when to tactfully retreat. And if my spider-senses fail me I'm generally pretty quick on my feet and can be out of the stable, whether through or over the door, quicker than you can say 'watch out'. So for every time the hoof has actually connected there have probably been another ten or twenty times that I've dodged the bullet and felt nothing more than the rush of air as the horse's foot has flown past my face.
Part of this is an accepted risk of the job. Horses are flight animals and naturally suspicious of anything out of their routine. I don't see them the 99% of the time that they're quiet, happy and contented just being horses. I only see them to inflict something that they regard as unpleasant - whether that be to put a gag on and examine their teeth, give them an injection, a rectal exam or try to place a needle into one of their joints. I went into this job because I like horses, but the truth is, with a few exceptions, the horses don't like me.
The horses I find easiest to deal with are those in professional yards. Racehorses, hunters, top level eventers. These horses may be seen as flighty and difficult by a lot of the horse world, but a horse kept in a busy regime, given plenty of work and, vitally, handled by professionals, tends to be a fairly easy animal for me to deal with. The last point is the crux. Professional horse people make handleable horses. If every second spent with a horse contributes to the sum of its education then having someone with years of knowledge, experience and intuition in charge of the horse 24/7 is like handing the horse a college degree. These are the people that I'm happy to have as my 'wingmen'. There are 5 or 6 of my clients that I would trust implicitly on the head of a horse I'm examining. They know when to distract the horse, when to be firm, where to put themselves in relation to the horse and when to warn me if they get a signal from the horse that it has reached the limit of its patience. They will also respect my safety and if I say I would rather the horse be twitched or sedated then there is no argument. Vets that work in clinics will have staff to work with all they time that they can have this relationship with (not to mention a set of stock to restrain the horse!). Us ambulatory vets have to cope with whoever is there at the time - and it can be a real lottery.
If you asked me to pick the horse which was most likely to injure me then it would most likely be a cob. I'm going to upset a few owners here but the stereotypical nightmare patient is a 15hh cob (big enough to be dangerous, small enough to be manoeuvrable), probably overweight and probably owned by a reasonably novice middle-aged lady. As a rule these horses have very few ground manners, are pushy, bolshy and have probably never been told off or asked to do anything they didn't want to do in their life. Add to that someone holding the horse who is inexperienced in reading the signals, doesn't instinctively know where to stand and probably won't let you use a twitch and you've got a recipe for disaster.
I use a lot more sedation than I used to. I probably sedate around 60% of the horses I do dentistry on now, though I would like that to be 95%! This is not because I'm scared of your horse or taking the easy way out. It's not even because I'm trying to rip you off for the cost of the sedation! It's because I think it's fairer for both the horse and me and ultimately for you, the client. I can do a much more thorough examination and treatment if the horse is relaxed. The horse has a relatively benign experience and it is consequently less stressful for the client. Plus the fact that I can do a better and more efficient job means that they get better value for money. It does not totally remove the risk of injury (one of the times I was knocked out was by a horse which had been sedated) but it reduces it to what I'd consider an acceptable level.
I do think that a lot of the risks that equine vets are exposed to, especially when treating horses out on yards as opposed to in a clinic, are unacceptable. In my ideal world horses would be regularly handled by a range of people, be taught manners and ground rules in a firm but fair way and clients would be lot more accepting of the advantages of correct restraint and sedation. Until such time I'll keep honing my lightning-sharp reflexes and when I get a bad feeling I'll walk away. I've only got one body to last me my working lifetime and sometimes it's just not worth the risk.
Part of this is an accepted risk of the job. Horses are flight animals and naturally suspicious of anything out of their routine. I don't see them the 99% of the time that they're quiet, happy and contented just being horses. I only see them to inflict something that they regard as unpleasant - whether that be to put a gag on and examine their teeth, give them an injection, a rectal exam or try to place a needle into one of their joints. I went into this job because I like horses, but the truth is, with a few exceptions, the horses don't like me.
