Local veterinary emergency care in the Twin Tiers has been dwindling to its current state of non-existence for several years. Fourteen years ago, when I began my career at Lake Road Animal Hospital, ER care was relegated to a group of five area practices to share coverage. Those five practices provided ER care for only the established clients of those five practices. Every other practice turned on their answering machine with a message to call Cornell if you have an emergency at the close of their business day. Coverage provided by the group of five veterinary practices working together had already been reduced by the time I arrived at Lake Road from 24 hours of coverage to coverage until 9 pm weeknights, 8 am to 7 pm on Saturday, and 9 am to 5 pm on Sunday. It has continued to decline each time a member practice lost a veterinarian to retirement, a life change, a change in ownership of a practice, etc.

Each departure has thrown that group of five practices into turmoil, as every provider understood the ramification of reducing care. But how could an ever-dwindling number of people provide the same quantity of service that had been offered previously? Veterinarians do need time to care for their own families and pets and to sleep sometimes. We have tried to recruit more area practices to participate to little avail. If we added one, another practice dropped off. There was simply no way to stitch together any feasible ER coverage for the remaining practices due to staffing shortages.

Veterinary medicine is a team sport. A single doctor (with or without a licensed veterinary technician) cannot always provide appropriate emergency care without assuming a significant risk of being sued for malpractice in the event of a poor outcome. The base-level standard of care for veterinary medicine increases seemingly daily. The days of James Herriot are long gone. Veterinary medicine has advanced significantly over the 30 years since Dr. Herriot’s death. And if a single doctor and technician are tasked with an emergency case, that often means they can provide care for no other pets during the window of time they are managing the single emergency. That fact backs up general day practices every single day around the world.

There is a limit to the number of pets a doctor can treat per day, and that number is highly dependent upon many factors: How critical is the patient? Which staff members are working? (This is important as not all team members have the same skills and abilities). What kind of treatment does the patient need, and does the practice even own the necessary equipment or supplies? If you have been turned away from a practice regarding your emergency, you should realize that when a receptionist tells you they cannot see you, it is NOT because they want to go home, but because they know the team is already taking care of as many patients as possible, or they don’t have the equipment or medications your pet is likely to need.

So what do we do?

I have had clients tell me that we need to hire more doctors. I agree, and we have been advertising for doctors since October 2020. We had TWO applicants between October 2020 and October 2021. One of those applicants withdrew their application when they realized we were part of an emergency group. The other was a local practitioner and would not have expanded the total number of doctors available to the area. Many other practices in the Twin Tiers are also advertising to hire doctors, and most of them have been advertising longer than Lake Road.

Why can’t we hire doctors?

The cost of living in NYS is higher than in many other areas of the country. Veterinary medicine does not have many patients covered with pet insurance (I believe about 2% of the US pet-owning population has pet health insurance), meaning the field is primarily a cash-based system. Veterinarians have always depressed their fees intentionally to ensure that clients can afford care. James Herriot would accept payment in the form of eggs to ensure patients received care! This practice has led to an industry-wide issue with poor wages and little to no health insurance for team members. And yet, we are still told daily that we’re only in veterinary medicine “for the money.” The median veterinary salary in the US in 2019 was $96,460, as reported by US News. Keep in mind this figure is for ALL veterinarians. Newly graduated veterinarians make less. Mixed animals (i.e., they treat large animals like farm animals and companion animals) veterinarians often make less.

Too many veterinary practices are in existence with a profit margin of 5 to 7%. That isn’t a sustainable business model, as it doesn’t allow for reinvestment into the practice. That does not leave enough money to provide for continuing education of our teams, money for new roofs on our practices, money to replace or repair equipment that breaks, better staff wages so we can retain our people, or growth of any kind. Many practices are literally scratching by year after year. And now we’re beginning to see those practices close their doors. Many of the people in those practices are so disenchanted with veterinary medicine that they just leave the field completely.

Veterinarians leave vet school with huge debt loads. Student loan debt can range from $200,000 to nearly $400,000, depending on where that doctor had to go for training. Many veterinarians live abroad for veterinary training because they can’t get into US schools, and that adds to their debt load. If you’re graduating with that kind of debt, you can’t afford to work in a practice that can only afford to pay you $95,000 a year unless you have a life partner with better financial circumstances.

Further, what do the Twin Tiers have to offer? Our area lacks jobs for other professionals (many of whom are married to veterinarians). If both parties cannot find employment, the couple or family isn’t likely to relocate here.

