I did not post anything over the weekend. I started to worry that the same thing was going to happen and the initial excitement faded away and I lost interest in blogging. Then I realized that I worked all weekend and when I am at work my days are not really interesting. Usually I am tired in the morning, but make my way to the gym, after that I go home, eat lunch and a few hours later I am back to the gym and work again.
I don't do mornings! To be honest this job just ruined my cycle, Ok I was always a night person, prefered to stay up late (just check the time of my blogs). I simply think I am more creative that time of the day. Contrary the mornings are horrible. Especially getting up "early". Well, that is a relative expression and my definition is very different from average people opinion about it. If I have to get up before 10am, I consider it early.
Saturday night and the following morning was horrible. The tendency is that we are usually busy, but managable in the evening, but after midnight we can't predict what will happen. This Satuday was something we call lately as usual madness. It pisses me off, frankly. People think that we are there for convenience. The way the world goes around these days is that you can do everything non-stop. You can shop, eat out, require customer service, etc. So people started to think that veterinary service is also something similar. It could be, but it is not their decision. As I explained earlier, my company and all the clinics consider themselves as dedicated emergency service. First of all I don't agree with this, because the setup we all work in is not suitable for emergency medicine. Our patient can stay on the premises 15 hours the most through the week and 45 hours in the weekend. Now, if we are talking about proper emergency and critical care (ECC), this timescale does not allow to provide the most advanced ECC. There are other obstacles though. The one-vet-one-nurse setup also makes it very difficult to look after and treat animals properly. We can only dream about working up a case as it should be done. The vet, but especially the nurse can be so busy that the in-patient care is less then efficient. The infrastructure is also against any state-of-the-art medicine. And at last, but not least the client's financial circumstances are also in the way to do our best to save, treat and cure the patient.
Considering all of the above, what we do rather could be called "battlefield medicine".
The patient comes in, go through a quick and most of the time not full physical examination and get the basic and essential treatment for the suspected problem. Quite often we only keep them alive for the usual practice, so the cilent can take them back to their vet and they can do the proper or more appropriate treatment. I understand the concept, certainly. We do not want to interfere with our member practices and "steal" their money doing more than absolutely necessery, but it could be very frustrating from time to time. One could say that a good vet does not need more time to work on cases. I thought that it was true and it was only me being not good vet enough when I looked up things in books and calculated drug doses accurately. Then I have been in the States and saw that internationaly well known lecturer vets opened up reference books or searched the Internet for articles relation to the case they were dealing with. So the reality was just the opposite than I had thought. A good vet do look things up and research and invest time into the cases.
Certainly there are advantages of the battlefield medicine. One can learn how to prioritize, make quick assesments, do effective consultations. There are also important attributes of a good vet, but not enough.
Oh and for me it was a very good opportunity to improve my English.
I was told once I got back from the US and introduced my idea to my staff and my managers that the UK is not ready for that kind of emergency service I had seen in the US. I can see where they are coming from, but I always say, if we wait for the country and the people to be ready for something, either they won't or someone else will do what we planned to do.
I am not a business person, I have a degree on veterinary medicine, but I read things and listened to people and learnt a few things about how to run a business well.
It seems to me that my company is either without concept which I doubt or without knowledge to accomplish what they planned. It is just common sense. If you start a business, you need to have a plan, a target group and financial background.
Now, we know that the proper emergency and critical care is an expensive hobby. I'm sure I would start the whole process to research the market and find those people who have enough money to spend on luxury (keeping animals is a luxury, trust me) and also have the intention to spend it. I would go to offices and companies who do surveys and statistics about the population and buy information (or if possible get it for free). Then I would take a map and a marker to mark the areas where these people live. So this way I would have the location of my future clinics. The next step would be to persue them with my idea (because the idea was good at the begining, offering OOH service, so not being competition to them) and choose only a few of them as future partners, mostly those who have large client basis. So doing these I may secured a fairly wide client basis packed with money ready to spend on their pets. The rest depends on how much money I have to invest. My company's concept was to use the premises belonging to one of our member practices, so this way they could save money (lots of...) on building a clinic. The downfall is that the building is not the company's property, so no alteration, remodelling is possible without the permission of the host practice and also the staff won't consider it as theirs, therefore they will be less enthusiastic to develop and improve it. So if I thought of a long term investment, I would build or buy a building. Buying is difficult, because veterinary clinics have special needs. So by this point, I have a building which is my own, a client basis through my member practices with money and a good plan which will be accepted easier by the member practices. The next step is the staff and I could face with the usual dilemma: hiring experienced and well-educated people for more money to pay them or find less experienced, but eager people, educate them on-site and pay them less money. I don't have so clear opinion on this as I had on the others. As I am very maximalist, I tend to hire experienced staff for more money. Again, in the long run it would be worth the investment, I am sure. Ok, here comes the maths now, playing with the mumbers such as expected number of clients per month, expenses per month, profit, etc. That is not my cup of tea, I would hire someone to do it. Well, so far we have the building, we filled it in with staff, contracted the member practices and secured a wealthy client basis, did the maths, so we have a picture of what we can expect financially. Certainly we need equipment on the premises, so let's go shopping. This is the area where I can't compromise. It is not possible to work with cheap or faulty ones, so I would buy the best. I am not saying not to look for discounts, sales or other ways to save money. Probably I would contract with suppliers for long term supply. Opening. Maintenance. Support. Relationship. Important things to concentrate after start. Finally playing hard. As the stand alone OOH practice is not feasable, eventually (after proved the highest quality of service to pet owners) turning the practice to a 24-hour clinic and being a referral center with high prices, but with even higher standards of care!
Well, that is my vision of the ECC service...