The horses I find easiest to deal with are those in professional yards. Racehorses, hunters, top level eventers. These horses may be seen as flighty and difficult by a lot of the horse world, but a horse kept in a busy regime, given plenty of work and, vitally, handled by professionals, tends to be a fairly easy animal for me to deal with. The last point is the crux. Professional horse people make handleable horses. If every second spent with a horse contributes to the sum of its education then having someone with years of knowledge, experience and intuition in charge of the horse 24/7 is like handing the horse a college degree. These are the people that I'm happy to have as my 'wingmen'. There are 5 or 6 of my clients that I would trust implicitly on the head of a horse I'm examining. They know when to distract the horse, when to be firm, where to put themselves in relation to the horse and when to warn me if they get a signal from the horse that it has reached the limit of its patience. They will also respect my safety and if I say I would rather the horse be twitched or sedated then there is no argument. Vets that work in clinics will have staff to work with all they time that they can have this relationship with (not to mention a set of stock to restrain the horse!). Us ambulatory vets have to cope with whoever is there at the time - and it can be a real lottery.
If you asked me to pick the horse which was most likely to injure me then it would most likely be a cob. I'm going to upset a few owners here but the stereotypical nightmare patient is a 15hh cob (big enough to be dangerous, small enough to be manoeuvrable), probably overweight and probably owned by a reasonably novice middle-aged lady. As a rule these horses have very few ground manners, are pushy, bolshy and have probably never been told off or asked to do anything they didn't want to do in their life. Add to that someone holding the horse who is inexperienced in reading the signals, doesn't instinctively know where to stand and probably won't let you use a twitch and you've got a recipe for disaster.
I use a lot more sedation than I used to. I probably sedate around 60% of the horses I do dentistry on now, though I would like that to be 95%! This is not because I'm scared of your horse or taking the easy way out. It's not even because I'm trying to rip you off for the cost of the sedation! It's because I think it's fairer for both the horse and me and ultimately for you, the client. I can do a much more thorough examination and treatment if the horse is relaxed. The horse has a relatively benign experience and it is consequently less stressful for the client. Plus the fact that I can do a better and more efficient job means that they get better value for money. It does not totally remove the risk of injury (one of the times I was knocked out was by a horse which had been sedated) but it reduces it to what I'd consider an acceptable level.
I do think that a lot of the risks that equine vets are exposed to, especially when treating horses out on yards as opposed to in a clinic, are unacceptable. In my ideal world horses would be regularly handled by a range of people, be taught manners and ground rules in a firm but fair way and clients would be lot more accepting of the advantages of correct restraint and sedation. Until such time I'll keep honing my lightning-sharp reflexes and when I get a bad feeling I'll walk away. I've only got one body to last me my working lifetime and sometimes it's just not worth the risk.
Wednesday, 12 November 2014
To sleep, perchance...
One of the hardest parts of starting to work as a vet in practice is learning to cope with both the lack of sleep and regularly disturbed sleep. We are required by law to provide a 24/7 service, and although some small animal practices have delegated their out-of-hours cover to specialist emergency clinics, this is not really logistically possible for equine practices. This means that, on occasion, the vet that you see at 5pm one evening may have been up and working for 36hrs straight. Quite often I have returned the following morning to re-visit I horse I saw in the middle of the night to find the client surprised to see me, expecting me to have the day off following a night on-call. If only!
To be honest as a new graduate I found this all relatively easy. Sure, as students we were used to working all day in the vet school, going out clubbing at night and turning up to spend the following day in clinics and lectures relatively bushy-tailed, if less bright of eye; all on the briefest of catnaps. And this was long before the advent of Red Bull! Nowadays I'm not sure whether it is age creeping up on me, or whether it has all worn a little thin after a couple of decades of being available to the horse-owing public round the clock, but I'm struggling.
