Old school, new school: On call and ticked off

February 28, 2017
Jeremy Campfield, DVM
Jeremy Campfield, DVM

Dr. Jeremy Campfield lives near Sacramento with his family, including an aging mini Aussie and an obstreperous pitbull mix that some mistake for a chocolate Lab (to the delight of her owners). When the family is not getting their hands dirty in the garden, Dr. Campfield indulges in his love for the outdoors with hiking, kitesurfing and climbing aboard any two-wheeled contraption. Please remember: Watch for cyclists, share the road, and pass them like you love them!

Dr. Greenskin is finally ready to set Dr. Codger straight on what she really thinks about some of the ways he does business in his veterinary clinic. Nothing can hold her back nowexcept for the intercom.

Illustration by Ryan OstranderAs much as Dr. Greenskin wants to spend just a bit more time possibly deliberating about maybe taking on perhaps a little more responsibility at the hospital, she hasn't had an opportunity to sit down and think through it yet. Yes, she's being wishy-washy. And keep in mind that Dr. Codger's generation places tremendous value on decisiveness.

The prospect of becoming more invested in both her profession and the clinic is exciting but terrifying. Dr. Greenskin is a cautious planner. Deciding whether or not to make a huge business investment is going to take serious focus and time-we're talking years.

Time isn't the only hindrance, however. Part of what's been slowing Dr. Greenskin down is an issue so blatantly problematic she's been unable to utter a word about it to Dr. Codger-namely, his antiquated views about emergency medicine, boarding animals and on-call duties.

Codger doesn't see a need to pay additional kennel staff on the weekends since he's compensating an on-call doctor. (To clarify, if it's written in the contract, that means the doctor is being compensated. Fairness of the rate is another matter.) Doc Codger talks constantly about how he worked by himself for the first several decades of building the business-so them young'uns gotta pay their dues! 

Interestingly, not once has young Dr. Greenskin suggested that newer veterinarians or team members owe any dues to people nearing their expiration date. Call it a paradigm shift, but Dr. Greenskin expects people to work hard for the sake of doing right by patients, clients and coworkers, not to prove their mettle to more seasoned colleagues. 

Nevertheless, twice a day on her on-call weekends and holidays, poor Dr. Greenskin sucks it up and heads over to the clinic to take care of the boarders. As for those after-hours emergencies, having to instruct pet owners how to restrain patients for blood work and radiographs in the absence of other staff raises ethical and legal concerns for the young doctor-not to mention how unnerving it is to be by herself at 2 a.m., even with the “best” clients.

Given that the practice is only two docs deep, Dr. Greenskin's seemingly perpetual newbie status has earned her the brunt of this unfortunate arrangement. When Greenskin first took the job, being on call didn't seem like a big deal. Now that she's settled in, even the nights she doesn't get called in are becoming more of a burden. When Greenskin reviewed last year's calendar, she was unable to enjoy so much as a sip of her favorite pinot grigio for months on end. And if her exorbitant expenditures on Amazon movies from the past year are any indication, her social life is suffering.

Dr. Greenskin is starting to consider these issues in the context of possibly owning the practice in the future. She knows that clinic valuation is based on gross income and profitability. The shoestring emergency services and problematic boarding profits all add up and factor into the price she will have to pay to get a piece (or all) of the business.

Greenskin is beginning to wonder if it makes sense to buy into something she doesn't wholeheartedly support. Her other options are to change her own views on the subjects or come up with a creative rearrangement that makes things more palatable.

As Dr. Greenskin mulls over the situation in between scribbling in her paper charts, good Dr. Codger strides into the break room to grab a crunchy dill pickle (which are always well-stocked). This room is lovingly referred to by clinic employees as “the dungeon.” It's hard to pinpoint whether it's the Civil War-era mold spores on the baseboards or the 1950s fiberglass kennels that have taken on a new life as employee cubbies that give the room its distinct utilitarian flair.

Dr. Codger is all smiles and praise while gnashing on the pickle. On this day, however, something gives him pause in his attempts to convince his associate to pick up the reins. She has a different air about her.

Meanwhile, Dr. Greenskin is getting up her nerve. She breaks the silence, her voice wavering: “I need to have a very serious talk with you, Dr. Codger.”

At that instant, the intercom phone system crackles loudly. It's the new head veterinary assistant. “I need both doctors in the treatment area right away! Something is going really, really wrong. I think this might be an emergency!” Dr. Greenskin bolts and Dr. Codger hobbles out of the vinegar-scented dungeon.

Will this conversation ever take place? Or will it just get swept under the rug again? Will there ever be 10 minutes without an animal or human crisis so the two doctors can make some forward progress?


Dr. Jeremy Campfield works in general practice in California's Sacramento Valley. He is an avid kiteboarder.