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The life of the single-handed practitioner

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01 November 2015, at 12:00am

GARETH CROSS talks to an old university friend who has set up on his own about the positives and negatives of going solo and how he manages to find any time to sleep between working all day and doing OOH

THIS month we are carrying on the theme of different types of veterinary practice and focusing on one practice which represents a minority group in the profession – the single-handed practitioner.

The average size of a vet practice in the UK is four FTE vets. Of these single-handed practices the few I know of personally have relinquished their OOHrs in the last few years. So when I heard that an old university friend had gone out and deliberately set up a singlehanded veterinary practice I was quite interested; when I found out he was doing all his own on-call I was struggling to find the right adjectives – fascinated, worried for his sanity, shocked, etc., all sprang to mind and other vets simply replied, “he must be mad”.

Well was he? Is he now? To find out I rang him up and the initial signs regarding his sanity were quite reassuring. He had just sat down to eat a slow cooked lamb bhuna he had made and asked me to phone back. Never get between a man and his curry.

Half an hour later we spoke on the phone and he agreed to answer some questions on e-mail. The practice is “Number 1 Vets” in Rugeley and is based in a converted pub. Interestingly if you look it up on Google Earth and use street view it is a pub on one side and a vets on the other.

He lives “above the shop” and commented that it was “cosmic synchronicity” that he had ended up living and working in a pub. It certainly would fit well with the student I knew just a “few years” ago.

So here is James Cadwallader’s take on veterinary life and it is a distinctly different take on work from the usual push for no OOHrs and corporate employment that attracts so many others.

I first asked for a brief professional biography since I last saw him: “I’d been qualified 11 years having worked in two practices prior to opening Number 1 Vets. The first two years of my career mixed then drifted more to SA and I’ve been exclusively SA for eight years now. I felt I needed a little more independence and to be allowed to develop a practice with my ethos. So Number 1 Vets opened in August 2011.”

When you left employment or were considering to do so, what were the options you considered and what were the things that put you off the JVP option (I think that’s what you said on the phone) and what things attracted you to running your own place? Have those pull factors been proved true or is it living up to expectations both in job satisfaction and financially?

I had looked at a JVP option to owning my own business but after discussions I felt it wasn’t the way forward for me. The lack of independence and the targeted/power selling approach made me think I wasn’t their ideal candidate. I wanted to deliver what I thought was best for the client rather than the parent company.

I offer my clients a traditional practice with a good service at a reasonable price. I don’t currently follow the business ethos of tying clients to the practice financially; rather we try to bond with the client through a friendly, reliable approach.

Doing my own OOH is a major factor in this. For the moment this seems to be working. I am as busy as I can cope with even with a part-time vet joining us a few months ago.

Was working as more or less a sole practitioner the aim or is it just a phase until you can expand?

There are a few sole practitioners about and I think it’s hard to get going as a single vet. The hours are a bit intimidating, support isn’t available to all and it’s been difficult finding assistance.

If someone had said how difficult it would be to find a second full-time vet, I wouldn’t have believed them. I think that certainly people find the smaller size of the practice a little scary perhaps imagining they would be left on their own to struggle.

At the end of the day it’s my practice and reputation so I would never leave my assistant struggling. Even when not at work my phone is always on. I was very lucky with my locum who saw how well the practice worked and what a team we were and decided to join us permanently.

Support wise, online CPD, an extensive library, a very helpful local referral service and friends have all helped over the years!

There are still a few sole practitioners around. What are the benefits and the drawbacks?

Despite working 360 days and nights for the first two years and probably 340 for the last two years I am happy. Being proud of what has been achieved by the team helps and there is light at the end of the tunnel with regards more time off. Financially I’m still worth more dead. I get pocket money off my wife and I hopefully get a proper holiday in 2017! Benefits of being my own boss... my ideals, my plans and my choices, right or wrong.

The practice is themed on my values and personality – what would I look for in service from other shops and businesses?

My team and I work out of a converted pub, the reception desk is the old bar and my border collie works behind the counter. All in all it’s a friendly, welcoming environment for the clients and animals alike.

Clients value continuity and the most common reason for new clients joining the practice is never seeing the same vet twice and personal recommendation.

Continuity is difficult not to achieve here but the clients have welcomed the part-time vet, understanding that I need to have a little bit of a break but we take care not to book the third reex of an eye ulcer in with the part-time vet if I’ve seen it twice before.

Our part-time vet’s arrival has made a considerable difference to my quality of life as well as allowing us to consult and operate more hours a week.

The negatives of sole practice are the hours, the never-ending oncall and a loss of social life. The slight problem of success and growth is more hours consulting, which creates more ops and less time to do them!

However, Cannock Chase is practically on my doorstep and the mountain bikes help keep me sane.

Your practice business structure is very traditional. Do you think the clients are very aware of it and do they comment on it? It certainly comes across on your website (we try very hard at ours with four vets to get good client continuity and one of the main reasons clients tell us they have come to us and left another practice is “We never see the same vet twice.”)

I can’t talk about how clients are seen or treated at corporate practices as I’ve only locumed in them and not really stayed there long enough, but I’ve seen a few schemes designed to tie the clients to the practice.

I’d rather bond with them and have them choose to come back rather than not being able to go elsewhere as they’re financially bound to the practice for another year.

A smiling face behind the counter, kind words when needed and a happy reception dog are enough to keep people coming back.

This is a big one: why did you choose to do your own on-call? I am assuming that there are OOHrs providers in your area – correct me if not. In the early days it must have been 100% sole charge on-call – how did you cope?

The decision to do OOH was the hardest but I have always believed that people want to see a familiar face or even just surroundings when something goes wrong in the middle of the night and loyalty works both ways.

An answerphone directs people to call the mobile in case of emergency so that tends to rule out time-wasting questions on the cost of flea treatment. I also get to give advice if needed and recommend if an animal does/doesn’t

really need seeing. It’s not always been easy but after a busy night if I can get a 20-minute snooze in the afternoon the nurses are very good at not interrupting me!

The nearest OOH provider that wouldn’t be a direct competitor would be about 40 minutes away. Two nearer hospital practices offer some service but would be direct competition. As with all OOH especially at a practice of 1.2 vets we don’t get called every night but some nights I’m awake more than I’m asleep.

But those are the nights you tend to remember and often when you get the Caesars and GDVs!

What’s the longer term plan – keep the small practice feel, build it up and sell out?

The long-term plans and hopes are for the practice to grow. There would be room for five or six vets here so we definitely future-proofed!

Looking to the dim and distant future I would far rather leave the practice to the established vets here (probably partners looking forwards) than sell out to a corporate group.

Being the owner on-site is a positive – staff are able to get answers to the important questions when needed, support when needed on the phone or to clients in the waiting room. Also clients are reassured that if a nurse is unhappy with an animal the vet is there to help.

As a boss though it is nice to be able to help the girls by answering a ringing phone or cleaning a kennel when they’re all busy; it’s a little way of thanking them for all the support I get from them.

Any advice for people considering setting up from scratch?

Be prepared to give up on life for a few years. Whatever you want in life has to be worked for and earned. I’ve chatted to a vet from a local practice who was moving to North Wales to take over a small practice there.

What goes around comes around so if you receive help, remember to give it if it helped!

That and you need an understanding and supportive other half! I couldn’t have done this without my wife, Sam, and my parents.

It is good to know that the increased corporatisation of the profession, while not necessarily a bad thing by any means, is not the only story in town.

There used to be a word used a lot when referring to vets that you don’t hear so much now but it springs to mind after reading James’ responses. I think the word was “vocation”.