Some colleagues report that they sleep very poorly when on-call, with one ear always half open for the shrill of the mobile phone. This has never been my experience. Like a cat I sleep any time, anywhere. Some would find it impossible to be roused from their bed by a 1am call, return to their bed at 3am and get back to sleep. Not me: my eyes are often closed before my head hits the pillow. I suspect that over the years this trait has served me well.
The cruelest call is the one which arrives 10 minutes after you have gone to sleep for the night. You leap to the phone, convinced that it is nearly morning, only to find that it is just minutes since you went to sleep. The feeling is hard to describe, but it is immensely disorientating. The call that you get just as you are pulling back into your drive after a night-time outing, making you set straight out for another, comes a close second in the cruelty stakes.
Although I am writing, as always, slightly in jest, I do feel that it's a serious subject. We don't get paid any more for turning out at any hour of the day or night. I often feel that I am not working at full capacity the day following a disturbed night. On extreme occasions I have felt unsafe driving and at risk of falling asleep at the wheel. It seems that there is little that can be done about it though. It's a 'suck it up' situation. For equine practices to operate at a staffing level that allowed for separate day and night staff they would have to raise the cost of veterinary provision to a level which the public would not accept. Don't get me wrong, we're not up all night, every night. However there comes a point where chronic lack of sleep and disturbed sleep impacts on your ability to function safely, your ability to provide a top quality service to your clients, your social life, your relationships, even your health. We all signed up for this. We all knew what we were getting ourselves into. We all, to some degree, suck it up and cope. It doesn't necessarily make it an ideal situation though.
To be honest as a new graduate I found this all relatively easy. Sure, as students we were used to working all day in the vet school, going out clubbing at night and turning up to spend the following day in clinics and lectures relatively bushy-tailed, if less bright of eye; all on the briefest of catnaps. And this was long before the advent of Red Bull! Nowadays I'm not sure whether it is age creeping up on me, or whether it has all worn a little thin after a couple of decades of being available to the horse-owing public round the clock, but I'm struggling.
Some colleagues report that they sleep very poorly when on-call, with one ear always half open for the shrill of the mobile phone. This has never been my experience. Like a cat I sleep any time, anywhere. Some would find it impossible to be roused from their bed by a 1am call, return to their bed at 3am and get back to sleep. Not me: my eyes are often closed before my head hits the pillow. I suspect that over the years this trait has served me well.
The cruelest call is the one which arrives 10 minutes after you have gone to sleep for the night. You leap to the phone, convinced that it is nearly morning, only to find that it is just minutes since you went to sleep. The feeling is hard to describe, but it is immensely disorientating. The call that you get just as you are pulling back into your drive after a night-time outing, making you set straight out for another, comes a close second in the cruelty stakes.
Although I am writing, as always, slightly in jest, I do feel that it's a serious subject. We don't get paid any more for turning out at any hour of the day or night. I often feel that I am not working at full capacity the day following a disturbed night. On extreme occasions I have felt unsafe driving and at risk of falling asleep at the wheel. It seems that there is little that can be done about it though. It's a 'suck it up' situation. For equine practices to operate at a staffing level that allowed for separate day and night staff they would have to raise the cost of veterinary provision to a level which the public would not accept. Don't get me wrong, we're not up all night, every night. However there comes a point where chronic lack of sleep and disturbed sleep impacts on your ability to function safely, your ability to provide a top quality service to your clients, your social life, your relationships, even your health. We all signed up for this. We all knew what we were getting ourselves into. We all, to some degree, suck it up and cope. It doesn't necessarily make it an ideal situation though.
