Christie and I recently had the start of a discussion about the fact that most veterinary ERs do not have specialists on staff after hours. They seem to be staffed with predominantly recent grads who are general practitioners (obviously there are exceptions; there are lots of seasoned and experienced ER docs out there). But when you need a specialist (for example, a surgeon) in the middle of the night, there are none to be found.
Many ER docs can perform surgery, and they do a very good job in the vast majority of cases. There are some cases, however, that would benefit from someone extensively trained in surgery through a residency program, and who only does surgery. Additionally, there are some owners who are more comfortable with (read: demand) a board-certified surgeon when their pet goes under the knife.
At 3 in the morning.
I think this is something that she and I can take further, but I wanted to poll the tiny and loyal readers of PetConnection to get their take on the issue.
Shift work, especially overnight work, is grueling and unhealthy. There is a reason that most jobs are 9-5, M-F: that is what our bodies have come to expect and can tolerate.
By contrast, a veterinary ER doc or technician can work 16 (in some cases, 24) hours straight with not so much as a pee break. Burnout is an ever-present threat, and the average lifespan of an ER doc is about 4-5 years.
At some point, we tire of the hours, the endless fights over money, the naked carelessness, neglect and outright cruelty that ER work can shove down your throat. Some can subsist on the adrenaline rush, or find a way to partition things so they can continue to function in the ER year after year, but for many, the toll becomes too much and they seek the so-called “cushy” shifts during the day.
One out is to become a specialist. This was the path I chose when the overnights and the burnout became too much to bear — coupled with the desire to start a family and actually, y’know, be home. N’stuff.
So, when the specialists have completed their training (which involves a crapton of overnight or on-call work) they typically think to themselves “I’ve paid my dues — hello day shift!”
On-call work also means a loss of freedom for the person doing it as well. It’s no picnic. Imagine if you were on call tonight. That means no glass of wine with dinner, no relaxing and knowing that the night is yours and no one can bother you. You are just one pager beep away from dropping everything in the middle and rushing in.
And, coming in in the middle of the night means that your day will almost certainly be craptacular the next day. Can you imagine leaving your family at home in the middle of the night to spend four hours doing surgery, knowing you are going to have a full docket of surgeries the next day, too? It only takes a few times for this to suck the soul and lead to the search for greener pastures.
Somehow, in human medicine, they manage to do it. They have surgeons on call all the time. (Not every specialty does this on-call rotation, though — you would be surprised what they let the green docs and residents do in some specialties). But for MDs there is usually a more spread-out on-call schedule (as there are more of them) and the financial rewards, sad to say, are significantly higher that for veterinarians.
So — what’s your take?
Do you begrudge the poor, tired ER doc’s wish for a simpler daytime existence, knowing that it may mean that there are fewer specialists around in the wee hours? Or are you of the camp that thinks a fully functional clinic should have a line-up of specialists in multiple disciplines a phone call away at all times?
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