Jan 18 2018

Important Announcement

We would like to inform all clients and seasonal residents that Bracebridge Animal Hospital and Huntsville Animal Hospital will no longer be providing after regular hospital hours emergency coverage. This decision comes after a very extensive analysis and review of the frequency and nature of emergency calls received and those cases actually seen by our respective hospitals.

Please know this decision did not come lightly and an exhaustive review of all the factors that contributed to this decision were taken into account. We recognize this may come as a disappointing surprise to some of you and encourage you to contact us if you have concerns or questions as to how we arrived at this decision.

To that end, it is imperative to understand the costs involved with operating after hours emergency coverage have continually escalated over recent years and the lifestyle balance for our professional staff was being compromised substantially.

We assure you there is still after hours emergency coverage available to the residents of Muskoka. The Barrie Huronia Veterinary Emergency Hospital is open for all evenings, weekends and holidays. There is also a new veterinary tele-health service available. Clients can speak directly with a veterinarian regarding questions or concerns with their pet and receive advice as to whether their pet may truly require being seen as an emergency outside of our regular hours of hospital operation. This service will enable clients to preclude the need for being seen after our regular hospital hours and thus reduce the costs associated with emergencies.

We trust you will understand this decision was made taking all parties into consideration. We have always valued, and will continue to value, the trust you have placed in us to be your pet’s health care provider. Rest assured we will continue to provide the outstanding client service you have become accustomed to and will always welcome you and your pets with open arms.

Sincerely,

Dr Jason McLeod and the Team at Huntsville Animal Hospital

 

Announcement (follow up to initial announcement regarding on-call discontinuation)

We recently advised our clients that we would no longer be providing emergency service outside of our regular office hours. There have been many questions and concerns raised and we wish to address those in a comprehensive format to help alleviate concerns. The following is a discussion of how this decision came to be and will be very detailed so that a thorough review of the factors is offered to our clients.

We appreciate this decision may have come as a surprise to many people. However, there was no way to introduce this gradually and absolutely no benefit to doing so. Most veterinary hospitals in Ontario refer their after hours emergencies to regional emergency hospitals because these facilities are equipped and staffed appropriately to handle true emergencies. This includes the majority of rural practices in Ontario and not just those in large city centres.

Huntsville and Bracebridge Animal Hospitals have decided to follow this path for a multitude of other factors. A thorough review of ALL emergency calls and patients actually seen over the past few years was examined. In that review it was determined that only 9.1-10.7 % of those were true emergencies warranting being seen outside of our regular office hours (the emergencies seen during our office hours were not included in this analysis). Out of that 10 %, only 2.2 % were emergencies for our own clients. The remaining 7.8 % were clients of other animal hospitals that were closed or would not see these people, cottagers or vacationers to the area, or people that never had taken their pets to a veterinarian.

The vast majority of perceived emergencies were calls received by our doctors, outside of their regular work hours, often in the middle of the night or when they were on family time. These calls consisted of clients insisting on speaking with a doctor for advice on subjects or concerns that were not emergent in nature at all.

So the hard questions were asked. Why should our staff of doctors and veterinary technicians be required to give up their personal time, and their sleep, for calls that by an overwhelming margin are not emergent in nature at all?

People have voiced their concerns to say that human ER doctors do this so why should we not provide the same service? Are we not obligated to provide such a service? What happens when my pet has a true emergency or how will I know if it is a true emergency?

Firstly, we recognize it is difficult for a non-veterinarian to know for certain whether their pet may truly require emergency care. Hence the reason we have aligned with Telehealth Pets service for after regular hours direct communication with a veterinarian. This will allow clients to speak directly with a veterinary professional and determine if the condition or concern warrants being seen immediately or whether it can wait until the regular hours of operation of our hospitals. We will still be readily accepting of and willing to see you and your pet during our office hours.

In the human world emergency physicians and nurses are scheduled specifically for their shifts and human hospitals are 24 hour facilities. This is exactly how veterinary emergency hospitals are aligned as well.  It should not be expected that our staff should be awakened each night they are on call to answer questions that could be addressed by a veterinary tele health service. I would hope that people can understand and accept this is a life style benefit to our staff members and their families.