Thursday, 9 October 2014
Horses for Courses
Over the last few weeks I have been doing quite a lot of vettings. It would seem to be the time of year when people are looking for their equine proteges for the 2015 season. Four year olds have been started and backed and lightly exposed to competition. They haven't had a chance yet to have proved themselves, or to have tried and failed, therefore every young horse is 16 hands of pure untapped potential. Price is usually decided on the basis of breeding and the success of older siblings. A lot of these horses are very impressive in the flesh too and the temptation is there - buy this horse and you are buying your ticket to top placings in eventing, show-jumping or dressage. With an immaculately-bred horse with good conformation who has been started by a professional how could you possibly fail to climb your way to the top of the competition ladder? For those with deep enough pockets, now is the time to buy your way into the dream.
However I am increasingly seeing these horses bought by, put politely, riders whose aspirations don't necessarily match their abilities. It puts me in a very difficult situation as I am not required to give my professional view on whether the purchaser is likely to be capable of handling and riding such a highly strung horse. I might make a few comments about progeny from a particular line being known to be 'hot', but if the purchaser wants to buy a particular horse then that is their choice and they are fully entitled to make it. I do see that fewer of them seem to be involving an experienced advisor in the transaction and this is not a trend that I welcome.
A few weeks ago I vetted a horse for someone who hadn't ridden for over a year and who wanted a youngster to bring on and do a bit of riding club and lower level eventing. Their budget was clearly not insubstantial judging by the value of the horse they had asked me to vet. The horse in question was a four year old with world class breeding on both sides. However both lines were known for their sharpness and 'suitability for professional riders'. The horse was not long imported and newly broken in. It was still weak and undermuscled yet hugely impressive under saddle with enormous paces - a good walk, flashy trot and very balanced, correct canter. It was also sharp as a tack. The professional producer riding it for the vetting had a few 'nearly' moments. Yet the purchaser still wanted it. They were besotted. What could I do? I spoke to the vendor a week or two later and mentioned the unsuitability of the match. He agreed and said he'd tried to get them to buy any other horse on the yard except this one, but they were determind to have it and willing to pay full price.
I'd like to think that this horse will be the perfect horse for the purchaser. That they keep it on a yard with expert help, advice and guidance. That when it is better fed and muscled up it won't be even more tricky to handle and ride. That matching a young, talented and athletic horse with a novice rider with no experience of youngsters will turn out just fine. But I doubt it. I can almost hear the train crash from here.
My job is purely to assess the soundness of the horse for the activities intended, not to cast doubt on the riding abilities of the purchaser. It passed the vetting with flying colours. I said nothing. Was I wrong?
However I am increasingly seeing these horses bought by, put politely, riders whose aspirations don't necessarily match their abilities. It puts me in a very difficult situation as I am not required to give my professional view on whether the purchaser is likely to be capable of handling and riding such a highly strung horse. I might make a few comments about progeny from a particular line being known to be 'hot', but if the purchaser wants to buy a particular horse then that is their choice and they are fully entitled to make it. I do see that fewer of them seem to be involving an experienced advisor in the transaction and this is not a trend that I welcome.
A few weeks ago I vetted a horse for someone who hadn't ridden for over a year and who wanted a youngster to bring on and do a bit of riding club and lower level eventing. Their budget was clearly not insubstantial judging by the value of the horse they had asked me to vet. The horse in question was a four year old with world class breeding on both sides. However both lines were known for their sharpness and 'suitability for professional riders'. The horse was not long imported and newly broken in. It was still weak and undermuscled yet hugely impressive under saddle with enormous paces - a good walk, flashy trot and very balanced, correct canter. It was also sharp as a tack. The professional producer riding it for the vetting had a few 'nearly' moments. Yet the purchaser still wanted it. They were besotted. What could I do? I spoke to the vendor a week or two later and mentioned the unsuitability of the match. He agreed and said he'd tried to get them to buy any other horse on the yard except this one, but they were determind to have it and willing to pay full price.
I'd like to think that this horse will be the perfect horse for the purchaser. That they keep it on a yard with expert help, advice and guidance. That when it is better fed and muscled up it won't be even more tricky to handle and ride. That matching a young, talented and athletic horse with a novice rider with no experience of youngsters will turn out just fine. But I doubt it. I can almost hear the train crash from here.
