Is it time for a haul-in?

Ever since the first equine veterinarian embarked on a farm call, two questions have plagued the industry:

1) How do we capture fees relative to the time and expense of travel?

2) How do we predict the time involved in that travel (and its subsequent impact on the daily appointment schedule)?

The simplest solution that addresses both of those concerns is to put the responsibility on the client by encouraging haul-in appointments.

Kyle Palmer, CVT

While it's unlikely that equine practice will fully transition away from ambulatory services, using a haul-in facility offers an alternative that benefits the client—and your practice—in a number of ways.

Most veterinarians I've spoken to say that the fee for their farm or house calls has never—and probably will never—reflect the actual travel time or fuel costs, not to mention other vehicle-related expenses. Many have simply stuck with a fee schedule that was implemented years ago—one that has risen unremarkably over time.

No doubt, picking a bare piece of land and scheduling a day's worth of calls that come to you would be a sharp improvement economically, but with just a little investment the concept can provide benefits that go beyond financial. Consider the components and benefits of a successful haul-in facility:

SHELTER

Being able to work on a patient with protection from wind and rain is a luxury that doesn't exist on some farm calls. A two- or three-sided pole barn can be adapted easily to create a comfortable workspace, and those who want to make a more significant investment might consider one or more stalls or a fully enclosed facility.

LIGHTING AND ELECTRICITY

Extension cords, mobile vehicles equipped with outlets, and head-lamps provide the minimum needs in the field, but nothing compares with having the power you need, as well as outlets, at your immediate disposal. Headlamps may still "rule," even in a haul-in scenario, but having the ability to create a broader field of illumination is helpful.

FOOTING

Unfortunately, not every horse owner can afford a stall barn with an improved work area, and conducting examinations and procedures on uneven ground can create safety risks for the horse, the owner, and the veterinarian. A round pen with a floor of the veterinarian's preferred surface material creates an ideal area to lunge a patient and will aid in lameness diagnoses.

STOCKS AND PALPATION CHUTE

Among the most dangerous procedures performed by equine veterinarians is the rectal palpation. Most experienced practitioners are able to use whatever is available in the field to avoid being kicked or injured, but a well-built stocks system provides confidence and protection during risky procedures.

ACCESS TO STAFF

While many equine practitioners have conceded that they need help during calls, many still prefer to practice alone. For mixed animal practitioners, locating a haul-in facility at the same location as your small animal clinic allows the dual use of staff members when needed.

RADIOGRAPHY PROCESSING

If you still use traditional film-based cassettes or a computed radiography system, being close to the processing unit is invaluable. The ability to quickly identify and retake a bad shot can save time, and allowing the owner to view the films in person is an option that doesn't exist without a digital radiography system.

AVAILABILITY OF SUPPLIES

Whether you have a mixed practice with a small animal clinic or simply a storage area at your haul-in facility, having supplies at hand will reduce the number of trips to a client's barn—or the need for them to travel a second time to you.

In the trenches

SCHEDULING AND COMPENSATION

Nothing compares with the time and fuel savings of having a haul-in schedule. In ambulatory practice, depending on your coverage area, it may be realistic to plan on four to six appointments per day. If your average invoice amount is $200, that's $800 to $1,200 per day that you're bringing in. With a properly scheduled day of haul-in appointments, it's possible to double that.

Average invoice amounts for haul-in cases may be slightly lower because they lack a house call charge, but you'll more than make up for it with a higher volume of invoices, saved fuel costs, and no drive time. If your average invoice drops to $150 but you see 12 clients instead of six, that's an increase of $600 per day—$150,000 per year.

THE FLIP SIDE

Despite the many benefits of a haul-in facility, there are drawbacks as well. Just as ambulatory practitioners struggle with traffic and unpredictable travel time, so will the clients who are driving to you. Ambulatory practitioners who typically have a full day of appointments and driving will find it difficult to wait around for the client who is always late or the one who gets lost.

Also, failure to provide a spacious entry and parking area can result in a lineup of horse trailers. Some practitioners elect to have a circular turnaround that allows trailers to come in and go back out, but clients who are early or late can make it difficult to see patients according to schedule. A large area with multiple, head-first-style parking spaces will prevent "out of order" appointments and keep your entry and other parking areas free.

Overall, there are a number of benefits to a haul-in facility, but it might not be the best solution for everyone. Do an honest evaluation of your work needs and finances before haulin' into this option.

Kyle Palmer, CVT, is a practice manager at Silver Creek Animal Clinic in Silverton, Ore. To comment, email ve@advanstar.com.