Case study: Investing in overnight care pays off

Clients like to know their pets will be taken care of by doctors they know and trust in an emergency, so having a doctor on staff 24 hours a day just makes sense to us, says Dr. Tom Nelson, co-owner of Animal Medical Center in Anniston, Ala. "Besides, the nearest emergency clinic is 60 miles away."

Since 2002, when Dr. Nelson and his team moved into a new facility with sleeping quarters upstairs, a doctor has been at the practice overnight to handle emergencies and monitor critical-care patients. The seven doctors rotate nights, each coming in at varying times for a regular shift and then staying the night. When the idea was first broached to the team, two doctors immediately volunteered to take the weekend shifts, making scheduling easier.

"We installed closed-circuit televisions in the hospital with monitors in the doctors' apartment, so the person on shift can easily keep an eye on critical-care patients, hospital wards, the boarding suite, and the entrance to the practice," he says. "Keeping a doctor on at the clinic overnight is good medicine, and it shows we care about our patients."

The practice charges clients with late-night emergencies $100, which includes an emergency fee and the regular exam fee, whether the patient is a regular or someone new. Of course, any additional treatment is extra. Emergency care brings in $400,000 in additional annual revenue. "And because the doctors split the shifts evenly, no additional pay is needed," Dr. Nelson says.

The practice recently added an overnight technician on Fridays, Saturdays, and Sundays to help during these typically busier periods. Technicians are paid $30 to spend the night and clock in anytime an emergency case is brought in to receive time and a half. "Our goal is to have a technician on all seven nights, but we'll be fine-tuning things as we go along," Dr. Nelson says.

"Other doctors send clients to us for emergencies, instead of the emergency clinic that's much farther away," he says. "I'm glad for such a strong community response."