My job is purely to assess the soundness of the horse for the activities intended, not to cast doubt on the riding abilities of the purchaser. It passed the vetting with flying colours. I said nothing. Was I wrong?
Wednesday, 24 September 2014
Paying Your Dues
Hands up who pays their vet bills straight away? Hands up who pays them eventually? Hands up who pays them... never?
One of the hardest things in veterinary practice is getting the money in. Particularly hard for us as vets as we have received next to no financial management training. Most of us are, in truth, pretty bad business people. But then we didn't choose this career because of our outstanding financial acumen. And we definitely didn't pick it because we thought we'd get rich. There is an inbuilt sense of guilt amongst vets about actually asking for money. Being seen as caring, and demanding money for our services, seem like rather uneasy bedfellows.
For some reason horse-owners in particular are remarkably bad payers. They are renowned for their delaying tactics and dodges. We understand that emergencies happen and are sympathetic to the sudden unexpected big bill, but a lot of our outstanding debts are for things like vaccinations. Really? We even have a policy of asking for payment at the time of routine treatment, but there is all too often an excuse, and once we're already at your yard it would seem churlish to drive off again without vaccinating your horse just because you 'forgot your wallet' - after all we've already booked that time slot to you and used the petrol.
Most of these people do pay eventually, some spontaneously, some with a little gentle coercion from our office staff. Occasionally, however, there is a client who walks off and abandons their debt completely - this is a little harder to swallow, and I think the tale below is one of the ones that has stung me the hardest.
Poppy was a little old pony with chronic lung disease. Poppy was retired and living out her life quite contentedly. We'd discussed finances with her owner, but to be honest, even with a lottery win there would be no miracles for Poppy. She managed OK day to day on a cocktail of steroids and various other drugs which, while not cheap, were in the grand scheme of vet bills a drop in the ocean. Poppy's owner managed to keep chipping away at her bill - every time she got paid she'd send us a cheque and while her bill never got fully paid off I appreciated her difficulties and her efforts to keep on top of it. Inevitably the time came that we could do no more for Poppy. It was time to let her go. I had actually taken a rare day off the day the call came, but because I had been responsible for Poppy all through her treatment the owner wanted me and only me to be present at the end, and I felt it was doing my best to both the owner and the pony for them to have a familiar face there at such a stressful time, regardless of the inconvenience it personally caused me. The deed was done and the owner was, understandably, very upset. I sat on the ground in the paddock with her for over an hour talking with her about her pony's life and confirming that her decision had been the right one for the pony. I then sent the owner home with a friend to have a cup of tea whilst I waited for the knackerman to come and take Poppy away. I helped him load her up, closed the gate and drove home, physically and emotionally drained.
Perhaps I was naive, but I expected the £50 cheques to keep appearing until the debt was cleared. However the moment I squeezed the owner's shoulder and helped her into her friend's car was the last I ever saw or heard from her. The remainder of the bill for the drugs (not a huge amount) has never been paid and I have never received a penny for my services that day in putting Poppy to sleep. Our letters are returned as 'not at this address', the phone number is no longer connected, the debt collection company have drawn a blank and to all intents and purposes Poppy's owner has disappeared into thin air. I'll be honest, it feels like a kick in the teeth. I have invested years and many thousands of pounds in my education and training. The drugs cost the practice money and have all been bought and paid for. The cost of the drugs used to put Poppy to sleep is not insubstantial without even factoring in my time and petrol. I have to say that the emotional hit is worse than the financial hit. I put a lot of myself into caring for Poppy and supporting her owner. I fielded long telephone calls debating treatment options and prognoses at the expense, often, of my own free time. In short, I cared.
