I wanted to start with this topic because I think it is important for everyone going to the vet ER with their pet to understand what might be causing the “hold up” As a busy individual myself I understand that nothing is more frustrating than feeling like people are wasting your time…So let us investigate why the ER clinic might be taking so long to see your pet.

To begin we need to remember that ER clinics do not have appointments so people are not trickling in like a well controlled stream. Often they are coming in large bursts of 2,3,or sometimes 4+ cases within a small window of time.

Many times  these cases are not regular clients meaning checking a new patient in and getting all the emergency contact information will act as quite the bottleneck. (and a VERY necessary one at that.) We also see cases on the “triage” system.

“Triage” is a fancy smanshy word we like to use that means “to sort”. We sort all the cases that present to us by level of urgency, pain level etc. This is why you might see a client that came in after you jump right ahead in line — seems a little unfair but trust me we are thinking very carefully about how to manage each case in order to optimize everyone’s outcomes.

When you first walk your pet through the door an ER technician/senior staff member is summoned and they may ask a few questions, collect some vitals and maybe a BRIEF history. With this info they can reliable gauge your pet’s urgency level. Now trust me on this — these folks are highly trained. If your pet is deemed really ill you may see/hear them ask permission to bring the pet directly back to the treatment area where the attending doctor can make medical decisions and provide treatments much quicker.

Here in lies a critical point — so important I will repeat it again. Because we rely on triage to optimize outcomes in the ER clinic, it is possible that individuals with less sick animals will be skipped over initially so that the more sick animals can be seen first. Our job as an ER vet is to try and communicate this to you, but at times when things are really “heating up” being proactive and asking the client service coordinator or other available staff for an update is a smart idea. Just try and remember that we just cannot predict with certainty what will charge through the door next.

Some examples of cases that may jump ahead of the line includes; difficulty breathing animals, hit by car animals, seizure cases and collapsed animals.

Some examples of cases that may go behind more severe cases includes; vomiting, diarrhea, weight loss over the past few days, sneezing etc.

Another potential bottleneck in ER medicine is emergency surgeries or a high demand for the same medical equipment. A great example is 3 cases that all need chest x-rays. This will slow things down because most clinics have only one x-ray suite. Surgeries can take some time because they require the skills of the doctor specifically — no one else is allowed to perform actual surgeries.

The last area of slow down – finances. This is something that I hear complaints about from time to time. Most of the time when finances are discussed in a negative manner it means we are not accurately portraying the value of the tests or treatments we are recommending. Once the value is communicated most pet owners quickly see just how much that blood test will help in finding out what ails fluffy.

That being said some treatment plans are cost prohibitive, and as a general rule 100% down-payment on the low-end of the treatment plan is required at many ER clinics. Not owning my own practice, I can only wisely speculate on why this is. But I can tell you that offering the highest quality of medicine with 24/7 certified technicians on staff in conjunction with the surgical tools and diagnostic equipment needed — can be quite expensive. Many clinics overtime have shifted away from the idea of “payment plans” instead allowing people to pay for the expenses using alternative forms of payment like CareCredit. (along with accepting most major credit and debit cards) Checks are usually not an option at ER clinics due to the very new relationship the clinic may have with the patient’s owner. When finances are tight, especially with a complicated case with a complicated treatment plan, it may take some extra time to collect the downpayment–thus taking more time. We just ask that others are patient while families decide what and how they wish to pursue treatment for their pet(s).

Alright lets sum it up for you that don’t like to read from top to bottom

  1. TRIAGE may allow other pets that are sicker than yours that come in after you to go ahead of your pet. SOLUTION; approach with an open mind, our job as the ER vet is to treat the most life threatening things first and if you are at the “back of the line” that is technically a good thing with regards to your pet’s stability. 
  2. ER veterinarians may be wrapped up  in a complicated procedure monopolizing their time and we can only exist in one place at a time SOLUTION; asking the front staff if the ER doc is in a medical procedure, and if so and if the situation allows it asking if there is a better time. 
  3. Finances are a common hold up – and down-payments of 100% are commonly requested. Sorting out these details can be a lengthy discussion. SOLUTION; know your ER hospital’s policy, know your own personal financial limits with regards to emergency situations, and don’t be afraid to be upfront with the vet about finances — this allows treatment plans to be tailored appropriately. 

A hidden secret; The ER’s I have seen tend to be the least busy around 5am  and 6am.

That’s all for now – rob

 

 

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