Hiring doctors is an answer to the issue, but it’s not one that will bear fruit anytime soon. It’s an arduous process, to say the least. Further, adding doctors will not create emergency care immediately. Many practices are hiring to fill vacancies, not to grow their practice. All I know for certain is that every practice in the area is TRYING on this front.

What else can we do?

Lake Road Animal Hospital has partnered with Guardian Vets to ensure that our clients are not left only with the option of calling Cornell. We pay a fee to offer this hotline to our clients, and this is likely the reason other practices have not chosen to partner with this service. Guardian Vets bases their monthly fee on the total number of doctors in your practice (which is a measure of the number of clients a practice has and, therefore, how many staff they will need to cover calls). We cannot open the service to all pet owners in the Twin Tiers as our monthly fee would sky-rocket due to the increased number of calls. We will support our clients, but we can not afford to support every practice’s clients. Guardian Vets is a national-level company staffed by veterinarians and technicians who are licensed to practice in the states they take calls from. They answer calls after we leave the practice until we return. They can offer guidance on whether the issue your pet is experiencing needs immediate veterinary care or can wait until we reopen. Is this true emergency care? No, but it is better than just calling Cornell. We wanted to alleviate all the calls going to Cornell for them to triage, as we know they are being crushed (along with every other ER facility in the country). This service allows our clients to know if they even need to contact an emergency clinic asap or wait until we can help their pet the next business day. There is always a percentage of calls that are really just perceived emergencies and can wait for our team to be available.

What can you do as a pet owner?

1. Establish a relationship with a veterinary practice. Do NOT wait until your pet is experiencing a health issue to call a veterinarian. Many practices do not have space to care for new patients. This is particularly true if your veterinary practice has lost doctors in the past two years. The remaining team is struggling to meet the day-to-day demand of veterinary care needed by existing patients. As I previously stated, there is a physical limit to what any veterinary team can do in a single day. Lake Road has helped as much as possible with overflow from area practices, but we also have limits.

2. Follow your veterinarian’s recommendations for preventative care based on your pet’s lifestyle. Another percentage of emergencies with pets are fully preventable. Ensure that your pets’ vaccinations are kept current. Spay or neuter your pet. Keep your pet contained to your own property. Those simple things can keep your pet out of an emergency situation.

3. Do NOT wait to call your veterinarian. If you see an issue, call. They will help guide you through the best course of action. Do not wait because you don’t have money for a veterinary bill today. The price will only increase as your pet’s condition deteriorates, and the likelihood of a positive outcome also dwindles with time. Veterinarians are adept at prioritizing care to meet a budget. In addition, Lake Road Animal Hospital offers no-interest payment plans to qualifying clients (and this is not just for clients with stellar credit scores, almost ANYONE can meet the qualifications).

4. Do not take to Facebook and ask your friends what to do before speaking with your veterinarian. They are not qualified to give you advice about something so precious as your pet’s life. Dr. Google can provide you with good questions to ask your veterinarian, but it should not replace the conversation.

5. If you are directed to an emergency facility, proceed there as quickly as possible and prepare yourself to wait in your car for an extended period. If you can find childcare, take it because having kids cooped up in your car during a stressful situation generally only adds to the stress. Remember that you may need to hear and process the news that will cause you significant emotions. Take a book, your cell phone, and charger, information necessary to apply for financing options, tissues, snacks, and drinks. Be grateful if you have to wait longer than others to get your pet inside, as that means your pet is not in critical condition.

6. Be KIND. Never forget that people are far more inclined to help you when you are kind to them. Yelling at people is no way to get them to want to help you. The people in veterinary medicine care deeply about your pet. They want to help. After being treated poorly for failing to meet unrealistic expectations, veterinary team members carry the sorrow, guilt, and anxiety that are thrust upon them for a very long time. Some commit suicide when the crush of verbal harassment becomes too great. Some leave veterinary medicine to pursue goals that do not involve being called names by clients. Most of them go home and cry and wonder why they get up and go back to work.

Everyone is stressed. Everyone has challenges others know nothing about. We understand that you are in a highly emotional state when you visit with an ill or injured pet, and we will give you great latitude with regard to your behavior. But try very hard to be kind, patient, and ask questions rather than sling insults.

We are all on the same side here. We all want animals to be happy and healthy. We need to work together to find solutions to the issues.