Now I'm sure most of you find the actions of Poppy's owner abhorrent. It is, after all, theft. Without factoring in any professional time we are probably around £300 out of pocket as a result of drugs and fuel not paid for. I have decided that there is little I can do except take it on the chin. However if you ever see a moment's doubt or hesitation in my eyes when you ask if you can pay your bill in installments you know why. Once bitten...
One of the hardest things in veterinary practice is getting the money in. Particularly hard for us as vets as we have received next to no financial management training. Most of us are, in truth, pretty bad business people. But then we didn't choose this career because of our outstanding financial acumen. And we definitely didn't pick it because we thought we'd get rich. There is an inbuilt sense of guilt amongst vets about actually asking for money. Being seen as caring, and demanding money for our services, seem like rather uneasy bedfellows.
For some reason horse-owners in particular are remarkably bad payers. They are renowned for their delaying tactics and dodges. We understand that emergencies happen and are sympathetic to the sudden unexpected big bill, but a lot of our outstanding debts are for things like vaccinations. Really? We even have a policy of asking for payment at the time of routine treatment, but there is all too often an excuse, and once we're already at your yard it would seem churlish to drive off again without vaccinating your horse just because you 'forgot your wallet' - after all we've already booked that time slot to you and used the petrol.
Most of these people do pay eventually, some spontaneously, some with a little gentle coercion from our office staff. Occasionally, however, there is a client who walks off and abandons their debt completely - this is a little harder to swallow, and I think the tale below is one of the ones that has stung me the hardest.
Poppy was a little old pony with chronic lung disease. Poppy was retired and living out her life quite contentedly. We'd discussed finances with her owner, but to be honest, even with a lottery win there would be no miracles for Poppy. She managed OK day to day on a cocktail of steroids and various other drugs which, while not cheap, were in the grand scheme of vet bills a drop in the ocean. Poppy's owner managed to keep chipping away at her bill - every time she got paid she'd send us a cheque and while her bill never got fully paid off I appreciated her difficulties and her efforts to keep on top of it. Inevitably the time came that we could do no more for Poppy. It was time to let her go. I had actually taken a rare day off the day the call came, but because I had been responsible for Poppy all through her treatment the owner wanted me and only me to be present at the end, and I felt it was doing my best to both the owner and the pony for them to have a familiar face there at such a stressful time, regardless of the inconvenience it personally caused me. The deed was done and the owner was, understandably, very upset. I sat on the ground in the paddock with her for over an hour talking with her about her pony's life and confirming that her decision had been the right one for the pony. I then sent the owner home with a friend to have a cup of tea whilst I waited for the knackerman to come and take Poppy away. I helped him load her up, closed the gate and drove home, physically and emotionally drained.
Perhaps I was naive, but I expected the £50 cheques to keep appearing until the debt was cleared. However the moment I squeezed the owner's shoulder and helped her into her friend's car was the last I ever saw or heard from her. The remainder of the bill for the drugs (not a huge amount) has never been paid and I have never received a penny for my services that day in putting Poppy to sleep. Our letters are returned as 'not at this address', the phone number is no longer connected, the debt collection company have drawn a blank and to all intents and purposes Poppy's owner has disappeared into thin air. I'll be honest, it feels like a kick in the teeth. I have invested years and many thousands of pounds in my education and training. The drugs cost the practice money and have all been bought and paid for. The cost of the drugs used to put Poppy to sleep is not insubstantial without even factoring in my time and petrol. I have to say that the emotional hit is worse than the financial hit. I put a lot of myself into caring for Poppy and supporting her owner. I fielded long telephone calls debating treatment options and prognoses at the expense, often, of my own free time. In short, I cared.
Now I'm sure most of you find the actions of Poppy's owner abhorrent. It is, after all, theft. Without factoring in any professional time we are probably around £300 out of pocket as a result of drugs and fuel not paid for. I have decided that there is little I can do except take it on the chin. However if you ever see a moment's doubt or hesitation in my eyes when you ask if you can pay your bill in installments you know why. Once bitten...
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