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Balance and boundaries in general equine practice

It is important to find a good work–life balance, and to put boundaries in place to ensure one doesn’t encroach on the other

18 June 2021, at 9:00am

General equine practice brings with it so much freedom and often bountiful client relationships that these elements are often what draws individuals to enter the field. I struggle to imagine a better office than the privacy of my trusty van, nor a better view than the undulating Suffolk countryside in summer and the magical forests of Norfolk in winter. When you arrive at a familiar stable yard to be greeted by your favourite “rat-catcher” or worst “guard dog” to be told the kettle is on, and conversations start with “How are the kids?”, these are the days I thank my lucky stars that I “made it” as an equine vet. Whether it is checking over an unhandled new arrival or euthanising the family pony, there are no visits I dread in terms of the clinical aspects, no matter how challenging some cases can be.

Equine practice is so rich in its diversity, from the horses themselves to the owners and professionals who live and work with them. Every situation varies widely in terms of emotions, finances, diagnostic capabilities, treatment options and what is viable practically. There is certainly little room for monotony in general practice, and this variation and unpredictability is often what equine vets thrive on. This may be why many equine vets (and other species’ vets!) accept the long hours and frequent on-call shifts, as it is just this type of working pattern, and perceived “commitment”, which probably attracted them in the first place.

However, the idyllic lifestyle is a double-edged sword to some. The familiarity which grows between vet and client is largely borne from the reduced number seen per day and increased time spent with each, when compared to much of small animal practice or human GPs and dentists. It is not uncommon in equine practice for clients to have your mobile number, although some practices do not encourage this for obvious reasons. When you work from your car and need to call ahead to inform them of your ETA, or call them back with news or results, you would need to block your phone number in order to avoid this. This may seem an obvious solution, but personally I have found it could create additional work in returning calls and requires greater input and communication effort from the office team. Never mind the more recent addition of WhatsApp to the array of communication means which can be used, this being a particular favourite as it allows the easy exchange of media and documents, of course. So, it works both ways… I would like the means to communicate freely and easily with my clients as required, but this particular street is definitely not one-way.

The phone book and photo albums on my mobile probably attest to the way in which I work. With over 2,000 contacts and 15,000 photos, and I dread to think how many WhatsApp messages, there is definitely a lot of “phone time” with this job. Those long drives through the countryside, windows down, sunglasses on, radio turned up loud, didn’t last long when I began work “on the road”. Soon enough, every minute in the car is spent returning calls, pulling over to write a message or email, finding somewhere to stop and watch 10 videos of a horse trotting round in circles. I wistfully remember days when I had time to stop at McDonald’s for a cheeky McFlurry. Now, more often than not I am watching the miles left in the tank and checking the distance to the nearest BP garage. Rarely do I see the office, so most paperwork is written on a Bluetooth keyboard, hoping the 4G is working on the iPad.

Improvements in communication have had an unfortunate effect on the accessibility of equine vets. Of course, I wouldn’t swap it – I love the technology and all that comes with it – but I do find myself occasionally breathing a sigh of relief when I enter a signal “dead zone”… peace and quiet, for now at least, and back to 90s classics. In recent times I have become much better at turning my phone off when I am not working, or not replying until I am back at work. At first, I worried they would think I don’t care, but I’ve realised I can’t deliver to all those clients to that degree for the rest of my working life. Last week, I took the kids away to the West Country, and while I took my work phone with me, I put the “out of office” reply on and changed the WhatsApp status to “on annual leave”. I smugly arrived to a true, and very consistent, “dead zone” on the edge of Exmoor and hit the pillow content in the knowledge that I was too far away to help anyway and they all have the practice number. The bubble was quickly burst on the way to the beach the following day, as we lassoed some megabytes of data from the healthy 4G that resided there... 23 WhatsApps (mostly unidentifiable skin lesions, wobbly videos of suspected lame horses and some links to horse adverts with the unmistakable background music choices better saved for Eurovision), 12 emails and five missed calls. It was only 10:30am. I checked the collapsed horse had indeed been attended to and left the rest in the glove box of the car.

The fact is, it is wonderful that my clients seek to engage with me so readily about their beloved horses. And some of those engagements are well meaning, respectful and create no offence when they are temporarily ignored. Others are sometimes blurred between client and “friend”. Many horse owners do feel that those professionals attending their horses regularly are part of their “horse’s team”. We too invest a lot of time, energy and emotion into their horse, and I am grateful that they acknowledge this by reciprocating when we need them to. What becomes difficult is that we are never charging for this additional, often “extra-curricular”, engagement and therefore it occurs on top of our normal workload. I feel obliged to squeeze this non-clinical, friendly interaction into any gaps that I have, not only throughout my working day but well into my own time as well. This leads me to a thought I had the other day… what if clients would pay an annual support fee or practice membership (a “retainer”?) which enabled them to call their vet for ad lib phone advice (which would be answered when the vet is able to do so). This could supplement the vet’s income to cover the time taken by the client over the year, which must be significant over that time. Many of my clients are good clients for the practice but a significant number abuse telephone advice disproportionately beyond the income they bring into the practice. Not many other professions would ever entertain the amount of remote support we give to our clients – for example, household engineers, lawyers and car mechanics – they just book you in when they can and charge appropriately for it.

Back in the day when practices were smaller and perhaps more embedded within the community, and where the vets were likely to already be or soon to become practice owners or partners, the advantages to giving pro bono advice to clients probably paid off in the long run. Or certainly one would know the clients well enough and quickly enough to know who to offer that service to and who not to. In larger practices, where you are an employee and the income generated by that client has no tangible influence on you as an individual, it is easy to assume you must keep them all happy for fear of getting complaints for not being helpful enough. This can result in sacrificing oneself to keep the clients content and wanting more, leading to burnout and disillusionment.

At some point, as your career progresses, you may become a practice owner and realise what is most important to you as an individual or what choices need to be made with clients to safeguard the financial health of your business. Or you may remain an employee who develops the confidence to pinpoint the clients who need a firmer set of boundaries, in order to protect yourself. Some people can tolerate far greater blending of their work life and personal life, and happily maintain this throughout their career. Others struggle more, particularly when families evolve and responsibilities vary through middle age, as it does for many. I, for one, am now much better at gauging how much of my time to invest in clients outside of consult time. I am increasingly conscious that this is often time I need to rest, reflect, zone out, just drive or be at home on time. In previous years, I have run on adrenaline, seeming to successfully juggle horse-owner counselling with my clinical work and home life. But as I get older, I find this unsustainable in the extreme at which I was functioning. I still answer all my calls and respond to all the messages, I even still watch all the videos, but I first make sure I have been to the loo, had a cup of tea and, if necessary, scheduled some “admin time” in order to do these things. The slower response time has shocked some clients, but none of them have stopped coming to our practice for their veterinary work as a result; they just all wait patiently for my response as any other normal human being would.