There’s something about the fundamental relationship between emergency hospitals and regular vets that breeds a little distrust…ill will…or in some instances, just plain enmity.

“Why’s that?”you might well wonder. Don’t emergency facilities give general practitioners the luxury of living without the stress of bleary-eyed evening hours or late night phone calls? I guess some vets just don’t know when they’ve got it good.

Truth is, sometimes the difference in practice styles between these two very different faces of pet healthcare leaves vets at odds with one another. The culture of a day practice is about servicing known entities (our regular clients and patients) while that of a 24-hour facility is inherently less personal. This gives rise to the reputation of e-clinics as opportunistic and cold places, even among vets. But someone’s go to do it, right?

Having worked on both sides of the aisle, I think I understand better than most the challenges each faces when dealing with the other. Yet even empathy hasn’t kept this general practitioner from sharing some pretty harsh words with the e-clinic vets from time to time.

I used to make a habit of showing up at midnight midweek or Sunday morning to check on my e-clinic cases. Occasionally, I’d find them mildly mismanaged or worse, languishing while the emergency vet was attending to less-than-critical patients with they-can-wait-till-Monday ailments.

I even (embarrassingly) went ballistic once when a client’s seizuring kitten (with a fever over 106!) hadn’t received orders for fluids, cooling and appropriate drugs (she had been admitted four hours before my rant). The e-vet and I were yelling at one another in the treatment room while the staff looked on with wide eyes.

E-clinics sometimes fall into the category of things we vets should’ve been careful about when we wished for them. Why? Because when an e-clinic isn’t interested in a general vet’s best interests, they often make clients look upon us with scorn for 1) feeding them to the [expensive] dogs when we can’t see them, 2) for all the wrongs the emergency vets might commit, including lapses in perceived degree of courtesy and 3) for pawning off our “failure” on another vet.

I’ve had emergency vets tell my clients their pets “weren’t sewn up right” after they’d chewed out their stitches, pull teeth on an “emergency” basis (without dental X-rays or appropriate equipment, I might add), repair ear hematomas (telling my clients the procedure was an emergency—I’ve never seen one explode yet), defer surgery in favor of more routine patients until (in one horrible case) my bloat referral died in the waiting room, miss a pneumothorax diagnosis on a hit by car case (so that after an all night vigil at the e-clinic it died in the morning as soon as it finally hit the surgeon’s doorstep). These are but a few of the horrors I’ve seen.

But wait…what sins might I have committed in my early years in practice as an emergency clinician? I hope they were few given that my alma mater was forty-five minutes away and I referred anything that looked even a shade too wooly. But who knows?

I’ve come to one conclusion on the e-vet versus the general vet, now that I have an e-clinic worth referring my patients to: An e-clinic should know that it’s in the business of serving the referring vet’s patients. If it’s worthy of its steep prices, it keeps this fact in mind above all others. When it treats my clients and their loved ones with the same respect I afford them, it means they’re doing a great job. It also means I can stop showing up at all hours…because now I can finally get a good night’s sleep.