In answering the question of what do I do if my pet has a true emergency we can offer the following commentary. As mentioned, we examined ALL emergencies and ALL emergencies calls received over the past two years. The majority of those were ones received during our regular office hours and will continue to be seen by us during our regular hours of operation.

For those calls received AFTER our regular hours, only 21.4 % were received from clients of our two hospitals. Of those calls received only approximately 10 % were true emergencies (2.2 %). Thus we are being expected by some people to be on call, disrupting our night’s sleep, or taking away from our family time, for only 2.2 % of calls received that actually require emergency care.

Some of our clients have expressed amazement at this statistic but it is true each year. The same underlying principles apply as to why there are 6 hour wait times to be seen at the ER at human hospitals- people come in for reasons that are not emergent in nature.

Some of our clients have expressed that we should only see true emergencies and only accept calls from true emergencies. Others have said we should share on-call with other clinics in the region to spread out the burden. Well, the simple fact is that is what has been done for many years and it still proves to be problematic. So we asked ourselves, why is it okay for people to sit in a human hospital for 4, 5, or 6 hours to be seen and yet we cannot expect clients to take an extra 45-60min to drive to Barrie for comprehensive emergency coverage?

We then further examined the distances that people drove to be seen by our emergency service and the time it took them to reach our hospitals. Almost all clients from the Bracebridge and Gravenhurst regions were equidistant to the Barrie Veterinary Emergency Hospital as they were to Huntsville. Thus, it really is the Huntsville based clientele that could be affected more greatly. So it was examined again to find out what percentage of emergencies this constituted and it was (not surprisingly) half of the clients (because we have one hospital in Bracebridge and one in Huntsville). Of these, the average time to be seen was well over an hour. This seemed very odd considering if these are emergencies why would it take so long to be seen. The reasons consisted of people who realized it was not as much of an emergency as they first thought, hence they did not bother to come (and did not let us know- then there were vets and technicians sitting and waiting in the middle of the night or a Sunday afternoon), they did not bother to come in as quickly (with excuses such as “we decided to finish our dinner”, or “watch the end of the game” or “I just expected I could come when I wanted”.

As can be imagined these are extremely frustrating scenarios and those are just a few examples.

Additionally, further analysis showed that only a handful of emergencies were such that time was of the true essence. Contrary to what may be believed by many clients, by far the majority of the “emergencies” seen are not truly time sensitive. In fact, even the majority of serious cases such as pets that are hit by cars, stomach torsions/bloat, cuts/lacerations, even broken bones, are not time sensitive. As sad as it is to say, most pets that are hit or run over by a car that are going to survive will survive whether they are seen within minutes or hours. Truly tragic or serious accidents where pets are run over usually die immediately or very shortly thereafter, or on route to emergency care. In fact, ALL cases of pets we have seen over the past two years that have been run over by a car that lived to make it to us would have lived whether we saw them within 15 minutes or many hours.

The final aspect of discussion we would like to put forth is in the numbers we presented already. The majority of emergencies we saw were from non-clients. Meaning that emergency care from other hospitals may not be what you are being led to believe. There is a foreseeable trend all over Ontario that emergency services are so incredibly expensive to provide, have such huge implications for the work-life balance of the veterinarians and veterinary technicians and that very few emergencies tuly require being seen outside of regular office hours that most hospitals are, or will be, choosing to discontinue these services and rely on regional Veterinary Emergency Hospitals.

I would offer to our clients that the chances you actually require truly emergent veterinary care for your pet this year, based on our statistics over many years, is approximately 0.04 %. The majority of situations that could arise for your pet are going to arise during our regular office hours and for those that do not, they will not actually be truly emergent in nature.

We have experienced a small number of negative responses to our announcement and people have transferred, or suggested they will be transferring, their care from our hospitals. We reviewed all of these complaints to date and only 2 clients have actually ever used our emergency service and only one was truly emergent in nature.

So we would like to thank you for taking the time to read through this comprehensive discussion. To those of you who have expressed kind words of understanding and empathy to our team members please know you words have had a profound effect on our morale. To those of you that feel that this is unacceptable I truly hope you can take the time to see why and how this decision was made, that it was not made lightly, and to realize the implications for you are likely to be insignificant.

We will be addressing our regular hours of operation to add hours in the evenings and on weekends to our regular operational hours as well. Hopefully this will alleviate any further concerns.

Sincerely,

Dr Jason McLeod

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