Veterinary Economics reader response: Overnight-only emergency clinics aren't "dangerous"

In April 2014, Veterinary Economics Editorial Advisory Board member Dr. Fred Metzger argued that transferring patients from an overnight-only emergency facility in the morning to the clients’ normal veterinarian could be dangerous to patients. This doctor in a letter to the editor doesn’t agree.

I read all your publications monthly and am usually impressed by the content and relevance of the subject matter. However, I was taken aback by the article about 24/7 care.

I practice in the same county as Dr. Fred Metzger. When he went to 24/7 care, I sent him an email thanking him for bringing new options to the local area. Dr. Metzger has improved the standard of care for most small animal hospitals in central Pennsylvania through the continual evolution of his veterinary practice. But as a participant of the competing emergency practice, I take umbrage to the dismissal of that practice as dangerous.

Is your publication a forum for general practice, or are you only advocating what your practitioner board deems necessary? Personal bias should never have appeared in the article. Is your job to inform or promulgate only what your board deems necessary?

Hopefully, you will get back to your mission of providing business tools, ideas and inspiration needed to fuel the passion for practice and leave the unnecessary personal bias out of well-intended articles.

John Shapira, DVM

Straley Veterinary Associates

Bellefonte, Pennsylvania

Dr. Metzger replies:

I appreciate Dr. John Shapira’s compliments about our “raising the standard of care in central PA” and I think central Pennsylvania pets greatly benefit from our competing ER’s. Dr. Shapira’s emergency practice does a great job and we frequently collaborate with their overnight doctors on cases.

I have been a member of the Veterinary Economics and Veterinary Medicine magazines’ practitioner advisory boards for over 15 years because I give my honest opinion and I’m not afraid to give input on controversial issues-that’s the mission of a practitioner’s advisory board.Does personal bias enter into an opinion-of course! However, anyone who knows me realizes that my goal is to always improve patient care and improve the standard of care in veterinary medicine worldwide. Sorry if I ruffle some feathers but if it helps someone’s beloved pet, so be it!

Many overnight ERs will send the patient back to the primary care doctor in the morning because the emergency hospital closes—but transporting a critical patient can be dangerous for the patient and the person doing the transporting. Many cases can be transferred easily, however, there are many examples where transporting may be detrimental.

Some surgical examples of cases that are better left in one place include:

> Fractures, especially complicated ones

> Gastric dilatation volvulus

> Recent laparotomies

> Thoracotomies

> Back surgeries

> Amputations

Some medical examples:

> Patients with chest tubes

> Serious arrhythmias

> Patients requiring continuous oxygen therapy

> Patients on ventilators

I’m also concerned about pet owner safety, because they must transfer pets that may be in pain, and most owners aren’t adequately trained to handle ill pets. I’m sure there are cases of serious automobile accidents caused when owners were preoccupied with their pets during transport.

And finally, would you want to be transported daily from the ER to your primary care physician every morning?

Cheers!

Fred Metzger, DVM, DABVP

Metzger Animal Hospital

State College, Pennsylvania

Dr. Fred Metzger graduated with honors from the Purdue School of Veterinary Medicine in 1986 and is a diplomate of the American Board of Veterinary Practitioners. He is as an adjunct professor at Penn State University, and he has written numerous publications. He practices at Metzger Animal Hospital in State College, Pa.

Do you have questions about around-the-clock facilities for Dr. Metzger or other Veterinary Economics Editorial Advisory Board members? Email us at ve@advanstar.com